Nelson Erik J, Wu Jennifer Y
Anesthesiology, Academic Office One, University of Colorado School of Medicine, Aurora, CO, USA.
Am J Case Rep. 2017 Jan 17;18:60-63. doi: 10.12659/ajcr.901402.
BACKGROUND Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. CASE REPORT We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness. The evaluation revealed paradoxical vocal cord movement, and all laboratory test values were normal. For her hemiplegia and sensory loss, she was evaluated for stroke with head MRI and CT scans, which were normal. CONCLUSIONS After extensive workup and consideration of multiple etiologies for her presenting signs and symptoms, the most likely diagnosis was conversion disorder.
背景 术后转换障碍较为罕见，但已有相关报道。通常在排除所有主要器质性病因后才能做出诊断。病例报告 我们描述了一名13岁女性的病例，她在接受全身麻醉进行上消化道内镜检查后，在麻醉后护理单元出现急性吸气性喘鸣，对言语或疼痛刺激无反应。后来在麻醉后护理单元，她又出现急性右半身瘫痪和感觉丧失。她首先接受了喘鸣和无反应原因的评估。评估发现声带反常运动，所有实验室检查值均正常。对于她的半身瘫痪和感觉丧失，通过头部MRI和CT扫描评估是否为中风，结果正常。结论 在对她的症状和体征进行广泛检查并考虑多种病因后，最可能的诊断是转换障碍。
