A question for doctors - med students

[kiwi57]

I'd respectfully suggest not performing any home diagnostic maneuvers. It is admirable that you want to help this person who is no doubt bewildered and confused by everything. I'd recommend that you simply be there for him and provide non-judgmental support. Internet diagnosis of CD is a dicey proposition.

The rule-out evaluation you've alluded to indicates he may have seen a neurologist which is a good specialty to sort this out provided the doc is thorough, experienced and empathetic. CD is largely a diagnosis of exclusion, but that doesn't mean that every test known to man needs to be performed. A thoughtful history and PE (a slowly vanishing set of skills) is often a judicious investment and should direct the remainder of the work-up.

As an FYI, the character on Band of Brothers, Private Albert Blithe, suffers a short term episode of 'hysterical blindness'.

kiwi57

[tb-av]

Keep in mind that about 50% of people thought to have a conversion disorder prior to the diagnostic testing end up having an actual disease.

Wow, that's not good... I'm thinking if you have to have something CD might be the better alternative. The only thing I have heard as a 'maybe' is some sort of strange migraine. I'll keep the arm drop test to myself. I was going to tell his wife since she's a nurse but I don't want him to have what ever it is and a broken nose.

If it is CD or possibly CD or even migraine that is stress related I just wanted to try to get all of them of the same wavelength of everybody needs to try to chill out a bit. ... but through a bunch of unusual circumstances a lot of them are under one roof and another one arrived because he's having open heart surgery Wed.

Thanks again to all.

[FL2011]

Kind of late to the party here but I agree with what's been said so far..... conversion disorder, seizures and migraines are near the top of my list.

Less likely TIA/Stroke as those symptoms don't really fit a specific vascular territory in the brain.

I'm assuming he had a full work-up in the hospital that included neurology eval, detailed history and exam, review of his meds, EEG, Brain CT +/- MRI, ECHO and basic labs.

As was mentioned, conversion disorder is pretty much a diagnosis of exclusion and we want to rule out something structurally wrong before attributing this to a more psychiatric cause.

Hopefully he gets some answers though and is motivated enough to get some follow up for this.