A 32-year-old recently divorced woman presents to her physician with visual disturbances that have persisted for 3 days. She reports difficulty with her vision. Upon examination, she exhibits tunnel vision and significant weakness in plantar flexion, despite being able to walk on her tiptoes without any issues. All laboratory tests and imaging studies return normal results.
What is the most likely diagnosis for this patient?
A-Conversion disorder
B- Meningioma
C- Multiple sclerosis
D-Transient ischemic attack
Answer
The patient’s symptoms, such as visual disturbances (specifically tunnel vision) and weakness in plantar flexion, along with normal laboratory tests and imaging studies, suggest a functional neurological disorder rather than an organic disease. She has weakness in plantar flexion but can still walk on her tiptoes without issue, which indicates an inconsistency between the patient’s reported symptoms and actual motor abilities. This, combined with the stress of a recent divorce, points toward a psychological rather than a neurological cause.
In this case, the most likely diagnosis is conversion disorder (also known as functional neurological symptom disorder), where psychological stress manifests as neurological symptoms without any identifiable organic cause.
Thus, the correct answer is A- Conversion disorder.
A