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A 22-year-old female presents to the ED with complaints of acute onset of decreased sensation in her right hand. She states her father had an MI yesterday and died before she could take him to the hospital. Her past medical history is unremarkable. Her vitals are: 120/80 mmHg, pulse rate is 76 bpm, and respiratory rate is 18/min.

What is the most likely diagnosis?

1) A factitious disorder
2) Conversion disorder
3) Neuritis of the radial nerve
4) Depersonalization/derealization disorder

Answer :

2) Conversion disorder

The most likely diagnosis for the 22-year-old female with acute decreased sensation in her right hand after her father's death is Conversion disorder, caused by psychological stress rather than a physical neurological condition.

The 22-year-old female's presentation to the emergency department with acute onset of decreased sensation in her right hand, following the stressful event of her father's myocardial infarction (MI) and subsequent death, suggests that the most likely diagnosis is Conversion disorder. Conversion disorder is characterized by the presence of neurological symptoms, such as numbness, that are not explained by medical neurological conditions and that may occur in response to psychological stress. Factitious disorder involves consciously faking illness for no clear reason, such as to assume the sick role or to gain attention. Neuritis of the radial nerve implies inflammation of the nerve, typically associated with trauma or repetitive injury, and is less likely in the absence of a relevant history. Depersonalization/derealization disorder is characterized by persistent feelings of detachment from one's body or surroundings, which is not the primary complaint here.

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