Gait Disturbance as Conversion Reaction Accompanying Anorexia Nervosa in a Young Adult: A Case Report and Literature Review

Abstract

Aim: Conversion disorder is a situation where psychological stress is expressed physically. This health problem is usually triggered by a stressful or a mental crisis. When involving a physical problem it is named as ’conversion disorder’. Psychogenic gait disturbance is a common conversion disorder. Anorexia nervosa is a totally different disease than conversion disorder by its clinical presentation and characteristics. We present a patient suffering from anorexia nervosa and developing conversion disorder in form of a gait disturbance. Presentation of Case: A 35 year-old woman was suffering from excessive obsessions about her body. She had avoidance of eating and loss of 18 kilograms. She was admitted to our hospital for obtaining a disabled certificate for her walking disability that continued for 6 months. Her gait disturbance was indeterminate as to being neurological or orthopedic and was aggravated by stress. Discussion: Even though anorexia nervosa and conversion disorder are two different pathologies, they may be seen together, meaning that patients with one disease may develop symptoms of another disease as means of secondary gain. However, a psychogenic movement disorder is a rare presentation in this situation. Conclusion: Psychogenic gait disturbances are relatively rare psychogenic movement disorders. Conversion disorder may be the underlying problem. In our case, patient was masking, involuntarily, her primary problem (anorexia nervosa) by attracting attention to her gait. Such situations complicate the diagnosis and treatment of both diseases, which should be kept in mind.