A case of bilateral ptosis with unsteady gait: Suggestibility and culture in conversion disorder.

Author: Al Sharbati, Marwan M, Viernes, Noona, Al Hussaini, Ala' adin, Zaidan, Ziad A J, Chand, Pratap, Al Adawi, Samir

Source:
The International Journal of Psychiatry in Medicine, 31(2), 225-232.
Report a case of a 14-yr-old girl who presented, following a sudden onset, with bilateral ptosis, gait disturbance, difficulty swallowing and loss of appetite, right hypochondriacal pain, and frontal headache. Protracted neurological and medical examinations were unremarkable; neither was precipitating psychological stresses evident. The condition, which manifests as typical conversion disorder, lasted for 1 yr. "Treatment" involving electrical stimulation of both eyes muscles and legs with positive reassurance resolved the symptom. This case supports the view that conversion disorder, not only involves a strong element of suggestion, but also incorporates socioculturally sanctioned prescriptions. In this case, which occurred in Oman, the sociocultural context might be related to the following: Studies in the Arab world suggest that those seeking psychiatric care do not verbalize psychic pain. In Oman, as well as in other Arab countries, the reluctance of patients to express feelings is thought to relate to cultural teaching of children that public expression of feelings is shameful.