Disclosures: Giuseppe Amore, MD, MPH: Nothing to disclose

Case Description: The patient presented with a right-sided facial droop, hemiplegia, and decreased sensation of upper and lower extremities. Computed tomography of her head and magnetic resonance imaging of her brain and spine were unremarkable. Numerous infectious disease and hypercoagulable blood tests were negative. Upon further investigation, patient reportedly suffered a mild traumatic brain injury (TBI) while playing sports 1 week prior to admission. On presentation to inpatient rehabilitation, she complained of numbness in the right maxillary and mandibular distribution of the facial nerve. Interestingly, sensation and motor function remained intact on the right side of her forehead only. Her remaining cranial nerves were intact. Deep tendon reflexes were intact throughout without the presence of pathological reflexes. Upon initiating physical and occupational therapy, she was able to transfer and ambulate 60 feet with a quad-based cane with moderate assistance.

Setting: Inpatient rehabilitation facility

Patient: A 13-year-old female with stroke-like symptoms after mild traumatic brain injury.

Assessment/Results: Upon discharge from inpatient rehab, she was at a supervision level for sit to stand, moderate assist for transfers, and ambulated up to 180 feet with large quad-based cane with moderate assistance.

Discussion: During the evaluation of weakness in a child, it is essential to rule-out different organic and potentially life-threatening etiologies. However, if an organic cause cannot be determined, a diagnosis of conversion disorder may explain the sudden onset weakness. Conversion disorder occurs more commonly in girls than boys and is most prevalent between the ages of 10 to 15 years old. Education about the disorder, cognitive behavioral therapy, and physical therapy are the most effective treatment options available.

Conclusion: There are limited studies addressing conversion disorder arising from a mild TBI in children. This case is a unique example of this rare complication and highlights the need for further investigation.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/sudden-onset-of-hemiplegia-and-sensory-deficit-after-a-mild-traumatic-brain-injury-in-a-13-year-old-female-a-case-report/