Tuberculous meningitis (TBM) with tuberculoma in a child presenting with conversion disorder

ABSTRACT Tuberculoma is a known tuberculosis (TB) sequela that accounts for 5%–30% of all intracranial lesions. Patients having an organic cause but presenting with psychological symptoms can add difficulties in the diagnosis and treatment of veiled medical illnesses. In the present report, we discuss the case of a child who presented with symptoms of conversion disorder but was later diagnosed with tuberculous meningitis with tuberculoma. A 15-year-old male child was brought to the psychiatric outpatient department with episodes of falls accompanied by unresponsiveness. He also had mild tremors in his hands. The falls were not associated with any injuries. The onset was associated with a stressor (death in the family). Episodes resolved dramatically when the patient was isolated. A diagnosis of conversion disorder was therefore considered. To investigate the cause of mild fever, a pediatrician’s opinion was sought. Computed tomography and cerebrospinal fluid analysis showed TB meningitis with intracranial tuberculoma. Medical conditions do masquerade as functional illnesses. Patients presenting with suspected conversion symptoms should be thoroughly examined for any unusual symptoms to prevent any delay in management.