Conversion Disorder With Mutism as the Presenting Symptom

Conversion disorder presents as a complex clinical challenge characterized by the manifestation of sensory and motor symptoms without identifiable neurological origins. This case report explores the case of a 20-year-old female with mutism attributed to conversion disorder. Despite extensive medical evaluations ruling out organic causes, the patient exhibited a complete inability to articulate words, attributed to acute conversion disorder with speech symptoms. The treatment approach involved a combination of antipsychotic and antidepressant medications, resulting in symptom resolution within two weeks. However, symptom relapse occurred upon discontinuation of medication, indicating a likelihood of future relapses. Differential diagnoses including neurological diseases, somatic symptom disorder, selective mutism, and factitious disorder were considered and ruled out based on clinical presentation and diagnostic criteria. This case highlights the importance of a thorough multidisciplinary diagnostic approach and individualized treatment strategies, including pharmacotherapy and supportive care, in managing conversion disorder. Recognition of temperamental, environmental, and socioeconomic risk factors may aid early diagnosis and improve prognosis in atypical presentations such as mutism.