A case of skeletal mandibular prognathism with conversion disorder manifested after orthognathic surgery

Abstract

Conversion disorder is a psychogenic disorder in which unconscious conflicts are replaced by voluntary motor and sensory physical symptoms. We report a case of conversion disorder after orthognathic surgery. The patient was a 33-year-old female diagnosed with skeletal mandibular prognathism who underwent a mandibular setback through a sagittal split ramus osteotomy. On the second postoperative day she experienced hyperventilation seizures, apneic seizures and loss of consciousness. She was diagnosed with conversion disorder since there was no evidence of organic abnormality in her general condition, and she had a history of seizures and stress in the workplace. Following adjustment of her antipsychotic, anxiolytic and antidepressant medications, the patient has improved to the point where she experiences no difficulty in daily life one year after surgery.