To the Editor:

We had a case of a 45-year-old woman with history of 25 years of anorexia nervosa, whose body mass index was 15.1 kg/m2. She underwent posterior cervical spinal fusion to improve spondylolisthesis. Recovery from anesthesia was delayed and sursumversion was observed. In addition, the patient complained of paralysis of the left arm postoperatively. No distinctive positive findings including cerebral hemorrhage or spinal abnormality on the basis of cranial computed tomography and magnetic resonance imaging were found. A few days of observation revealed that she was able to move her hands while sleeping. Finally, we diagnosed her symptoms as postoperative conversion disorder.

Conversion disorder is described as a psychological disorder, characterised by somatic symptoms with no physiological abnormalities, but with an underlying psychological basis [1, 2]. Our patient had the risk factors for conversion disorder, which include a previous physical disability such as anorexia nervosa, and a tendency to occur in adolescent or young adult females under 50 years of age.

Because surgery for severe anorexia nervosa patients is increasing in the 2000s [2], anesthesiologists may encounter postoperative conversion disorder as a stroke mimic or surgical complication.