Differential Diagnosis

• Single most likely diagnosis
  • (a) Conversion disorder: This condition is characterized by the presence of neurological symptoms that cannot be explained by a medical condition, and are often precipitated by psychological stressors. The patient's symptoms of transient urinary incontinence and weakness of the right leg following a stressful event (being jilted by her boyfriend) are consistent with conversion disorder.
• Other Likely diagnoses
  • (b) Multiple sclerosis: This is an autoimmune disease that affects the central nervous system, causing a wide range of neurological symptoms, including weakness, numbness, and urinary incontinence. However, the symptoms are typically more persistent and progressive, and may not be as closely tied to psychological stressors.
• Do Not Miss
  • Spinal cord compression or injury: Although less likely, it is crucial to rule out conditions that could cause rapid progression of neurological symptoms, such as spinal cord compression or injury, which could be life-threatening if not promptly addressed.
  • Neuropathies or radiculopathies: Conditions such as Guillain-Barré syndrome or radiculopathy could also present with weakness and urinary incontinence, and would require urgent medical attention.
• Rare diagnoses
  • Acute disseminated encephalomyelitis (ADEM): A rare autoimmune condition that can cause a range of neurological symptoms, including weakness and urinary incontinence, following a viral infection or vaccination.
  • Neurosarcoidosis: A rare condition in which sarcoidosis affects the nervous system, causing a range of neurological symptoms, including weakness and urinary incontinence.