This report is intended to share unique patient cases featuring a common but inadequately researched problem in adolescents with concussion

Despite evidence associating concussion with increased risk of mental illness, the literature has limited information examining functional speech disorder as a sequala of concussion in teen athletes [Table 1].

A PubMed search was completed using the following key words: functional speech disorder, conversion disorder, concussion, pediatrics. A total of five articles resulted and were reviewed.

A 14yo female with a concussion from volleyball had a protracted course of recovery due to anxiety. Months later, she was struck by a tennis ball without a second concussion. She developed a non-physiologic stutter and atasia-abasia. She recovered with cognitive behavioral therapy (CBT).  A 16yo female with history of depression sustained a concussion playing soccer with an associated slurred speech. Two weeks later, her initial concussion symptoms resolved however she began stuttering. She was treated by adjusting her psychiatric medications. Two years later she sustained another concussion which caused a reoccurrence of stuttering. Symptoms improved after a partial day program with psychiatry and intensive speech therapy. An 18yo male wrestler with no psychiatric history suffered a concussion. He developed catatonia with echolalia. He was unable to participate in CBT, however symptoms have partially  improved with diazepam.

This series highlights pediatric athletes presenting with functional speech disorders after concussion or an event triggering anxiety of concussion. The development of conversion disorder of speech was independent of any pre-disposing psychiatric history. Psychological treatment with CBT or medication successfully improved conditions in all cases. Providers should counsel patients and families of potential stress-response symptoms that can occur with concussion. Ongoing research is needed to establish patterns of these conditions and provide evidenced based guidelines to best direct treatment of these young athletes.