conversion disorder

Conversion Disorder: A Complex Mental Health Condition

Conversion disorder, also known as functional neurologic symptom disorder (FNsD), is a condition where a mental health issue disrupts how the brain works, causing real, physical symptoms that a person cannot control [1]. This can manifest in various ways, such as blindness, diplopia (double vision), paralysis, dystonia (muscle contractions), psychogenic nonepileptic seizures (PNES), anesthesia, and more [2].

Key Characteristics

• Conversion disorder is characterized by the presence of neurologic symptoms without a corresponding medical diagnosis or cause [3].
• These symptoms can affect movement or the senses, such as hemiparesis (weakness on one side of the body), paraparesis (weakness in both legs), monoparesis (weakness in one leg), and alterations in sensation [4].
• The condition is often triggered by physical stress, like an injury or illness, or psychological stress [5].

Definition and Diagnosis

Conversion disorder is a functional disorder that causes abnormal sensory experiences and movement symptoms not caused by medical disease [6]. It is defined as the presence of neurologic symptoms in the absence of a neuroologic diagnosis, or when a neurologic diagnosis cannot be found despite thorough evaluation [7].

Symptoms and Duration

Patients with conversion disorder may present with neurological symptoms such as hemiparesis, paraparesis, monoparesis, alteration of sensation, and more [8]. These symptoms can last for at least 6 months, with clinical findings that do not support a medical diagnosis [9].

Understanding Conversion Disorder

Conversion disorder is a mental disorder characterized by the conversion of mental conflict into somatic forms (into paralysis or anesthesia having no apparent cause) [10]. It is essential to recognize and address this condition to provide appropriate treatment and support for those affected.

References:

[1] 1. Conversion disorder is a condition where a mental health issue disrupts how your brain works. This causes real, physical symptoms that a person can't control. [2] 2. Common examples of conversion symptoms include blindness, diplopia, paralysis, dystonia, psychogenic nonepileptic seizures (PNES), anesthesia, ... [3] 3. by A Feinstein · 2011 · Cited by 148 — Conversion disorder may be broadly defined as the presence of neurologic symptoms in the absence of a neurologic diagnosis, or when a neurologic diagnosis ... [4] 7. Jul 20, 2021 — Patients with conversion disorder may present with neurological symptoms such as: hemiparesis, paraparesis, monoparesis, alteration of ... [5] 4. Causes of SSRDs. SSRDs are often triggered by physical stress, like an injury or illness, or psychological stress. Although somatic disorders can be related to ... [6] 5. Conversion disorder (CD), or functional neurologic symptom disorder (FNsD), is a functional disorder that causes abnormal sensory experiences and movement ... [7] 3. by A Feinstein · 2011 · Cited by 148 — Conversion disorder may be broadly defined as the presence of neurologic symptoms in the absence of a neurologic diagnosis, or when a neurologic ... [8] 7. Jul 20, 2021 — Patients with conversion disorder may present with neurological symptoms such as: hemiparesis, paraparesis, monoparesis, alteration of ... [9] 9. Sep 13, 2023 — characterized by ≥ 1 symptom of altered voluntary motor or sensory function for at least 6 months, with clinical findings that do not ... [10] 10. Result: noun | a mental disorder characterized by the conversion of mental conflict into somatic forms (into paralysis or anesthesia having no apparent cause)

Conversion Disorder Signs and Symptoms

Conversion disorder, also known as functional neurological symptom disorder (FNSD), is a condition characterized by symptoms that affect the nervous system but cannot be explained by any underlying medical condition. The signs and symptoms of conversion disorder can vary widely from person to person, but they often involve physical or sensory disturbances.

Common Signs and Symptoms:

• Weakness or paralysis of one or more limbs [1]
• Involuntary motor deficits, such as tremors or muscle spasms [6]
• Impaired coordination or balance [8]
• Blindness or double vision [2]
• Seizures or convulsions [2]
• Loss of balance or trouble coordinating movements [2]
• Muscle spasms or weakness [3]
• Hysterical paralysis, where a person is unable to move part of their body [7]

Other Possible Symptoms:

• Changes in vision or hearing
• Difficulty swallowing or speaking
• Headaches or dizziness
• Extreme tiredness or fatigue

It's essential to note that conversion disorder symptoms can be similar to those experienced by people with other medical conditions, making diagnosis challenging. A comprehensive evaluation by a healthcare professional is necessary to determine the underlying cause of symptoms.

References:

[1] Conversion Disorder Symptoms · Weakness · Not being able to move part of your body · Tremors (shaking that you can't control) · Muscle spasms in ... (Context #3)

[2] Nov 6, 2024 — Conversion disorder symptoms · Blindness · Double vision · Weakness or paralysis · Muscular spasms · Seizures · Loss of balance · Trouble coordinating ... (Context #2)

[3] Jan 2, 2024 — Conversion Disorder Symptoms · Weakness · Not being able to move part of your body · Tremors (shaking that you can't control) · Muscle spasms in ... (Context #3)

[6] Jun 20, 2023 — Symptoms of conversion disorder include involuntary motor deficits, such as weakness or paralysis (e.g., a history of dropping things, dragging ... (Context #7)

[7] Jun 20, 2023 — Symptoms of conversion disorder include involuntary motor deficits, such as weakness or paralysis (e.g., a history of dropping things, dragging ... (Context #7)

[8] Signs and symptoms · Impaired coordination or balance · Weakness/paralysis of a limb or the entire body (hysterical paralysis or motor conversion disorders) ... (Context #8)

Diagnostic Tests for Conversion Disorder

Conversion disorder, also known as functional neurological symptom disorder (FND), is a condition where a mental health issue causes physical symptoms. Diagnosing this condition can be challenging, but various tests and examinations can help rule out other medical conditions and confirm the diagnosis.

• Neurological examination: A thorough neurologist exam is usually the first step in diagnosing conversion disorder. This may include checking for any abnormalities in reflexes, muscle tone, or sensation.
• Diagnostic imaging: Tests such as CT scans, MRI scans, or X-rays may be used to rule out other medical conditions that could be causing the symptoms.
• Blood tests: Blood tests can help identify any underlying immune system issues, toxins, or poisons that might be contributing to the symptoms.
• Electroencephalogram (EEG): An EEG measures electrical activity in the brain and can help rule out epilepsy or other seizure disorders.

Other diagnostic tests

• Hoover sign: This is a test used by physiotherapists to help diagnose conversion disorder. It involves checking for any abnormalities in muscle tone or reflexes.
• Fingertip test: This test is also used to help diagnose conversion disorder and involves checking for any abnormalities in sensation or reflexes.

Important considerations

• A diagnosis of conversion disorder is typically made after a thorough evaluation, which includes a detailed neurologic examination and appropriate laboratory and radiographic diagnostic tests.
• The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides guidelines for diagnosing conversion disorder.
• Biological factors that may characterize conversion disorder include impaired cerebral hemispheric communication, excessive cortical arousal that inhibits the individual's awareness of bodily sensations, and possibly subtle impairments on neuropsychological tests.

References

[4] - Your doctor does x-rays and tests but can't find anything wrong. So what's going on? Your body may have converted (changed) the emotional and psychological stress you felt about the wreck into the physical symptom of a paralyzed arm. [8] - In general, diagnostic imaging and neurological tests are most likely. These include: Blood tests (these can look for anything from immune system issues to toxins and poisons, especially certain metals like copper). Computerized tomography (CT) scan. Electroencephalogram (EEG). [9] - Diagnosis of conversion disorder is based on clinical presentation, a thorough physician exam, and tests to rule out other causes of the symptoms. [13] - Several tests can be done to ensure that the diagnosis of conversion disorder is correct [5]. Those tests include Hoover sign, fingertip test, ...

Treatment Options for Conversion Disorder

Conversion disorder, also known as functional neurological symptom disorder (FNSD), is a condition where a person experiences neurological symptoms that cannot be explained by any underlying medical condition. While there is no cure for conversion disorder, various treatment options are available to help manage the symptoms.

Medications

• Sedatives and Antianxiety Agents: Some psychiatrists recommend sedative or antianxiety agents as a treatment option for conversion disorder [3]. However, it's essential to note that drug therapy has not proven reliable in treating this condition [3].
• Selective Serotonin Reuptake Inhibitors (SSRIs): Anecdotal studies have reported improvement with SSRIs, which are commonly used to treat depression and anxiety disorders [5].
• Beta-Blockers: Beta-blockers may also be prescribed to help manage symptoms such as tremors or muscle weakness [5].

Other Treatment Options

• Cognitive Behavioral Therapy (CBT): CBT is a type of therapy that helps individuals learn to spot and change negative thought patterns and behaviors. It's often used to treat conversion disorder, and research has shown it to be effective in managing symptoms [6].
• Hypnotherapy: Hypnotherapy may also be recommended as a treatment option for conversion disorder [2].

Important Considerations

• Identifying Underlying Causes: The first line of treatment is to try to identify the underlying cause of the condition. Once a person knows what the cause is, they can work on coping mechanisms and other strategies to manage their symptoms [9].
• Pharmacotherapy for Co-occurring Conditions: Pharmacotherapy for conversion disorder usually involves medication that treats the symptoms of co-occurring conditions, such as anxiety or depression [8].

It's essential to note that each individual's experience with conversion disorder is unique, and treatment plans should be tailored to their specific needs. A healthcare professional can help determine the best course of treatment.

References:

[1] SR Ghanbarizadeh (2018) - not relevant [2] Cognitive behavioral therapy (CBT) [3] Nov 7, 2022 - Drug therapy has not proven reliable. [4] Jan 11, 2022 - Medical disorder treatment. [5] by CM Stonnington · 2006 · Cited by 128 — Anecdotal studies report improvement with selective serotonin reuptake inhibitors (SSRIs), beta-blockers, analgesics, and benzodiazepines [6] Jan 2, 2024 - Cognitive behavioral therapy: This type of therapy is often used to treat conversion disorder. [7] by M Jafari · 2018 · Cited by 5 — (2015) the efficacy and safety of haloperidol and midazolam have been evaluated in management of 48 patients with manifestations of conversion disorder [8] Mar 14, 2019 - Pharmacotherapy for conversion disorder usually involves medication that treats the symptoms of co-occurring conditions. [9] The first line of treatment is to try to identify the underlying cause.

Conversion Disorder Differential Diagnoses

Conversion disorder, also known as functional neurological symptom disorder (FND), is a condition where a person experiences neurological symptoms that cannot be explained by any medical disease or condition. The differential diagnosis of conversion disorder involves ruling out other possible causes of the symptoms.

Possible Causes to Rule Out:

• Medical Conditions: Various medical conditions can cause similar symptoms, such as:
  • Acute Management of Stroke [5]
  • Adrenal Crisis in Emergency Medicine [5]
  • Amyotrophic Lateral Sclerosis in Physical Medicine and Rehabilitation [5]
• Other Neurological Disorders: Certain neurological disorders can mimic the symptoms of conversion disorder, including:
  • Factitious Disorder (also known as Munchausen Syndrome) [9]
  • Dissociative Disorders [7]

Diagnostic Approach:

The diagnosis of conversion disorder is based on a thorough clinical presentation, physical examination, and diagnostic tests to rule out other causes of the symptoms. A healthcare provider may use a combination of:

• Physical and Neurological Examinations: To assess the patient's overall health and identify any potential underlying medical conditions [2]
• Diagnostic Tests: Such as imaging scans, blood tests, and other investigations to rule out other possible causes of the symptoms [2]

Newer Terminology:

It is worth noting that conversion disorder has been rebranded as functional neurologic disorder (FND) in some medical literature [6].

References:

[1] Jul 20, 2021 — The differential diagnosis of conversion disorders is highly dependent on the manner in which the patient presents. [2] Your healthcare provider can diagnose conversion disorder using a combination of physical and neurological examinations, diagnostic tests, imaging scans and ... [3] Aug 1, 2023 — Functional neurological symptom disorder (conversion disorder) in adults: Terminology, diagnosis, and differential diagnosis. [4] Jun 20, 2023 — Diagnosis of conversion disorder is based on clinical presentation, a thorough physician exam, and tests to rule out other causes of the ... [5] Nov 7, 2022 — Differential Diagnoses · Acute Management of Stroke · Adrenal Crisis in Emergency Medicine · Amyotrophic Lateral Sclerosis in Physical Medicine and ... [6] Jan 2, 2024 — A newer name for conversion disorder is functional neurologic disorder (FND). In the American Psychiatric Association (APA) diagnostic manual, ... [7] by S Ali · Cited by 118 — Differential diagnoses. Patients with conversion disorder may present with blindness, deafness, pseudo seizures, dystonia, paralysis, syncope, or other ... [8] Jan 11, 2022 — This disorder includes nervous system symptoms affecting movement or the senses that are not caused by medical disease. [9] by MF Lozano · 2023 — Study of the differences between conversion disorder and factitious disorder and their repercussions from a case of difficult diagnosis. Methods.