What Is Conversion Disorder?
Conversion disorder (functional neurologic symptom disorder) is a condition that is characterized by neurologic symptoms that cause distress, and/or impairment in the absence of a physical cause.
What Are Symptoms of Conversion Disorder?
Symptoms of conversion disorder include:
- Nonepileptic seizures (also called dissociative seizures/attacks or psychogenic nonepileptic seizures/attacks)
- Abnormal generalized limb shaking
- Sudden motionless unresponsiveness
- Apparent impaired consciousness or loss of consciousness
- Weakness and paralysis
- Dropping things
- “Dragging” or sudden buckling of the affected leg
- Affected limb doesn’t feel “part” of them or “belong” to them (may be a form of depersonalization and other dissociative symptoms)
- Panic attacks
- Physical injury to the affected limb
- Movement disorders
- Speech disturbances
- Slurred speech
- Stuttering speech
- Telegrammatic speech (omitting conjunctions and definite articles)
- Foreign accent syndrome
- Globus sensation
- Feeling of a “lump” or “ball” in the throat
- Sensory complaints
- Numbness and tingling
- Feeling of being “cut in half” (midline splitting)
- Feeling one side or part of the body “doesn’t belong”
- Visual symptoms
- Blurred vision
- Double vision
- Involuntary eye movement (nystagmus)
- Visual field defects
- Complete blindness
- Cognitive symptoms
- Poor concentration and memory
- Impaired fluency
- Jumbling of words when speaking
- Difficulty finding the right word
- Variability in speed of response
What Causes Conversion Disorder?
The cause of conversion disorder is unknown. Physical or psychological stressors are believed to be factors in some cases. Conversion disorder may be the brain’s way of helping cope with these stressors.
Some research has also shown increased or reduced blood flow to certain areas of the brain, which may cause neurological symptoms associated with conversion disorder.
It is also believed that first-degree female relatives of a person with conversion disorder (sister, mother, or daughter) have a 14-times higher chance to develop symptoms than other women in the general population, likely due to shared environmental and risk factors.
How Is Conversion Disorder Diagnosed?
Conversion disorder is diagnosed with observation of symptoms. Other causes for the symptoms must first be ruled out.
- The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric diagnostic criteria for conversion disorder include:
- One or more symptoms of neurological dysfunction (altered voluntary motor or sensory function)
- No clinical findings that would explain the symptoms
- The symptom or deficit is not better explained by another medical or mental disorder
- The symptom or deficit causes significant distress, psychosocial impairment, or warrants medical evaluation
What Is the Treatment for Conversion Disorder?
In some patients, the symptoms of conversion disorder may improve over time and no treatment is needed.
For patients who have severe symptoms, symptoms that linger or recur, or other mental or physical health problems, treatment may include:
- Patient education: informing a patient about the diagnosis can often help them cope with symptoms
- Physical therapy
- Cognitive behavioral therapy (CBT)
- Pharmacotherapy such as antidepressants
- Brief psychodynamic psychotherapy
- Multidisciplinary inpatient treatment
- Physical rehabilitation
- Psychological rehabilitation
- Occupational therapy
- Family therapy
- Group therapy
- Treatment of related physical or psychological stressors
- Other interventions
- Repetitive transcranial magnetic stimulation (TMS)
- Abreaction (narcotherapy) (rarely used), involves light sedation
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