29B. Conversion disorders

Page created on June 3, 2021. Not updated since.

Definition

Conversion disorder is a psychiatric disorder which manifests with neurological symptoms. The neurological symptoms cannot be fully explained by any neurological disorder the patient has.

Like the name suggests, the patient subconsciously “converts” their psychiatric problems (trauma, anxiety, etc.) into a neurological symptom.

Clinical features

Virtually any neurological symptom can occur, but some are more common and characteristic than others. Unilateral symptoms usually affect the left side and not the right. Common symptoms include headache, vertigo, hemisensory loss, hemiparesis, pseudoseizures.

“Impossible” neurological symptoms may also be present, like hemiparesis or hemiplaegia which affects the face as well.

La belle indifference is also characteristic. The patient is unbothered and calm when describing their neurological symptoms, even if they are severe. This is because conversion symptoms usually relieve the mind of some underlying anxiety or psychiatric problem

Diagnosis and evaluation

It’s essential to exclude neurological disease before referring the patient to psychiatry.

Treatment

Psychotherapy.


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Neurology 2

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