conversion disorder

definition

- A disorder in which a person experiences blindness, paralysis, or other symptoms affecting the nervous system that cannot be explained solely by a physical illness or injury. - Symptoms usually begin suddenly after a period of emotional or physical distress or psychological conflict." Additionally, the individual is not consciously faking their symptoms

etiology

- Environmental (childhood trauma) - Acquired (it is believed that emotional symptoms (sadness, anger, etc.) may be converted into physical symptoms that affect the nervous system)

facts

1. Conversion disorder is a disorder in which a person experiences blindness, paralysis, or other symptoms affecting the nervous system that cannot be explained solely by a physical illness or injury. Symptoms usually begin suddenly after a period of emotional or physical distress or psychological conflict." Additionally, the individual is not consciously faking their symptoms (as is the case with factitious disorder). 2. The symptoms of conversion disorder can be very distressing and may have an enormous impact on a person's wellbeing. Certain symptoms, such as seizures or temporary paralysis, may increase a person's risk of permanent disability. Some symptoms may prohibit them from carrying out everyday activities. Moreover, a person may experience problems at work and in relationships and may feel they have a reduced quality of life.

medications

Medications are not effective for functional neurological disorders, and no drugs are approved by the Food and Drug Administration specifically as a treatment. However, medications, such as antidepressants, may be helpful if there is co-occurring depression, other mood disorders, pain, and/or insomnia.

medical course

OT PT psychotherapy (CBT, hypnosis) speech therapy stress reduction/distraction techniques

age

may appear at any time from early childhood through older adulthood, most patients experience their first symptoms during adolescence or early adulthood.

precautions

● A high correlation exists among alcohol use/misuse. Consequently, clinicians should be mindful of their client's potential alcohol use/misuse when prescribing benzodiazepines or antidepressants, as alcohol can exacerbate the sedative effects of these medications. ● There is also a high correlation between benzodiazepine dependence/misuse. Therefore, it is important that the client is closely monitored for possible misuse if this drug is prescribed.

other specifiers

● Acute episode: Symptoms present for less than 6 months ● Persistent: Symptoms occurring for 6 months or more ● With psychological stressor (specific stressor) ● Without psychological stressor

comorbidities

● Anxiety disorders, especially Panic Disorder ● Depressive disorders ● Somatic Symptom Disorder ● Personality disorders ● Neurological and other medical conditions commonly coexist ● High correlation of alcohol and benzodiazepine dependence and misuse

risk factors

● Having a neurological disease or disorder, such as epilepsy, migraines or a movement disorder ● Recent significant stress or emotional or physical trauma ● Having a mental health condition, such as a mood or anxiety disorder, dissociative disorder or certain personality disorders ● Having a family member with a functional neurological disorder ● Possibly having a history of physical or sexual abuse or neglect in childhood

signs affecting the senses

● Numbness or loss of the touch sensation ● Speech problems, such as inability to speak or slurred speech ● Vision problems, such as double vision or blindness ● Hearing problems or deafness

symptoms diagnostic criteria

● One or more symptoms of altered motor or sensory function (e.g., visual impairment, paralysis), with clinical findings that do not show physiological causes for the symptoms. ● Symptoms cause significant distress or deficit in social, occupational or other important areas of functioning or they're significant enough to warrant medical evaluation.

contraindications

● Stimulant drugs are likely to exacerbate the effects of SSRI and SNRI antidepressants (and vice versa) and may result in serotonin syndrome. Patients should be warned of signs of serotonin syndrome and be monitored.

signs affecting body movement and function

● Weakness or paralysis ● Abnormal movement, such as tremors, dystonic movements and/or difficulty walking ● Abnormal limb posturing ● Loss of balance ● Difficulty swallowing ● Seizures or episodes of shaking and apparent loss of consciousness (nonepileptic seizures) ● Episodes of unresponsiveness resembling syncope or coma

specify symptom type

● With weakness or paralysis ● With abnormal movement (e.g., tremor, dystonic movement, myoclonus, gait disorder) ● With swallowing symptoms ● With speech symptom (e.g., dysphoria, slurred speech) ● With attacks or seizures ● With anesthesia or sensory loss ● With special sensory symptom (e.g., visual, olfactory, or hearing disturbance) ● With mixed symptoms