Chapter-06 Conversion disorder

Definition  Conversion disorder refers to a condition in which there are isolated neurological symptoms that can not be explained the mechanism of pathology.

Classification  Conversion disorder is divided into four sub type :  1. With motor symptoms or deficit- impaired co- ordination or balance, paralysis, or localized weakness, difficulty in swallowing and urinary retention.  2. With sensory symptoms or deficit – symptoms as loss of touch or pain sensation, double vision, blindness or deafness and hallucination.

Classification  3.With seizures or convulsion - seizures or convulsion with voluntary motor or sensory components.  4. With mixed presentation – symptoms of more than one category are evident.

Clinical features  1) According to sub type of disorder, symptoms are presented.  2) Young females are affected than male.  3) stress acts as precipitating factor. Before onset some psychological stress is associated with this patient.  4) Victims are highly responsive to suggestion.  5) Sypmtoms are reinforced by over caring.

Clinical features  6)People with conversion disorder may show a relative lack of obvious concern about nature and implication of symptoms. It is called La belle indifference.  7) Sign symptoms discrepancy may present.  8) Sufferers may get secondary gain from this symptoms.

Treatment of acute conversion disorder 1. Obtain medical and psychiatric history from patient and informants. 2. Carry out appropriate medical and psychiatric examination and arrange investigations for physical causes. 3. Reassure that the condition is temporary. 4. Avoid reinforcing symptoms and disability a) To avoid over caring and allow the patient to do his/her daily activities. b) Don’t focus on these symptoms. c) Focus on the cause of stress to dissolve.

Treatment of acute conversion disorder 5. Offer continuing help with anxiety related psychiatric or social problems. Note: Epilepsy may be defined as tendency to recurrent seizures. A seizure consisting paroxysmal electrical discharge in brain and its clinical sequelee.

The End