Conversion Disorder: An Overview

Conversion Disorder, also known as Functional Neurological Symptom Disorder, involves neurological symptoms (e.g., motor or sensory deficits) that are not fully explained by a medical condition or substance use. These symptoms arise due to psychological conflicts or stress, manifesting as physical issues.

 

Historical Context

• Earlier Term: Previously called Hysteria or Hysterical Neurosis, Conversion Type in the DSM-II.

• The term "hysteria" originates from the Greek word "hystera" (womb), reflecting early beliefs that the disorder was linked to uterine dysfunction in women. This idea was debunked over time.

• Freud’s Influence: Sigmund Freud proposed the concept of conversion, suggesting that psychological distress is "converted" into physical symptoms.

 

Signs and Symptoms (DSM-5 Criteria)

1. One or More Symptoms:

   • Altered voluntary motor or sensory function (e.g., paralysis, blindness, seizures).

2. Incompatibility:

   • Symptoms are inconsistent with recognized neurological or medical conditions.

3. Significant Distress:

   • Symptoms cause distress or impair social, occupational, or other areas of functioning.

4. Not Better Explained:

   • No evidence of another medical condition or mental disorder.

 

Examples of Symptoms

• Motor: Weakness or paralysis, abnormal movements, tremors, or gait abnormalities.

• Sensory: Loss of sensation, numbness, or blindness.

• Seizure-like Episodes: Known as pseudoseizures or psychogenic non-epileptic seizures (PNES).

 

Hypothetical Case Study: Conversion Disorder

Case Study: Rina, a 25-year-old law student, develops sudden paralysis in her legs after failing an important exam. Despite extensive medical testing, no physiological cause is found. She expresses feelings of guilt and stress related to her perceived failure. Her symptoms improve after psychotherapy sessions focused on addressing her emotions.

 

Definition of Fits (Seizures)

A fit, or seizure, refers to sudden, uncontrolled electrical disturbances in the brain. It can cause changes in behavior, movements, feelings, or consciousness. Fits are broadly categorized into epileptic (due to epilepsy) and non-epileptic (psychological or other causes).

 

Epilepsy: Overview

Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures caused by abnormal electrical activity in the brain.

 

Causes:

• Genetic predisposition.

• Brain injury, infections, or structural abnormalities.

• Unknown causes in many cases.

 

Symptoms:

• Generalized Seizures: Affect the entire brain (e.g., tonic-clonic, absence seizures).

• Focal Seizures: Originate in one part of the brain (e.g., simple partial or complex partial seizures).

 

Diagnosis:

• Electroencephalogram (EEG) to detect abnormal brain activity.

• Imaging (MRI/CT scans) to identify structural issues.

 

Differences Between Conversion Disorder and Epilepsy

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​Hypothetical Case Studies

Case Study: Conversion Disorder

Rohit, a 30-year-old factory worker, experiences sudden blindness after witnessing a traumatic accident at work. Medical tests reveal no physical cause for his vision loss. Therapy helps Rohit process his trauma, gradually restoring his sight.

 

Case Study: Epilepsy

Ananya, a 15-year-old student, has recurrent episodes of loss of consciousness, jerking movements, and confusion. An EEG confirms abnormal brain activity consistent with epilepsy. With prescribed anticonvulsant medications, her seizures are well-controlled.

 

Management and Treatment

Conversion Disorder:

1. Psychotherapy:

   • Cognitive Behavioral Therapy (CBT) to address underlying emotional conflicts.

   • Trauma-focused therapy for unresolved issues.

2. Relaxation Techniques:

   • Mindfulness and stress management practices.

3. Education:

   • Teaching patients and families about the disorder to reduce stigma.

 

Epilepsy:

1. Medication:

   • Anticonvulsants to manage and prevent seizures.

2. Lifestyle Adjustments:

   • Regular sleep patterns, stress management, and avoiding seizure triggers.

3. Surgical Options:

   • For refractory epilepsy not controlled by medications.

4. Support:

   • Counseling for emotional and social challenges related to living with epilepsy.

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Understanding the differences between conversion disorder and epilepsy ensures accurate diagnosis and tailored treatment, helping patients achieve better outcomes. SEVEE Care offers therapy for conversion disorder and supports those dealing with psychological stress, empowering clients to overcome challenges. For medical management of epilepsy, referrals to specialized neurologists are recommended.