Clinical Manifestations and Management of Conversion Disorders

Conversion disorder, the acute onset of sensory or motor loss unexplained by physical findings, has long been reported in the neurologic and psychiatric literature. It was once thought to be largely covariate with the "hysterical" (now referred to as "histrionic") personality, but recent work finds that conversion disorder more often presents in the absence of this personality disorder. Conversion disorder may also be part of a chronic pattern of physical expression of psychologic distress known as somatization disorder. Other psychiatric illnesses (particularly mood and anxiety disorders) are frequently comorbid, and conversion disorder and their treatment may affect the prognosis of conversion disorder symptoms. The neurologist suspecting a case of conversion disorder is advised to complete a thorough neurologic evaluation, and to have a low threshold for psychiatric consultation, which facilitates prompt comanagement that may increase the likelihood of a return to premorbid function.