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Hysterical conversion reactions mimicking neurological disease
I H Bangash1, G Worley, R S Kandt
1Department of Pediatrics, Duke University Medical Center, Durham, NC.
American Journal of Diseases of Children (1960)
|November 1, 1988
Summary
Diagnosing hysterical conversion reactions (HCRs) in children with neurological symptoms like paralysis or seizures is possible without ruling out all organic causes. Prompt diagnosis leads to rapid recovery and sustained remission.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Neuroscience
Background:
- Hysterical conversion reactions (HCRs) present with diverse neurological symptoms in children.
- Misdiagnosis of organic disease is common, leading to delayed or incorrect treatment.
Purpose of the Study:
- To evaluate the diagnostic criteria and treatment outcomes for childhood HCRs.
- To emphasize the feasibility of diagnosing HCRs based on clinical presentation.
Main Methods:
- Retrospective analysis of seven children diagnosed with HCRs.
- Review of patient history, neurological examination findings, and treatment responses.
Main Results:
- All seven children presented with neurological symptoms including paralysis, headache, seizures, or episodic blindness.
- Six out of seven patients were initially misdiagnosed with organic conditions.
- Recovery or initial improvement occurred within days of HCR diagnosis.
- No relapses were reported between three and 11 months post-diagnosis.
Conclusions:
- A positive diagnosis of HCR in childhood is achievable when neurological symptoms lack an anatomic or physiological basis.
- Exhaustive exclusion of all organic causes is not a prerequisite for diagnosing HCR.
- Timely diagnosis and management of HCRs lead to favorable patient outcomes.