Rare Pulmonology News

Disease Profile

Conversion disorder

Prevalence
Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.

Unknown

Age of onset

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ICD-10

#N/A

Inheritance

Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease

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Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype

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X-linked
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.

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X-linked
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder

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Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.

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Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.

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Not applicable

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Other names (AKA)

Functional neurological disorder; FND; Functional movement disorder

Categories

Behavioral and mental disorders

Summary

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.[1]

Conversion disorder is thought to be caused by the body’s reaction to a stressful physical or emotional event.[2][3] Some research has identified potential neurological changes that may be related to symptoms of the disorder.[4] Diagnosis of conversion disorder is based on identifying particular signs that are common among people with the disorder, as well as performing tests to rule out other causes of the symptoms.[2] Treatment may include psychotherapy, hypnosis, and stress management training to help reduce symptoms. Treatment of any underlying psychological disorder is also recommended. The affected body part may require physical or occupational therapy until symptoms resolve.[2]

Symptoms

Symptoms of conversion disorder can include a variety of neurological symptoms. Common symptoms of the disorder include sudden blindness, paralysis, loss of the voice, trouble coordinating movements (ataxia), loss of the sense of smell (anosmia), loss of sense of touch, or tingling in the extremities.[5] Some people with conversion disorder may experience seizures or hallucinations.[2]

People are more at risk for a conversion disorder if they also have a mental illness, dissociative disorder, or personality disorder. Conversion disorder is more common in women, people of lower socioeconomic status, and people in the military. Most affected individuals first develop symptoms of conversion disorder during adolescence or adulthood.[5]

Cause

The exact cause of conversion disorder is not well understood. Some researchers believe that conversion disorder is most common after instances of physical or psychological stressors. It may be that symptoms of the disorder allow affected individuals to provide a physical outlet to the stress in their lives.[1][2] In other instances, affected individuals do not seem to have a stressor that is causing the symptoms. In these cases, the cause of conversion disorder is unknown.[3]

Research into the cause of conversion disorder has found that the brain imaging of some individuals with the disorder shows increased or reduced blood flow to certain areas of the brain.[4] If areas of the brain that are responsible for communication with other body parts have reduced blood flow, this may cause neurological symptoms associated with conversion disorder. It is possible that these changes in blood flow may be caused by the brain receiving information about physical or emotional stressors.[6] Regardless of the cause of the disorder, it is important to remember that the symptoms are very real; affected individuals are not faking symptoms of the disorder.[5]

Diagnosis

The diagnosis of conversion disorder is based on a healthcare provider observing symptoms consistent with the disorder. Other causes of similar symptoms should be ruled out to avoid a misdiagnosis. It is best for a neurologist and a psychiatrist to work together on making the diagnosis of the disorder. Current diagnostic criteria for conversion disorder include:[2]

  • One or more symptoms of neurological dysfunction
  • No physical findings that may explain the symptoms
  • No other disease is known that better explains the symptoms
  • The symptom causes significant distress or impairment so that medical evaluation is desired

In some cases, people who are diagnosed with conversion disorder are later found to have another neurological disease. In these cases, treatment and management should be based off of recommendations established for that disease.[2]

Treatment

For some people, the symptoms of conversion disorder may improve with time, even without treatment. This can occur after they receive a diagnosis of the disorder, reassurance that the symptoms aren’t caused by an underlying problem, and validation that the symptoms are real.[2]

Individuals with severe symptoms, symptoms that linger or keep coming back, or other mental or physical health problems may require treatment. The specific type of treatment depends on the particular signs and symptoms of the disorder and may include:[2][7]

 

Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Learn more

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • The Mayo Clinic Web site provides further information on Conversion disorder.
  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

    In-Depth Information

    • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
      Conversion Disorders
      Pediatric Conversion Disorder
      Conversion Disorder in Emergency Medicine
    • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
    • PubMed is a searchable database of medical literature and lists journal articles that discuss Conversion disorder. Click on the link to view a sample search on this topic.

      References

      1. Berger FK, Zieve D, and Conaway B. Conversion disorder. MedlinePlus. November 18, 2016; https://www.nlm.nih.gov/medlineplus/ency/article/000954.htm.
      2. Marshall SA, Landau ME, Carroll CG, Schwieters B, and Llewellyn A. Conversion disorders. Medscape Reference. November 9, 2015; https://emedicine.medscape.com/article/287464-overview.
      3. Vermeulen M and Willems MH. Conversion disorder: from DSM IV to DSM 5 or from a psychiatric to a neurological diagnosis. Tijdschrift Voor Psychiatrie. 2015; 57(8):569-576. https://www.ncbi.nlm.nih.gov/pubmed/26402892.
      4. Gurses N, Temucin CM, Lay Ergun E, Ertugrul A, Ozer S, and Demir B. Evoked potentials and regional cerebral blood flow changes in conversion disorder: a case report and review. Turkish Journal of Psychiatry. Spring 2008; 19(1):101-107. https://www.ncbi.nlm.nih.gov/pubmed/18330748.
      5. Conversion disorder. National Organization for Rare Disorders. 2003; https://rarediseases.org/rare-diseases/conversion-disorder/.
      6. Owens C and Dein S. Conversion disorder: the modern hysteria. Advances in Psychiatric Treatment. 2006; 12:152-157. https://apt.rcpsych.org/content/aptrcpsych/12/2/152.full.pdf.
      7. Dimsdale JE. Conversion Disorder (Functional Neurological Symptom Disorder). Merck Manual. https://www.merckmanuals.com/home/mental-health-disorders/somatic-symptom-and-related-disorders/conversion-disorder. Accessed 8/13/2017.

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