Conversion disorder

Neurological disorder not attributed to organic disease, but arises from unconscious psychological stress.

Condition that manifest as sudden neurologic symptoms unexplained by any physical examination or neurologic findings.

Symptoms often occur after a stressful event and are not feigned or deliberately produced but probably represent the conversion of underlying emotional distress into physical symptoms.

Patients usually present with a motor, sensory or visual deficit.

Cognitive symptoms such as amnesia, aphasia and pseudo-dementia may occur.

Classified as a somatoform disorder or a dissociative disorder.

Symptoms are incongruent with anatomy, physiology, or known diseases, or are inconsistent at different times.

May be associated with a disruption of awareness, self identity, sensation, memory, and control of body movements.

Disassociation aspects may include feelings of disconnectedness from one’s own body or from one’s environment.

Attributed to psychological conflicts or recent stress.

Symptoms associated with CD may lead to primary and secondary gains.

The primary gain of CD is the channeling or conversion of emotional arousal into physical symptoms which takes away the focus from emotional conflict and reduce anxiety.

Theoretically, unconsciously produce symptoms defend against unacceptable psychological impulses.

Neuroimaging studies suggest a neurophysiological basis for CD triggered by psychological stressors.

It is suggested that modulation of sensory and motor planning is impaired by disruption of the anterior cingulate cortex, orbitofrontal cortex, and limbic brain regions.

Neurophysiological changes include decreased activation of the frontal and sub cortical areas involved in motor control during conversion paralysis, reduced activation is somatosensory cortices doing conversion anesthesia and reduce the activation of the visual cortex during conversion blindness.

Associated factors include exposure to recent stress or emotional trauma, female sex with a female to male ratio ranging from 2:1 to 10:1, family history, a personal history of having another mental health condition, and the history of physical or sexual abuse.

Really presents in children younger than 10 years or adults older than 35 years.

Prevalence influenced by societal and cultural factors.

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