Conversion Disorder
Conversion disorder (also known as functional neurological system disorder) is a condition in which a person experiences physical and sensory problems, such as paralysis, numbness, blindness, deafness or seizures, with no underlying neurologic pathology. These problems are serious enough to negatively impact important life functions, such as academic performance, social relationships and family life.
Children with conversion disorder are not faking or intentionally producing their physical or sensory problems. They are real, but the problems are not caused by underlying medical problems; rather, they are impairments in the normal functioning of the body. Conversion disorder is often, but not always, driven by poorly expressed distress, for which relief is provided by the existence of the symptoms.
Symptoms
Conversion disorder involves the loss of one or more bodily functions. Examples include:
Weakness or paralysis
Loss of balance or difficulty walking
Tremors or seizures
Vision problems, such as double vision or blindness
Hearing problems or deafness
Difficulty speaking or inability to speak
Difficulty swallowing
To be considered conversion disorder, one or more of these problems must be present and be serious enough to interfere with a child’s ability to function successfully — at school, in social interactions, or at home.
Treatment Options
Children and families who receive a diagnosis of conversion disorder can initially be confused about or resistant to the idea that the problems have no medical or neurologic cause, and therefore are not treated medically. It is critical that the medical team make it clear that the problems are real, quite distressing, and not “in the child’s head.” It is, likewise, important that the team emphasize that this condition is highly treatable. An explanation of the relationship between mind and body, and how the two interact, is often a helpful starting point. For some children and their families, this explanation will be enough to begin the process of recovery.
The hallmark of effective treatment for conversion disorder is emphasis on returning to age-appropriate functioning. This can begin with reinstitution of regular daily routines, and return to school and other activities.
For young people with weakness, tremor or sensory loss, additional rehabilitative treatment may be needed. This may include:
Counseling — cognitive behavioral therapy or psychotherapy to address anxiety and thinking patterns about symptoms, as well as avoidance of any underlying stressors. Counseling may also be needed to address any co-occurring mental health conditions, such as depression or anxiety.
Physical or occupational therapy — to strengthen and loosen muscles that may have weakened and tightened through inactivity.
Medications — to supplement the counseling treatment for stress and anxiety and for any associated mental health conditions.