Functional neurological disorder/conversion disorder

Description

Functional neurological disorder — a new and broader term that includes what some people call conversion disorder — feature nervous system (neurological) symptoms that can't be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning.

The signs and symptoms vary, depending on the type of functional neurologic disorder, and may include specific patterns. Typically, this disorder affects your movement or of the senses, such as the ability to walk, swallow, see or hear. The symptoms can vary in severity and may come and go or be persistent. However, it cannot be produced intentionally or control their symptoms.

The cause of a functional neurological disorder is unknown. The condition can be caused by a neurological disorder or a reaction to stress or psychological or physical trauma, but that is not always the case. Functional neurological disorder that is related to how the brain works, in place of a damage in the brain of the structure (such as a stroke, multiple sclerosis, infection, or injury).

The early diagnosis and treatment, especially in the education about the condition, you can help with the recovery.

Symptoms

The signs and symptoms of functional neurological disorder that can vary, depending on the type of neurological symptoms, functional, and are significant enough to cause disability and warrant a medical evaluation. Symptoms can affect the movement of the body and of the function and the senses.

The signs and symptoms that affect the body's movement and function can include:

  • Weakness or paralysis
  • The abnormal movement, such as tremors or difficulty walking
  • Loss of balance
  • Difficulty swallowing or a sensation of a "lump in the throat"
  • Seizures or episodes of agitation and the apparent loss of consciousness (non-epileptic seizure)
  • The episodes of lack of response

The signs and symptoms that affect the senses can include:

  • Numbness or loss of sensation of touch
  • Speech problems, such as the inability to speak or slurred speech
  • Vision problems, such as double vision or blindness
  • Hearing problems or deafness
  • The cognitive difficulties that involve memory and concentration

When to see a doctor

Seek medical attention for signs and symptoms that worry you or interfere with your ability to function. If the underlying cause is a neurological disease or other medical condition, prompt diagnosis and treatment may be important. If the diagnosis is functional neurological disorder, treatment can improve symptoms and help to prevent problems in the future.

Causes

The exact cause of a functional neurological disorder is unknown. Theories about what happens in the brain to produce symptoms are complex and involve multiple mechanisms that may differ, depending on the type of functional neurologic symptoms.

Basically, the parts of the brain that control the functioning of the muscles and the senses can be involved, even though there is no disease or abnormality exists.

The symptoms of functional neurological disorder that can appear suddenly after a stressful event, or with emotional or physical trauma. Other triggers may include changes or interruptions in the functioning of the brain at the structural, cellular or metabolic level. But the trigger for the symptoms, they may not always be identified.

Risk factors

Factors that may increase your risk of functional neurological disorder, including:

  • Have a neurological disease or disorder, such as epilepsy, migraine or a movement disorder
  • The last significant stress or emotional or physical trauma
  • Have a mental health condition, such as a mood or anxiety disorder, dissociative disorder, or certain personality disorders
  • Have a family member with a neurological condition or symptoms
  • Having a history of physical or sexual abuse or neglect in childhood

Women may be more likely than men to develop functional neurological disorder.

Complications

Some of the symptoms of functional neurological disorder, especially if not treated, it can result in substantial disability and poor quality of life, similar to the problems caused by medical conditions or diseases.

Functional neurological disorder that may be associated with:

  • The pain
  • Anxiety disorders including panic disorder
  • Depression
  • Insomnia
  • Fatigue

Functional neurological disorder/conversion disorder

Diagnosis

There is No evidence of functional neurological disorder. The diagnosis usually involves the assessment of the symptoms and to rule out any neurological or other medical condition that could cause the symptoms.

Functional neurological disorder that is diagnosed based on what is present, such as specific patterns of signs and symptoms, and not only by what is absent, such as the lack of structural changes in a magnetic resonance imaging or abnormalities in the EEG.

Tests and diagnosis usually involves a neurologist, but may include a psychiatrist or other mental health professional. Your health care provider can use any of these conditions: functional neurological disorder (FND), functional neurological symptom disorder, or an older term called conversion disorder.

Sometimes the disorder can be called by a term that specifies the type of functional neurologic symptoms that you have. For example, if your symptoms include problems with walking, your health care provider can call functional gait disorder or functional weakness.

The assessment may include:

  • Physical exam. Your health care provider examines you and asks in-depth questions about your health and your signs and symptoms. Certain tests can be removed from the neurological disease or other medical conditions as the cause of their symptoms. Which tests you have depend on your signs and symptoms.
  • Psychiatric examination. If appropriate, your neurologist may refer you to a mental health professional. He or she will ask you questions about your thoughts, feelings, and behavior, and describe their symptoms. With your permission, the information of the members of the family or other persons that may be useful.
  • Diagnostic criteria in the DSM-5. Your health care provider can compare your symptoms to the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American psychiatric Association.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists these criteria for conversion disorder (functional neurological symptom disorder):

  • One or more of the symptoms that affect the movement of the body or of your senses
  • The symptoms can not be explained by a neurological or other medical condition or another mental health disorder
  • The symptoms cause significant distress or problems in social, work or other areas, or are significant enough for the medical evaluation is recommended

Treatment

Treatment of functional neurological disorder that will depend on your particular signs and symptoms. For some people, a multidisciplinary team approach that includes a neurologist; psychiatrist, or other mental health professional; speech, physical and occupational therapists; or others may be appropriate.

Learning about functional neurological disorder

The understanding of what is functional neurological disorder is, the symptoms are real, and that the improvement is possible may help with the treatment options and recovery. The symptoms may start to improve after an explanation of the condition and the comfort of your health care provider that the symptoms are not caused by a serious underlying neurological or other medical condition.

For some people, the education and the peace of mind that you do not have a serious medical problem, it is the most effective treatment. For others, additional treatments may be beneficial. Involve loved ones can be useful for understanding and support.

Medical treatment of disorders of

Your medical team provides the treatment of any underlying neurological or other medical condition you may have that could be a trigger for symptoms.

Therapies

Depending on your needs, therapies may include:

  • Physical or occupational therapy. Working with a physical therapist or occupational therapist can improve the movement of the symptoms and prevent complications. For example, to regulate the movement of the arms or legs may help to prevent muscle tension and weakness, if you have paralysis or loss of mobility. The Gradual increase in exercise can improve your ability to function.
  • Speech therapy. If your symptoms include problems with speech or swallowing, working with a speech therapist (speech-language pathologist can help.
  • The reduction of stress or distraction techniques. Stress reduction techniques can include the application of methods such as progressive muscle relaxation, breathing exercises, physical activity and exercise. Distraction techniques can include music, talking with another person, or deliberately changing the way you walk or move.

The Mental health of the options

Although functional, neurological symptoms are not "all in your head," emotions and the way you think about things that can have an impact on their symptoms and their recovery. Psychiatric treatment options may include:

  • The cognitive-behavioral therapy (CBT). A type of psychotherapy, cognitive-behavioral therapy (CBT) helps you become aware of inaccurate or negative thinking so that you can see situations more clearly and respond to them in a more effective way. it can also help you learn how to better manage stressful life situations and symptoms. This can be particularly beneficial if your symptoms include seizures are not epileptic. Other types of psychotherapy can be useful if you have interpersonal problems, or a history of trauma or abuse.
  • The treatment of other mental health conditions. Anxiety, depression, or other mental health disorders may worsen the symptoms of functional neurological disorder. The treatment of mental health conditions along with a functional neurological disorder that can aid recovery.

Drugs

The medications are not effective for functional neurological disorder, and there are no drugs approved by the Food and Drug Administration specifically as a treatment. However, medications such as antidepressants can be helpful if you also have depression or other mood disorders, or you are having pain or insomnia.

Regular Follow-Up

A Regular follow-up with your health care team is important to monitor your recovery and make changes to your treatment plan as needed.

Preparing for your appointment

You can start by seeing your primary care provider. He or she may refer you to a neurologist. You may want to take a family member or friend along, if possible, to help you remember information and support.

What you can do

To prepare for your appointment, make a list of:

  • The symptoms you are experiencing, including any that may seem unrelated to the reason for your appointment
  • Key personal, family and social life of information, including any major stresses or recent life changes
  • All the drugs, vitamins, herbs, or other supplements you are taking and the dose
  • Questions to ask your health care provider

Some questions to ask your health care provider include:

  • What is likely causing my symptoms or condition?
  • There are other possible causes?
  • What kinds of tests do I need?
  • What treatment approach do you recommend?
  • For how long do I need to be treated?
  • What can I do to reduce the risk of my recurring symptoms?
  • You should see a specialist?
  • If I need to take medications, what are the main side effects?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there brochures or other printed material I can have?
  • What sites do you recommend?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you a series of questions. Be prepared to answer to reserve a time to go through any of the points that you want to devote more time. Your health care provider may ask:

  • What are your symptoms?
  • When did you first notice these symptoms?
  • How the symptoms changed over time?
  • How do your symptoms affect your ability to function?
  • Do you think that may be causing your symptoms?
  • Have you been diagnosed with any other medical conditions or mental health problems?
  • Make use of alcohol or recreational drugs? What's the frequency?

Your doctor will ask additional questions based on your responses, symptoms, and needs. Prepare and anticipate the questions will help you make the most of your appointment time.

Symptoms and treatment of Functional neurological disorder/conversion disorder