What characterizes conversion disorder (functional neurological symptom disorder) and how is it identified?

What characterizes conversion disorder (functional neurological symptom disorder) and how is it identified?

• A. Symptoms feigned for external gain.
• B. Neurological symptoms not explained by medical causes and inconsistent with neurological exam; not intentionally produced.
• C. Symptoms caused by direct brain injury visible on imaging.
• D. Symptoms always motor only.

Answer: (B)

Conversion disorder is characterized by neurological symptoms that are not explained by medical disease and are inconsistent with known neurological structures or exam findings, and they are not intentionally produced. In practice, clinicians diagnose it after a thorough medical evaluation shows no organic cause and reveals signs that the deficit doesn’t fit a recognizable neuroanatomical pattern. The key is that the person isn’t consciously faking or seeking to gain something; there’s no deliberate deception involved, even though psychological factors may be involved in the onset or course of symptoms. This distinguishes it from feigning or malingering, where there is a deliberate motive to deceive for external gain, and from conditions with an actual brain injury or disease, where imaging or tests reveal a concrete organic cause. It also matters that the symptoms can be motor or sensory and may fluctuate, rather than being limited to a single pattern like motor-only.

Conversion disorder is characterized by neurological symptoms that are not explained by medical disease and are inconsistent with known neurological structures or exam findings, and they are not intentionally produced. In practice, clinicians diagnose it after a thorough medical evaluation shows no organic cause and reveals signs that the deficit doesn’t fit a recognizable neuroanatomical pattern. The key is that the person isn’t consciously faking or seeking to gain something; there’s no deliberate deception involved, even though psychological factors may be involved in the onset or course of symptoms.

This distinguishes it from feigning or malingering, where there is a deliberate motive to deceive for external gain, and from conditions with an actual brain injury or disease, where imaging or tests reveal a concrete organic cause. It also matters that the symptoms can be motor or sensory and may fluctuate, rather than being limited to a single pattern like motor-only.