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Conversion syndrome describes a condition in which physical symptoms arise for which there is no clear explanation. According to the U.S. National Library of Medicine, conversion syndrome is "a condition in which a person has blindness, paralysis or other nervous system that cannot be explained by medical evaluation".[1] The term stems from the 19th century European conception of hysteria, which itself can be traced back to Ancient Egyptian papyri from the 16th century BC. Psychiatrists now separate out conversion disorder, in which the complaints are neurologic, from similar conditions in which the complaints can be about such things as pain.Conversion syndrome was not formerly considered a separate disorder but was categorized with somatization disorder until the work of Jean-Martin Charcot and Paul Briquet . Charcot and Briquet discovered the pattern of traumatic events correlated with the appearance of physical symptoms. While both men contributed to the current understanding of the disorder, the term comes from Freud. Through work with patients Freud theorized that symptoms of the syndrome represented inner conflictes of psychological stress.[2] Patients with conversion and hysteria led Sigmund Freud to his theories on the unconscious and the talking cure, and the same patient population intrigued such physicians as Pierre Janet, J. M. Charcot, and Josef Breuer. Freud theorized that unacceptable emotions led to psychological conflict that was then converted into physical symptoms.
Typically conversion syndrome begins with some stressor, trauma, or psychological distress that manifests itself as physical symptoms. Usually the physical symptoms of the syndrome affect the senses and movement. For example, someone experiencing conversion syndrome may become temporarily blind due to the stress of the loss of a parent or spouse. While there can be a wide range in severity and duration, symptoms are typically short-lived and relatively mild [3]
As Stated, there can be many symptoms of conversion syndrome. Some of the most typical symptoms include blindness, partial or total paralysis, inability to speak, deafness, numbness, difficulty swallowing, incontinence, balance problems, seizures, tremors, and difficulty walking. These symptoms are attributed to conversion syndrome when a medical explanation for the afflictions cannot be found. Also with these symptoms, typical signs of conversion syndrome are the sudden onset of one or more of the above symptoms.[4] Symptoms of conversion syndrome usually occur suddenly, however symptoms are usually relatively brief, with the average duration being 2 weeks in people hospitalized for conversion syndrome-related presentations. While symptoms do not usually last a long time, recurrence is frequently seen. In fact, about 20% to 25% of conversion syndrome sufferers reported a symptomatic episode within a year. Conversion disorder is typically seen in individuals 10 to 35 years old [5]
Much recent work has been done to identify the underlying causes of the somatoform disorders as well as to better understand why conversion and hysteria appear more commonly in women. Current theoreticians tend to believe that there is no single reason that people tend to somatize, or use their bodies to express emotional issues. Instead, the emphasis tends to be on the individual understanding of the patient as well as on a variety of therapeutic techniques. While the exact causes of conversion syndrome are unknown, symptoms of the disorder seem to relate to the occurrence of a psychological conflict or stressor. Usually the onset of the disorder correlates to a traumatic or stressful event, There are also certain populations that are considered at risk for conversion disorder including people suffering from a medical illness or condition, people with personality disorder, and individuals with dissociative identity disorder.[6]
There are a number of different treatments that are available to treat and manage conversion syndrome. While occasionally symptoms do disappear on their own, many people benefit from a variety of treatment options. Treatments for conversion syndrome include hypnosis, psychotherapy, physical therapy, stress management, and transcranial magnetic stimulation. Treatment plans will consider duration and presentation of symptoms and may include one or multiple of the above treatments [7]
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