Conversion disorder

A woman collapses at home and is brought to a hospital, apparently paralyzed and numb on her right side. But her reflexes are normal, and sensation is lost only in the right arm and right leg — not the usual pattern resulting from a stroke. She staggers when she walks but engages in conversation with fellow patients and hospital staff as though the symptoms are not troubling her much.

It turns out that the paralysis and numbness developed while the patient was watching her husband and adolescent son argue. The husband had already thrown two older sons out of the house after arguments about their behavior. The patient was determined not to let this happen to the third son, her favorite. Now it looked to her as though a fist fight, or worse, was about to begin. She says she remembers thinking, "I hate these two jerks, and if they weren't so big, I would knock them both out." Then she felt the weakness on her right side. When they saw her collapse, the men dropped their argument and brought her to the hospital, where they visit her every day.

Conversion disorder is classified psychiatrically as a somatoform disorder, meaning that the symptoms create the appearance of medical illness that has no clear medical explanation. What distinguishes it from other somatoform disorders, such as hypochondria and somatization disorder, is that it affects mainly sensory and motor functions that are normally under voluntary control. So the symptoms are more dramatic — not merely nausea, pain, dizziness, insomnia, and fatigue, but apparent blindness, deafness, muteness, paralysis, or seizures.

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