Health Library

Functional neurological disorder

Conversion disorder; Functional neurological symptom disorder; Hysterical neurosis

Functional neurological disorder (formerly called conversion disorder) is a mental condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.

I Would Like to Learn About:

Causes

functional neurological disorder symptoms may occur because of a psychological conflict.

Symptoms usually begin suddenly after a stressful experience. People are at risk of functional neurological disorder if they also have:

• A medical illness
• A dissociative disorder (escape from reality that is not on purpose)
• A personality disorder (inability to manage feelings and behaviors that are expected in certain social situations)

People who have functional neurological disorder are not making up their symptoms in order to obtain shelter, for example (malingering). They are also not intentionally injuring themselves or lying about their symptoms just to become a patient (factitious disorder). Some health care providers falsely believe that functional neurological disorder is not a real condition and may tell people that the problem is all in their head. But this condition is real. It causes distress and cannot be turned on and off at will.

The physical symptoms are thought to be an attempt to resolve the conflict the person feels inside. For example, a person who believes it is not acceptable to have violent feelings may suddenly feel numbness in their arms after becoming so angry that they wanted to hit someone. Instead of allowing them to have violent thoughts about hitting someone, they experience the physical symptom of numbness in their arms.

Symptoms

Symptoms of a functional neurological disorder include the loss of one or more bodily functions, such as:

• Blindness
• Inability to speak
• Numbness
• Paralysis

Common signs of functional neurological disorder include:

• A debilitating symptom that begins suddenly
• History of a psychological problem that gets better after the symptom appears
• Lack of concern that usually occurs with a severe symptom

Exams and Tests

The provider will do a physical exam and may order diagnostic tests. These are to make sure there are no physical causes for the symptom.

Treatment

Talk therapy and stress management training may help reduce symptoms.

The affected body part or physical function may need physical or occupational therapy until the symptoms go away. For example, a paralyzed arm must be exercised to keep the muscles strong.

Outlook (Prognosis)

Symptoms usually last for days to weeks and may suddenly go away. Usually the symptom itself is not life threatening, but complications can be debilitating.

When to Contact a Medical Professional

See your provider or mental health professional if you or someone you know has symptoms of functional neurological disorder.

Related Information

References

American Psychiatric Association. Somatic Symptom and Related Disorders. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: American Psychiatric Association Publishing; 2022.

Gerstenblith TA, Kontos N. Somatic symptom disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 24.

Review Date: 11/6/2022  

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: verify here.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2023 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.