Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-27T02:47:33.187Z Has data issue: false hasContentIssue false

Chapter 28 - Hysteria

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
Get access

Summary

One of the most vexing issues in a busy emergency department is patients with neurologic psychogenic conversion disorders, also known as functional neurologic symptoms or hysteria. To understand and treat these patients requires patience, understanding, composure, knowledge of neuroanatomy and physiology, and a comprehension of human nature. Long experience evaluating patients with neurologic disorders may be the most important factor, and younger emergency physicians may not have this ability fully developed.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Carson, A, Brown, R, David, A, et al. Functional (conversion) neurological symptoms: research since the millennium. J Neurol Neurosurg Psychiatry 2012;83:842850.CrossRefGoogle ScholarPubMed
Duncan, R. Psychogenic nonepileptic seizures: diagnosis and initial management. Expert Rev Neurother 2010;10(12):18031809.CrossRefGoogle ScholarPubMed
Fekete, R, Baizabal-Carvallo, J, Ha, A, Davidson, A, Jankovic, J. Convergence spasm in conversion disorders: prevalence in psychogenic and other movement disorders compared with controls. J Neurol Neurosurg Psychiatry 2012;83:202204.Google Scholar
Ganos, C, Aguirremozcorta, M, Batla, A, et al. Psychogenic paroxysmal movement disorders: clinical features and diagnostic clues. Parkinsonism Relat Disord 2014;20:4146.CrossRefGoogle ScholarPubMed
Glick, T, Workman, T, Gaufberg, S. Suspected conversion disorder: foreseeable risks and avoidable errors. Acad Emerg Med 2000;7:12721277.CrossRefGoogle ScholarPubMed
Hingray, C, Maillard, L, Hubsch, C, et al. Psychogenic nonepileptic seizures: characterization of two distinct patient profiles on the basis of trauma history. Epilepsy Behav 2011;22:532536.CrossRefGoogle ScholarPubMed
Kaplan, M, Dwivedi, A, Privitera, M, et al. Comparisons of childhood trauma, alexithymia, and defensive styles in patients with psychogenic non-epileptic seizures vs. epilepsy: implications for the etiology of conversion disorder. J Psychosomat Res 2013;75:142146.Google Scholar
Marquez, A, Farias, S, Apperson, M, et al. Psychogenic nonepileptic seizures are associated with an increased risk of obesity. Epilepsy Behav 2004;5:8893.CrossRefGoogle ScholarPubMed
Merskey, H. Conversion symptoms revised. Semin Neurol 1990;10(3):221228.CrossRefGoogle ScholarPubMed
Panagos, P, Merchant, R, Alunday, R. Psychogenic seizures: a focused clinical review for the emergency medicine practitioner. Postgrad Med 2010;122(1):3438.CrossRefGoogle ScholarPubMed
Parra, J, Iriarte, J, Kanner, A. Are we overusing the diagnosis of psychogenic non-epileptic events? Seizure 1999;8:223227.CrossRefGoogle ScholarPubMed
Razvi, S, Mulhern, S, Duncan, R. Newly diagnosed psychogenic nonepileptic seizures: health care demand prior to and following diagnosis at a first seizure clinic. Epilepsy Behav 2012;23:79.CrossRefGoogle Scholar
Riggio, S. Psychogenic seizures. Emerg Med Clin N Am 1994;12(4):10011012.Google Scholar
Scheidt, C, Baumann, K, Katzev, M, et al. Differentiating cerebral ischemia from functional neurological symptom disorder: a psychosomatic perspective. BMC Psychiatry 2014;14:158163.CrossRefGoogle ScholarPubMed
Schwingenschu, P, Katschnig, P, Seiler, S, et al. Moving toward “laboratory-supported” criteria for psychogenic tremor. Move Disord 2011;26(14):25092515.CrossRefGoogle Scholar
Sevush, S, Brooks, J. Aphasia vs. functional disorder: factors in differential diagnosis. Psychosomatics 1983;24(9):847848.CrossRefGoogle ScholarPubMed
Shaibani, A, Sabbagh, M. Pseudoneurologic syndromes: recognition and diagnosis. Am Fam Phys 1998;57(10):24852494.Google ScholarPubMed
Siket, M, Merchant, R. Psychogenic seizures: a review and description of pitfalls in their acute diagnosis and management in the emergency department. Emerg Med Clin N Am 2011;29:7381.Google Scholar
Stone, J, Carson, A. Functional neurologic symptoms: assessment and management. Neurol Clin 2011;29:118.CrossRefGoogle ScholarPubMed
Stone, J, Carson, A, Duncan, R, et al. Symptoms “unexplained by organic disease” in 1144 new neurology out-patients: how often does the diagnosis change at follow-up? Brain 2009;132:28782888.Google Scholar
Stone, J, Carson, A, Sharpe, M. Functional symptoms in neurology: diagnosis and management. ACNR 2005;4(6):811.Google Scholar
Stone, J, Carson, A, Sharpe, M. Functional symptoms and signs in neurology: assessment and diagnosis. J Neurol Neurosurg Psychiatry 2005;76(Suppl I):i1i12.Google ScholarPubMed
Stone, J, Smyth, R, Carson, A, et al. Systemic review of misdiagnosis of conversion symptoms and “hysteria.BMJ 2005;331(7523):989993.CrossRefGoogle Scholar
Stone, J, Smyth, R, Carson, A, Warlow, C, Sharpe, M. La belle indifference in conversion symptoms and hysteria. Br J Psychiatry 2006;188:204209.CrossRefGoogle Scholar
Teasell, R, Shapiro, A. Misdiagnosis of conversion disorders. Am J Phys Med Rehabil 2002;81:236240.CrossRefGoogle ScholarPubMed
Young, J, Rund, D. Psychiatric considerations in patients with decreased levels of consciousness. Emerg Med Clin N Am 2010;28:595609.CrossRefGoogle ScholarPubMed
Ziv, I, Djaldetti, R, Zoldan, Y, Avraham, M, Melamed, E. Diagnosis of “non-organic” limb paresis by a novel objective motor assessment: the quantitative Hoover’s test. J Neurol 1998;245:797802.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×