title: [Hysterical conversion].
abstract: "Hysterical" conversion hasn't vanished, and remains a diagnostic, therapeutic and relational challenge for the clinician. Conversion may be associated with organic disease. From the clinical point of view, two subtypes of conversion symptoms, namely psychogenic nonepileptic seizures and functional movement disorders, have been individualized. Physical signs of neurological inconsistency, and classical arguments in favor of a psychological etiology have been recently reevaluated, which allows, along with the progress of neurological investigations, to minimize the rate of misdiagnosis. Functional neuroimaging has shed light on the brain mechanisms involved in conversion phenomena. From a nosological point of view, there is a tension between the whish to "banalize" the conversion symptoms as mere "functional neurological symptoms", which makes easier to communicate the diagnosis to the patient and may remove the stigma from the diagnosis; and the wish of certain authors to "revive" hysteria, emphasizing the core phenomenon of dissociation and its close relationship with trauma. Proposed treatment of conversion disorder are numerous, although poorly evaluated and often insatisfactory, but recent publications insist on the importance of communicating the diagnosis to the patient in a honest, nonjudmental and understandable way, at the earliest phase of the disorder.
authors.affiliation: Service de médecine interne, hôpital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne Cedex 2, France. pascal.cathebras@chu-st-etienne.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Cathébras
authors.forename: Pauline
authors.initials: P
authors.lastname: Régny
mesh_terms: D003291:Conversion Disorder / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D011379:Prognosis