title: [Neurology of hysteria (conversion disorder)].
abstract: Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.
authors.affiliation: Department of Neurology, Teikyo University School of Medicine.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sonoo
mesh_terms: D003291:Conversion Disorder / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007046:Hysteria / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology