17975 Conversion Disorder

Overview

Functional neurological disorder, sometimes called conversion disorder, is a condition where the brain and nervous system don't work together as they should. This causes physical symptoms like weakness, shaking, or vision problems, even though medical tests show no damage or disease. It is a real condition, not something a person imagines or makes up.

It is fairly common. Around 4 to 12 people in every 100,000 are diagnosed each year, though many more may have milder symptoms that are not recorded.

Anyone can develop functional neurological disorder, but it most often appears in teenagers and young adults. Women are about two to three times more likely to be affected than men.

Symptoms

Common symptoms

• Weakness or paralysis in an arm or leg
• Tremor or shaking that may look like Parkinson's disease
• Seizure-like episodes that do not involve the usual electrical brain changes
• Difficulty walking or keeping balance
• Numbness, tingling, or loss of sensation
• Speech problems or a hoarse voice
• Vision problems such as double vision, blurred vision, or temporary blindness
• Memory or concentration problems

Symptoms in children

• Children may stop speaking (mutism) or have seizure-like episodes.
• They may have tic-like movements or an unusual way of walking.
• Symptoms often appear after a viral illness or stress at school.

Symptoms in older adults

• Older adults may have tremor, walking problems, or weakness after a fall or illness.
• Symptoms may be mistaken for a stroke or normal aging.
• Anxiety or depression can also be present.

Causes

Main causes

• The exact cause is not fully understood, but it involves how the brain processes signals between areas that control movement, sensation, and emotion.
• Stress, emotional trauma, or a physical illness can trigger symptoms.
• Sometimes there is no identifiable trigger at all.
• The problem is in the 'software' of the brain, not the 'hardware' — the structure looks normal, but the function is affected.

Risk factors

• Being female
• Having experienced physical, emotional, or sexual abuse
• Living with chronic stress or anxiety
• Having a personality disorder or other mental health condition
• Having recently had a physical injury or infection
• Having a family member with a neurological disorder (which can influence how symptoms develop)

When to see a doctor

See a doctor urgently if:

• See a doctor urgently (same day or within 24 hours) if you have new physical symptoms that make you unable to walk, see, speak, or use a limb — to rule out stroke or other serious conditions.
• If you have repeated seizure-like episodes, get urgent medical advice.
• If you have thoughts of harming yourself, contact your local emergency mental health service immediately.

Book a routine appointment if:

• Make a routine appointment if symptoms are affecting your day-to-day life.
• If symptoms have come and gone for more than a few weeks, or if you have persistent worries about your health, talk to a doctor.
• Seek advice if symptoms do not match any known disease pattern and you want reassurance.

Diagnosis

Diagnosis is made based on the pattern of symptoms and a full medical examination. Doctors look for symptoms that do not follow the usual patterns of neurological disease, and they often notice positive signs — such as symptoms that change or disappear when attention is drawn away.

Tests that may be done

• A detailed medical history and neurological examination
• Blood tests to check for infections, vitamin deficiencies, or thyroid problems
• Imaging like MRI or CT scans of the brain to rule out stroke, tumours, or multiple sclerosis
• Electroencephalogram (EEG) to rule out epilepsy if seizure-like episodes occur

What to expect at your appointment

You will likely be referred to a neurologist (a brain and nervous system specialist). Sometimes a psychiatrist or psychologist is also involved. Diagnosis may take time, but it usually comes after other conditions are ruled out. You should be given a clear explanation of the diagnosis and what it means.

Treatment

Treatment often involves a team of professionals, including a neurologist, physiotherapist, occupational therapist, and psychologist. The goal is to help the brain relearn normal functions. It takes time and patience, but many people improve.

Self-care at home

• Learn about the condition — understanding it can reduce fear and make symptoms easier to manage.
• Keep a diary of symptoms and possible triggers, such as stress or tiredness.
• Gradually increase activity with guidance from a therapist.
• Practise relaxation, breathing exercises, or mindfulness to manage stress.
• Set realistic goals and celebrate small improvements.

Medical treatments

Medicines are not usually prescribed specifically for functional neurological disorder. However, if you also have anxiety, depression, or pain, a doctor may suggest treatment for those. Any medication should be explained clearly, including benefits and side effects. Physical therapy and psychological therapy like cognitive behavioural therapy (CBT) are the main approaches. Never stop or change any medication without consulting your doctor.

Living with this condition

Live day by day. Symptoms can come and go, and that is common. Focus on what you can do, not what you cannot. Pace yourself — rest when tired and build up activity slowly.

Lifestyle tips

• Keep a regular sleep routine.
• Find enjoyable hobbies or activities that take your mind off symptoms.
• Stay connected with friends and family who understand and support you.
• Learn to say no and manage stress before it builds up.

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, whole grains, and protein. Gentle exercise like walking, swimming, or yoga can help, but it is best to agree on an exercise plan with your doctor or physiotherapist. Staying active helps your brain and body communicate better.

Mental health and emotional wellbeing

Living with functional symptoms can feel frustrating and isolating. It is completely normal to feel anxious, low, or angry. Talking to a therapist can help you process emotions and learn coping skills. Remember, your symptoms are real and your feelings matter.

Prevention

There is no sure way to prevent functional neurological disorder, but learning to manage stress, addressing past trauma, and seeking early help for emotional difficulties may reduce the risk of severe episodes.

Complications

If left untreated

• Without treatment, symptoms may become long-lasting and harder to change.
• Muscle weakness can lead to muscle wasting or stiff joints (contractures).
• Falling may cause injuries.
• Loss of work or social life can lead to depression and anxiety.

Long-term outlook

The outlook is good for many people. About half of people with conversion disorder improve significantly within a year, especially with early treatment. Recovery can happen gradually, and setbacks are common. With a supportive care team and steady effort, many people return to normal routines and hobbies.

Find support

International organisations

• NHS ↗
• Neurosymptoms.org ↗

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.