Assessments and Treatments for Neurological Symptoms That Do Not Match Organic Findings

• Published in: Brain and nerve = Shinkei kenkyū no shinpo Vol. 70; no. 9; p. 971
• Main Authors: Yasuda, Takaaki, Hatakeda, Junichi, Yoshimasu, Haruo
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.09.2018
• Subjects: Conversion Disorder - complications; Conversion Disorder - diagnosis; Diagnosis, Differential; Humans; Nervous System Diseases - complications; Nervous System Diseases - diagnosis; Psychiatry
• ISSN: 1881-6096
• DOI: 10.11477/mf.1416201117

Many clinicians treat patients with neurological symptoms such as muscle weakness and involuntary movements, that do not correspond to organic findings. The differential diagnosis of patients with medically unexplainable symptoms includes conversion disorder, somatic symptom disorder, and illness anxiety disorder among others. Conversion disorder is a mental disorder with pseudo-neurological symptoms that are not due to an organic abnormality. For its diagnosis it is necessary to show that the symptoms and findings are not compatible with neurological diseases. Conversion disorder and any neurological diseases can coexist, in which cases neurologists and psychiatrists should cooperate when treating the patient. However, it is difficult to clearly distinguish individual symptoms by their mechanism. Patients complaining of physical symptoms, including those with conversion disorder, require careful explanation that takes into account the patient's explanatory model. Clinicians must switch from an acute disease model to a chronic disease model. These patients are more likely to concentrate consciously on their physical condition and clinicians should help patients avoid ruminating on their physical symptoms. Because it is not simple to completely exclude physical disorders and prove that the symptoms are psychogenic, confirming a diagnosis should be performed carefully.