Conversion disorder Flashcards

2
Q

What is a conversion disorder?

A

Pt presents with a motor or sensory impairment with no organic cause identified during testing (physical manifestation of a psychological problem)

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3
Q

What age and how long does a conversion disorder normally last?

A

Usually 10-35yrs old

Short - weeks to months
Though can be chronic or relapse

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4
Q

How is it different to malingering?

A

Difference

  • Symptoms or deficits significantly impact on the Pt, warranting medical evaluation
  • Pt has nothing to gain from having a pathology
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5
Q

What will testing show? (e.g. weakness?)

A

Inconsistent responses and results will be different to that of other pathologies

E.g. weakness

  • whole movements rather than muscle groups
  • agonists and antagonists can contract simultaneously
  • Give way weakness
  • Muscle wasting absent
  • Reflexes are normal
  • Weakness level may be inconsistent with function
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6
Q

Name 2 secondary problems

A

Contracture

Pressure areas

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7
Q

Risk factors for conversion disorder

A

Risks

  • family member with disorder
  • sexually abused as a child
  • very stressful home/work life
  • female
  • lower socioeconomic class
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8
Q

Physiotherapy management of conversion disorder (6)

A

PT

  • Minimise time assessing as assessment
  • Goals should encourage rapid improvement
  • Feedback focused on what they are doing well (not what needs fixing)
  • Convince the Pt that they are able to do tasks
  • Pick outcome measures you know they will do well on
  • Use outcome measures to demonstrate improvement and normal performance
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9
Q

Why might physio work?

A

Legitimises their condition and ?gives them permission? to get better

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10
Q

Clinical presentation of conversion disorder

A

Presentation

  • Stroke-like impairments
  • Impaired hearing/vision
  • Pseudoseizures (no cyanosis, EEGs don’t show)
  • Tremor
  • Fixed dystonias
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11
Q

Factors for favourable prognosis

A

Factors

  • sudden onset
  • stress before onset
  • short interval between Dx and Rx
  • high intelligence
  • absence of psychiatric disorder
  • aphonia and blindness as presentation
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