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8 tests rolled into a mnemonic to detect weakness in suspected conversion disorder

DSM-5 criteria for conversion dis­order (or functional neurological symptom disorder) requires find­ings that are incompatible with recog­nized neurologic or medical conditions.1 Knowledge of signs specific to conversion disorder may help you diagnose the illness with confidence.

We review signs suggestive of conver­sion disorder. These can be remembered using the mnemonic How About Finding Some Conversion Weakness [in an other­wise] Strong Guy/Gal? (Table2).

Inconsistencies in motor function can be observed on examination. Signs may be consciously or unconsciously produced. Although most of the tests mentioned have high positive and negative predictive values (noted in the Table2) they have limited sensitivity and specificity,3 and the presence of a positive sign does not exclude the possibility of comorbid disease.


 



Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

References


1. Stone J, LaFrance WC Jr, Levenson JL, et al. Issues for DSM- 5: conversion disorder. Am J Psychiatry. 2010;167(6):626-627.
2. Daum C, Hubschmid M, Aybek S. The value of ‘positive’ clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review. J Neurol Neurosurg Psychiatry. 2014;85(2):180-190.
3. Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: assessment and diagnosis. J Neurol Neurosurg Psychiatry. 2005;76(suppl 1):i2-i12.

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Vineet Punia, MD, MS
Neurology Resident

Douglas Opler, MD
Assistant Professor
Department of Psychiatry


Rashi Aggarwal, MD
Assistant Professor and Associate Residency Training Director
Department of Psychiatry

Rutgers New Jersey Medical School
Newark, New Jersey

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Current Psychiatry - 13(9)
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conversion disorder, somatic disorder, neurologic, functional neurological symptom disorder
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Vineet Punia, MD, MS
Neurology Resident

Douglas Opler, MD
Assistant Professor
Department of Psychiatry


Rashi Aggarwal, MD
Assistant Professor and Associate Residency Training Director
Department of Psychiatry

Rutgers New Jersey Medical School
Newark, New Jersey

Author and Disclosure Information

 

Vineet Punia, MD, MS
Neurology Resident

Douglas Opler, MD
Assistant Professor
Department of Psychiatry


Rashi Aggarwal, MD
Assistant Professor and Associate Residency Training Director
Department of Psychiatry

Rutgers New Jersey Medical School
Newark, New Jersey

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DSM-5 criteria for conversion dis­order (or functional neurological symptom disorder) requires find­ings that are incompatible with recog­nized neurologic or medical conditions.1 Knowledge of signs specific to conversion disorder may help you diagnose the illness with confidence.

We review signs suggestive of conver­sion disorder. These can be remembered using the mnemonic How About Finding Some Conversion Weakness [in an other­wise] Strong Guy/Gal? (Table2).

Inconsistencies in motor function can be observed on examination. Signs may be consciously or unconsciously produced. Although most of the tests mentioned have high positive and negative predictive values (noted in the Table2) they have limited sensitivity and specificity,3 and the presence of a positive sign does not exclude the possibility of comorbid disease.


 



Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

DSM-5 criteria for conversion dis­order (or functional neurological symptom disorder) requires find­ings that are incompatible with recog­nized neurologic or medical conditions.1 Knowledge of signs specific to conversion disorder may help you diagnose the illness with confidence.

We review signs suggestive of conver­sion disorder. These can be remembered using the mnemonic How About Finding Some Conversion Weakness [in an other­wise] Strong Guy/Gal? (Table2).

Inconsistencies in motor function can be observed on examination. Signs may be consciously or unconsciously produced. Although most of the tests mentioned have high positive and negative predictive values (noted in the Table2) they have limited sensitivity and specificity,3 and the presence of a positive sign does not exclude the possibility of comorbid disease.


 



Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

References


1. Stone J, LaFrance WC Jr, Levenson JL, et al. Issues for DSM- 5: conversion disorder. Am J Psychiatry. 2010;167(6):626-627.
2. Daum C, Hubschmid M, Aybek S. The value of ‘positive’ clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review. J Neurol Neurosurg Psychiatry. 2014;85(2):180-190.
3. Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: assessment and diagnosis. J Neurol Neurosurg Psychiatry. 2005;76(suppl 1):i2-i12.

References


1. Stone J, LaFrance WC Jr, Levenson JL, et al. Issues for DSM- 5: conversion disorder. Am J Psychiatry. 2010;167(6):626-627.
2. Daum C, Hubschmid M, Aybek S. The value of ‘positive’ clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review. J Neurol Neurosurg Psychiatry. 2014;85(2):180-190.
3. Stone J, Carson A, Sharpe M. Functional symptoms and signs in neurology: assessment and diagnosis. J Neurol Neurosurg Psychiatry. 2005;76(suppl 1):i2-i12.

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Current Psychiatry - 13(9)
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Current Psychiatry - 13(9)
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58-59
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58-59
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8 tests rolled into a mnemonic to detect weakness in suspected conversion disorder
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8 tests rolled into a mnemonic to detect weakness in suspected conversion disorder
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conversion disorder, somatic disorder, neurologic, functional neurological symptom disorder
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conversion disorder, somatic disorder, neurologic, functional neurological symptom disorder
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