way to demonstrate incompatibility (i.e., demonstrating that physical signs elicited
through one examination method are no longer  positive when tested a different way). Ex-
amples of such examination findings include
• Hoover’s sign, in which weakness of hip exte nsion returns to normal strength with con-
tralateral hip flexio n against resistance.
• Marked weakness of ankle plantar-flexion when  tested on the bed in an individual who
is able to walk on tiptoes;
• Positive findings on the tremor entrainmen t test. On this test, a unilateral tremor may
be identified as functional if the tremor ch anges when the individual is distracted away
from it. This may be observed if the individual is asked to copy the examiner in making
a rhythmical movement with their unaffected hand and this causes the functional
tremor to change such that it copies or “entrains” to the rhythm of the unaffected hand
or the functional tremor is suppressed, or no longer makes a simple rhythmical move-
ment.
• In attacks resembling epilepsy or syncope (“ psychogenic” non-epileptic attacks), the
occurrence of closed eyes with resistance to  opening or a normal simultaneous electro-
encephalogram (although this alone does not exclude all forms of epilepsy or syncope).
• For visual symptoms, a tubular visual field (i.e., tunnel vision).
It is important to note that the diagnosis of conversion disorder should be based on the
overall clinical picture and not on a single clinical finding.
Associated Features Supporting Diagnosis
A number of associated featur es can support the diagnosis of  conversion disorder. There
may be a history of multiple similar somatic symptoms. Onset may be associated with
stress or trauma, either psychological or physi cal in nature. The potential etiological rele-