Conversion Disorder (Functional Neurological Symptom Disorder) 319
Specify if:
Acute episode:  Symptoms present for less than 6 months.
Persistent:  Symptoms occurring for 6 months or more.
Specify if:
With psychological stressor  (specify stressor)
Without psychological stressor
Diagnostic Features
Many clinicians use the alternative names of “functional” (referring to abnormal central
nervous system functioning) or “psychogenic” (referring to an assumed etiology) to de-
scribe the symptoms of conversion disord er (functional neurol ogical symptom disor-
der). In conversion disorder, there may be on e or more symptoms of various types. Motor
symptoms include weakness or paralysis; abno rmal movements, such as tremor or dys-
tonic movements; gait abnormalities; and abnormal limb posturing. Sensory symptoms
include altered, reduced, or absent skin sens ation, vision, or hearing. Episodes of abnor-
mal generalized limb shaking with apparent im paired or loss of consciousness may resem-
ble epileptic seizures (also called psychogenic or non-epileptic seizures ). There may be
episodes of unresponsiveness  resembling syncope or coma. Other symptoms include re-
duced or absent speech volume (dysphonia/apho nia), altered articulation (dysarthria), a
sensation of a lump in the th roat (globus), and diplopia. 
Although the diagnosis requires that the symptom is not explained by neurological
disease, it should not be ma de simply because results from investigations are normal or
because the symptom is “bizarre.” There must be clinical findings that show clear evidence
of incompatibility with neurological disease. Internal inconsistency at examination is one
way to demonstrate incompatibility (i.e., demonstrating that physical signs elicited