Konversionsstörungen mit funktionellen neurologischen Symptomen

Disorders with functional neurological symptoms, better known by the traditional term conversion disorders, have a long history in psychotherapy and have not lost any of their enigmatic nature to this day. They present with neurologically impressive symptoms that, however, remain without biomedical findings and explanations. Three groups are particularly prominent: movement disorders (e.g., gait disturbances or paralysis), sensory disorders (e.g., visual impairment up to functional blindness), and dissociative seizures that resemble epilepsy but show a completely normal EEG. Distinguishing pediatric and neurological differential diagnoses is medically complex.

The guide first informs about the state of research regarding symptoms, classification, and differential diagnosis. Diagnostic procedures focus on a structured history of symptom progression, preceding individual and family developmental conditions, current triggering factors, and psychosocial follow-up burdens. The treatment guidelines offer a wide range of behavioral medicine and psychotherapeutic interventions. Based on a coherent disorder concept for the family, the individualized therapy includes a combination of symptom-centered and conflict-oriented approaches. These include, among others, the communication of diagnosis, psychoeducation, addressing excessive illness anxiety, activation and mobilization, contingency management, interventions for school absenteeism, imagination and mental training, mindfulness-based methods, self-control techniques for seizures, physiotherapy, as well as conflict-oriented methods such as parts work and chair techniques. Various practical materials and case examples facilitate the implementation of the guidelines in clinical practice.