Advertisement

What’s All the Hysteria About? A Modern Perspective on Functional Neurological Disorders

      Almost 4000 years ago, the Egyptians attributed unexplained physical symptoms in women to abnormal movements of the uterus. This idea remained fixed in medical practice for millennia, with Hippocrates ultimately coining the term “hysteria” (from the Greek word for uterus) to describe such cases. The term remains in common use today: colloquially, it refers to any sort of madness or inexplicable behavior; clinically, it most commonly refers to unexplained neurologic symptoms. These symptoms—ranging the gamut from seizure-like episodes to paralysis—are both common and vexing for clinicians. But until recently, researchers have made relatively little progress toward understanding what causes these syndromes (spoiler alert: it is not a wandering uterus).
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kaplan R.
        O Anna: Being Bertha Pappenheim—historiography and biography.
        Australas Psychiatry. 2004; 12: 62-68
        • Freud S.
        Selected Papers on Hysteria and Other Psychoneuroses. 2nd, enlarged ed. Brill AA, trans.
        The Journal of Nervous and Mental Disease Publishing Company, New York, NY1912 (bartleby.com. 2010)
        • Demartini B.
        • D’Agostino A.
        • Gambini O.
        From conversion disorder (DSM-IV-TR) to functional neurological symptom disorder (DSM-5): When a label changes the perspective for the neurologist, the psychiatrist and the patient.
        J Neurol Sci. 2016; 360: 55-56
        • Spence S.A.
        • Crimlisk H.L.
        • Cope H.
        • Ron M.A.
        • Grasby P.M.
        Discrete neurophysiological correlates in prefrontal cortex during hysterical and feigned disorder of movement.
        Lancet. 2000; 355: 1243-1244
        • Stone J.
        • Zeman A.
        • Simonotto E.
        • Meyer M.
        • Azuma R.
        • Flett S.
        • et al.
        FMRI in patients with motor conversion symptoms and controls with simulated weakness.
        Psychosom Med. 2007; 69: 961-969
        • Voon V.
        • Gallea C.
        • Hattori N.
        • Bruno M.
        • Ekanayake V.
        • Hallett M.
        The involuntary nature of conversion disorder.
        Neurology. 2010; 74: 223-228
        • Voon V.
        • Brezing C.
        • Gallea C.
        • Ameli R.
        • Roelofs K.
        • LaFrance Jr., W.C.
        • et al.
        Emotional stimuli and motor conversion disorder.
        Brain. 2010; 133: 1526-1536
        • Stone J.
        • Carson A.
        • Duncan R.
        • Roberts R.
        • Warlow C.
        • Hibberd C.
        • et al.
        Who is referred to neurology clinics?—the diagnoses made in 3781 new patients.
        Clin Neurol Neurosurg. 2010; 112: 747-751
        • Carson A.
        • Lehn A.
        • Ludwig L.
        • Stone J.
        Explaining functional disorders in the neurology clinic: a photo story.
        Pract Neurol. 2016; 16: 56-61
        • Stone J.
        • Carson A.
        • Hallett M.
        Explanation as treatment for functional neurologic disorders.
        Handb Clin Neurol. 2016; 139: 543-553

      Linked Article

      • Erratum
        Biological PsychiatryVol. 85Issue 5
        • Preview
          Erratum to: “What’s All the Hysteria About? A Modern Perspective on Functional Neurological Disorders,” by Madva, Ross, and Cooper (Biol Psychiatry 2019; 85:e3--e4); 10.1016/j.biopsych.2018.11.003 .
        • Full-Text
        • PDF