Multiple sclerosis can present with a number of varied symptoms, with each case being quite different due to the way the disease presents and progresses in the patient. Because there is no way to predict which part of the central nervous system will be affected at what point in the disease, it is very difficult to determine and diagnose the development of multiple sclerosis, especially since there are several other diseases and ailments that show similar symptoms in the beginning.
What are conversion and psychogenic disorders?
Conversion and psychogenic disorders are sometimes both referenced under the umbrella of functional neurological disorders. These are defined by symptoms of the nervous system that don’t match the patient’s physical condition. There is no medical explanation for the symptoms, such as a neurological condition or other disease.
In most cases, the symptoms appear following some intensely stressful or anxious episode or situation, leading scientists to believe that the symptoms are related to the psychological need for a physical outlet for the distress.
Conversion and psychogenic disorders vs MS: Symptoms and similarities
Conversion and psychogenic disorders manifest in several different types of symptoms, depending on the triggering incident or experience that is believed to have caused the onset. In many cases, these symptoms may appear to suggest that the patient is developing multiple sclerosis, especially if this isn’t the first episode of such symptoms.
Some of these might include:
- Weakness, especially in the limbs, or even temporary paralysis
- Difficulty walking or with movement and unusual movement like tremors or spasms
- Dizziness and difficulty with balance
- Problems swallowing and the feeling of having something stuck in the throat
- Non-epileptic seizures or tremors
- Numbness, tingling, or loss of sensation in the extremities
- Slurred speech or other problems speaking
- Double or blurred vision or temporary blindness
Another similarity between the two conditions is that they both seem to relapse and remit, with symptoms coming and then disappearing for a period of time. Unfortunately, the cause of those symptoms coming and going are quite different, as are the overall diagnoses and prognoses.
Conversion and psychogenic disorders and MS: Differences
One of the biggest differences between multiple sclerosis and the broad range of conversion and psychogenic disorders is the cause behind them. With MS, an autoimmune response to the protective layer of protein and fat (myelin) on the central nervous system causes inflammation, destruction of the myelin, and damage to the nerves. All of this accounts for the symptoms that come with multiple sclerosis. In psychogenic and conversion disorders, there is nothing physical that affects the nervous system. No underlying physical condition is found. It is literally “all in the patient’s head”, meaning that the symptoms are produced psychologically as a coping mechanism for stress and traumatic situations.
There are other differences, too, including:
- With multiple sclerosis, risk factors are based mainly on physical traits. For example, females, people between the ages of eighteen and forty, Caucasians, and those with an immediate family member who has the disease are at higher risk for developing MS. With psychogenic disorders, risk factors do include having a family member with such a disorder but lean more toward personal trauma, such as already having a neurological disorder or disease (such as migraines or epilepsy), having suffered recent emotional or physical trauma, having mood or anxiety disorders or other psychological diagnoses, or having a history of physical or sexual abuse or even neglect during childhood.
- In most cases, conversion and psychogenic disorders are easily remedied, with no lasting damage to the body. However, this requires that the patient is willing to cooperate with treatment methods. On the other hand, with MS, symptoms cannot be remedied and will relapse, eventually progressing to a constant condition that worsens over time.
- To diagnose MS, as well as any conversion or psychogenic disorder, it’s important to rule out any other possible cause of symptoms, but there is a different path to diagnosis for each. While some of the same tests may be run, the tests are looking for different things. Multiple sclerosis is looking for signs of damage to the nervous system by the immune system, while a diagnosis of conversion and psychogenic is confirming a lack of anything that could suggest a physical condition that would explain the symptoms.
- The criteria that must be met for a diagnosis of a conversion or psychogenic disorder is spelled out by the American Psychiatric Association.
- One or more symptoms that are manifested must affect body movement or one of the five senses.
- No neurological, medical, physical, or mental condition can explain the symptoms that are present in the patient (the patient is not “crazy” or “ill”).
- The abnormal movements are not deliberate and are caused subconsciously (the patient is not “faking it”).
- While these movements are real and often interfere with normal daily life and functionality, there is no evidence of any neurological damage.
- The disorder is treatable and likely curable.
To treat conversion and psychogenic disorders, patients have to be open and accepting of the diagnosis and willing to work on negating them. While the same is true of MS, it’s not as vital as treating a disorder that begins with a psychological effect. For these disorders, the treatment regimen also typically includes non-narcotic painkillers that will aid in reducing pain and antidepressants that can help treat the mental aspect of the disorder and even cure it. By comparison, multiple sclerosis often requires anti-inflammatories, immunosuppressants, and sometimes opioids or even chemotherapy, none of which will cure the disease.