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Motor Conversion Symptoms and Pseudoseizures: A Comparison of Clinical Characteristics

Received July 2, 2003; revision received Feb. 25, 2004; accepted March 10, 2004. From the Division of Clinical Neurosciences, School of Molecular and Clinical Medicine, Western General Hospital, University of Edinburgh; the Division of Psychiatry, School of Molecular and Clinical Medicine, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh; and the Department of Neurology, University of Southern Denmark, Esbjerg Hospital, Esbjerg, Denmark. Address reprint requests to Dr. Stone, Division of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU U.K.; jstone{at}skull.dcn.ed.ac.uk (email).

The authors prospectively studied consecutive neurological inpatients with either motor conversion symptoms or pseudoseizures of recent onset. Patients were administered a structured psychiatric diagnostic interview, a measure of perceived parental care, and a life events inventory. They found that patients with pseudoseizures (N=20, mean age=27 years): 1) were younger than patients with motor conversion symptoms (N=30, mean age=39 years), 2) were more likely to have a borderline personality disorder), 3) were more likely to have a lower perception of parental care and to report incest, and 4) reported more life events in the 12 months before symptom onset. These differences in their characteristics and associated factors raised the question of whether it is helpful to group patients with pseudoseizures and motor conversion symptoms in a single diagnostic category of conversion disorder. An alternative view, that gives primacy to the symptoms rather than a disorder, may enable more precise research questions to be posed.

Key Words: borderline personality • epilepsy • child abuse • somatoform disorders

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