NEUROLOGIC MANIFESTATIONS OF CHILDHOOD HYSTERIA

During a four and one-half-year period, 32 children (23 girls, 9 boys) referred for neurologic evaluationwere diagnosed as having conversion hysteria. These patients were reviewed to develop a composite picture of the neurologic symptoms of childhood hysteria. Presenting complaints included seizures, paralysis, syncope, vertigo, pain, paresthesias, blindness, diplopia, blurred vision, tics, and intellectual deterioration. Twenty-four patients required hospitalization due to the acuteness of their presenting symptoms: the average hospital stay was six days. Twenty percent of the hospitalized patients remitted spontaneously, but 50% required extensive psychiatric evaluation and therapy before improvement. Difficulty of diagnosis was most apparent in the pseudoseizure population, all of whom could readily mimic seizure activity and most of whom were receiving anticonvulsants. An important differential feature in the pseudoseizure group was the usual normalcy of the electroencephalogram. In none of the patients was hysteria considered by the referring physician. © 1979 The C. V. Mosby Company.