Abstract Details

Title Association of Conversion Disorder and Migraine

Topic Headache

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-022

Objective

The primary objective of this study was to look at the prevalence of Migraine in patients diagnosed with Conversion Disorder at our institution.

Background

Prevalence of conversion disorder in general population is 0.05 % and prevalence of migraine is 14.7%. Studies of patients with non-epileptic seizure have found high rates of headache complaints. We were interested to see whether patient with conversion disorder had increased incidence of migraine, other types of headache, and pain.

Design/Methods We identified patients with diagnoses of dissociative and conversion disorders (ICD10 F44.0-F44.9) and (ICD9300.11) using Leaf database, identified diagnosis of migraine in ICD9 and ICD10, and other types of headaches. Their demographics was examined.

Results 2303 patients had conversion disorder (ICD 9 and 10), and out of these, 472 patient had migraine. Most common type of conversion disorder was conversion disorder with seizures and convulsions 34% (n=275), followed by conversion with motor symptom or deficit 19% (n=153), conversion with mixed symptoms 11% (n=51), and conversion with sensory system of deficit 7% (n=33). In our data, 20% of patients with conversion disorder had migraine. There was a female preponderance ratio of 4:1 (F:376, M:95). 67% of women (n=220) were below 55 years old, and 61% of males were (n=58) below 55 years old.

Conclusions

Headache associated with conversion is often under-recognized and may be dismissed as simply part of the conversion symptoms rather than receiving treatment. While conversion disorder is a rare condition, it appears to have significant comorbidity with migraine headache. From studies done with PNES and migraine, People with PNES and migraine report having a more severe form of migraine with more frequent and longer duration of attacks. It is possible that treatment for conversion could help migraine, and likely it is bidirectional, and treatment of migraines could lead to improvement in conversion symptoms.

Authors/Disclosures
Daniel Krashin, MD (Seattle VA) PRESENTER	Dr. Krashin has nothing to disclose.
Natalia Murinova, MD, FAAN (University Of Washington)	Dr. Murinova has nothing to disclose.

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