A 28-year-old soldier returns from deployment and develops episodes of bilateral limb shaking without loss of consciousness or postictal confusion. EEG during an episode is normal. The MOST appropriate term for his condition in DSM-5 is:

• A Factitious Disorder — as the patient consciously simulates seizures
• B Conversion Disorder (Functional Neurological Symptom Disorder) — with attacks or seizures ✓
• C Malingering — since there is secondary gain (military benefits)
• D Brief Psychotic Disorder with conversion features

Explanation

DSM-5 renamed Conversion Disorder to Functional Neurological Symptom Disorder (FNSD), emphasising that diagnosis is based on positive neurological signs of functional origin (Hoover sign, non-anatomic sensory loss, la belle indifférence, variable weakness on distraction) rather than excluding organic disease alone. Non-epileptic attacks/seizures (PNES — Psychogenic Non-Epileptic Seizures) with normal EEG during the event represent a key presentation. Factitious disorder involves deliberate feigning for the sick role; malingering is feigning for external incentive — FNSD involves no conscious intent.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.