Hysteric conversion reaction(HCR/GAD)

Generalized Anxiety disorder/HCR:

Clinical Features:

• 1)Psychogenic non-epileptic seizures (PNES).
• 2)Sense-related disruptions.
• 3)Pain
• 4)Unusual muscle tension, spasms, twitches and tremors
• 5)Muscle weakness or paralysis.
• 6)Trouble swallowing (dysphagia).
• 7)Dizziness.
• 8)Fainting or passing out (syncope).

Investigations:

• 1)CBC
• 2)CT Scan of Brain 
• 3) EEG
• 4)MRI of brain

Rx:

• Reassurance
  
• Patient eduction -psychotherapy
  
• Electroconvulsive therapy
  

1. Tab. Esita(Escitalopram)(10mg)

• 1+0+0.…...2 month

2. Tab. Indever(propanolol)  (40mg)

• 1/2+0+1/2..…..1 month

3.Tab. Zolium(alprazolam) (0.5mg)

• o+o+1.…..1 month

4.Cap.Sergel(Esomeprazol) (20mg)

• 1+0+1…...10 days 

Advice : 

• 1)cognitive behavioral therapy (CBT)
  
• 2)psychotherapy.
• 3)relaxation techniques, such as meditation or yoga.
• 4)physical therapy.
• 5)maintaining a healthy work and life balance.
• 6)seeking additional support from friends, family, and the community.