Aims Factitious Disorder is a psychiatric condition where patients deliberately simulate illness in order to adopt the sick role. Though it has been closely associated with neurology since its origins, recent estimates have suggested that neurological presentations represent a declining proportion of factitious cases. We hypothesised that the absence of a test distinguishing factitious neurology from hysteria would mean the diagnosis of factitious neurological disorder was increasingly rarely made.

Methods We examined published cases by performing a literature search for all new cases of factitious disorder from 1951 to 1965, and from 2001 to 2005, cases being classified by presentation. An additional search of all neurological presentations from 1951 to 2005 permitted a secondary, qualitative analysis.

Results Our search yielded 87 described cases of factitious neurological presentations overall. They constituted 13.6% of presentations from 1951 to 1965, falling to 7.2% of presentations from 2001to 2005, though this difference was not significant. Though cases were relatively common compared with other medical specialities, they were strikingly different in terms of their demographics. In brief, while the paradigm of factitious.