James A Haley VA Hospital, University of South Florida College of Medicine, Tampa, FL Correspondence: jonathan.stewart1{at}va.gov To the Editor: Capgras syndrome (CS) was first described in 19231 and is characterized by the belief that someone, often a close relative, has been replaced by an imposter. Although initially reported in schizophrenia, a substantial proportion of cases are related to neurologic pathology, noted almost invariably in the right hemisphere.2 We present a patient who developed CS in the context of a left-hemisphere traumatic brain injury (TBI).Case Report A 72-year-old, right-handed man with no previous psychiatric or cognitive problems suffered a motorcycle accident resulting in intraparenchymal, subdural, and subarachnoid hemorrhages. He had a difficult hospitalization but ultimately returned home. Neuropsychiatric sequelae reportedly included memory and executive impairment and paranoia, the latter responding well to quetiapine. CT scan showed encephalomalacia limited to the left inferior frontal lobe. About 2 months after discharge, he was seen in our clinic. His wife reported his having discontinued his quetiapine 1 month earlier because of worries about potential side effects. Since that time, she reported paranoid ideation about neighbors stealing from him, but also episodes of his misidentifying her as someone impersonating his wife in order
Capgras Syndrome Related to Left-Hemisphere Injury
Abstract
James A Haley VA Hospital, University of South Florida College of Medicine, Tampa, FL Correspondence: jonathan.stewart1{at}va.gov To the Editor: Capgras syndrome (CS) was first described in 19231 and is characterized by the belief that someone, often a close relative, has been replaced by an imposter. Although initially reported in schizophrenia, a substantial proportion of cases are related to neurologic pathology, noted almost invariably in the right hemisphere.2 We present a patient who developed CS in the context of a left-hemisphere traumatic brain injury (TBI).Case Report A 72-year-old, right-handed man with no previous psychiatric or cognitive problems suffered a motorcycle accident resulting in intraparenchymal, subdural, and subarachnoid hemorrhages. He had a difficult hospitalization but ultimately returned home. Neuropsychiatric sequelae reportedly included memory and executive impairment and paranoia, the latter responding well to quetiapine. CT scan showed encephalomalacia limited to the left inferior frontal lobe. About 2 months after discharge, he was seen in our clinic. His wife reported his having discontinued his quetiapine 1 month earlier because of worries about potential side effects. Since that time, she reported paranoid ideation about neighbors stealing from him, but also episodes of his misidentifying her as someone impersonating his wife in order
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Capgras Syndrome Related to Left-Hemisphere Injury
Fils, Jean M.; Stewart, Jonathan T.
Follow Journal of Neuropsychiatry & Clinical Neurosciences
, Volume 23 (3): E6
American Psychiatric Publishing, Inc (Journal) – Aug 1, 2011
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