Unusual Neurological Conditions

A Collection of Unusual Neurological States


“It’s hard to imagine life without emotions. We live for them, structuring circumstances to give us moments of pleasure and joy, and avoiding situations that will lead disappointment, sadness, or pain. The rock critic Lester Bangs once said, “The only questions worth asking today are whether humans are going to have any emotions tomorrow, and what quality of life will be if the answer is no.”

Joseph Le Doux. “The Emotional Brain”


In the following states, the NLPerson familiar with strategy elicitation and form will note that it is the kinesthetic component of the psycho-neurological strategy that is affected or deleted in some way.


Kluver-Bucy Syndrome

Damage to the front of the temporal lobe and the amygdala just below it can result in a strange condition called Kluver-Bucy Syndrome. Classically, the person will try to put anything to hand into their mouths and typically attempt to have sexual intercourse with it. A classic example is of the unfortunate chap arrested whilst attempting to have sex with the pavement. Effectively, it is the “what” pathway that is damaged with regards to foodstuff and sexual partner. As Ramachandran puts it, “they are not hypersexual, just indiscriminate. They [monkeys with surgically modified temporal lobes] have great difficulty in knowing what prey is, what a mate is, what food is and in general what the significance of any object might be.”


Klüver-Bucy Syndrome
Successful Treatment With Carbamazepine

“We recently encountered a patient suffering from posttraumatic Klüver-Bucy syndrome whose condition deteriorated on standard drug therapy.”
More here: https://jamanetwork.com/journals/jama/article-abstract/357020 (subscription required)


Capgras’ Syndrome

Brilliantly described by Ramachandran, Capgras’ syndrome is another neurological syndrome that is often mistaken for insanity. The Capgras’ patient will typically identify people close to them as being imposters – identical in every possible way, but identical replicas. Classically, the patient will accept living with these imposters but will secretly “know” that they are not the people they claim to be. When Capgras’ occurs secondary to other disorders such as the schizophrenias, the experience can take on a frightening dimension along the lines of “Invasion of The Body snatchers”.

Neurologically speaking, Capgras’ Syndrome occurs when the kinesthetic component of facial recognition is damaged. The result being that the strategy of facial recognition no longer has the internal kinesthetic on which to exit. Thus the patient gets caught up in an eternal loop in his strategy and needs to form an explanation (the delusion) in order to understand why this experience should occur.


Capgras Syndrome and Parkinson’s Disease

“Capgras Syndrome affects between 16 and 28% of people with Lewy body dementia, around 15% of those with Alzheimer’s, and is present but less common in people with basic Parkinson’s. Those with anxiety have a 10x risk of developing Capgras syndrome.” More here: https://parkinsonsdisease.net/clinical/capgras-syndrome/


Cotard’s Syndrome

Named after a French psychiatrist Jules Cotard, this syndrome is characterized by the patient believing that he is dead, a walking corpse. This “delusion” is usually expanded to the degree that the patient might claim that he can smell his own rotting flesh and feel worms crawling through his skin (a recurring experience of people chronically deprived of sleep or suffering amphetamine/cocaine psychosis). The French physician Charles Bonnet described a lady who insisted of dressing in a death shroud and being put in a coffin. She demanded to be buried and when refused, remained in her coffin until she died several weeks later.

Ramachandran posits that Cotard’s syndrome is a more extreme form of Capgras’ syndrome where the kinesthetic recognition to all stimuli is absent (whereas in Capgras’ syndrome, the kinesthetic component is lost only from facial recognition). Whilst the exact neurological mechanism of Cotard’s syndrome is not fully understood (and it is neurological and not a psychiatric syndrome par se) the damage is likely to be in the right temporal lobe. Cotard’s syndrome is nearly always associated with a severe (psychotic) depressive state, which is not surprising if we consider that the individual is unable to neurological create any kinesthetic to any sensory stimulus.


A Case Report of Cotard’s Syndrome

“Ms. L, a 53-year-old Filipino woman, was admitted to the psychiatric unit when her family called 911 because the patient was complaining that she was dead, smelled like rotting flesh, and wanted to be taken to a morgue so that she could be with dead people. Upon interview in the hospital, the patient expressed fear that “paramedics” were trying to burn down the house where she was living with her cousin and her brother. She also admitted to hopelessness, low energy, decreased appetite, and somnolence.”  More here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695744/


Fregoli Syndrome

This is an extraordinary experience where the person misidentifies another person as someone who clearly he is not. Indeed, he may begin to see the same person everywhere he looks, something demonstrated in that marvelous film, “Being John Malchovick”. Typically, this state is said to be secondary to states such as the schizophrenias but can occur in isolation to other disorders. Ramachadran suggests this state results from having an excess of connections between the facial recognition centers and the amygdala (the opposite of Capgras’ syndrome).

The person with Fregoli syndrome will need to explain to themselves their unusual neurological experience so we end up with someone who might claim: “They keep changing their clothes and their hairstyles but I know it is them. They should get a medal for acting, they are so good, but I can tell it is them from the way they stand and move about.”

Several writers, including Ramachandran, have suggested that this mechanism may be the basis of racist stereotypes:

“Perhaps a single unpleasant episode with one member of a visual category sets up a limbic connection that is inappropriately generalized to include all members of that class and is notoriously impervious to “intellectual correction” based on information stored in higher brain centers. Indeed one’s intellectual views may be coloured (no pun intended) by this emotional knee-jerk reaction; hence the notorious tenacity of racism.”


A “Contemporary” Case of Frégoli Syndrome

“…He had developed the belief that his daily facial cream strongly attracted female students and claimed that this cream was able to perfect his facial look. He spent an excessive amount of time on Facebook, where he met a young woman with whom he wished to engage in an intimate relationship, but the young woman withdrew. Subsequently, he developed the belief that each time he was contacted by other young women via Facebook, it was in fact the young woman with whom he had been in contact before and who now was disguising herself…”  More here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357570/ 


Alien Hand Syndrome

Probably a version of “left hemi-neglect”, brain damage in the right place can disconnect the left hand (controlled by the right, unconscious cerebral hemisphere) leaving the left hand without conscious control and the person at the mercy of the unconscious whims of the right hemisphere.


The alien hand syndrome

“A 77-year-old woman presented with the complaint of observing her left hand moving without her knowledge while watching television. Her left hand stroked her face and hair as if somebody was controlling it. These movements lasted only half an hour but on recovery, she had left hemiparesis. Alien hand syndrome as the presentation of cardioembolic stroke is extremely rare but can be terrifying to patients.”  More here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059570


Foreign Accent Syndrome

I’m not entirely sure if this deserves to be a syndrome. This is a rare event that I’ve seen just once. Following a head injury to the left side of the brain (fall from a horse) the middle-aged female patient who spoke previously with a southern English accent now spoke with a distinctly South African drawl. It is suggested by some that the brain, having suffered damage to the speech and language centres, “reverts” to earlier imprints, but I suggest the speech production is changed to a way that we think sounds like a foreign accent. With this particular patient, who made a full recovery apart from the change in accent, she had never previously been to South Africa.


Understanding foreign accent syndrome

Foreign accent syndrome (FAS) is widely understood as an unusual consequence of structural neurological damage, but may sometimes represent a functional neurological disorder. This observational study aimed to assess the prevalence and utility of positive features of functional FAS in a large group of individuals reporting FAS.  More here: https://jnnp.bmj.com/content/90/11/1265


Video: “Michael’s Funny Feelings.”

A 10 minute documentary about Michael, for whom something strange happens. 

 

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