Alice in Wonderland and 4 psychiatric conditions – 06/13/2023 – Health

Most people are familiar with psychiatric disorders such as schizophrenia and bipolar disorder. But there are some conditions so unusual that many psychiatrists will not encounter a single case in their entire working lives.

Here, I present five of the rarest – and strangest – syndromes known to psychiatry.

1. Fregoli Syndrome

Fregoli syndrome happens when someone believes that different people are actually the same person who simply changes appearance. People with this syndrome often feel persecuted by someone they believe is in disguise.

The disorder is named after the Italian stage actor Leopoldo Fregoli (1867-1936), who was known for his remarkable ability to change appearance quickly on stage.

Fregoli syndrome typically occurs in conjunction with other mental disorders such as bipolar disorder, schizophrenia, and obsessive-compulsive disorder. It can also be caused by brain damage and the use of the drug levodopa during the treatment of Parkinson’s disease.

A 2018 study concluded that fewer than 50 cases have been reported worldwide since the discovery of this condition. But a more recent study, from 2020, reported an incidence of 1.1% among stroke patients. Therefore, there are certainly more than 50 cases, but it is still something very rare.

There is no known cure for Fregoli syndrome, but treatment with antipsychotic drugs can reduce symptoms.

2. Cotard’s Syndrome

Cotard’s syndrome, also known as “walking corpse syndrome”, occurs when people have the delusional belief that they are dead and do not exist. Others believe parts of their bodies are missing.

The syndrome is named after the French neurologist Jules Cotard (1840-1889), who first described the condition in 1882.

Schizophrenia, depression and bipolar disorder are risk factors for Cotard’s syndrome. But it has also been reported as a rare side effect of the antiviral drug acyclovir.

The syndrome is believed to originate from the disconnect between the regions of the brain that recognize faces and the regions that associate emotional content with that facial recognition.

This rare condition is typically treated with antidepressants, antipsychotics, and mood stabilizers, in addition to electroconvulsive therapy.

3. Alien hand syndrome

Alien hand syndrome is one of the strangest neurological disorders out there.

It occurs when a person’s hand seems to have a mind of its own and acts autonomously. The person’s feeling is that their hand does not belong to them.

This syndrome was first identified in 1908, but was only clearly defined in the early 1970s.

The expression “alien hand syndrome” was coined by the American neurophysiologist Joseph Bogen (1926-2005) to describe unusual willful behavior occasionally observed during recovery from certain types of brain surgery.

People suffering from alien hand syndrome typically have sensory processing disorders and dissociate from their hand’s actions.

Research indicates that people with the syndrome often personify the alien hand and may believe it is possessed by some other spirit or extraterrestrial life form.

Causes of the syndrome include dementia, stroke, prion disease (a fatal brain disease), tumors, and seizures. Cases of alien hand syndrome have also been reported among patients who have had surgery to separate the left and right hemispheres of the brain in the treatment of severe epilepsy.

The syndrome is very rare. A 2013 analysis found only 150 cases in medical journals.

While there is no known cure for alien hand syndrome, the symptoms can be managed and minimized to some extent by keeping the affected hand busy and involved in a task – giving it an object to hold, for example.

Other treatments include botulinum toxin injections and mirror box therapy. Patients with a case of stroke tend to have better treatment success.

4. Ekbom Syndrome

Ekbom syndrome is a tactile hallucination that makes people believe they are infested with parasites. They often feel bugs crawling under their skin.

The syndrome is named after the Swedish neurologist Karl Ekbom (1907-1977), who first described the condition in the late 1930s.

The exact number of people who suffer from this syndrome is unknown, but one study reported that there are about 20 new cases per year in a large referral clinic in the United States.

According to a meta-analysis of 1,223 cases of Ekbom, the syndrome is more common among women (who account for two-thirds of patients) and in people over 40 years of age. Symptoms typically last for three to four years.

Ekbom syndrome is associated with a number of conditions, including paranoid schizophrenia, organic brain disease, neurosis, and paranoid personality disorder. It has also been reported in people with alcohol withdrawal, cocaine abuse, stroke, dementia, and damage to a part of the brain called the thalamus.

Patients suffering from Ekbom syndrome are often unwilling to receive psychological treatment because they are convinced that the problem requires medical treatment.

5. Alice in Wonderland Syndrome

In Alice in Wonderland syndrome, also known as Todd syndrome, the person’s sense of body image, sight, hearing, touch, and space/time are distorted.

People with the condition typically perceive objects as if they are smaller than they are and people appear larger than they are. Or the opposite: objects are perceived as larger than they are and people seem smaller.

These experiences may be accompanied by feelings of paranoia.

Little is known about the incidence of this disorder, which mainly affects children and migraine sufferers.

People with the condition can become frightened and panic. Therefore, successful treatment often includes rest and relaxation.

In most cases, it is a condition that lasts for a relatively short time. The most recent study on Alice in Wonderland syndrome reported that about half of patients are successfully treated.

*Mark Griffiths is Director of the International Games Research Unit and Professor of Behavioral Addiction at Trent University of Nottingham, UK.

This article was originally published on the academic news site The Conversation and republished under a Creative Commons license. Read the original English version here.