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Post on 14-Apr-2017
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Capgras Syndrome is one of the rarest and most intriguing in neurology. Even though
while dreaming we can have Capgras Syndrome like perceptions, the feature that sticks out the
most is that the patient, usually mentally together in other aspects, comes to view close friends or
family as imposters. They may say that the person in question is identical or looks like the
relative or friend but they really aren’t. It’s noted that a percentage of patients with Capgras
Syndrome have epilepsy or an odd looking temporal lobe. Over a third of diagnoses have
occurred with traumatic brain lesions, suggesting that Capgras is organic and functional based.
Note that Capgras should not be confused with prosopagnosia, which is characterized by
inability to recognize the faces of people and usually caused by bilateral lesions in the inferior
temporal lobes. There are two components to recognizing visually a familiar face, one being
responsible for conscious recognition of the face, where the other is in charge of the limbic-
mediated emotional arousal meaning the feeling of familiarity. A lack of association between the
two not only explains states like déjà vu but would explain why it’s possible to respond to skin
conductance even when failing to recognize a face.
There is no certain causes known for Capgras Syndrome, although research studies have
evolved several believable theories. One being from neurologist V.S. Ramachandran,
Ramachandran believes theres a malfunction between the brains visual cortex and the emotional
feeling of “familiarity” causing the patient to believe they are seeing a exact duplicate not the
actual person. Visually everything is correct but emotionally and familiarity wise they aren’t
present, conclusion being theres an exact imposter. A study done of 47 patients showed 81% had
a neurodegenerative disease, most commonly Lewy Body Disease. There are many features that
pertain to Capgras Syndrome such as the patient has a brain injury or disease, the patient realizes
that a person or place is just like the “real” one but insists it isn’t, the imposter is always
someone or somewhere the patient is familiar with, and it is a biological disorder. Again not to
be confused with Prosopagnosia which is a form of facial misidentification which is different
from Capgras in the fact that it causes a complete inability to recognize familiar faces. Capgras
has easy recognition of the face but doesn’t agree that’s the persons true identity. Patients are
often so disturbed by their reflection that they remove or cover mirrors in there home.
Treatments for Capgras Syndrome include individual therapy which may be best to treat
delusions. Persistence is key in establishing a therapeutic empathy without giving validation to
the delusional system of the patient or openly confronting the delusions. Some cognitive tests
may be used such as reality testing or reframing as well as prescribing antipsychotics or other
medications. In order to properly treat Capgras Syndrome you have to make sure its properly
diagnosed as it has similar symptoms as several other diagnoses such as schizophrenia,
alzheimer’s disease, huntington’s disease, multiple sclerosis, traumatic brain injury, substance
induced delusions, mood disorders with delusions, and dementia.
Although there is not much information on the dangers of people with Capgras
Syndrome, there are some reported cases where the patients suffering have become violent
leading to injury or death. The fact that there is very little research done on this subject and no
easy way to predict violence, amazingly, considering theres great hostility and resentment shown
by the patients towards the “imposters”. We should take into consideration if the “imposter” is
living with the patient or is easily accessable to the patient. If so things could easily escalate to a
violent level, but with the right care they can accept living with the “imposter”.
I chose Capgras Syndrome because my sister has this mental disorder. I personally have
seen the effects it can have on ones own relationship with the patient or even the patients
relationship with family or friends. As scary as this may seem to you, you have to take a moment
and think how this mentally effects the person with the syndrome, after all they are the ones they
don’t recognize their own mother, father, brother, sister or even their own children. If you know
anyone with this don’t judge rashly take time to educate yourself on the disability and how to
properly handle situations when they arise. My sister thanks me on a regular basis because she
can now recognize when shes suffering through an episode and she calls me to help bring her
back to “reality” as they say. Remember the first step to handling Capgras Syndrome is to
acknowledge something isn’t right and to seek therapy, guidance or help of any kind!
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