Differences

Last edited on December 22, 2021

This shows you the differences between two versions of the page.

--- teaching:rare-unusual-syndromes [on May 18, 2020]
+++ teaching:rare-unusual-syndromes [on June 29, 2020]
@@ Line 5: / Line 5: @@
 ===== Charles Bonnet Syndrome =====
+<WRAP group>
+<WRAP half column>
+**Charles Bonnet Syndrome (CBS)** is a common condition among people with serious vision loss characterized by temporary visual hallucinations. CBS is not due to a psychiatric condition, symptom of dementia, or other any other disease.[([[http://www.cnib.ca/en/your-eyes/eye-conditions/Pages/Charles-Bonnet-syndrome.aspx|CNIB: What is Charles Bonnet Syndrome?]])] Rather, it is a condition specifically related to pathological vision loss. This is more common in individuals with macular degeneration, glaucoma, and diabetic retinopathy. Although it can be common, awareness is limited, which can cause confusion and concern among those experiencing and diagnosing it. There is no treatment, but symptoms usually resolve within 12-18 months. Patients can be reassured that this is a normal symptom to have that will self-resolve.[([[https://mmcneuro.wordpress.com/2013/01/04/charles-bonnet-syndrome-when-the-blind-start-to-see-things/|Neurology Update: Charles Bonnet Syndrome, when the blind start to see things]])]
+<callout type="info" title="Lilliputian Hallucinations">
+**"Little people"** - or also known as **Lilliputian visions or hallucinations** - are not uncommon in Charles Bonnet Syndrome.[(http://www.charlesbonnetsyndrome.org/index.php/12-latest-news/5-i-see-little-people-lilliputian-visions-in-charles-bonnet-syndrome)] The term "Lilliputian" is taken from the famous children's story, //Gulliver's Travels//, about Gulliver’s arrival at the land of Lilliput which is populated by tiny people. In 1909, Dr. Raoul Leroy introduced the term to medical literature noting that Lilliputian hallucinations depicts seeing people, animals and objects of greatly reduced size. He noted such visions have been reported for aeons and that its medical causes are varied. Many living with CBS report "seeing" miniature people who are about the size of a finger. Such tiny people can be "seen" directing a miniature horse-drawn carriage or driving a matchbox-sized vehicle.  Sometimes, they are reported as being brightly costumed. Commonly, they comprise a mass procession like rows of a marching musical band or a phalanx of soldiers. These scenes tend to move across the person's visual field of view.
+</callout>
+</WRAP>
+<WRAP half column>
 <HTML><span class="imgcaption_rightwrapper" style="width:100%">
 <span class="imgcaption media img-responsive right">
@@ Line 11: / Line 21: @@
 </span>
 </span></span></HTML>
-**Charles Bonnet Syndrome (CBS)** is a common condition among people with serious vision loss characterized by temporary visual hallucinations. CBS is not due to a psychiatric condition, symptom of dementia, or other any other disease.[([[http://www.cnib.ca/en/your-eyes/eye-conditions/Pages/Charles-Bonnet-syndrome.aspx|CNIB: What is Charles Bonnet Syndrome?]])] Rather, it is a condition specifically related to pathological vision loss. This is more common in individuals with macular degeneration, glaucoma, and diabetic retinopathy. Although it can be common, awareness is limited, which can cause confusion and concern among those experiencing and diagnosing it. There is no treatment, but symptoms usually resolve within 12-18 months. Patients can be reassured that this is a normal symptom to have that will self-resolve.[([[https://mmcneuro.wordpress.com/2013/01/04/charles-bonnet-syndrome-when-the-blind-start-to-see-things/|Neurology Update: Charles Bonnet Syndrome, when the blind start to see things]])]
+</WRAP>
+</WRAP>
-<callout type="info" title="Lilliputian Hallucinations">
-**"Little people"** - or also known as **Lilliputian visions or hallucinations** - are not uncommon in Charles Bonnet Syndrome.[(http://www.charlesbonnetsyndrome.org/index.php/12-latest-news/5-i-see-little-people-lilliputian-visions-in-charles-bonnet-syndrome)] The term "Lilliputian" is taken from the famous children's story, //Gulliver's Travels//, about Gulliver’s arrival at the land of Lilliput which is populated by tiny people. In 1909, Dr. Raoul Leroy introduced the term to medical literature noting that Lilliputian hallucinations depicts seeing people, animals and objects of greatly reduced size. He noted such visions have been reported for aeons and that its medical causes are varied. Many living with CBS report "seeing" miniature people who are about the size of a finger. Such tiny people can be "seen" directing a miniature horse-drawn carriage or driving a matchbox-sized vehicle.  Sometimes, they are reported as being brightly costumed. Commonly, they comprise a mass procession like rows of a marching musical band or a phalanx of soldiers. These scenes tend to move across the person's visual field of view.
-</callout>
 == Further Reading ==
@@ Line 25: / Line 32: @@
 ===== Fregoli delusion =====
+<WRAP group>
+<WRAP half column>
+**Fregoli syndrome** (or delusion) is the delusional belief that one or more familiar persons, usually persecutors following the patient, repeatedly change their appearance and appear in the person's life.[([[http://journals.sagepub.com/doi/pdf/10.3109/00048679409075874|Mojtabai, R. (1994). Fregoli syndrome. Australian & New Zealand Journal of Psychiatry, 28(3), 458-462.]])] This syndrome has often been discussed as a variant of the Capgras syndrome in the literature, but these two syndromes have different phenomenological structures and age and sex distributions. The condition is named after the Italian actor [[https://en.wikipedia.org/wiki/Leopoldo_Fregoli|Leopoldo Fregoli]], who was renowned for his ability to make quick changes in his appearance during his stage acts.
+As in Capgras syndrome, Fregoli syndrome occurs most often in patients with schizophrenia, although it has also been reported in patients with dementia or epilepsy and after traumatic brain injury. Again, the management does not differ from the treatment of the underlying disorders, and usually involves antipsychotic medications, although in cases of dementia cognitive-enhancing treatments and nonpharmacologic approaches that diminish disorganization should be used. Aggression can be a risk from this delusion.[([[https://www.hindawi.com/journals/crips/2011/351824/|Ashraf, N., Antonius, D., Sinkman, A., Kleinhaus, K., & Malaspina, D. (2011). Fregoli syndrome: an underrecognized risk factor for aggression in treatment settings. Case reports in psychiatry, 2011.]])]
+</WRAP>
+<WRAP half column>
 <HTML><span class="imgcaption_rightwrapper" style="width:100%">
 <span class="imgcaption media img-responsive right">
@@ Line 31: / Line 45: @@
 </span>
 </span></span></HTML>
+</WRAP>
+</WRAP>
-**Fregoli syndrome** (or delusion) is the delusional belief that one or more familiar persons, usually persecutors following the patient, repeatedly change their appearance and appear in the person's life.[([[http://journals.sagepub.com/doi/pdf/10.3109/00048679409075874|Mojtabai, R. (1994). Fregoli syndrome. Australian & New Zealand Journal of Psychiatry, 28(3), 458-462.]])] This syndrome has often been discussed as a variant of the Capgras syndrome in the literature, but these two syndromes have different phenomenological structures and age and sex distributions. The condition is named after the Italian actor [[https://en.wikipedia.org/wiki/Leopoldo_Fregoli|Leopoldo Fregoli]], who was renowned for his ability to make quick changes in his appearance during his stage acts.
-As in Capgras syndrome, Fregoli syndrome occurs most often in patients with schizophrenia, although it has also been reported in patients with dementia or epilepsy and after traumatic brain injury. Again, the management does not differ from the treatment of the underlying disorders, and usually involves antipsychotic medications, although in cases of dementia cognitive-enhancing treatments and nonpharmacologic approaches that diminish disorganization should be used. Aggression can be a risk from this delusion.[([[https://www.hindawi.com/journals/crips/2011/351824/|Ashraf, N., Antonius, D., Sinkman, A., Kleinhaus, K., & Malaspina, D. (2011). Fregoli syndrome: an underrecognized risk factor for aggression in treatment settings. Case reports in psychiatry, 2011.]])]
 == Further Reading ==
@@ Line 41: / Line 55: @@
 ===== Capgras delusion =====
+<WRAP group>
+<WRAP half column>
+**Capgras delusions**, named after a French psychiatrist who described the illusion of doubles, is a delusion of misidentification. A person will have a delusional belief that an acquaintance, usually a spouse or other close family member, has been replaced by an identical looking impostor. An example would be a patient who thinks their mother and father have each been replaced by an imposter.
+Capgras delusions occur most often in patients with schizophrenia, although it has also been reported in patients with dementia or epilepsy and after traumatic brain injury. The management does not differ from the treatment of the underlying disorders, and usually involves antipsychotic medications, although in dementia patients, cognitive enhancing treatments and nonpharmacologic strategies that diminish disorganization should be used.
+<callout type="info" title="Reduplicative Paramnesia">Reduplicative paramnesia consists of the delusional belief that a place or location has been duplicated, in that it exists in 2 or more places simultaneously, or that it has been 'relocated' to another site. It is basically the delusion of doubles of the Capgras syndrome, only that is does not refer to a person but to a place. "Reduplicative paramnesia" was first used by neurologist Arnold Pick in 1903 to describe a condition in a patient with suspected Alzheimer disease.</callout>
+<callout type="info" title="What is the difference between Fregoli and Capgras?">
+Fregoli and Capgras delusions //sound// similar but are different!
+  * In Fregoli delusions, the patient believes that there is a single individual (usually a persecutor) is masquerading as several other people, whose appearances he or she assumes at different times.
+  * In Capgras delusions, the patient believes that their close family members or loved ones have each been replaced with an impostor.
+  * The difference is that in Fregoli delusions, the patient believes that there is one person who is impersonating and appearing as multiple people in their life (including people who the patient may not be close to, e.g. - "This man who is after me is pretending to be a cashier at the grocery store, and now he is pretending to be the doctor and nurse."). Compare this to Capgras, where it usually involves someone that the patient is emotionally connected with (e.g. - "My mother has been replaced with an imposter").
+</callout>
+</WRAP>
+<WRAP half column>
 <HTML>
 <span class="imgcaption_rightwrapper" style="width:100%">
@@ Line 56: / Line 86: @@
 </HTML>
-**Capgras delusions**, named after a French psychiatrist who described the illusion of doubles, is a delusion of misidentification. A person will have a delusional belief that an acquaintance, usually a spouse or other close family member, has been replaced by an identical looking impostor. An example would be a patient who thinks their mother and father have each been replaced by an imposter.
+</WRAP>
+</WRAP>
-Capgras delusions occur most often in patients with schizophrenia, although it has also been reported in patients with dementia or epilepsy and after traumatic brain injury. The management does not differ from the treatment of the underlying disorders, and usually involves antipsychotic medications, although in dementia patients, cognitive enhancing treatments and nonpharmacologic strategies that diminish disorganization should be used.
-<callout type="info" title="Reduplicative Paramnesia">Reduplicative paramnesia consists of the delusional belief that a place or location has been duplicated, in that it exists in 2 or more places simultaneously, or that it has been 'relocated' to another site. It is basically the delusion of doubles of the Capgras syndrome, only that is does not refer to a person but to a place. "Reduplicative paramnesia" was first used by neurologist Arnold Pick in 1903 to describe a condition in a patient with suspected Alzheimer disease.</callout>
-<callout type="info" title="What is the difference between Fregoli and Capgras?">
-Fregoli and Capgras delusions //sound// similar but are different!
-  * In Fregoli delusions, the patient believes that there is a single individual (usually a persecutor) is masquerading as several other people, whose appearances he or she assumes at different times.
-  * In Capgras delusions, the patient believes that their close family members or loved ones have each been replaced with an impostor.
-  * The difference is that in Fregoli delusions, the patient believes that there is one person who is impersonating and appearing as multiple people in their life (including people who the patient may not be close to, e.g. - "This man who is after me is pretending to be a cashier at the grocery store, and now he is pretending to be the doctor and nurse."). Compare this to Capgras, where it usually involves someone that the patient is emotionally connected with (e.g. - "My mother has been replaced with an imposter").
-</callout>
 == Further Reading ==
   * [[https://www.ncbi.nlm.nih.gov/pubmed/25219764|Langdon, R., Connaughton, E., & Coltheart, M. (2014). The Fregoli delusion: a disorder of person identification and tracking. Topics in cognitive science, 6(4), 615-631.]]
   * [[https://jaapl.org/content/42/3/369#sec-9|Klein, C. A., & Hirachan, S. (2014). The masks of identities: who's who? Delusional misidentification syndromes. Journal of the American Academy of Psychiatry and the Law Online, 42(3), 369-378.]]
 ===== Cotard delusion =====
+<WRAP group>
+<WRAP half column>
+**Cotard delusion** is a specific nihilistic delusion named after Jules Cotard, a French neurologist, who first described the condition, which he called le délire de négation (negation delirium), in 1880. The affected person holds the delusional belief that he or she is already dead, does not exist, is putrefying or has lost his or her blood or internal organs.
+It is most frequently observed in patients with psychotic depression or schizophrenias and is managed by focusing on the treatment of the underlying disorder. It can also secondary to a traumatic brain injury.
+</WRAP>
+<WRAP half column>
 <HTML>
@@ Line 87: / Line 116: @@
 </span>
 </HTML>
-**Cotard delusion** is a specific nihilistic delusion named after Jules Cotard, a French neurologist, who first described the condition, which he called le délire de négation (negation delirium), in 1880. The affected person holds the delusional belief that he or she is already dead, does not exist, is putrefying or has lost his or her blood or internal organs.
+</WRAP>
+</WRAP>
-It is most frequently observed in patients with psychotic depression or schizophrenias and is managed by focusing on the treatment of the underlying disorder. It can also secondary to a traumatic brain injury.
 == Further Reading ==