Capgras syndrome

Capgras syndrome is what is known as a delusional misidentification disorder. It is a mirror disease in which patients do not recognize people's faces, often not even their own, but an unconscious recognition is detected when performing certain scans. Sometimes the delusional idea of ​​substitution does not fall on people but on domestic animals or even objects.

How is it produced?

Facial recognition is based on brain areas located in the temporal, occipital and part of the limbic system. In the inferotemporal zone (fusiform gyrus) facial recognition occurs and it is believed that there may be a lack of connection between this facial recognition and the emotions that a familiar face elicits. Emotions believed to be controlled by amygdala, a region located within the temporal region of the brain. If this connection is not given, the patient can recognize someone's face but does not associate any emotion to the vision of a familiar face, that is, they recognize it consciously or visually but not unconsciously or emotionally.

Who can get it?

Despite the fact that there is a psychiatric component, since it is frequently seen in patients diagnosed with paranoid, it has been seen that in many cases there is a brain involvement that may explain symptoms of this syndrome in patients who have suffered brain injuries or are affected by some type of. This syndrome has been seen in patients with advanced dementia, traumatic brain injury, cerebrovascular accident (CVA), or in patients with paranoid schizophrenia or other psychotic disorders. It has occasionally been seen in patients with diabetes mellitus, hypothyroidism, or chronic migraines, as well as in people who have used ketamine, an illegal drug.

Symptoms

People who develop this syndrome may experience the following symptoms overnight:

• Perfectly recognize a person's face but detect "something strange" that does not fit the person.
• Feeling of anguish when feeling that the person they knew perfectly seems to have been replaced by another.
• Paranoid ideation to know what is happening.
• Sometimes duplicative paramnesia, which is another delusional disorder that consists of believing that a common place in the patient's life has been duplicated and that there are two versions of the same place. This pathology has been related to frontal lobe injuries.

Diagnosis

The diagnosis will be based on the explanation of the delusional ideation made by the patient. It is necessary to rule out the consumption of toxins such as ketamine and take a good anamnesis in search of background psychiatric, head trauma, brain injury or signs of dementia. Likewise, a correct neurological examination and an imaging study at the brain level using computerized axial tomography () and nuclear magnetic resonance () are necessary. It would not be unreasonable to also perform an electroencephalogram () to rule out possible foci of brain involvement.

Treatment

In case of presenting an underlying tax injury to be treated, such as a brain hematoma or a neoplasm, an attempt will be made to approach the most conservative treatment possible by neurologists and neurosurgeons. In cases of dementia or schizophrenia disorder, the use of antipsychotic drugs can give good results. The cognitive therapy it can be a good medium-term tool to make the lives of these patients more bearable and less anxious.

There are no specific measures to to prevent Capgras syndrome. In case of presenting delusional ideas such as those described above, it is important to put yourself in the hands of a specialist as soon as possible.

• It is known as delusional misidentification disorder.
• The person who suffers it thinks that their relatives have been replaced by identical doubles who pretend to be them.
• Cognitive therapy can be a good medium-term tool to make the lives of these patients more bearable and less anxiety-ridden.