Delusions of Death in a Patient with Right Hemisphere Infarction
Delusions of Death in a Patient with Right Hemisphere Infarction
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DOI：
10.1097/wnn.0b013e31827504c7
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发表时间：
2012-12-01
影响因子：
1.4
通讯作者：
Mori, Etsuro
中科院分区：
文献类型：
--
作者：
Nishio, Yoshiyuki;Mori, Etsuro
虽然在科塔尔妄想中已经假设了右半球功能障碍的作用，但仍不清楚哪些功能受到干扰。我们在这里报告的第一个已知的病人单侧右半球病变和死亡妄想（1的2种类型的科塔尔妄想）。这个人开始相信他已经死了，因为他的右半球梗塞了，包括额叶、颞叶、顶叶和丘脑。他在人格解体/现实丧失和对人和地点的错觉性错误识别的背景下产生了死亡妄想。神经心理学测试显示左半脑空间忽视和一般注意力缺陷。患者的身体所有权感和面部识别能力得以保留。这个案例表明，异常的熟悉感，这已经牵连在几个妄想性错误识别综合征，有助于显着的发展妄想死亡。如果这是真的，那么涉及到对人和地点的识别以及对活着的感觉的情感过程可能部分重叠，这些情感过程可能由右半球支持。
Although a role for right hemisphere dysfunction has been hypothesized in Cotard delusion, it remains unclear which functions are disturbed. We report here the first known patient with unilateral right hemisphere lesions and delusions of death (1 of the 2 types of Cotard delusion). This man began to believe that he was dead after suffering a right hemisphere infarction involving the frontal, temporal, and parietal lobes, as well as the thalamus. He had delusions of death in the context of both depersonalization/derealization and delusional misidentifications of people and places. Neuropsychological testing revealed left hemispatial neglect and deficits in general attention. The patient's sense of body ownership and face recognition abilities were preserved. This case suggests that abnormal feelings of familiarity, which have been implicated in several delusional misidentification syndromes, contribute significantly to the development of delusions of death. If this is true, affective processes involved in the identification of people and places and in the feeling of being alive may partially overlap, and these affective processes may be supported by the right hemisphere.