The phenomenon of the mirror stranger

    Welcome to the iCover Blog Pages ! Today we would like to talk about an unusual incident that occurred with the venerable 78-year-old father of a family from the city of Tours (France), described in a recent issue of the popular science magazine Neurocase . The journal publishes articles on neuropsychiatry, neuropsychology, and behavioral neurology.

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    Complaints with which patient B. entered the department of neurology in the French town of Tours were puzzled by experienced specialists, because he complained that he had ceased to recognize his reflection in the mirror. Moreover, the impostor from the “looking glass”, with whom he was trying to establish a dialogue, began to be aggressive and behave extremely defiantly.

    Patient B. is divorced, has four children, was treated for follicular lymphoma, and suffered from a long series of cardiovascular diseases. At the same time, according to the attending physicians, no complaints and mental deviations were recorded in the man until he contacted specialists. The stranger, according to the patient's assurances, began to appear to him in the mirror over the past 10 days.

    The man, according to the patient’s testimony, behaved extremely unusual: he was hiding in the bathroom mirror and was surprisingly similar to Monsieur B. himself in terms of hair color, body shape, clothes and even gestures. Dialogues with the “stranger” extremely perplexed Monsieur B., because he, according to him, knew almost everything about him. Before going to the clinic, B. said, communication at first even gave him some pleasure, he made the habit of setting a dining table by the mirror with appliances for two people. The honor and respect shown, according to the patient, eventually turned out to be the insult and threats from the stranger for the latter. The rapid development of events with unpredictable results discouraged B.'s daughter so much that she decided to contact her father in a specialized clinic. Monsieur B. did not mind.

    The results of the clinical examination, the encephalogram and blood test data did not reveal any abnormalities. The man was perfectly oriented in space, recognized his relatives and friends. Dysfunctions were detected only by the results of magnetic resonance imaging, which recorded atrophy of the posterior parts of the brain. An additional blood test revealed beta-amyloids - abnormally folded proteins that form plaques in blood vessels. Based on the results of the examination, the patient was prescribed treatment - the antipsychotic amisulfide and the drug esciltalopram, used for chronic and acute schizophrenia.

    Three months of treatment under the guidance of specialists made it possible to cope with mental disorders - the patient said that the obsessive stranger was no longer with him. But how complete the cure is, is too early to say.

    The opinion of experts


    Descriptions of cases when a person ceases to recognize himself in the mirror, as the French publication testifies, is found only twice in the scientific literature. In 1968, a 61-year-old woman from New Zealand with atrophy of a part of the brain experienced similar symptoms describing communication with a frightening “double stranger” in the mirror. And two decades later, a woman with atrophy of the temporoparietal zone complained to doctors about her reflection in the mirror.

    At that time, a few cases, such as those described above, were associated with Kapgra syndrome (false recognition syndrome) - a special form of the so-called “delirium of the negative double”. The syndrome was first described by the French psychiatrist Jean Capgrom and his colleague Jean Reboul-Lachot in 1923. According to their observations, patients, who most often included elderly people, stated that their relatives, relatives and friends, at least once, were replaced by doubles. Some of them are sure: somewhere there is their own invisible double, who is responsible for the negative acts they perform.

    Kapgra syndrome, according to experts, is a companion of other mental diseases, and, in particular, schizophrenia, involutional melancholy, exogenous-organic psychosis, twilight stupefaction, delirium ..., moreover, they suffer from the manifestations of the syndrome, or rather, the symptom more often than women.

    Unlike the Kapgra symptom, a disorder with the opposite effect - prosopagnosia (prosopagnosia, or face-blindness) is characterized by problems when a person ceases to recognize faces familiar to him. At the same time, the emotional response to them is preserved. Prosopagnosia develops against a lesion of the right lower occipital region. Often the lesion extends to the adjacent departments of the parietal and temporal lobes.

    For the first time, a more or less complete description of cases of prosopagnosia can be found in the works of the English neurologist John Hughlings Jackson and the French psychiatrist Jean-Martin Charcot in the mid-19th century. At the same time, the term “prosopagnosia” (other Greek prosopon - “face”, agnosia - “do not recognize”) was introduced into the terminology in 1947 by the German neuroscientist Joachim Bodamer. He diagnosed the case of a 24-year-old patient who survived after a severe bullet wound to the head, but ceased to recognize not only his relatives, friends and colleagues, but also himself.

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    If you trust the latest statistics, then up to 2% of the world's population suffers from prosopagnosis, which in terms of is quite an impressive figure - about 140 million people. Mild forms of prosopagnosia, according to scientists, are characteristic of 10% of the population, which is expressed in poor memory for individuals in general.

    According to modern concepts, Kapgra syndrome is the opposite of prosopagnosia and describes a situation where a person is able to distinguish well enough the faces of acquaintances, but does not experience an “emotional response” to them.

    The first symptoms indicating the development of the disease, as a rule, form after 30 years of age. However, there are cases when the disease affects adolescents. So signs of Kapgra syndrome suddenly appeared in a 15-year-old girl who, resting in a cafe with her father and brother, said that they were pouring drugs on her. While in the hospital, she stopped recognizing her mother, considering her an impostor, while she mistook the night attendant for her father, who appeared with evil intentions.

    Kapgra syndrome is often associated with aggressive behavior of the patient. According to the testimony of Italian scientists, those suffering from this ailment immediately become furious whenever they think or see an imaginary threat, which can lead to the most sad consequences. Moreover, the manifestation of aggression on their part is a peculiar form of self-defense.

    Kapgra syndrome is one of two types: autoscopic - when the patient is convinced that he sees a double, and cases when the double remains invisible. In addition to these two main types, there are at least five more types of false recognition syndrome:

    1. Fregoli's syndrome: the patient is sure that the person he knows has taken on someone else's appearance.
    2. Reverse Fregoli syndrome: the patient is convinced that others take him for someone else.
    3. Intermetamorphosis syndrome: the patient believes that not only the psychic essence of the personality is changing, but also its appearance.
    4. Syndrome of own doubles: the patient thinks that he has a double.
    5. Syndrome of reverse own doubles: the patient believes that he was replaced by an impostor.

    The case of Monsieur B., described above by us, according to the authors of the publication, is atypical, "... since the patient experienced problems with recognition not in relation to another person or himself, but in relation to his reflection in the mirror," the patient’s attending physician admits Cappuccino Diar Detof from Turs University Hospital.

    The authors of the publication believe that the cause of the atypical form of deviation is a much more complex mechanism, which was the result of a whole complex of disorders in the patient's brain activity. “This case describes a very rare amazing condition in which the patient perceives himself as a mirror stranger,” says Dr. Paul Wright of the Jewish Medical Center in New York.

    A single harmonious scientific explanation of the root causes of the manifestation of the Kapgra symptom, based on a solid evidence base confirmed by statistics, does not yet exist. According to recent studies, one of the reasons for the development of Kapgra syndrome can be malfunctions in the area of ​​the visual system of the brain responsible for facial recognition.

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