Background and development of Capgras delirium after subarachnoid hemorrhage (SAH)
59 years old patient, graduated in exact sciences and former professor of institute.
She's the biggest of three brothers.
She describes a happy childhood, was very attached to her father, was an extroverted child, her husband, and independent.
Impossible mental illness, mental illness, mental illness, mental illness and mental illness.
He debuted with a psychotic broth with paranoid ideation at 30 years of age after stopping his wedding project.
Manic and depressive episodes are alternated requiring some of them hospital admission, although they can develop normal life without occupational affectation between periods until the third of their income in the year 2006, motivated by a recent episode of disabling mental illness in the patient.
Relapse was always related to treatment discontinuation with Litio.
Alcohol abuse is also observed during this time.
The diagnosis until December 2009 was: "Biopolar Disorder with psychotic symptoms with and without psychotic symptoms remission" and "Alcohol abuse".
Since she is ill-defined, only her parents and siblings are related, due to her lifestyle and manic symptomatology, she is considered the "black sheep" of the family.
In 2009 she suffered a subarachnoid hemorrhage (SAH).
CT scan revealed left temporoparietal involvement surrounded by wide edema; mass effect on the ipsilateral ventricular system and acute left parietal hematoma with severe impairment of the level of consciousness, sensitivity, motor skills and speech.
When she woke up from the coma she says that the first thing she sees is the face of an old teacher companion who united her a relationship of affection.
After this he says that his brothers "are not his brothers", attributing the change to the friend professor.
CD is susceptible to friends and acquaintances.
Abandoned by his partner at that time, he will be the brother who becomes disabled of his care.
Case vignette after SAH.
Subsequently, it requires several hospitalizations due to psychiatric symptoms; there are practically no asymptomatic periods.
At the acute care unit upon admission to the EMU, the patient presented mild insomnia, psychosis with idea of paranoidthymic, affective, kinesthetic, social isolation, and hyperesic isolation.
Lithium salts were removed due to nephropathy secondary to diabetes insipidus, and valproic acid was established.
Diagnosis: 'Schizoaffective mixed disorder, with psychotic symptoms with psychotic features and not with mental disorders'; 'Alcohol abuse'.
In February 2012 she was admitted to the EMU to start a "individualized rehabilitation plan".
• Medical evaluation revealed moderate functional limitation with generalized hypotonia.
History of hypothyroidism and NID-DM, both in remission.
Potomania and enuresis secondary to episodes of nephrogenic insipid diabetes that were corrected with self-recording and thiazides.
• Neuropsychological examination (WAIS IV) showed cognitive impairment both in working memory and processing speed, although levels reflect a "normal" level, around 100 CI, is presupposed with much higher academic history.
He had socially undesirable verbal behaviors that would suggest frontal affectation, perhaps consequent to the manifestation of abusive alcohol consumption.
• Psychopathological assessment: Presence of several delusions, of bodily influence, of telepathy and CD, and a phenomenon called simple warning.
The same professor who provokes identity supplantation also takes things out and pushes him.
It communicates telepathically with it through the numbers displayed on TV and the clicks heard in the crystals.
The characteristics of CD are shown in Table 1.
It should be noted that although at first there was some hostility towards the "double of the brother", the feelings became positive, now it is much better with him than before the episode of SAH.
Psychopathological stabilization is achieved with Deaf 1300 mg/day, Olanzapine 20 mg/day, Risperidone 6 mg/day, Complejo Vitamin B adherence to treatment".
Mayor in December 2012.
Residual positive psychotic symptoms and partial insight.
