Sunday, March 22, 2015

Cotard delusion Living Dead disease

Named after French neurologist Jules Cotard name - who first described the disease, syndrome involves denying his existence. Cotard syndrome is a rare syndrome involving depression, suicidal patient and belief that life is over and it is already dead. In some cases, patients feel that their body is already in the process of putrefaction and the body is deprived of blood or internal organs. In rare cases, patients are considered gods, immortals.It is assumed that neurological or psychiatric disease origins. Symptoms - Depression; - Thoughts of suicide; - Negative thinking; Denial own existence;
- Denying the need for food;
- The belief that the body no longer exists;
- The belief that life is over;
- Autotitling as god, immortal;
- The impression that the body is in a state of putrefaction;
- Consideration body as vacuum - deprived of blood or internal organs;
Causes and Treatment
Cotard delusion is seen in severe mental disorders - psychoses - such as schizophrenia or bipolar disorder, but can occur in the context of neurological diseases, and is associated particularly with depression and migraine. Treatment is difficult and serotonergic tricyclic antidepressants and have low efficiency. Electroconvulsive therapy is - so far - the only promising treatment.
Case Study
S. is a 28 year old housewife months pregnant 6, who presented to the emergency room complaining of symptoms such as sleep disturbance, decreased appetite and interest in daily activities. Also, the patient mentioned that his liver is in a state of decay, heart and stomach lacks completely and when not moving their body feels. Symptoms occurred when, with her ​​husband, the patient moved to rent an apartment very small because of frequent disagreements with laws. In a first phase, S. ranged from loneliness which challenged the lack of interest in any activity, sleep disturbances and palpitations. Appeared then feelings of guilt and regret leaving old homes. Worried, her husband persuaded her to go to a medical consultation, which ended with the diagnosis of weakness and prescribing a treatment focused on multivitamins; after six weeks of treatment, the symptoms persisted, so he decided to consult S. yet another doctor. At his direction, then followed for 2 weeks treatment meant to improve abdominal discomfort (due to lack of stomach and liver rot). The lack of results, the doctor led him to transfer the case of a surgeon. After multiple investigations, including ultrasound and endoscopy, suspicious symptoms presented by the patient, the surgeon has extended the initial treatment, which added an antibiotic. Overwhelmed, in our consultations and doctors who have labeled suspicious vague symptoms, the patient attempted suicide, bringing the attention of a psychiatrist. During the consultation, the patient struck by a relevant and coherent discourse; accused insomnia, lethargy, difficulty concentrating and despair. Even in an advanced state of depression, the patient smiled occasionally, due mistrust of doctors in related symptoms; did not show any concern for the task, and expressed ambivalent feelings - love and hate - to her unborn child. All examinations and physical tests were normal parameter, except hemoglobin - 8.5 mg / dl - anemia. The final diagnosis: major depressive disorder and Cotard syndrome. After eight weeks of treatment, the patient's condition has improved.
Conclusions
The importance of this case lies in the fact that often, mental illness symptoms reported by patients treated with distrust by doctors and diagnisticate as vague, meaningless . Cotard delusion is rare, especially among young people. The case presented above, the woman for 28 years, is the first reported case in a pregnant woman. The delay caused by nefamiliaritatea psychiatric diagnosis symptoms of the disease, results in worsening condition and delay the start of appropriate treatment .

Cotard Delusion is a neuropsychiatric disorder in sufferers feel they died, that there are no old or lost their blood or internal organs. In some cases persist in patients idea of immortality. The syndrome was named after Jules Cotard, a French neurologist who described it as the negation delirium, recorded at a certain Mademoiselle X.
Symptoms: The patient claims to be death or delirious in the context of the dead who returned.
Causes disconnecting the cortex areas which associates with the girls and the associated emotions recognitiei centers . This separation makes familiarity there are no sensations. Cotard delusion was also identified in schizophrenia, mania, depression or other neurological disorders. The impression that the sufferer died and may result in side effects of some dorguri as  acyclovir, especially its main metabolite CMMG.
Treatment: difficult and serotonergic tricyclic antidepressants or shows a very low efficiency. Promising results were observed electroconvulsive therapy, but also to the dialectic nature of the disease for some is as biological as it is cognitive, linguistic and intellectual. Living Dead syndrome presents a bizarre face of human nature. Mentioned in films like Synecdoche, New York or in books like Killing yourself to Live: 85% of the true story, but in real cases such as the Vampire enshrined in Sacramento, serial killer Richard Chase, who claimed that blood or convert in dust, Cotard syndrome unfolds in increasingly strange as we soar in the various cases.

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