Capgras' Syndrome in Dementia with Lewy Bodies

Abstract

We report the occurrence of Capgras' syndrome, or the delusion of doubles, in a patient with dementia with Lewy bodies. The patient believed that several similar-looking impostors had replaced his wife of over 50 years. Uncharacteristically, he adopted a friendly attitude with these impostors. This unusual convivial reaction to the impostors may result from differential involvement of the dual visual pathways processing facial recognition and emotional responses to faces. The delusion resolved spontaneously, coincident with worsening of the dementia. In a retrospective chart review of 18 autopsy-confirmed cases of dementia with Lewy bodies, delusions were reported in 5 subjects (27.8%), of whom 1 had misidentification delusions much like Capgras' syndrome. (J Geriatr Psychiatry Neurol 2002; 15:000–000).

Get full access to this article

View all access options for this article.

References

1. Capgras J , Reboul-Lachaux J. , Illusions des sosies dans un délire systématisé chronique. Bull Soc Clin Méd Ment 1923; 11: 6–16.

2. Roane DM , Rogers JD , Robinson JH , Feinberg TE. , Delusional misidentification in association with parkinsonism. J Neuropsychiatry Clin Neurosci 1998; 10: 194–198.

3. Edelstyn NMJ , Oyebode F. , A review of the phenomenology and cognitive neuropsychological origins of the Capgras syndrome. Int J Geriatr Psychiatry 1999; 14: 48–59.

4. Blessed G , Tomlinson E , Roth M. , The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968; 114: 797–811.

5. Wechsler D. , Manual for the Wechsler Adult Intelligence Scale-Revised. San Antonio, TX: Psychological Corporation, 1981.

6. McKeith IG , Perry EK , Perry RH. , Diagnosis and treatment of dementia with Lewy bodies (DLB): report of the second DLB International Workshop. Neurology 1999; 53: 902–905.

7. Verghese J , Crystal HA , Dickson DW , Lipton RB. , Validity of clinical criteria for the diagnosis of dementia with Lewy bodies. Neurology 1999; 53: 1974–1982.

8. Folstein MF , Bylsma FW. , Noncognitive symptoms of Alzheimer disease. In: Terry RD , Katzman R , Bick KL , Sisodia S , eds., Alzheimer disease. 2nd Ed. New York: Lippincott Williams & Wilkins, 1999: 25–38.

9. Harwood DG , Barker WW , Ownby RL , Duara R. , Prevalence and correlates of Capgras syndrome in Alzheimer's disease. Int J Geriatr Psychiatry 1999; 14: 415–420.

10.

10. Forstl H , Burns A , Jacoby R , Levy R. , Neuroanatomical correlates of clinical misidentification and misperception in senile dementia of the Alzheimer type. J Clin Psychiatry 1991; 52: 268–271.

11.

11. Bauer RM. , Autonomic recognition of names and faces in prosopagnosia: a neuropsychological application of the Guilty Knowledge Test. Neuropsychologia 1984; 22: 457–469.

12.

12. Ramachandran VS. , What neurological syndromes can tell us about human nature: some lessons from phantom limbs, Capgras syndrome, and anosognosia. Cold Spring Harb Symp Quant Biol 1996; 61: 115–134.

13.

13. Wacholtz E. , Can we learn from the clinically significant face processing deficits, prosopagnosia and Capgras delusion? Neuropsychol Rev 1996; 6: 203–257.

14.

14. Turner RS , Chervin RD , Frey KA , et al., Probable diffuse Lewy body disease presenting as REM sleep behavior disorder. Neurology 1997; 49: 523–527.

15.

15. Turner RS , D'Amato CJ , Chervin RD , Blaivas M. , The pathology of REM sleep behavior disorder with comorbid Lewy body dementia. Neurology 2000; 55: 1730–1732.

16.

16. Diesfeldt HF , Troost D. , Delusional misidentification and subsequent dementia: a clinical and neuropathological study. Dementia 1995; 6: 94–98.

17.

17. Buschke H. , Cued recall in amnesia. J Clin Neuropsychol 1984; 6: 433–440.

18.

18. Reitan R. , Investigation of Halstead's measures of biological intelligence. Arch Neurol Psychiatry 1955; 48: 475.

19.

19. Kaplan E , Goodglass H , Weintraub S. , Boston Naming Test. Philadelphia: Lea & Febiger, 1983.

20.

20. Spreen O , Strauss E. , A compendium of neuropsychological tests. 2nd Ed. New York: Oxford University Press, 1998: 447–459.

21.

21. Benton AL , Hamsher K. , Multilingual Aphasia Examination. Iowa City, IA: University of Iowa Press, 1978.