Tuesday, April 16, 2024

Rare disease day

Rare and odd medical syndromes are hard for many people to understand — and are often hard to treat, according to medical experts.

Rare Disease Day is Feb. 28, 2023, a "globally-coordinated movement" concerning rare diseases that works toward "equity in social opportunity, health care and access to diagnosis and therapies for people living with a rare disease," according to Rarediseaseday.org.

Read on to learn more about three very rare and baffling disorders.

In the following three conditions, sufferers believe they are dead, suffer severe size distortions in their visual perception or speak in a foreign language and don't understand why or how it's happened.

Here's what to know about these conditions.

Cotard’s Syndrome or Walking Dead Syndrome

Cotard’s Syndrome, sometimes called Walking Dead Syndrome, is a relatively rare neuropsychiatric condition that was first described by Dr. Jules Cotard, a Parisian neurologist, in 1882.

That's according to Dr. Anne Ruminjo, a second-year psychiatry resident at Beth Israel Medical Center in New York, as well as Dr. Boris Mekinulov, a unit attending physician at Kingsbrook Jewish Medical Center in Brooklyn.

They describe the condition in a case report published in the medical journal Psychiatry MMC.

(Ruminjo A, Mekinulov B. A Case Report of Cotard's Syndrome. Psychiatry (Edgmont). 2008 Jun;5(6):28-9. PMID: 19727279; PMCID: PMC2695744.)

Cotard’s Syndrome comprises any one of "a series of delusions" stemming from a belief that a person has "lost organs, blood or body parts" or "has lost one’s soul or is dead," the physicians note in their report.

Cases have been noticed in patients with "mood disorders, psychotic disorders, and medical conditions," they said.

"Most cases of Cotard’s are more responsive to electroconvulsive treatment (ECT) than to pharmacological treatment," they share in the report.

The doctors explained a case of Cotard’s Syndrome that they were involved with as part of their work.

"Ms. L, a 53-year-old Filipino woman, was admitted to the psychiatric unit when her family called 911 because the patient was complaining that she was dead, smelled like rotting flesh and wanted to be taken to a morgue so that she could be with dead people," the doctors reported.

"The patient was complaining that she was dead, smelled like rotting flesh and wanted to be taken to a morgue so that she could be with dead people."

They said the patient was fearful that "paramedics" were trying to burn down the house where she was living with family members — and admitted to "hopelessness, low energy, decreased appetite and somnolence."

After treatment with medication during a hospital stay, the patient — during discharge, the doctors reported — "denied nihilistic or paranoid delusions and hallucinations and expressed hopefulness about her future and a desire to participate in psychiatric follow-up care."

Alice in Wonderland Syndrome

Alice in Wonderland Syndrome (AIWS) is a set of symptoms that produce an "alteration of body image," reported Dr. Anne Weissenstein, Dr. Elisabeth Luchter and Dr. Stefan Bittmann of the Pediatric Mind Institute in Gronau, Germany, in a report published in the Journal of Pediatric Neurosciences.

(Weissenstein A, Luchter E, Bittmann MA. Alice in Wonderland syndrome: A rare neurological manifestation with microscopy in a 6-year-old child. J Pediatr Neurosci. 2014 Sep-Dec;9(3):303-4. doi: 10.4103/1817-1745.147612. PMID: 25624952; PMCID: PMC4302569.)

"An alteration of visual perception is found in that way that the sizes of body parts or sizes of external objects are perceived incorrectly."

"An alteration of visual perception is found in [the] way that the sizes of body parts or sizes of external objects are perceived incorrectly," the doctors noted.

They added, "The most common perceptions [occur] at night."

While all causes of AIWS cases are "still not known exactly," the physicians shared that some causes are "typical migraine, temporal lobe epilepsy, brain tumors and psychoactive drugs and Epstein-Barr virus infections."

AIWS has no effective treatment, they noted.

Treatment plans consist of migraine prophylaxis (medication) and migraine diet, they reported.

"Chronic cases of AIWS do exist," they also pointed out.

Foreign Accent Syndrome

Foreign Accent Syndrome (FAS) is a speech disorder that causes a sudden change in spoken words, causing the sufferer to be perceived as speaking with a "foreign" accent, according to the University of Texas at the Callier Center in Dallas.

The center treats thousands of patients with a variety of hearing, language and speech disorders, according to its web page.

FAS is most often caused by brain damage due to "a stroke or traumatic brain injury," the center indicates.

"Other causes have also been reported, including multiple sclerosis and conversion disorder — and in some cases no clear cause has been identified."

Speech may be "altered in terms of timing, intonation and tongue placement," the center explains, "so that is perceived as sounding foreign."

"Remarkably, the brain damage had altered her melody of language, and she spoke with a German-like accent."

However, a sufferer’s speech remains "highly intelligible" and does not "necessarily sound disordered," the center also notes.

FAS has been documented in cases around the world, the same source indicates, including accent changes from "Japanese to Korean, British English to French, American English to British English and Spanish to Hungarian."

In perhaps the most well-known case of FAS, a 28-year-old woman was hit on the head by a bomb fragment after British bombers attacked Oslo, Norway, on Sept. 6, 1941.

The particular case is shared in a medical abstract by Dr. Erland Hem, adjunct professor in the Department of Behavioral Medicine at University of Oslo, Norway, and published by the National Institutes of Health (NIH).

(Hem E. En eiendommelig språkforstyrrelse etter bombelesjon i hjernen [A peculiar speech disorder due to bomb injury of the brain]. Tidsskr Nor Laegeforen. 2006 Dec 14;126(24):3311-3. Norwegian. PMID: 17170795.)

She was "seriously wounded" with a "large defect in the cranium frontally on the left side" — and doctors did not think she was not going to live.

"The brain damage altered her melody of language and she spoke with a German-like accent."

After being unconscious for three to four days, she then awoke — and had "right-sided hemiplegia and complete aphasia," the medical abstract indicates.

"She gradually recovered and two months later she was discharged from hospital," the same source says.

"Remarkably, the brain damage had altered her melody of language and she spoke with a German-like accent."

"This led to problems for her during the war: she was, for example, not served in shops."

The case story was published after the war by the Norwegian neurologist Georg Herman Monrad-Krohn. (MONRAD-KROHN GH. Dysprosody or altered melody of language. Brain. 1947 Dec;70(Pt 4):405-15. doi: 10.1093/brain/70.4.405. PMID: 18903253.)

It is the best-known case of Foreign Accent Syndrome, the abstract notes.


See: https://childnervoussystem.blogspot.com/2023/08/foreign-accent-syndrome.html



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