Since it became fashionable zombies, we all want to be one. Not that we have become cannibals and a brain has become our favorite food. Is that one becomes attached to the undead and make you want to get something broken and makeup to go out and scare others. Clearly, unless we are way to a costume party, they will call us for fools. But beware, there are those who are really. Crazy? Dead? Both of them…
Although the idea seems straight out of a novel by Stephen King, there is a condition that makes you a living dead. It's called Cotard syndrome and may well be considered the rarest disease in the world. The sufferer believes that its internal vital organs are paralyzed, their intestines do not work, and their heart is not beating, which have no nerves, no blood or brain. Imagine their bodies in a state of putrefaction and looks, it smells and feels as if this were true. Visual hallucinations occur, as seen in a mirror-shaped body; olfactory hallucinations, and have unpleasant odors, to meat in putrefaction, or tactile hallucinations, feeling that has worms sliding over his skin.
In its more advanced stages, the patient defends the idea that he is dead and is even surrounded by dead, putting people close to him in this area. Along with this belief of death, the patient maintains a sense of immortality, as if he had become a "lost soul". Although this is a typical delusion of the worst depressions such as psychotic or delusional, it can be seen in other severe mental illnesses, such as dementia with psychotic symptoms, schizophrenia, psychosis due to medical conditions or toxic.
This syndrome owes its name to Jules Cotard (1840-1889), a French neurologist who first described the condition in 1880 in a case report of a 43 year old. "Mademoiselle X says it has no brain or nerves or chest or stomach, or intestines; it has only skin and bones of a decomposing body. No soul, for her there is no God and the Devil either. He says he has no need to eat to live and can’t die naturally. Only cease to exist forever if burned. The fire be your only salvation. "He described his patient Cotard. Those who suffer from this disease, do not believe that going to die ... "already dead"...
In 1995 he first performed a clinical classification based on the tests. In a retrospective analysis of 100 cases Cotard syndrome is subdivided into three types. A first type includes a form of psychotic depression, characterized by anxiety, melancholy delusions of guilt and auditory hallucinations. A second type, described as Cotard syndrome type I was associated with hypochondriacal delusions and nihilistic, and absence of depressive episodes. The last group was the Cotard syndrome type II, with anxiety, depression, auditory hallucinations, delusions of immortality, nihilistic delusions and suicidal behavior, and prominent features.
Recently, neurologist Steven Laureys of the University of Liege in Belgium, commented on a patient with this syndrome: "I've been analyzing the PET readings for 15 years and have never seen anyone who was standing, interacting with people, a scan result as abnormal. His brain function is similar to that of a person during anesthesia or sleep. See this pattern in someone who is awake is quite unique. "
Scientifically still they continue to study its causes, although neurology currently set to malfunction of the amygdala and other limbic structures of the brain responsible for emotional--those as the most likely answer you reason. However, it is still an unusual disease.
Main symptoms of Cotard's syndrome:
• Belief that there is no body. It is a delusion the patient believes to be living some real form when only occurs in imagination
• Belief that are running out of blood.
• Negative thoughts
• Belief that are already dead with olfactory delusions they even smell rotting
• Belief that the worms under their skin
• Belief that they are immortal
• Belief that they are breaking
• Belief that have no internal organs.
• Analgesia or no pain
Management and treatment
Specific management of Cotard syndrome is focused mainly on the management of the underlying clinical condition which is part. As noted in patients with affective disorders, antidepressants can be effective; however, due to the presence of delusions, the electroconvulsive therapy has been strongly suggested by some authors and even has come to pose as the treatment of choice.
When the syndrome is associated with a condition of chronic schizophrenic illness, the prognosis worsens. However, in other schizophrenic patients where the onset of symptoms is rapid onset, use of antipsychotic drugs may favor a good answer.
If the syndrome occurs behind any organic entity, the treatment is the condition that has determined. However, if it appears as an initial presentation of a clinical picture of dementia will be very little chance of improvement in the patient. If the syndrome arises, for example, as a result of a secondary confusional state to an organic condition, as the case reported associated with typhoid, it is clear that the treatment of the disease lead to a complete recovery of the patient.
Other measures to be considered in the management of Cotard syndrome is monitoring the patient, in terms of the possibilities of self-harm and special recommendation in the case of patients with depressive symptoms prevalence of suicide and especially once established the treatment, the patient in the recovery phase reaches regain mobility more actively.
The Cotard syndrome prognosis is guarded. Full recovery of the patient can arise suddenly and spontaneously, even in the most severe cases way. However, in cases of moderate intensity they have not developed classical clinical presentation and complete recovery can be rapid or gradual. If the condition is due to an underlying organic condition, evolution is closely related to the patient's chances of recovery of the condition being treated. Sometimes, in the presence of depressive symptoms it may happen that a resolution of depressive symptoms is achieved, but remain delusions.
When the picture is part of a schizophrenic illness, the picture is resolved to the extent that other psychotic symptoms also resolved. Similarly, if the symptoms continue for many years, they can then coexist with chronic schizophrenic condition.
In some cases, life for the patient becomes tolerable and shows a double orientation. It is to say, it is immersed in a fabulous pseudoreality and, in turn, is able to maintain contact with others. Delirium sometimes has become completely encapsulated consulate, and then the individual is able to assume a jovial mood, and engage in philosophical discussions about their own existence or nonexistence.
Dr. Steven Laureys is in his office at the University of Liege in Belgium, when it receives a call from his secretary. "It's really important to come and talk to this patient," says so hectic. "He's telling me he's dead."
The patient is called Graham, he is 48 years and one day in 2004 he got out of bed with the conviction that he had died. A few months earlier he had attempted suicide by electrocution, putting a light cord in the bathtub, and the episode caused a depression that led to what is known as Cotard syndrome.
"It's hard to explain," he says. "I feel like my brain no longer existed. They insisted doctors the pills would not work because I had no brain. I fried them in the bathtub." His condition became so extreme that Graham came home one day and went to the cemetery to stay. "I just felt I should be there," he explains. "It was the closest I could be death."
The case went to Adam Zeman, of the University of Exeter in the UK, and Steven Laureys of Liege, whom he underwent a brain imaging test to see what was going on in his head. Concrete, performed a positron emission tomography (PET) and what they found left them impressed: the metabolic activity of the cerebral cortex was more like a person in a vegetative state or anesthetized that a person "wakes up".
"Our data," they write in the study published in the journal Cortex, "suggest that the profound alteration of thought and experience, expressed in Cotard syndrome, it reflects a profound alteration in brain regions responsible for the 'core consciousness' ". His hypothesis, in the absence of further studies of the phenomenon is that the reduction of metabolism occurred in Graham experience that altered the world in which he believed did not exist.
And we say "thought" because, as revealed in New Scientist, Graham has recovered thanks to psychotherapy and medication and left to suffer the syndrome. "I do not feel my brain is dead," he confesses. "Things get a little strange sometimes".
What do you think about this disease?