![]() ![]() Due to his belief that mirrors represent a separate place, TH tried to reach into the mirror to retrieve the object rather than reaching over his shoulder. While TH was looking into a mirror, the researcher held an object behind TH in such a way so it was reflected in the mirror. Patient TH was in the early stages of dementia and was affected by mirror agnosia. There are two famous case studies of patients with mirrored-self misidentification that have contributed to the overall understanding of this delusion. Therefore, in these rare cases, despite damage to the entire facial recognition area of the brain, the patient is still able to recognize relatives but unable to recognize the self in the mirror. When looking in a mirror, the patient can only use facial cues to recognize one self. When such extensive neurological damage occurs, the affected patient relies on non-facial cues to identify relatives. Such extensive damage in mirrored-self misidentification patients is rare typically patients retain the ability to recognize others’ reflections in the mirror. In a few select case studies, patients with this delusion have such extensive right-hemisphere cranial damage that one is also unable to identify close relatives and others with whom the patient has close association. As no patients with solely left hemisphere damage have been reported to experience this delusion, this points to the delusion being strongly associated with right hemisphere dysfunction. While approximately 50% of all patients exhibit left hemisphere damage, all patients with this hemispheric dysfunction also have cranial lesions in the right hemisphere. These cranial distortions point to right frontal atrophy and general right hemisphere dysfunction. Patients with this delusion also tend to have larger right anterior horns than the typical person. ![]() Injury to the right frontal lobe is found in 35% of cases and can also inhibit one's ability to reject delusional beliefs on the basis of implausibility. Patients can no longer logically reject delusional beliefs. Patients tend to experience a distortion of the right dorsolateral prefrontal cortex, which impairs the patient's belief evaluation system. An impairment in the right hemisphere, the likely source of the "self" in the brain, can inhibit one's ability to recognize faces, especially one's own. The right hemisphere, particularly frontal right hemisphere circuits, is involved in processing self-related stimuli and helps one recognize a picture or reflection of oneself. As such, it can be incumbent upon the patient's family to recognize symptoms of the delusion, mainly that the patient is unable to recognize him or herself in the mirror but has an intact ability to recognize the reflections of others.Īll patients with mirrored-self misidentification have some type of right hemisphere dysfunction. Furthermore, a standard neurological or neuropsychological workup tends to overlook the existence of this delusion because affected patients have extensive cognitive degeneration that is the main focus of medical attention. The exact prevalence of patients with this delusion is relatively unknown because the typical patient has many comorbidities this makes it difficult to separate the symptoms of mirrored-self misidentification from other existing psychological conditions. Patients with schizophrenia, right frontal ischemic stroke, and rarely patients with Parkinson's disease have also reported being affected by this delusion. Approximately 2% to 10% of all patients with Alzheimer's disease have mirrored-self misidentification. Mirrored-self misidentification, a type of DMS, occurs most typically in patients with dementia, especially Alzheimer's disease. Prevalence ĭelusional misidentification syndromes (DMS) can occur in patients with a wide variety of cranial dysfunctions. DMS patients are not aware of their psychological condition, are resistant to correction and their conditions are associated with brain disease – particularly right hemisphere brain damage and dysfunction. A patient with a DMS condition consistently misidentifies places, objects, persons, or events. This delusion is also classified as one of the delusional misidentification syndromes (DMS). It is an example of a monothematic delusion, a condition in which all abnormal beliefs have one common theme, as opposed to a polythematic delusion, in which a variety of unrelated delusional beliefs exist. It is caused by right hemisphere cranial dysfunction that results from traumatic brain injury, stroke, or general neurological illness. This delusion occurs most frequently in patients with dementia and an affected patient maintains the ability to recognize others' reflections in the mirror. Mirrored-self misidentification is the delusional belief that one's reflection in the mirror is another person – typically a younger or second version of one's self, a stranger, or a relative. ![]()
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