Capgras syndrome in a very late onset, treatment resistant schizophrenia

Abstract

We report a Malay man, with underlying chronic medical illnesses, presenting with positive symptoms of schizophrenia, including Capgras syndrome (CS) at the age of 73. Physical examination and blood investigations were normal and brain CT scan showed age-related cerebral atrophy. Neuropsychological assessment showed probable right hemisphere lesions but relatively intact memory and intellectual functions. Several neuroleptics including depot injections were tried but ineffective. Positive symptoms including CS eventually improved with clozapine before his death from myocardial infarction. This case report highlights the uncommon occurrence of CS in treatment resistant schizophrenia (TRS) of very late onset and its treatment challenges.

Capgras syndrome associated with limbic encephalitis in a patient with diffuse large B-cell lymphoma

“…19 Therefore, it is crucial to rule out a possible organic etiology when the onset is at an older age. 17 To our knowledge, there are no reports of DMS directly associated with LE or lymphoma in the medical literature. We found only a few case reports linking DMS to other neurological autoimmune diseases.…”

“… 16 The etiology of DMS and its subtypes varies in different populations studied but it is typically associated with psychiatric illness and neurological disorders, especially neurodegenerative diseases and particularly Lewy body dementia. 17 Nonetheless, several other focal and diffuse neurological conditions have been associated with DMS in smaller studies or case reports including Parkinson disease, right hemispheric stroke, 15 neurosyphilis, 18 and hypothyroidism. 19 Therefore, it is crucial to rule out a possible organic etiology when the onset is at an older age.…”

Capgras syndrome in a first-episode, late-onset and super-refractory schizophrenia case

“…However, the combination of these three conditions in a single case is a very rare event and so far seldom reported 1 . We report a case of a patient with LOS presenting with of CS and super-refractoriness since its first crisis.…”