Cotard Syndrome in Semantic Dementia

Abstract

Background Semantic dementia is a neurodegenerative disorder characterized by the loss of meaning of words or concepts. semantic dementia can offer potential insights into the mechanisms of content-specific delusions. Objective The authors present a rare case of semantic dementia with Cotard syndrome, a delusion characterized by nihilism or self-negation. Method The semantic deficits and other features of semantic dementia were evaluated in relation to the patient's Cotard syndrome. Results Mrs. A developed the delusional belief that she was wasting and dying. This occurred after she lost knowledge for her somatic discomforts and sensations and for the organs that were the source of these sensations. Her nihilistic beliefs appeared to emerge from her misunderstanding of her somatic sensations. Conclusion This unique patient suggests that a mechanism for Cotard syndrome is difficulty interpreting the nature and source of internal pains and sensations. We propose that loss of semantic knowledge about one's own body may lead to the delusion of nihilism or death.

Clinicopathological Study of Patients With C9ORF72-Associated Frontotemporal Dementia Presenting With Delusions

“…Other case reports showed complex delusions, 30 grandiose delusions, 31 and Cotard delusions. 32 Snowden et al reported that most of the delusions with their C9ORF72 mutation cases were somatic delusions such as alterations in temperature perception, preoccupation with bowel movements, and leg pain, 5 which was different from our series showing various delusions.…”

Psychotic Symptoms in Frontotemporal Dementia

“…A few cases in the literature have reported some improvements in symptoms when antipsychotics were initiated [53][54][55]. Patients with FTD are sensitive to the side effects of antipsychotics, with extrapyramidal symptoms occurring in 33 % and severe in 21 % [56].…”

Suicidal Behavior and Loss of the Future Self in Semantic Dementia

“…Patients with SD may be moved to attempt suicide given their likelihood of depression (Rohrer and Warren, 2010; Thompson et al, 2003). Patients with SD who are prone to depression may arrive at the nihilistic belief that they, in effect, do not exist or are losing their self, and their belief leads them to attempt suicide (Mendez and Ramirez-Bermudez, 2011). …”

“…First, it is a single case report. Still, other patients with SD have had similar difficulties with their sense of future self, as well as similar nihilistic reactions to “not knowing” (Mendez and Ramirez-Bermudez, 2011). Unlike these other people, our patient illustrates the clinical implications of “not knowing” in the form of suicidal behavior.…”