Skip to main content

Advertisement

SpringerLink
Log in

Uncommon and/or bizarre features of dementia

  • Review Article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

This study aimed at describing uncommon or bizarre symptoms observed in patients suffering from dementia. Medline and Google scholar searches were conducted for relevant articles, chapters, and books published since 1967. Search terms used included uncommon presentation, behavioural and psychological symptoms, dementia, Alzheimer’s disease, and fronto-temporal dementia. Publications found through this indexed search were reviewed for further relevant references. The uncommon symptoms are described as case-reports and there are no systematic investigations. Bizarre behaviours arising late in life should be thoroughly investigated as symptoms of dementia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Galton CJ, Patterson K, Xuereb JH, Hodges JR (2000) Atypical and typical presentations of Alzheimer’s disease: a clinical, neuropsychological, neuroimaging and pathological study of 13 cases. Brain 123(Pt 3):484–498

    Article  PubMed  Google Scholar 

  2. Alladi S, Xuereb J, Bak T, Nestor P, Knibb J, Patterson K, Hodges JR (2007) Focal cortical presentations of Alzheimer’s disease. Brain 130:2636–2645

    Article  CAS  PubMed  Google Scholar 

  3. Crutch SJ, Lehmann M, Schott JM, Rabinovici GD, Rossor MN, Fox NC (2012) Posterior cortical atrophy. Lancet Neurol 11:170–178

    Article  PubMed Central  PubMed  Google Scholar 

  4. Warren JD, Fletcher PD, Golden HL (2012) The paradox of syndromic diversity in Alzheimer disease. Nat Rev Neurol 8:451–464

    CAS  PubMed  Google Scholar 

  5. Caixeta LF, Taleb AC, Ghini BG, Soares VL, Caixeta Vde M, Vargas C (2013) Posterior cortical atrophy–a prototypical case of dementia beginning with visual symptoms: case report. Arq Bras Oftalmol 76:314–316

    Article  PubMed  Google Scholar 

  6. Shakespeare TJ, Ryan NS, Petrushkin H, Crutch SJ (2012) Identifying cortical visual dysfunction in posterior cortical atrophy. Optom Pract 13:159–162

    Google Scholar 

  7. Balasa M, Gelpi E, Antonell A, Rey MJ, Sánchez-Valle R, Molinuevo JL, Lladó A, Neurological Tissue Bank/University of Barcelona/Hospital Clínic NTB/UB/HC Collaborative Group (2011) Clinical features and APOE genotype of pathologically proven early-onset Alzheimer disease. Neurology 76:1720–1725

    Article  CAS  PubMed  Google Scholar 

  8. Snowden JS, Stopford CL, Julien CL, Thompson JC, Davidson Y, Gibbons L, Pritchard A, Lendon CL, Richardson AM, Varma A, Neary D, Mann D (2007) Cognitive phenotypes in Alzheimer’s disease and genetic risk. Cortex 43:835–845

    Article  PubMed  Google Scholar 

  9. Cipriani G, Dolciotti C, Picchi L, Bonuccelli U (2011) Alzheimer and his disease: a brief history. Neurol Sci 32:275–279

    Article  PubMed  Google Scholar 

  10. Poletti M, Nuti A, Cipriani G, Bonuccelli U (2013) Behavioral and psychological symptoms of dementia: factor analysis and relationship with cognitive impairment. Eur Neurol 69:76–82

    Article  PubMed  Google Scholar 

  11. Cipriani G, Vedovello M, Nuti A, Di Fiorino M (2011) Aggressive behavior in patients with dementia: correlates and management. Geriatr Gerontol Int 11:408–413

    Article  PubMed  Google Scholar 

  12. Cipriani G, Vedovello M, Ulivi M, Nuti A, Lucetti C (2013) Repetitive and stereotypic phenomena and dementia. Am J Alzheimers Dis Other Demen 28:223–227

    Article  PubMed  Google Scholar 

  13. Cipriani G, Vedovello M, Lucetti C, Di Fiorino A, Angelo Nuti, Angelo Nuti (2013) Dementia and suicidal behavior. Aggress Violent Behav 18:656–659

    Article  Google Scholar 

  14. Cipriani G, Danti S, Vedovello M, Nuti A, Lucetti C (2014) Understanding delusion in dementia: a review. Geriatr Gerontol Int 14:32–39

    Article  PubMed  Google Scholar 

  15. Cipriani G, Vedovello M, Nuti A, Di Fiorino A (2012) Dangerous passion: Othello syndrome and dementia. Psychiatry Clin Neurosci 66:467–473

    Article  PubMed  Google Scholar 

  16. Thibierge G (1894) Les acaraphobes. Rev Gen Clin Ther 8:373–376

    Google Scholar 

  17. Koo J, Lee CS (2001) Delusions of parasitosis: a dermatologist’s guide to diagnosis and treatment. Am J Clin Dermatol 2:285–290

    Article  CAS  PubMed  Google Scholar 

  18. Ekbom KA (1938) Der pr¨asenile dermatozoenwahn. Acta Psych Neurol Scand 13:227–59. (Reprinted) (2003) The pre-senile delusion of infestation. Hist Psychiatry 14:232–56

  19. Slaughter JR, Zanol K, Rezvani H, Flax J (1998) Psychogenic parasitosis: a case series and literature review. Psychosomatics 39:491–500

    Article  CAS  PubMed  Google Scholar 

  20. Hinkle NC (2010) Ekbom syndrome: the challenge of “invisible bug” infestations. Annu Rev Entomol 55:77–94

    Article  CAS  PubMed  Google Scholar 

  21. Hinkle NC (2011) Ekbom syndrome: a delusional condition of “bugs in the skin”. Curr Psychiatry Rep 13:178–186

    Article  PubMed  Google Scholar 

  22. Fellner MJ, Majeed MH (2009) Tales of bugs, delusions of parasitosis, and what to do. Clin Dermatol 27:135–138

    Article  PubMed  Google Scholar 

  23. Trabert W (1995) 100 years of delusional parasitosis. meta-analysis of 1,223 case reports. Psychopathology 28:238–246

    Article  CAS  PubMed  Google Scholar 

  24. Fleury V, Wayte J, Kiley M (2008) Topiramate-induced delusional parasitosis. J Clin Neurosci 15:597

    Article  CAS  PubMed  Google Scholar 

  25. Steinert T, Studemund H (2006) Acute delusional parasitosis under treatment with ciprofloxacin. Pharmacopsychiatry 39:159–160

    Article  CAS  PubMed  Google Scholar 

  26. Krauseneck T, Soyka M (2005) Delusional parasitosis associated with pemoline. Psychopathology 38:103–104

    Article  PubMed  Google Scholar 

  27. World Health Organization (1993) The ICD-10 Classification of mental and behavioural disorders: diagnostic criteria for research

  28. Diagnostic and Statistical Manual of Mental Disorders (2013) Fifth Edition. American Psychiatic Association, Washington, DC

    Google Scholar 

  29. Ramirez-Bermudez J, Espinola-Nadurille M, Loza-Taylor N (2010) Delusional parasitosis in neurological patients. Gen Hosp Psychiatry 3:294–299

    Article  Google Scholar 

  30. Harvey RJ (1996) Review: delusions in dementia. Age Ageing 25:405–408

    Article  CAS  PubMed  Google Scholar 

  31. Duggal H, Singh I (2010) Delusional parasitosis as a presenting feature of dementia. J Neuropsychiatry Clin Neurosci 22:123.e11–123.e12

    Article  Google Scholar 

  32. Musso MW, Jones GN, Heck MC, Gouvier D (2013) Delusional parasitosis as a presenting feature of HIV dementia: a case study. Appl Neuropsychol Adult 20:66–72

    Article  PubMed  Google Scholar 

  33. Renvoize EB, Kent J, Klar HM (1987) Delusional infestation and dementia: a case report. Br J Psychiatry 150:403–405

    Article  CAS  PubMed  Google Scholar 

  34. Riding J, Munro A (1975) Pimozide in the treatment of monosymptomatic hypochondriacal psychosis. Acta Psychiatr Scand 52:23–30

    Article  CAS  PubMed  Google Scholar 

  35. Freudenmann RW, Lepping P (2008) Second-generation antipsychotics in primary and secondary delusional parasitosis: outcome and efficacy. J Clin Psychopharmacol 28:500–508

    Article  CAS  PubMed  Google Scholar 

  36. Huber M, Lepping P, Pycha R, Karner M, Schwitzer J, Freudenmann RW (2011) Delusional infestation: treatment outcome with antipsychotics in 17 consecutive patients (using standardized reporting criteria). Gen Hosp Psychiatry 33:604–611

    Article  PubMed  Google Scholar 

  37. Lepping P, Russell I, Freudenmann RW (2007) Antipsychotic treatment of primary delusional parasitosis: systematic review. Br J Psychiatry 191:198–205

    Article  PubMed  Google Scholar 

  38. Aw DCW, Thong JY, Chan HL (2004) Delusional parasitosis: case series of 8 patients and review of the literature. Ann Acad Med Singap 33:89–94

    CAS  PubMed  Google Scholar 

  39. Poorbaugh JH (1993) Cryptic arthropod infestations: separating fact from fiction. Bull Soc Vector Ecol 18:3–5

    Google Scholar 

  40. Ganser SJM (1965) A peculiar hysterical state. Archiv fur Psychiatrie und Nervenkrankheiten, 1898, translation by Schorer CE. Br J Criminol 5:120–126

    Google Scholar 

  41. Snyder SL, Buchsbaum MS, Krishna RC (1998) Unusual visual symptoms and Ganser-like state due to cerebral injury: a case study using (18)F-deoxyglucose positron emission tomography. Behav Neurol 11:51–54

    Article  PubMed  Google Scholar 

  42. Sigal M, Altmark D, Alfici S, Gelkopf M (1992) Ganser syndrome: a review of 15 cases. Compr Psychiatry 33:134–138

    Article  CAS  PubMed  Google Scholar 

  43. Miller P, Bramble O, Buxton N (1977) Ganser syndrome in children and adolescents. J Am Acad Child Adolesc Phychiatry 36:112–115

    Article  Google Scholar 

  44. Anupama M, Rao KN, Dhananjaya S (2006) Ganser syndrome and lesion in the temporoparietal region. Indian J Psychiatry 48:123–125

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  45. Wirtz G, Baas U, Hofer H, Nyffeler T, Seifritz E, Müri R, Gutbrod K (2008) Psychopathology of Ganser syndrome. literature review and case discussion. Der Nervenartz 79:543–557

    Article  CAS  Google Scholar 

  46. Doongaji DR, Apte JS, Bhat R (1975) Ganser state (syndrome): an unusual presentation of a space occupying lesion of the dominant hemisphere. Neurol India 23:143–148

    CAS  PubMed  Google Scholar 

  47. Latcham R, White A, Sims A (1978) Ganser syndrome: the aetiological argument. J Neurol Neurosurg Psychiatry 41:851–854

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  48. Weiner H, Braiman A (1955) The Ganser Syndrome: a review and addition of some unusual cases. Am J Psychiatry 111:767–773

    Article  CAS  PubMed  Google Scholar 

  49. Ng B, Garcıa ED (2010) Ganser syndrome in a patient with dementia: a case report. SRX Neuroscience. doi:10.3814/2010/219261

    Google Scholar 

  50. Ladowsky-Brooks RL, Fischer CE (2003) Ganser symptoms in a case of frontal-temporal lobe dementia: is there a common neural substrate? J Clin Exp Neuropsychol 25:761–768

    Article  PubMed  Google Scholar 

  51. Cipriani G, Picchi L, Dolciotti C, Bonuccelli U (2010) Cotard: l’uomo e la sindrome [Cotard: the man and the syndrome]. Giorn Ital Psicopat 16:174–178

    Google Scholar 

  52. Cotard J (1880) Du délire hypocondriaque dans une forme grave de mélancolie anxieuse. Ann Mèd Psychol 4:168–174

    Google Scholar 

  53. Chiu HFK (1995) Cotard’s syndrome in psychogeriatric patients in Hong Kong. Gen Hosp Psychiatr 17(54):5

    Google Scholar 

  54. Conchiglia G, Della Rocca G, Grossi D (2008) When the body image becomes ‘empty’: Cotard’s delusion in a demented patient. Acta Neuropsychiatrica 20:283–284

    Article  Google Scholar 

  55. Kertesz A, Jesso S, Harciarek M, Blair M, McMonagle P (2010) What is semantic dementia?: a cohort study of diagnostic features and clinical boundaries. Arch Neurol 67:483–489

    Article  PubMed  Google Scholar 

  56. Mendez MF, Ramírez-Bermúdez J (2011) Cotard syndrome in semantic dementia. Psychosomatics 52:571–574

    Article  PubMed Central  PubMed  Google Scholar 

  57. Cipriani G, Lucetti C, Vedovello M, Nuti A (2012) Diogenes syndrome in patients suffering from dementia. Dialogues Clin Neurosci 14:455–460

    PubMed Central  PubMed  Google Scholar 

  58. Berlyne N, Twomey J, Henderson Smith SL (1975) Diogenes syndrome. Lancet 1:515

    Article  Google Scholar 

  59. Esposito D, Rouillon F, Limosin F (2003) Diogenes syndrome in a pair of siblings. Can J Psychiatry 48:571–572

    PubMed  Google Scholar 

  60. Hanon C, Pinquier C, Gaddour N, Sa’id S, Mathis D, Pellerin J (2004) Diogenes syndrome: a transnosographic approach. Encephale 30:315–322

    Article  CAS  PubMed  Google Scholar 

  61. MacKnight C (2001) Taking the solitude out of self-neglect in the elderly. Can Alzheimer Dis Rev p 18–21

  62. Radebaugh TS, Hooper FJ, Gruenberg EM (1987) The social breakdown syndrome in the elderly population living in the community: the helping study. Br J Psychiatry 151:341–346

    Article  CAS  PubMed  Google Scholar 

  63. Lebert F (2005) Diogene syndrome, a clinical presentation of fronto-temporal dementia or not? Int J Geriatr Psychiatry 20:1203–1204

    Article  PubMed  Google Scholar 

  64. Clark AN, Mankikar GD, Gray I (1975) Diogenes syndrome: a clinical study of gross neglect in old age. Lancet 1975(15):366–368

    Article  Google Scholar 

  65. Capgras J, Reboul-Lachaux J (1923) L’illusion des “sosies” dans un delire systematise chronique. Bull Soc Clin Med Ment 11:6–16

    Google Scholar 

  66. Breen N, Caine D, Coltheart M (2000) Models of face recognition and delusional misidentification: a critical review. Cogn Neuropsychol 17:55–71

    Article  CAS  PubMed  Google Scholar 

  67. Cipriani G, Vedovello M, Ulivi M, Lucetti C, Di Fiorino A, Nuti A (2013) Delusional misidentification syndromes and dementia: a border zone between neurology and psychiatry. Am J Alzheimers Dis Other Demen 28:671–678

    Article  PubMed  Google Scholar 

  68. Harciarek M, Kertesz A (2008) The prevalence of misidentification syndromes in neurodegenerative diseases. Alzheimer Dis Assoc Disord 22:163–169

    Article  PubMed  Google Scholar 

  69. Tsai SJ, Hwang JP, Yang CH, Liu KM, Lo Y (1997) Capgras’ syndrome in a patient with vascular dementia: a case report. Kaohsiung J Med Sci 13(639–642):1

    Google Scholar 

  70. Peritogiannis V (2010) Capgras syndrome and vascular dementia. J Neuropsyhiatry Clin Neurosci 22(123):E30

    Google Scholar 

  71. Tsai S, Hwang J, Yang C, Liu K (1996) Physical aggression and associated factors in probable Alzheimer disease. Alzheimer Dis Assoc Disord 10:82–85

    Article  CAS  PubMed  Google Scholar 

  72. Van den Stock J, de Gelder B, De Winter FL, Van Laere K, Vandenbulcke M (2012) A strange face in the mirror. face-selective self-misidentification in a patient with right lateralized occipito-temporal hypo-metabolism. Cortex 48:1088–1090

    Article  PubMed  Google Scholar 

  73. Van den Stock J, de Gelder B, Van Laere K, Vandenbulcke M (2013) Face-selective hyper-animacy and hyper-familiarity misperception in a patient with moderate Alzheimer’s disease. J Neuropsychiatry Clin Neurosci 25:E52–E53

    Article  Google Scholar 

  74. Tohen M, Shulman KI, Satlin A (1994) First-episode mania in late life. Am J Psychiatry 151:130–132

    Article  CAS  PubMed  Google Scholar 

  75. Brooks JO 3rd, Hoblyn JC (2005) Secondary mania in older adults. Am J Psychiatry 162:2033–2038

    Article  PubMed  Google Scholar 

  76. Van Gerpen MW, Johnson JE, Winstead DK (1999) Mania in the geriatric patient population: a review of the literature. Am J Geriatr Psychiatry 7:188–202

    Article  PubMed  Google Scholar 

  77. Nilsson FM, Kessing LV, Sørensen TM, Andersen PK, Bolwig TG (2002) Enduring increased risk of developing depression and mania in patients with dementia. J Neurol Neurosurg Psychiatry 73:40–44

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  78. Woolley JD, Wilson MR, Hung E, Gorno-Tempini ML, Miller BL, Shim J (2007) Frontotemporal dementia and mania. Am J Psychiatry 164:1811–1816

    Article  PubMed  Google Scholar 

  79. Tseng WS, Tzeng NS (2012) A rivastigmine-precipitated manic episode in a patient with Alzheimer-type dementia. Int Psychogeriatr 24:1697–1699

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare no financial or other conflict of interests.

Author information

Authors and Affiliations

  1. Neurology Unit, Hospital of Viareggio, Via Aurelia, 55043, Lido di Camaiore, Lucca, Italy

    Gabriele Cipriani, Claudio Lucetti, Sabrina Danti, Martina Ulivi & Angelo Nuti

Authors
  1. Gabriele Cipriani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claudio Lucetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabrina Danti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martina Ulivi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Angelo Nuti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gabriele Cipriani.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cipriani, G., Lucetti, C., Danti, S. et al. Uncommon and/or bizarre features of dementia. Acta Neurol Belg 115, 19–25 (2015). https://doi.org/10.1007/s13760-014-0306-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-014-0306-y

Keywords

Search

Navigation