The Walking Corpse Syndrome

Walking Corpse Syndrome or Cotard’s Syndrome is a mental disorder in which patients experience delusions that they are dead, do not exist, are putrefying or have lost their vital organs.

Walking Corpse Syndrome or Cotard’s Syndrome is an uncommon neuropsychiatric disorder in which patients experience delusions or false beliefs that they are dead, do not exist, are putrefying or have lost their vital organs. In some cases, they can even smell the rotting flesh. The condition can simply be described as “existence denial“. It is sometimes accompanied by symptoms of guilt, anxiety and negativity. Paradoxically, some patients may have delusions of immortality.

Walking Corpse Syndrome / Cotard’s Syndrome was first described by Jules Cotard way back in 1880 as ‘délire des negations’ or negative deliriums.

Studies indicate that the disease is more prevalent in older patients with depression. It is also more likely to occur in patients with disorders like schizophrenia, bipolar disorders, brain injury, brain atrophy, seizure disorders, depression, brain tumors, stroke, and migraine and in patients with delirious states. Women may be more commonly affected than men.

Though the exact cause is not known, lesions in frontal and temporal regions (front and sides) of the right hemisphere of the brain have been associated with the disease.

Some patients suffering from ‘Walking Corpse Syndrome’ have died of starvation since they deprived themselves of food thinking that they are already dead. The patients also have a tendency to attempt suicide and harm themselves.

The condition is diagnosed on the basis of symptoms of the patient. Tests are used to diagnose associated diseases and rule out other conditions. Current treatment involves medication with antidepressants, antipsychotics and mood stabilizers. Electroconvulsive therapy in combination with medications has been reported to be more effective than medications alone.

Causes and Risk factors of Walking Corpse Syndrome

Walking Corpse Syndrome occurs due to lesions in frontal and temporal regions of the right hemisphere of the brain.

The exact cause for ‘Walking Corpse Syndrome’ is not known. However, studies suggest that the cause is localized in the frontal and temporal regions of the right hemisphere of the brain.

Risk factors that have been associated with Cotard’s syndrome are-

The condition is more common in older individuals with depressive disorders

It is associated with other mental disorders like schizophrenia, bipolar disorders and dementia

It has been associated with other conditions affecting the brain like brain atrophy, brain tumors, seizure disorders, brain injury, migraine, Parkinson’s disease and stroke

it could also be a consequence of an adverse drug reaction to acyclovir, an antiviral drug, in patients with kidney failure. These patients are unable to excrete a metabolite of acyclovir called CMMG, which accumulates in the blood and causes the symptoms

Signs and Symptoms of Walking Corpse Syndrome

People with ‘Walking Corpse Syndrome’ believe that they are dead.

Patients with ‘Walking Corpse Syndrome’ have a vague feeling of anxiety in the initial stages. This is followed by a belief that they are dead, do not exist, are putrefying (they can even smell rotting flesh) or have lost their vital organs.  Some patients actually feel that they are immortal.

Clinical features include depression, feeling of guilt, negativity and insensitivity to pain. The patients may also believe that they are paralyzed or have auditory or smell-based hallucinations.

People affected by this disorder cannot recognize their own face and do not show any interest in social life or pleasure. They are always paranoid and neglect their own hygiene. They have a suicidal tendency or may harm themselves. They lose sense of reality and have distorted view of the world.

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