Crazy Crazy Facts

Walking Corpse Syndrome

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,
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
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.
Yamada suggested a classification of
Cotard's syndrome; he divided it into
three stages based on the symptoms:
Germination stage : In this stage, the
patient shows characteristic features
of depressive mood, extreme worry
of unwellness and excessive fear of
one's illness, despite medical
treatment.
Blooming stage: In this stage, the
patient experiences true features of
the syndrome i.e. delusion of being
dead or immortal; this stage is
associated with anxiety and
negativism.
Chronic stage: In this stage, the
individual shows severe depression
due to emotional disturbances or
paranoia.
Diagnosis of Walking Corpse Syndrome
'Walking Corpse Syndrome' is
diagnosed based on the patient's
history and symptoms. Tests are
used to exclude other conditions as
well as to diagnose associated
diseases. These tests include:
Blood test
CT Scan (Computed tomography)
MRI (Magnetic Resonance Imaging)
SPECT (Single-photon emission
computed tomography)
Electroencephalogram (EEG)
Treatment of Walking Corpse Syndrome
Walking Corpse Syndrome / Cotard's
syndrome is treated with medications
in combination with
electroconvulsive therapy.
Treatment of 'Walking Corpse
Syndrome' includes the following:
Identification and treatment of risk
factors : Risk factors for 'Walking
Corpse Syndrome' should be identified
and treated.
Antidepressants, antipsychotics and
mood stabilizer medications :
Antidepressants, antipsychotics and
mood stabilizers are used in the
treatment of Cotard's syndrome.
Based on the underlying condition,
the patient should be treated with a
single drug or combination of
medications. Mood stabilizers have
beneficial effects in patients with
bipolar disorder.
Electroconvulsive Therapy: Many
cases have shown that a combination
of electroconvulsive therapy (ECT)
with medications was more effective
to manage the condition as
compared to medications alone. ECT
involves placing electrodes on the
patient's head and administering the
small impulses.
The overall prognosis of disease is
determined by severity of the
disorder and the treatment strategies
used to manage it. Some patients
recover with proper treatment. Some
die of starvation. The patients also
have suicidal tendencies and should
be watched over.
Interesting Cases of Walking Corpse
Syndrome
Some interesting cases of Walking
Corpse Syndrome reported in
medical literature are listed below:
A 53-year old Filipino woman was
brought to a hospital when she
complained that she was dead,
smelled like rotting flesh, and
wanted to be taken to a morgue to
be with dead people. Upon
questioning, she expressed fear that
"paramedics" were trying to burn
down her house. She also
complained of hopelessness, low
energy, decreased appetite, and
excessive sleepiness. She responded
to treatment with medications.
A patient who was taken to South
Africa from Edinburgh after a period
of hospitalization was convinced that
he was taken to hell after his death.
He believed that he had died of
septicemia, AIDS or an overdose of
yellow fever injection. He felt that it
was not his mother who
accompanied him, but her spirit.