11 Understanding Cotard’s syndrome and its connection to other neurological conditions is essential to identifying appropriate treatment modalities. 1Ī variety of associated neurological conditions have been described, including migraines, 2 subdural hemorrhage, 3 cerebral atrophy, 4 cerebral arterio-venous malformation, 5 multiple sclerosis, 6 cerebral infarction, 7 superior sagittal sinus thrombosis, 8 parietal lobe tumor, 9 temporal lobe epilepsy, 5 Parkinson’s disease, 10 encephalopathy, 1 and brain injury. While Cotard’s is often described as being a psychiatric syndrome, published studies have shown a strong correlation between a preexisting neurological disease and the condition. The current status of Cotard’s syndrome is its conceptualization as a manifestation of an underlying disorder. 1 Though described initially in 1880, very little is understood about this disorder, and its inclusion in the DSM-5 as a specific listing has been avoided. A number of effective treatments are available.Ĭotard’s syndrome is a rare neuropsychiatric condition that manifests as nihilistic delusions ranging from denial of the existence of body parts to negation of self-existence. Nondominant hemisphere lesions may play a role in the pathophysiology. To conclude, Cotard delusions occur in the context of a relatively wide spectrum of neurological, psychiatric, and medical disorders and present with various neural changes. Treatments included ECT, pharmacotherapy, behavioral therapy, psychotherapy, rehydration, and removal of offending drugs. On neuroimaging, four patients exhibited frontal lobe changes, four demonstrated generalized volume loss, and five had ischemic changes seven patients demonstrated right-sided or bilateral hemisphere lesions.

The resulting 12 patients had a median age of 52 years (range: 30–85 years).

Two of the 14 were excluded due to them being under age 18. The search identified 18 patients, 14 of whom had Cotard delusions. Clinical and neuroimaging data were also recorded for these patients. The electronic medical records of the identified patients were then reviewed for evidence of a true diagnosis of Cotard’s. A search of the Mayo Clinic database for patients with mention of signs and symptoms associated with Cotard’s in their records between 19 was conducted. The authors evaluated associated diagnoses, neuroimaging, and treatments recorded in patients diagnosed with Cotard’s syndrome at their institution. The majority of published literature on the topic is in the form of case reports, many of which are several years old. Cotard’s syndrome, a condition in which the patient denies his or her own existence or the existence of body parts, is a rare illness that has been reported in association with several neuropsychiatric diagnoses.

Diogenes syndrome dsm 5