Successful electroconvulsive therapy of Cotard syndrome with bitemporal hypoperfusion
Lohmann, T.; Nishimura, K.; Sabri, O.; Klosterkötter, J.
Der Nervenarzt 67(5): 400-403
1996
ISSN/ISBN: 0028-2804 PMID: 9005351 Document Number: 463536
A case study is presented to illustrate a rare condition described by Cotard as "delire de negation". The central symptom is a nihilistic delusion with denial of one's own existence of oneself and that of the external world. In the present case, the syndrome became manifest as an escalation of a recurrent depressive disorder late in life. After initial resistance to therapy, the syndrome was successfully treated with electroconvulsive therapy. For the first time, we report the regional cerebral blood flow measured by 99mTc-HMPAO-SPECT before and after therapy. Before treatment, significant bitemporal hypoperfusion relative to the cerebellum was found, which was no longer demonstrable on remission.