Fregoli syndrome

Delusional misidentification syndromes (DMS) are conditions in which

the patients pathologically misidentify people, places, objects or events.
Fregoli syndrome is one of the misidentification delusional
syndromes in which the individual believes that different people are in fact
a single person who changes appearance or is in disguise and, in some
cases, is camouflaged in order to persecute the subject. People affected
usually recognize strangers as if they were family, even if there is no
physical resemblance.
The delusion is named after the italian actor Leopoldo Fregoli who is
best known for his fast ability to change appearance during a stage
performance.

Symptoms

delusions

visual memory deficit

deficit in self-monitoring

deficit in self-awareness

hallucinations

deficit in executive functions

deficit in cognitive flexibility

history of seizure activity

epileptogenic activity

Such syndrome may be present in patients with psychiatric disorders

such as schizophrenia and mood disorders, and with neurological diseases
such as Alzheimer, Parkinson and brain injury (trauma, vascular). The

syndrome is often of a paranoid nature, with the delusional person believing

themselves persecuted by the person they believe is in disguise.

Causes

Levodopa treatment
This treatment is used on dopamine responsive dystonia and the
Parkinsons disease. Its side effects include delusions and
hallucinations. Studies show that the accumulation of this treatment is
the main cause of Fregoli Delusion. After withdrawal from treatment,
people experiencing the delusion were found to improve.

Traumatic brain injury

Injuries to the temporo-parietal and frontal brain areas have been
known to cause the Fregoli syndrome. These injuries lead to a deficit in
memory and executive functions.

Abnormal function of working memory

DMS is thought to occur due to a dissociation between identification
and recognition processes, exhibiting prolonged latencies with working
memory.

Treatment
In some case studies, the patients recovered slowly over time. In other
cases, especially in those of elderly patients, the delusions may continue or
become worse, progressing into general dementia. Patients have responded
with varying success to an array of treatments including cognitive and
behavioral therapies (CBT), and the use of medications such as antipsychotics, anti-convulsants, sedatives, and tranquilizers.

*Capgras Delusion causes a person to believe their friends or family

members have been replaced with impostors.