The autoscopic phenomena in neurological clinic: a study of two cases

Abstract

Autoscopic phenomena are part of the reduplicative misidentification syndromes. These disorders may be a manifestation of both neurological and psychiatric conditions and consist of a double perception of the own body. These phenomena have been attributed to a dysfunction of the nondominant gyrus angularis. Two cases with this symptom are described. Case 1: A female with previous history of multiple sclerosis presented with episodes in which she saw herself in her extrapersonal space. Holter EEG was normal. An MRI scan showed multiple T2 hyperintensities. She was treated with carbamazepine and the symptom subsided. Case 2: A man presented with visual loss in the left field and episodic visualization of his own image. Examination confirmed left homonymous hemianopia. Serum glucose was 417 mg/dL. MRI was normal. Glycemia correction made the autoscopia disappear. In case 1, ephaptic transmission is proposed as the pathogenic mechanism and in the case 2, transient glucose toxicity is likely to explain the autoscopic phenomena.