Lithium Intoxication Presenting as a Mixed Misidentification Syndrome

Abstract

A case is reported of lithium intoxication presenting with a mixed misidentification syndrome including features of Capgras syndrome. CT scanning showed cerebral atrophy, greater on the right, consistent with earlier evidence, suggesting that misidentification syndromes are more common with right hemisphere lesions.

Capgras Syndrome: A Review of the Neurophysiological Correlates and Presenting Clinical Features in Cases Involving Physical Violence

“…Reports of an association between CS and medical and neurological conditions have led to the belief that cerebral dysfunction underlies the delusion's development. The syndrome has been linked to dopaminergic overactivity (61)(62)(63), and serotonin abnormality has been implicated in some (54) but not all studies (55,64). Similarly, reduced platelet monoamine oxidase activity has been noted by some (65) but not by others (66).…”

Prevalence of Capgras syndrome in Alzheimer’s patients: A systematic review and meta-analysis

“…Initially, the etiology of CS seemed to be necessarily linked to psychotic episodes. There are reports of several cases of the syndrome associated with organic pathologies over the years, such as myxedema,7 , 8 encephalitis,9 multiple sclerosis,10 and lithium intoxication 11. In psychotic disorders, Capgras syndrome is still more common today in patients with schizophrenia and degenerative dementias.…”