1. Cotard parasomnia: le délire de negation that occur during the sleep-wake dissociation?
- Author
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Panagis Drakatos, Danielle Wasserman, Laura Pérez-Carbonell, Ivana Rosenzweig, Luigi Ferini-Strambi, Adam Birdseye, Michaelis Koutramanidis, Iain Duncan, Guy D. Leschziner, Alexander Nesbitt, Valentina Gnoni, Sean Higgins, Gnoni, V., Higgins, S., Nesbitt, A. D., Wasserman, D., Duncan, I., Birdseye, A., Perez-Carbonell, L., Drakatos, P., Koutramanidis, M., Ferini-Strambi, L., Leschziner, G. D., and Rosenzweig, I.
- Subjects
Pulmonary and Respiratory Medicine ,Dissociation (neuropsychology) ,Case Reports ,Electroencephalography ,Cotard delusion ,03 medical and health sciences ,0302 clinical medicine ,Salience network ,Non-REM parasomnia ,medicine ,EEG ,Default mode network ,Sleep-wake transition ,medicine.diagnostic_test ,Major intrinsic networks ,Eye movement ,Panic ,Parasomnia ,medicine.disease ,Sleep in non-human animals ,030228 respiratory system ,Neurology ,Neurology (clinical) ,medicine.symptom ,Sleep ,Psychology ,030217 neurology & neurosurgery ,Cognitive psychology - Abstract
Unpleasant dreamlike mentation can occur during non-rapid eye movement parasomnias, leading to associated panic attacks. The mentations are rarely remembered and are likely underreported. However, they may lead to significant personal distress and, if not addressed, may contribute to poorer clinical outcomes. Cotard le délire de negation are very rare nihilistic delusions, historically described with psychotic disorders. Their association with a variety of neurologic disorders, including migraine and cluster-headache, has also been reported. Here we present three cases of Cotard parasomnia during which distinct states of consciousness defined by nihilistic ideation occurred. Patients described believing they are dead or dying, while unable to perceive or experience their bodies in whole, or in part, as their own. A source analysis of the electroencephalographic fingerprint of these mentations suggests right-hemispheric hypoactivity subsequent to confusional arousals. Mechanistically, an aberrant activation of two major intrinsic brain networks of wakefulness, the salience network and the default mode network, is argued. CITATION: Gnoni V, Higgins S, Nesbitt AD, et al. Cotard parasomnia: le délire de negation that occur during the sleep-wake dissociation? J Clin Sleep Med. 2020;16(6):971–976.
- Published
- 2020