Prosopometamorphopsia: The Woman Who Saw Dragons

Neuroskeptic iconNeuroskeptic
By Neuroskeptic
Dec 5, 2014 5:31 PMMay 21, 2019 5:31 PM

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A 52 year old woman suffered from a strange problem: she saw dragons wherever she looked.

distort

Here’s the medical case report in The LancetProsopometamorphopsia and facial hallucinations from a team of researchers including the famous Oliver Sacks.

In July, 2011, a 52-year-old woman presented to our psychiatric outpatient clinic with a life-long history of seeing people’s faces change into dragon-like faces and hallucinating similar faces many times a day.

What does a dragon look like? According to the patient, when someone turns into one, their faces become

Black, grew long, pointy ears and a protruding snout, and displayed a reptiloid skin and huge eyes in bright yellow, green, blue, or red.

These hallucinations didn’t just occur when the woman was looking at real faces. The dragons also came out of nowhere

She saw similar dragon-like faces drifting towards her many times a day from the walls, electrical sockets, or the computer screen, in both the presence and absence of face-like patterns, and at night she saw many dragon-like faces in the dark.

What was causing these strange phenomena? The authors of the case report confess that they’re not sure. Brain scanning revealed no obvious cause:

Neurological examination, blood tests, and electroencephalogram (EEG) were normal, and MRI brain showed only a few white-matter abnormalities

The authors nonetheless go on to speculate as to the neurological basis of the woman’s complaints, but I think that if they were to speak freely, they’d admit that it’s a mystery.

Our story has a happy ending, at least. The woman was put on rivastigmine, an anti-dementia medication, and this vanquished the dragons (mostly). Previously she had been unable to hold down a job because the hallucinations interfered with her social interactions, but now

She has remained in the same job for the past 3 years and her interaction with colleagues is greatly improved.

Blom JD, Sommer IE, Koops S, & Sacks OW (2014). Prosopometamorphopsia and facial hallucinations. Lancet, 384(9958) PMID: 25435453

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