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Shocking PET Scan Explains ‘Dead’ Feeling

June 3, 2013
Written by: , Filed in: Diagnostic Imaging, Neuroradiology, Nuclear Medicine
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Steven Laureys, MD, PhD, had never been summoned this way before.

“It’s the first and only time my secretary has said to me, ‘It’s really important for you to come and speak to this patient because he’s telling me he’s dead,'” said Dr. Laureys, a neurologist at the University of Liège in Liège, Belgium.

The patient was a British man named Graham. Suffering from depression, he had attempted suicide by electrocuting himself in his bathtub. He survived. He was convinced that his brain had not.

Doctors told him he couldn’t be walking and talking without a brain. “I just got annoyed,” he recalled, according to a story about his case in New Scientist. “I didn’t know how I could speak or do anything with no brain, but as far as I was concerned I hadn’t got one.”

Dr. Laureys and another neurologist, Adam Zeman, BM BCh, of the University of Exeter in Exeter, England, requested a PET scan on Graham’s brain. The results left them stunned, according to Dr. Laureys:

I’ve been analyzing PET scans for 15 years, and I’ve never seen anyone who was on his feet, who was interacting with people, with such an abnormal scan result. Graham’s brain function resembles that of someone during anesthesia or sleep. Seeing this pattern in someone who is awake is quite unique, to my knowledge.

The scan showed extremely low metabolic activity across large areas of the frontal and parietal brain regions—consistent with that of someone in a vegetative state. “It seems plausible,” Dr. Zeman said, “that the reduced metabolism was giving him this altered experience of the world and affecting his ability to reason about it.”

Drs. Laureys and Zeman are among the authors of a letter about the case published online April 12 in Cortex.

Graham apparently suffered from an extremely rare condition called Cotard’s syndrome, characterized by delusions of being dead or of having lost blood or internal organs. The PET scan was a first for a Cotard’s patient.

“I lost my sense of smell and my sense of taste,” Graham said. “There was no point in eating because I was dead.” He began visiting a nearby graveyard. “I just felt I might as well stay there. It was the closest I could get to death. The police would come and get me, though, and take me back home.”

Graham’s brother and others cared for him and made sure he ate. With psychotherapy and drug treatment, he has improved. “I couldn’t say I’m really back to normal,” he said, “but I feel a lot better now and go out and do things around the house. I don’t feel that brain dead anymore. Things just feel a big bizarre sometimes.”

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