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BMC Psychiatry
Published in: BMC Psychiatry 1/2024

Open Access 01-12-2024 | Lung Cancer | Case Report

Depersonalization and derealization as sequelae of a temporal lobe lesion: a case report

Authors: Jasmyn E. A. Cunningham, Caitlin S. R. Lees, MD, MA, MSc

Published in: BMC Psychiatry | Issue 1/2024

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Abstract

Background

Depersonalization and derealization can occur not just from psychiatric causes but also from various organic etiologies, such as seizures and intracerebral structural abnormalities. However, there have been no previous reported cases to the authors’ knowledge detailing isolated depersonalization and derealization in the absence of clinical seizure activity or other psychiatric pathology, as sequelae of structural intracerebral lesions.

Case presentation

In this case report, we detail the unique presentation of a 68-year-old woman under the care of palliative medicine who experienced depersonalization and derealization secondary to a metastatic lesion in her temporal lobe, in the parahippocampal gyrus to medial occipitotemporal gyrus region. These symptoms were present in the absence of any clinical seizure activity or other psychiatric symptomatology and largely resolved with the use of steroidal therapy, before returning secondary to disease progression.

Conclusions

We discuss the relationship among isolated depersonalization and derealization with pathology of the left posterior temporal lobe in the context of this interesting case. This case expands our knowledge of the neurobiology of these phenomena, given the specific localization of the intracerebral pathology and temporal specificity of symptoms relative to tumor growth and treatment course.
Footnotes
1
The patient had a non-small cell lung cancer (moderately-poorly differentiated adenocarcinoma).
 
Literature
1.
Sierra M, Berrios GE. Depersonalization: a conceptual history. Hist Psychiatry. 1997;8(21):213–29.CrossRefPubMed
2.
Bob P. Dissociation, forced normalization and dynamic multi-stability of the brain. Neuro Endocrinol Lett. 2007;28(3):231–46.PubMed
3.
American Psychiatric Association T. Diagnostic and statistical Manual of Mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.CrossRef
4.
World Health Organization (WHO). International Classification of Diseases, Eleventh Revision (ICD-11): Licensed under Creative Commons Attribution-NoDerivatives 3.0 IGO licence (CC BY-ND 3.0 IGO); 2019/2021 [Available from: https://​icd.​who.​int/​browse11
5.
Dugas L, Sierra M, Berrios GE. A case of depersonalization. Hist Psychiatry. 1996;7(27):455–61.CrossRef
6.
Dietl T, Bien C, Urbach H, Elger C, Kurthen M. Episodic depersonalization in focal epilepsy. Epilepsy Behav. 2005;7(2):311–5.CrossRefPubMed
7.
Lambert MV, Sierra M, Phillips ML, David AS. The spectrum of organic depersonalization: a review plus four new cases. J Neuropsychiatry Clin Neurosci. 2002;14(2):141–54.CrossRefPubMed
8.
Sierra M, Berrios GE. Depersonalization: neurobiological perspectives. Biol Psychiatry. 1998;44(9):898–908.CrossRefPubMed
9.
Hollander E, Carrasco JL, Mullen LS, Trungold S, DeCaria CM, Towey J. Left hemispheric activation in depersonalization disorder: a case report. Biol Psychiatry. 1992;31(11):1157–62.CrossRefPubMed
10.
Simeon D, Guralnik O, Hazlett EA, Spiegel-Cohen J, Hollander E, Buchsbaum MS. Feeling unreal: a PET study of depersonalization disorder. Am J Psychiatry. 2000;157(11):1782–8.CrossRefPubMed
11.
Heydrich L, Marillier G, Evans N, Seeck M, Blanke O. Depersonalization- and derealization-like phenomena of epileptic origin. Ann Clin Transl Neurol. 2019;6(9):1739–47.CrossRefPubMedPubMedCentral
12.
Heydrich L, Dieguez S, Grunwald T, Seeck M, Blanke O. Illusory own body perceptions: case reports and relevance for bodily self-consciousness. Conscious Cogn. 2010;19(3):702–10.CrossRefPubMed
13.
Sierk A, Daniels JK, Manthey A, Kok JG, Leemans A, Gaebler M, et al. White matter network alterations in patients with depersonalization/derealization disorder. J Psychiatry Neurosci. 2018;43(5):347–57.CrossRefPubMedPubMedCentral
14.
Mullan S, Penfield W. Illusions of comparative interpretation and emotion; production by epileptic discharge and by electrical stimulation in the temporal cortex. AMA Arch Neurol Psychiatry. 1959;81(3):269–84.CrossRefPubMed
15.
Penfield W, Perot P. The brain’s record of auditory and visual experience. A final summary and discussion. Brain. 1963;86:595–696.CrossRefPubMed
16.
Gloor P, Olivier A, Quesney LF, Andermann F, Horowitz S. The role of the limbic system in experiential phenomena of temporal lobe epilepsy. Ann Neurol. 1982;12(2):129–44.CrossRefPubMed
17.
Halgren E, Walter RD, Cherlow DG, Crandall PH. Mental phenomena evoked by electrical stimulation of the human hippocampal formation and amygdala. Brain. 1978;101(1):83–117.CrossRefPubMed
18.
Grigsby J, Kaye K. Incidence and correlates of depersonalization following head trauma. Brain Inj. 1993;7(6):507–13.CrossRefPubMed
19.
Malamud N. Psychiatric disorder with intracranial tumors of limbic system. Arch Neurol. 1967;17(2):113–23.CrossRefPubMed
20.
Lilja A, Salford LG. Early mental changes in patients with astrocytomas with special reference to anxiety and epilepsy. Psychopathology. 1997;30(6):316–23.CrossRefPubMed
21.
Ceylan EM, Onen Unsalver B, Evrensel A. Medial cranial Fossa Meningioma diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. Case Rep Psychiatry. 2016;2016:3827547.PubMedPubMedCentral
22.
Smirnov VY. Paroxysmal psychopathological symptoms in patients with brain tumors in the right and left temporal lobes. Neurosci Behav Physiol. 1977;8(1):86–9.CrossRefPubMed
23.
Carlson EB, Putnam FW. An update on the dissociative experiences scale. Dissociation. 1993;6(1):16–27.
24.
Steinberg M, Rounsaville B, Cicchetti D. Detection of dissociative disorders in psychiatric patients by a screening instrument and a structured diagnostic interview. Am J Psychiatry. 1991;148(8):1050–4.CrossRefPubMed
25.
Velasco R, Villagran M, Jove M, Simo M, Vilarino N, Alemany M, et al. Encephalitis induced by immune checkpoint inhibitors: a systematic review. JAMA Neurol. 2021;78(7):864–73.CrossRefPubMed
26.
Mula M, Pini S, Cassano GB. The neurobiology and clinical significance of depersonalization in mood and anxiety disorders: a critical reappraisal. J Affect Disord. 2007;99(1–3):91–9.CrossRefPubMed
27.
28.
29.
Parvizi J, Braga RM, Kucyi A, Veit MJ, Pinheiro-Chagas P, Perry C, et al. Altered sense of self during seizures in the posteromedial cortex. Proc Natl Acad Sci U S A. 2021;118:29.CrossRef
30.
Metadata
Title
Depersonalization and derealization as sequelae of a temporal lobe lesion: a case report
Authors
Jasmyn E. A. Cunningham
Caitlin S. R. Lees, MD, MA, MSc
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2024
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-024-05641-2

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