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Case report: Capgras syndrome: a clinical manifestation of watershed cerebral infarct complicating the use of extracorporeal membrane oxygenation

Jean Marc Dejode*, François Antonini, Pierre Lagier and Claude Martin

Author Affiliations

Department of Anesthesia and Intensive Care, CHU Nord, Marseilles, France

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Critical Care 2001, 5:232-235 doi:10.1186/cc1029

Published: 13 July 2001

Abstract

Ischaemic cerebral accidents are frequent following extracorporeal membrane oxygenation (ECMO), especially after fixing the reinjection cannula in the right primitive carotid artery, which leads to an interruption in downstream flow. We describe a rare and unusual symptom of cerebral ischaemic accident that is known as Capgras syndrome. This feature is interesting because it may be documented by computed tomography (CT) scan and particular electroencephalography signals. It appears that our observation represents the first documented case of Capgras syndrome complicating ECMO. This incident emphasizes the potential hazards associated with right common artery ligature for venoarterial extracorporeal membrane oxygenation (VAECMO). In addition, it shows that this psychiatric symptom (that has been interpreted psychodynamically for many years) can have an organic basis, which should be studied.

Keywords:
Capgras syndrome; cerebrovascular lesion; extracorporeal membrane oxygenation (ECMO); illusion of doubles; periodic lateralized epileptiform discharge (PLED)