Delusion of oral parasitosis and thalamic pain syndrome.
BACKGROUND
Delusional parasitosis is an uncommon psychiatric condition in which patients have the immutable conviction that small, living organisms, such as worms, insects, or larvae infest their skin or other organs.


OBJECTIVE
The authors describe a case of an unusual association of delusional parasitosis and thalamic pain syndrome after left-posterior thalamic hemorrhage. The patient initially suffered from dysesthesia and burning pain typical of thalamic pain syndrome and subsequently developed delusional oral parasitosis ("worms" infesting her mouth).


RESULTS
Sulpiride 100 mg/day administered in addition to amitriptyline gradually improved her delusions within 3 months.


CONCLUSIONS
The authors speculate that this specific type of delusion can be elicited by the disruption of the somatosensory pathway and that the subsequent cortical sensory deafferentiation and reorganization arising from this disruption may contribute to the development of delusional parasitosis.
Hanihara
Tokiji
T
Department of Occupational Therapy, School of Health Science, Shinshu University School of Medicine, Matsumoto, Japan. qhaniha@shinshu-u.ac
Takahashi
Tohru
T
Washizuka
Shinsuke
S
Ogihara
Tomomi
T
Kobayashi
Miyuki
M
D000818:Animals; D003702:Delusions / Q000175:diagnosis / Q000523:psychology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010272:Parasitic Diseases / Q000175:diagnosis / Q000523:psychology*; D020521:Stroke / Q000523:psychology; D013577:Syndrome; D014057:Tomography, X-Ray Computed