Delusions of a second jaw

Image from Wikipedia. Click for sourceThere’s a brief but interesting case study in the General Hospital Psychiatry journal of a patient who is described as having ‘extremely grotesque somatic delusions’.

The case was a 54-year-old man. He had no past history or family history of psychiatric disorders. His social and occupational histories were quite normal. In August of 2005, he felt that “something has stuck between under front teeth.” From September, he felt that “there is another lower jaw with teeth between the real upper jaw and real lower jaw, and there is another tongue between the false lower jaw and the real lower jaw”; “the teeth on the false lower jaw are growing steadily”; “I try to cut the false teeth off with the real teeth, but the false teeth do not stop growing”; “the false teeth melt into holes in the false lower jaw, but later grow again from those holes”; “something like spaghetti is coming into and going out from the holes” and “the false lower jaw rolls up and is coming into the throat.” Because of these annoying sensations, he had mild depressive symptoms such as depressed mood, decrease in appetite, restlessness and fatigue. Despite these symptoms, he was able to continue working.

The patient was treated with the antipsychotic drug risperidone and reportedly recovered well.

As part of his assessment he was also given a SPECT brain scan, that found reduced blood flow in the temporal and parietal lobes.

Although still not well studied, various other single case studies have found that delusions concerning body size, shape or transformation correlate with changes in parietal lobe function.

Owing to the role of the parietal lobe in maintaining our ‘body image’, it is thought that problems in this area could lead to unusual experiences of body distortion which could, in part, spark delusional beliefs.

Link to case study.
Link to PubMed entry for same.

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