The pathophysiology and appropriate pharmacological interventions for delusional parasitosis (DP) remain unknown. Here, we present a case of DP following brain infarction of the right temporoparietal region. Pharmacotherapy with risperidone resulted in a dramatic therapeutic response over a short period. In a sequential N-isopropyl-p-[(123)I]-iodoamphetamine single photon emission computed tomography ([(123)I]-IMP SPECT) study, post-treatment SPECT images revealed a marked increase of rCBF in the large areas including the bilateral frontal and left temporoparietal regions, the right parietal operculum and the bilateral basal ganglia, in contrast to pre-treatment SPECT images showing a global decrease of rCBF. Our clinical outcome suggests the efficacy and safety of risperidone for treatment of DP and that both dopaminergic and serotonergic dysfunction may play a role in DP. Our sequential SPECT findings suggest that psychiatric improvement of DP is associated with increased rCBF.
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Delusional parasitosis (Ekbom's syndrome).
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Chronic pruritus accounts for approximately 1 % of all physician visits, and providers are often confronted with how to treat patients with pruritus. Scabies is oftentimes a concern by both patients and providers, and anti-scabietic treatments are generally considered safe and effective. However, the pruritus will continue if there is an alternate etiology.
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Article Synopsis
- Ekbom's syndrome, or delusional parasitosis, is a rare psychiatric disorder characterized by a strong belief in having an infestation without hallucinations or major thought issues.
- It has two forms: primary, which features delusions and unusual sensations, and secondary, caused by an underlying health issue.
- A case study shows that atypical antipsychotics like aripiprazole and brexpiprazole can effectively treat primary Ekbom's syndrome, with brexpiprazole potentially causing fewer side effects like tremors.
Article Synopsis
- Delusional parasitosis is a psychotic disorder where individuals believe they are infested with parasites, while shared paranoid disorder (folie à deux) occurs when two closely related people share similar delusions.
- A case study involving a married couple revealed that the husband experienced sensations and beliefs about parasites, leading to the wife also developing similar symptoms, indicating a shared delusion.
- Treatment included medications like sertraline and risperidone, but due to side effects and financial constraints, the husband's condition required adjustments, and separating the couple's sleeping arrangements significantly alleviated the wife's symptoms.
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