Delusional paralysis: an unusual variant of Cotard's syndrome

Cotard's syndrome, a highly impressive psychopathological condition, occurs mainly in depressive disorders and entails nihilistic delusions concerning the body and the non-existing of the self as outstanding features, accompanied by hypochondriacal delusions and ideas of guilt as well as immortality. We here report on a female patient presenting with an unusual variant of the syndrome: most prominently, she had the delusion to be paralysed, although displaying psychomotor agitation, and that neuroleptic agents had devoured her nerve ganglia. Upon ECT, symptoms rapidly improved. Psychopathological implications and the nosological position of Cotard's syndrome are discussed.