Mirrored Self-Misidentification Syndrome: A Systematic Review of Cases

Area of Science:

• Neuroscience
• Psychiatry
• Geriatrics

Background:

• Mirrored self-misidentification syndrome (MSMS) is a rare condition where individuals cannot recognize their own reflection.
• It is a type of delusional misidentification syndrome, often associated with underlying neurological or psychiatric conditions.

Purpose of the Study:

• To systematically review the epidemiology, clinical presentation, and management of MSMS.
• To identify potential pathophysiological mechanisms and contributing factors.

Main Methods:

• A comprehensive literature search of case reports and series on MSMS.
• Univariate analyses of patient demographics, clinical, paraclinical, and treatment data.
• Evaluation of the methodological quality of included studies.

Main Results:

• 36 patients from 28 articles were analyzed; median age was 77 years, predominantly female (60.7%).
• Over half had dementia (Alzheimer's, Lewy Body, vascular); other diagnoses included stroke and schizophrenia.
• Right hemisphere dysfunction was noted in 45.1% of brain MRIs; both pharmacological and non-pharmacological interventions showed some efficacy.

Conclusions:

• MSMS is rare and frequently presents in patients with dementia.
• Frontal and right hemisphere dysfunctions are implicated in MSMS pathophysiology.
• Findings support the concept of a "neuroanatomy of the self" localized in the non-dominant hemisphere.