Seth Gordon (sethg_prime) wrote in little_details,
Seth Gordon

stroke leading to Capgras (“impostor”) delusion

Setting: [Alternate universe version of] present-day northeastern United States

A character in my WIP is a sixty-something-year-old woman who gets a right-hemisphere stroke leading to the Capgras delusion (she believes that her loved ones have been replaced by impostors). Her relatives want to believe that after a year or so of rehab, this woman will not just get over that specific delusion, but be able to resume the work and family responsibilities she had before the stroke. Her nephew, a neurologist, could spin a plausible-to-a-layman story about how this might happen, but in his heart he knows that his aunt’s mental disability is permanent; she might recover enough to feed and dress herself and so forth, but never enough that, for example, she could be trusted to manage someone else’s investments.

I know that brain damage is not tidy enough to give someone one particular picturesque syndrome and leave everything else alone, so I would like to know what other physical/mental/emotional changes someone with this level of dysfunction might have, and how much they would be alleviated after a few weeks or a few months of treatment. Also, I would like to know roughly what the “yes she can recover” and “no this is permanent” arguments would look like. (Imagine a court hearing with duelling expert witnesses.)

I have Googled terms like “Capgras syndrome prognosis” and “right hemisphere stroke prognosis” and the main things that I learned were (a) lots of things can cause the Capgras delusion, and (b) the effects and prognoses for strokes can be all over the map. I found the NIH Stroke Scale and similar metrics, but it looks like when people talk about how those metrics correlate with prognosis, they are talking about prognosis over a term of a few months rather than years.

Thanks in advance.
Tags: ~medicine: illnesses to order, ~psychology & psychiatry (misc)

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