Reduplicative paramnesia

Perhaps the delusion that is most pathognomonic of brain injury, and which is also associated with postictal confusional states, is reduplicative paramnesia. The term reduplicative paramnesia covers a range of phenomena, which are often observed concurrently. Pick (42>, who introduced the term, used it to describe a patient who believed she had visited a duplicate hospital. Other phenomena covered by the term include the following:

• any delusion involving duplication, for example that events have been duplicated or that the patient has a second left leg

• delusions involving misidentification of place, with or without duplication, including delusional disorientation for place.

Delusional disorientation for place may involve the belief that the current location is a duplicate of the true location or in some way displaced, for example that the hospital is in a different country. The patient may have two incompatible attitudes to orientation; this is sometimes referred to as a double orientation. For example, a patient who lives in Edinburgh acknowledges that he is in a hospital in London, but says that his home is just a few yards down the road.

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