Health. What is prosopometamorphopsia, which makes you see demonic faces?

Health.  What is prosopometamorphopsia, which makes you see demonic faces?

One morning in 2020, when Victor Sharrah woke up, he thought he was going crazy: he saw his roommate with pointy ears, gigantic eyes and a mouth cut to the edges of his face. Trying to keep calm, this 58-year-old man went to walk his dog, before seeing passers-by with equally distorted faces.

“My first thought was that I had woken up in a world of demons,” he testifies by telephone from his home in Tennessee (United States). “I started to panic” and to think that “I was going to be interned in psychiatry”, rewinds this chef.

A very disabling visual disorder

In fact, Victor Sharrah has not “totally lost his mind”, he suffers from an extremely rare visual disorder, called prosopometamorphopsia (PMO), which distorts faces without preventing their recognition. A study was published last week in the very serious medical journal The Lancet.

If Victor Sharrah sees demonic-looking faces, others perceive elf-like features, explains Antonio Mello, specialist researcher at PMO. Some see one half of the face underneath the other, others see purple or green faces, or faces in constant motion. Sometimes the disease manifests itself for only a few days. More than three years later, Victor Sharrah still suffers from it.

Features of elves, faces of demons…

Antonio Mello and other researchers from Darthmouth College (United States) succeeded in creating the first images, almost as realistic as photos, representing the perception of faces by people with PMO, they explained in the study published Friday.

To create these images, researchers asked Victor Sharrah to compare photos of Antonio Mello and another person’s face on a computer screen with the distortions he could see in their real faces. Because in two dimensions, on screen or on paper, Victor Sharrah normally sees faces. It is only in three dimensions that they take on demonic appearances.

Unknown causes

The exact cause of this disorder is unknown. Jason Barton, a neurologist at the University of British Columbia, was not involved in the study, but he said it is “a symptom” with multiple causes. In the majority of cases studied by this researcher, “something happened in the brain correlated with this abnormal experience”

Victor Sharrah has a brain injury, the result of an injury when he worked as a truck driver in 2007.
But it would not be linked to his disorder, according to Antonio Mello, because MRI images located his lesion in the hippocampus, a part of the brain “not associated with the image processing network”.

75 cases recorded

Approximately seventy-five cases of prosopometamorphopsia have been reported to date in the scientific literature. But the researchers’ laboratory has been contacted by more than 70 patients over the past three years. And the disorder’s terrifying symptoms mean it is often misdiagnosed as schizophrenia or psychosis, according to Antonio Mello.

Victor Sharrah only discovered PMO after sharing his experience in a virtual support group for bipolar people. It was a huge relief: “It meant I wasn’t psychotic.” The American adapted to his strange world in three years, but sometimes, in a place like a supermarket, the crowd of demons still seems “overwhelming” to him.

Often kept secret…

Many patients, who know their vision is distorted, wonder whether they should reveal their perceptions to others, at the risk of appearing crazy. Antonio Mello thus spoke of a man who, for years, had not admitted to his wife that his face appeared distorted to her.

Victor Sharrah chose to share his experience so that others avoid hospitalization for psychosis, but also the trauma he felt.

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