Capgras syndrome and cognitive impairment following traumatic brain injury: case report

Background: Capgras syndrome is a type of delusional misidentification in which one believes that a person, usually a close relative, has been replaced by an exact double. It is a symptom of either a psychotic disorder or an organic disorder. Case presentation: A 52-year-old Black man presented to a psychiatry clinic with a one-week history of aggressiveness due to a feeling of unfamiliarity in his own house and a strong belief that an identical imposter had replaced his wife. These symptoms were preceded by a penetrating traumatic brain injury (TBI) two months prior, which caused the loss of his right eye. Brain MRI showed bilateral frontal lobe lesions and right globe post-traumatic enucleation. His symptoms improved with 3 mg of haloperidol twice a day, combined with 500 mg of sodium valproate twice a day, orally, after the initial trial of 1.5 mg of haloperidol twice daily produced an inadequate response. Conclusion: This case highlights the need for assessment of neuropsychiatric manifestations post-TBI and proper management to prevent complications.