Event-related potentials as an index of lost cognitive control and lost self in a TBI patient with duration increasing post-traumatic Delusional Misidentification Syndrome concluded with Cotard Syndrome

The goal of the study was twofold: 1) to evaluate the QEEG/ ERPs indexes of functional brain impairment in a TBI patient diagnosed with chronic lost cognitive control and lost self caused by post traumatic, and here increasing over time, delusional misidentification syndrome concluded with Cotard syndrome in the blooming stage, with nihilistic delusions concerning the body and existence, and the delusion of being dead, and 2) to explore the mind of a patient whose identity has been disengaged, and who experiences the loss of his self and relations with his immediate surroundings with all the tragic consequences that entails. I herein present a 52-year-old patient, who – after a serious head injury due to a car accident 20 years ago, which re- sulted in focal injuries in the frontal and temporal areas of the right hemisphere – developed Cotard syndrome. After arousal from a 63-day coma and 98 days of post-traumatic amnesia, he manifested: (1) the loss of autobiographical memory, (2) a lost self, (3) forgotten family ties (including his lover). The study revealed that the patient’s cognitive control system is completely destroyed: no cognitive components have been found. Recall from memory has been completely disturbed (a low amplitude of N170). The two hemispheres work inco- herently with the right hemisphere revealing a serious delay in memory recall.