Department of Occupational Therapy, School of Health Science, Shinshu University School of Medicine, Matsumoto, Japan.
Psychosomatics. 2009 Sep-Oct;50(5):534-7. doi: 10.1176/appi.psy.50.5.534.
Delusional parasitosis is an uncommon psychiatric condition in which patients have the immutable conviction that small, living organisms, such as worms, insects, or larvae infest their skin or other organs.
OBJECTIVE/METHOD: The authors describe a case of an unusual association of delusional parasitosis and thalamic pain syndrome after left-posterior thalamic hemorrhage. The patient initially suffered from dysesthesia and burning pain typical of thalamic pain syndrome and subsequently developed delusional oral parasitosis ("worms" infesting her mouth).
Sulpiride 100 mg/day administered in addition to amitriptyline gradually improved her delusions within 3 months.
The authors speculate that this specific type of delusion can be elicited by the disruption of the somatosensory pathway and that the subsequent cortical sensory deafferentiation and reorganization arising from this disruption may contribute to the development of delusional parasitosis.
妄想性寄生虫病是一种罕见的精神疾病，患者坚信有小的活体生物，如蠕虫、昆虫或幼虫寄生在他们的皮肤或其他器官上。
目的/方法：作者描述了一例左丘脑后出血后妄想性寄生虫病和丘脑痛综合征的不寻常关联。患者最初患有丘脑痛综合征的感觉异常和灼痛，随后出现妄想性口腔寄生虫病（“虫子”寄生在她的口腔中）。
在阿米替林的基础上加用舒必利 100mg/天，3 个月内逐渐改善了她的妄想。
作者推测，这种特定类型的妄想可能是由于躯体感觉通路的中断引起的，而由此产生的皮质感觉去传入和重组可能有助于妄想性寄生虫病的发展。
