Imagine if one day, a demon walked through your house. You might be more than a little concerned.
Yet that is exactly what happened to Victor Sharrah three years ago when his flatmate suddenly developed a ‘demon face’, with wide, stretched eyes, a distended mouth, pointed ears and deep grooves across his cheeks and brow.
The problem however, wasn’t with the flatmate.
Victor had developed a rare condition called prosopometamorphopsia (PMO), which causes the brain to turn regular faces into ‘demonic’ ones.
‘I thought, “What the hell did I just see?”,’ said Victor, 59, from Clarksville in Tennessee. ‘It was like something out of a Star Trek movie, like a demon face.’
Victor left the flat to walk his dog, and noticed everyone around him had the same distorted face.
‘I was really freaking out at that point,’ said the former truck driver. ‘I was going to go have myself committed.’
However, Victor first posted about his experiences in an online support forum for those with bipolar disorder, which he has a history of, and an expert quickly spotted the signs of PMO.
‘She explained that I hadn’t lost my mind or need to be committed,’ said Victor, speaking to The Times.
The chance online encounter is perhaps incredibly lucky for Victor, given there have only been 75 cases of PMO ever recorded. His case is particularly intriguing given it does not affect faces seen on screen, only in real life, allowing researchers at Dartmouth to create accurate visualisations of what Victor is seeing.
Lead author Antônio Mello said: ‘In other studies of the condition, patients with PMO are unable to assess how accurately a visualisation of their distortions represents what they see because the visualization itself also depicts a face, so the patients will perceive distortions on it too.’
But in Victor’s case, researchers were able to modify the face on screen to match the face he saw in real life – and show just how alarming the condition is. The condition is ‘much more traumatic than the pictures can convey’, said Victor.
The condition can arise from a head injury, but also ischemic strokes – those caused by a temporary restriction of blood flow to an area of the brain – migraines and epilepsy.
In Victor, it may have been caused by a head injury sustained in 2007 while working, but he also suffered possible carbon monoxide poisoning four months before his flatmate turned demonic.
And while for some the symptoms last only a few days or weeks, they can last for years.
Seeing dragons
Those with prosopometamorphopsia may not always see demons. In one case, a woman had spent her entire life watching human faces morph into dragons.
Writing in the Lancet, researchers said: ‘She could perceive and recognise actual faces, but after several minutes they turned black, grew long, pointy ears and a protruding snout, and displayed a reptiloid skin and huge eyes in bright yellow, green, blue, or red.
‘She saw similar dragon-like faces drifting towards her many times a day from the walls, electrical sockets, or the computer screen, in both the presence and absence of face-like patterns, and at night she saw many dragon-like faces in the dark.’
The team was able to find the right medication to keep the visions under control.
The condition affects a region of the brain called the fusiform face area (FFA), which manages facial recognition. A more common issue is that of ‘face blindness’, or prosopagnosia, in which sufferers have difficulty recognising other people’s faces.
In PMO, the brain distorts the image as it processes it.
The Dartmouth team is keen to increase public awareness about the condition – and help ensure it is properly diagnosed.
Senior author Dr Brad Duchaine said: ‘We’ve heard from multiple people with PMO that they have been diagnosed by psychiatrists as having schizophrenia and put on anti-psychotics, when their condition is a problem with the visual system.
‘And it’s not uncommon for people who have PMO to not tell others about their problem with face perception because they fear others will think the distortions are a sign of a psychiatric disorder.
“It’s a problem that people often don’t understand.”
The study is published in the Lancet.
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