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A Medical Quiz of Halloween Horrors – Can you decipher the paranormal ?

Movies, folk lore & tales of horror have fascinated mankind forever. I woke up one night around 2 AM to use the restroom. After I laid down again to go back to sleep, a few minutes later I heard a giggle of a little child in the dark 😨 – which absolutely scared the living hell outta me. I jumped out of my bed, turned the lights on and saw…. an empty room. That night my lights stayed on for for the rest of the night. Maybe it was just a auditory hypnagogic hallucination ?

Does every paranormal experience have a medical or physiologic basis ? Try out this spooky little quiz to test your knowledge of medical basis of ghosts & other unspeakable horrors…. 👻

#1. Werewolves are a common theme of horror movies. When a person thinks he is a wolf and shows wolf like behavior - what is the condition called ?

The famous case of Austin Harouff in Florida recently had highlighted the condition of Clinical Lyncanthropy , a psychotic condition where a person believes he or she has transformed into an animal, and behave accordingly – often a wolf historically, although the type of animal may depend on the local culture. Now thought to be a type of Schizophrenia or bipolar disorder, it is treated with antipsychotics and antidepressants Click here for more interesting reading regarding this.

#2. 35 year old nurse Nathan works long hours & has insomnia. He reads the bible at bedtime & drinks a little wine to help him sleep. In the last 4 weeks he has woken up 5 times to a terrifying demonic presence in his room. When this happens he cannot move, but can look around. He often sees a scary person standing in his room staring at him. He tries to shout but can't, so instead he just closes his eyes shut & hope this 'demon' leaves him alone. Eventually he wakes up normally but very scared from the experience. What condition is this ?

Sleep paralysis is a scary symptom, considered a sleep disorder where a person wakes up in the middle of Rapid Eye Movement (REM) sleep cycle. During REM sleep cycle, we are actively dreaming and our bodies are natually rendered paralyzed  for our own safety so that we don’t act out our dreams, except for our eyes. In the early morning as we are trying to transition back to wakefulness, in some people (due to stress, poor sleep habits, alcohol, some meds, etc. )  the REM cycle and Wakefulness stage can intercept and and result in a awake mind but body still paralyzed from their dream state.

Click here for a good explanation

#3. 60 year old Melanie complains of her house being haunted, hears objects creak & move, feels someone is watching her from the dark corners behind doors and her backyard at night. She feels targeted since she always tends to get sick with colds, cuts and accidents at home. She has felt a "presence" in this house since she moved in 2 years ago, had similar experiences in her last house. Her two daughters have had similar experiences. She grew up listening to ghost stores in her family , she loves going to church

Haunted Person syndrome (HPS) is formally recognized in the world of psychology and is gaining traction as the research advances. Not recognized as a Medical illness as such. People who grow up with certain beliefs (that can run culturally in their society and family) can project their beliefs on everyday occurrences to explain various things and this reinforces their beliefs as things happen. For example they view every new accident or personal sickness they suffer, even if years apart, as a chain of events caused by an external entity which otherwise we might not think much of.  In a family, the inclination to believe and see normal occurrences in the light of the paranormal can rub off to other family members and corroborate and strengthen each others beliefs.

This case report analysis is a fascinating read on understanding Haunted Person syndrome. Psychological tools now exist , such as the Revised Paranormal Beliefs scale, to quantify the probability of feeling ‘haunted’

Not a Conversion disorder – these are acute physical manifestation of a disease without an organic disease

Not Schizophrenia: There can be a thin red line between Schizophrenia & HPS initially, but Schizophrenia is pathological which results in decreased functioning and mental isolation of the patient and paranoia and hallucinations

Not a Ghost Sickness , which is seen in certain cultures after a close family member or friend passes away

 

#4. Which disease is associated with the myth of vampires ?

#5. Lydia brings her 58 year old mother Rhonda to see you in urgent care. "She is seeing dead people". Intrigued you ask Rhonda more. She says "I died 6 months ago, everyone around me must be dead". She has been bed-ridden for a month saying her legs have died. She stopped eating since 2 days. "My stomach is dead & rotting away". 6 months ago she was the lone survivor of a car accident where she lost her husband, sister, brother-in-law & a nephew. Before the accident she had mild depression & took Fluoxetine daily, now quit taking that. She has otherwise been healthy. What is this condition called ?

Cotard syndrome or “Walking Corpse Syndrome” is a delusional disorder where the patient believes that a part of whole of them is dead or doesn’t exist. This is thought to be a manifestation of severe depression which can be triggered by a stressful event and can even take on delusions and psychotic features. This can be treated with anti-depressants, anti-psychotics . ECT can be helpful if a result of severe depression.  Acylovir and Valacyclovir toxicity in renal failure can sometimes present with this and is treated with dialysis.

Here’s a interesting case report of Cotard Syndrome 

#6. 14 year old Anita, a popular cheerleader kid in a school in a poor neighborhood had a rough childhood with divorced parents and an alcoholic dad. She snuck into a theater with her BFF on Halloween week & watched the scary clown movie "IT". She was so spooked she couldn't sleep at night. The scene of the clown biting off the first kid's arm kept playing in her mind. Next day she & her friend were unusually quiet. They described the movie & scene in great detail to their classmates during recess. Later when she complained of pain & numbness in her hand, teacher had her sent to Urgent care to see you. In the following days, 10 more kids complained of pain & numbness in one or both hands. What is going on ?

Mass Psychogenic Illness or Mass Hysteria is an incompletely understood phenomenon but is increased thought to be a type of conversion disorder. A somatic manifestation of inward stress triggered by a event, and if occurs in someone that a group looks up to or is popular and feel connected, it can ‘spread’ to others in a group.

A notable case happened in Le Roy, NY in 2011, makes for a fascinating read on a more detailed story on NY times 

Another interesting example is the June Bug Outbreak 

Finish

Results

Oh my ! Smartypants !

Are you watching too many horror movies ?

P.S: Enjoy this clip for TV Series ‘Evil’ about ‘Sleep Demons’

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