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Case Reports: Unusual presentation of more common disease/injury
Déjà vécu with recollective confabulation: an unusual presentation of Alzheimer’s disease
  1. Xin Zhang1,2,
  2. Nora Breen3 and
  3. Kaitlyn Parratt1
  1. 1Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  2. 2National Hospital of Neurology and Neurosurgery, University College London Hospitals, London, UK
  3. 3Macquarie University Hospital, Macquarie University, Sydney, New South Wales, Australia
  1. Correspondence to Dr Xin Zhang; x.zhang2{at}nhs.net

Abstract

A man in his 80s presented with gradual onset of a persistent and delusion-like perception that novel encounters are repetitions of previous experiences. Within 2 years of symptom onset, he had impaired verbal memory and executive dysfunction on neuropsychological assessment. Cerebrospinal fluid core Alzheimer’s disease (AD) biomarkers analysis supported probable AD. Generalised and left temporal atrophy was seen on MRI of the brain. Neurological fludeoxyglucose-positron emission tomography (PET)/CT showed left temporal and bilateral frontal lobe hypometabolism. His presenting symptom is known as déjà vécu with recollective confabulation, a rare phenomenon associated with AD and other neurodegenerative disorders. While several potential mechanisms have been previously proposed, the fludeoxyglucose-PET/CT hypometabolism in the temporal and frontal lobes in this case suggests dual deficits in recognition memory and metacognition may be culprit mechanisms. Although uncommon, déjà vécu with recollective confabulation is a fascinating phenomenon that can provide a unique insight into memory and delusional processes in dementia.

  • Memory Disorders
  • Dementia, Alzheimer's type

https://doi.org/10.1136/bcr-2023-255411

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—XZ, NB and KP. The following authors gave final approval of the manuscript—XZ, NB and KP.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.