Spook-tacularly Weird!

-Written by Dr. Shreyjit Kaur

‘Halloween’ (short for All Hallows Eve) is an annual celebration observed on October 31, in many Western Christian and some non-Christian countries of the world, dedicated as, “the day of the dead souls”. It is deemed to be originated from the ancient Celtic festival of ‘Samhain’ when people would light bonfires and wear costumes to ward off evil spirits and ghosts. Over the time, Halloween has evolved into a holiday dedicated to various mirthful activities and events such as festive gatherings, dressing up in themed costumes, carving jack-o-lanterns, eating treats, sweets and candies and, the most hilarious of all – trick-or-treating! 

Catering to the “medico” inside each one of us while staying true to the spirit of Halloween, let’s divulge some of the weirdest and spookiest medical conditions, known to humankind.

1. Stone Man Syndrome

Also known as fibro-dysplasia ossificans progressiva (FOP), it is an extremely rare genetic connective tissue disorder defined by the abnormal development of bone in parts of the body where bone is not normally present (heterotopic ossification), such as the ligaments, tendons, and skeletal muscles. Thus, progressively immobilizing joints and making mobility challenging or impossible. The aberrant episodic formation of bone at several soft tissue locations commonly results in stiffness, restricted mobility, and ultimately ankylosis (joint fusion) of afflicted joints (neck, back, shoulders, elbows, hips knees, wrists, ankles, jaw – often in that order).

2. Alice In Wonderland Syndrome

The term “Alice in Wonderland syndrome” (AIWS) refers to a group of symptoms characterized by an alteration of body image. In this condition, an alteration in visual perception occurs when the sizes of body components or external objects are perceived inaccurately; most prevalent at night. AIWS is linked to migraine, temporal lobe epilepsy, brain tumors, psychotropic medications, or Epstein-Barr virus infections. Furthermore, like the visual perception gets warped, so does the auditory and tactile perception.

3. Tree Man Disease

Epidermodysplasia verruciformis is a rare genetic skin disorder, also known as Lewandowsky-Lutz syndrome or tree man disease. It is characterized by the skin’s abnormal susceptibility to human papillomaviruses (HPVs) specifically HPV-5 and HPV-8.  It is characterized by the appearance of scaly macules and sometimes exuberant pseudo-tumoral papules, especially on hands and feet. The most frequently observed skin lesion is a macular rash similar to that of pityriasis versicolor associated with verrucous scaly papules. The risk of malignant transformation to squamous cell carcinoma is high.

4. Alien Hand Syndrome

Alien hand syndrome or Dr. Strangelove syndrome is a condition in which one hand is not controlled by the mind. The person loses control of the hand, which acts as if it has its own mind. The possible causes include neurosurgery (especially of corpus callosum), brain tumors, aneurysms, degenerative diseases of the brain and uncommonly stroke. The alien hand may exhibit self-groping and self-oppositional behavior. There has also been documented autocriticism, with the subject slapping the alien hand with the normal hand. The person loses control of the affected hand, as if it were under the command of an external force. The alien hand may grab onto things, forcing the person to use the other limb to free the objects. In extreme cases, the alien hand has been reported to even suffocate the patient!

5. Cotard Delusion

Walking corpse syndrome or Cotard’s syndrome is a rare neuropsychiatric condition that manifests in the patients as nihilistic delusions ranging from denial of the existence of body parts to negation of self-existence or firm belief that their body parts are putrefying. Various neurological conditions associated with this have been described e.g., migraines, subdural hemorrhage, cerebral atrophy, cerebral arterio-venous malformation, multiple sclerosis, cerebral infarction, encephalopathy, brain injury etc.

6. Parry–Romberg Syndrome

Progressive hemifacial atrophy, often known as Parry-Romberg Syndrome, is a rare and poorly understood degenerative disorder. It is characterized by a gradual and progressive atrophy of the unilateral facial tissues including bones, muscles, subcutaneous tissue and skin. A sharply marked line between normal and abnormal skin forms, known as coup de sabre. Alopecia and pigmentation of the affected skin are also common. Other notable symptoms of this condition include enophthalmy, deviation of the mouth and nose to the affected side, and unilateral exposition of teeth when the lips are damaged.

7. Morgellons Disease

Morgellons disease (MD) is a dermatological condition marked by the presence of multicolored filaments that lie beneath, are lodged in, or protrude through the skin. A strong association with psychiatric disorders has also been proposed such as bipolar affective disorder, schizophrenia, obsessive-compulsive disorder, and depression. There has been much controversy surrounding this disorder with some describing it as a form of delusional mental illness, and the other as an underlying spirochetal infection causing a filamentous dermopathy. However, most dermatologists believe Morgellons disease is a psychiatric condition, similar to delusional parasitosis, and is caused by compulsive skin picking.

8. Cancrum oris

Noma or cancrum oris is a mutilating necrotizing disease with an unknown etiology; however, it is widely accepted to be caused predominantly by a poly-bacterial infection with subsequent ischemia. The resulting necrotizing fasciitis, myonecrosis, and osteonecrosis destroy facial structures, resulting in significant functional disability and disfigurement. It primarily affects children, particularly those in Sub-Saharan Africa who are malnourished or debilitated by the systemic diseases such as measles, tuberculosis, malaria and even HIV infection.

9. Werewolf Syndrome

Hypertrichosis, also known as werewolf syndrome, is a rare condition characterized by excessive growth of hair anywhere on a person’s body affecting both males and females. The abnormal hair growth may cover the face and body or even occur in small patches. Hypertrichosis can be present at birth or even develop over time.

10. Exploding Head Syndrome

Exploding head syndrome (EHS) is a benign parasomnia defined by the perception of a sudden, loud sound while asleep, resulting in a sudden and frightening arousal. This generally occur during the wake-sleep/sleep-wake transition period and lasts less than a second. The most commonly described sounds include explosions, gunshots, thunder etc. but it may be any loud noise. Although no significant pain is associated with the experience but it can be nonetheless quite frightening.

Finally, wrapping up the list with a special mention – Stendhal syndrome:

It is a psychosomatic condition involving symptoms such as fatigue, palpitations, spells of dizziness, confusion, disorientation, loss of identity and even hallucinations, allegedly occurring when certain individuals of sensitive nature and impressionable personality (and overburdened with the stress of travel) become exposed to objects, artworks, architecture or phenomena of great beauty and antiquity! 

That’s all Folks! Happy Halloween!

References:

1. www.rarediseases.org/rare-diseases/fibrodysplasia-ossificans-progressiva
2. Weissenstein A, Luchter E, Bittmann MA. Alice in Wonderland syndrome: A rare neurological manifestation with microscopy in a 6-year-old child. J Pediatr Neurosci. 2014 Sep-Dec;9(3):303-4. doi: 10.4103/1817-1745.147612. PMID: 25624952; PMCID: PMC4302569.
3. Agharbi FZ. Epidermodysplasie verruciforme: à propos d’un cas [Epidermodysplasia verruciformis: about a case]. Pan Afr Med J. 2018 May 29;30:78. French. doi: 10.11604/pamj.2018.30.78.16058. PMID: 30344862; PMCID: PMC6191268.
4. Panikkath R, Panikkath D, Mojumder D, Nugent K. The alien hand syndrome. Proc (Bayl Univ Med Cent). 2014 Jul;27(3):219-20. doi: 10.1080/08998280.2014.11929115. PMID: 24982566; PMCID: PMC4059570.
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6. Deshingkar SA, Barpande SR, Bhavthankar JD, Humbe JG. Progressive hemifacial atrophy (Parry-Romberg Syndrome). Contemp Clin Dent. 2012 Apr;3(Suppl 1):S78-81. doi: 10.4103/0976-237X.95111. PMID: 22629073; PMCID: PMC3354790.
7. www.dermnetnz.org/topics/morgellons-disease
8. Feller L, Khammissa RAG, Altini M, Lemmer J. Noma (cancrum oris): An unresolved global challenge. Periodontol 2000. 2019 Jun;80(1):189-199. doi: 10.1111/prd.12275. PMID: 31090145; PMCID: PMC7328761.
9. www.healthline.com/health/hypertrichosis
10. Khan I, Slowik JM. Exploding Head Syndrome. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560817/
11. Bamforth I. Stendhal’s Syndrome. Br J Gen Pract. 2010 Dec 1;60(581):945–6. doi: 10.3399/bjgp10X544780. PMCID: PMC2991758.