Extremely rare syndrome causes people to see demon faces

For the first time, scientists have recreated what patients with prosopometamorphopsia (PMO) syndrome see when looking at other people's faces.

The disfigured face Sharrah saw when she looked at people. Photo: Antônio Mello — The disfigured face Sharrah saw when she looked at people. Photo: *Antônio Mello*

One winter morning three years ago, Victor Sharrah woke up to see his roommate going into the bathroom. However, when Sharrah looked at his friend's face, he was horrified by the stretched lines that resembled a "demon face." In Sharrah's eyes, his friend's mouth and eyes were stretched out, his ears were pointed, and there were deep wrinkles on his forehead. In fact, his friend's face had not changed at all; instead, a syndrome had changed the way Sharrah saw it. He was extremely scared because the same thing happened when he looked at other people's faces.

"I tried to explain to my roommate what I saw and he thought I was crazy," Sharrah shared. "Imagine waking up one morning and suddenly everyone in the world looks like a character from a horror movie."

Sharrah, now 59 and living in Clarksville, Tennessee, was diagnosed with prosopometamorphopsia (PMO), an extremely rare neurological disorder that causes people's faces to appear distorted. Fewer than 100 cases have been reported since 1904, and many doctors have never heard of the condition. But Sharrah's case could raise awareness of the mysterious syndrome and provide insight into the lives of people with PMO. For the first time, researchers were able to create a digital simulation of what a distorted face looks like for someone like Sharrah with PMO, and published their findings in The Lancet on March 23, according to Smithsonian .

Faces only distorted when Sharrah looked at people in person. When he looked at faces in photographs or on a computer screen, the images appeared completely normal. This discrepancy allowed the researchers to use photo-editing software to recreate what Sharrah saw. They did this by showing Sharrah a photo of a person’s face while that person stood in the room with him. As he described the differences between the photo and the real person, the team adjusted the photo until it matched Sharrah’s description.

Symptoms of PMO vary significantly from person to person. Faces can appear puffy, pale, or have odd patterns, and distinctive features can shift to different areas of the face. When viewed in a mirror, a patient’s own face can become distorted. So while the digitally altered images represent what Sharrah sees when she looks at other people’s faces, they may not match the experiences of other PMO patients. Still, the images are useful for understanding the types of distortions patients may see, says Jason Barton, a neuroscientist at the University of British Columbia in Canada, who was not involved in the study.

Doctors often confuse PMO with mental health conditions like schizophrenia or psychosis. While there is some overlap in symptoms, a big difference is that people with PMO don’t think the world is actually distorted, they’re aware that their perspective is different, says study co-author Antônio Mello, a cognitive psychologist and neuroscientist at Dartmouth College.

“Many people are reluctant to mention their symptoms because they fear that others will think the distortions are a sign of a mental disorder,” says Brad Duchaine, a psychologist and brain scientist at Dartmouth College. For many people, PMO symptoms disappear within days or weeks. But for some, like Sharrah, they can last for years.

Researchers are not sure what causes PMO, although it is suspected to result from problems in the part of the brain that processes facial images. Some patients develop PMO after suffering a stroke, an infection, a tumor, or a head injury, while others have a sudden illness that cannot be clearly explained.

For Sharrah, four months before his symptoms began, he suffered carbon monoxide poisoning. More than a decade earlier, he had suffered a serious head injury when he fell backward and hit his head on the floor. But in his case, adjusting the light to a specific green tone allowed him to see his true face.

The researchers hope the new paper will help doctors accurately diagnose PMO. They also hope the findings will help PMO patients feel less alone.

An Khang (According to Smithsonian )

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