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Visualizing “Demonic” Facial Distortions: A Rare Case Of PMO

Victor Sharrah, a 59-year-old resident of Clarksville, Tennessee, had always taken pride in his sharp eyesight. However, his world suddenly turned eerie when he woke up one day feeling as if he had entered a realm inhabited by demons. He recalls, "First thought: I must have woken up in a demon world. You can’t imagine. I was that scared." This terrifying experience marked the onset of a rare neurological condition known as prosopometamorphopsia (PMO). PMO alters how individuals perceive facial features, distorting their shape, size, texture, or color. It's quite uncommon, with fewer than 100 reported cases worldwide.


For Sharrah, the faces of those around him looked unnaturally stretched, with ears, noses, and mouths twisted and deep creases in their skin. He found it impossible to recognize his own family members, which led to a sense of isolation and fear.

What captivated researchers about Sharrah's case was the distinctive nature of his visual impairments. Unlike typical PMO patients, his distortions manifested exclusively during face-to-face encounters, remaining absent in photographic or screen representations. This peculiarity offered a unique avenue for investigation, prompting collaboration between Sharrah and Dartmouth College researchers for digitally replicating the distortions he perceived, contributing to groundbreaking research.


Sharrah’s detailed descriptions gave a glimpse of his daily experience while the team utilized sophisticated image-editing software to recreate the unsettling visages that

haunted him. The resulting images, published in The Lancet, yielded comprehension of PMO’s intricate presentations. The cause of the disorder is still a mystery. Some suggest dysfunctions within the brain's facial network as potential contributors. While certain instances correlate with conditions like cranial pain, stroke, or epilepsy, others lack discernible causative factors.


In Sharrah's case, the complexity arises from a history of carbon monoxide poisoning and severe headaches, which presented challenges for diagnosis and treatment. Scans showed a mark on the left side of his brain, hinting at cognitive problems, yet the precise correlation with PMO remains elusive to researchers. According to Dr. Antônio Mello, the leader of the study, PMO presents a variety of symptoms. Each case shows a new form of the disorder, emphasizing the intricacy and diagnostic hurdles associated with it.


Furthermore, PMO's lack of widespread recognition raises concerns about potential misattribution to mental health conditions, as noted by Dr. Brad Duchaine, urging for increased awareness to mitigate misunderstandings and offer proper support to affected individuals. Sharrah's story is characterized by resilience and determination, transitioning from initial shock and apprehension to becoming a vocal advocate, thereby illuminating the challenges and triumphs associated with rare neurological conditions like PMO.


His dedication to assisting those with PMO demonstrates the strength we possess during challenging times. As our understanding of PMO grows, there is a need to extend assistance and dispel misconceptions surrounding the disorder. Sharrah's experience serves as a beacon of hope, illustrating the transformative power of empathy and collective efforts in confronting neurological complexities. Researchers aim, as they continue to explore PMO, to instill hope in those who view the world through a different lens.

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