What people with demon face syndrome see

Understanding Demon Face Syndrome

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In March 2024, several prominent news organizations covered the story of Victor Sarrah, a 58 year old man from Tennessee who has a rare condition called demon face syndrome. Experts estimate that fewer than 100 people throughout the world have this disorder, which affects their ability to accurately perceive other people’s faces.

What is Demon Face Syndrome?

The first thing to know about demon face syndrome is that clinicians don’t use that term (not officially, at least). The clinical name of demon face syndrome is prosopometamorphopsia.

The second thing to know is, contrary to what the “demon face” descriptor suggests, prosopometamorphopsia doesn’t affect the appearance of people who have it. Instead, when someone who has this condition looks at other people, their facial features appear to be distorted, often taking on characteristics that some would describe as “demonic.”

According to a review that appeared in the June 2021 edition of the journal Cortex, there have been 81 documented cases of what we now call demon face syndrome over the past 100 years. That review also revealed the following about this condition:

  • British neurologist MacDonald Critchley is credited with creating the term prosopometamorphopsia in 1953.
  • The earliest recorded description of a patient who has what would be diagnosed today as demon face syndrome is from 1904.
  • Of the 81 documented cases of demon face syndrome, 52 (64%) involved women, 28 (35%) involved men, and one involved a patient whose gender was not recorded.
  • The youngest person to have a documented case of prosopometamorphopsia was 14 and the oldest was 94. The mean age of patients whose cases are recorded is 49.
  • For 74 of the 81 patients (92% of the group), the only distortions they experienced involved faces of other people. The other seven patients reported a variety of additional visual distortions, including seeing colors, seeing no colors, and seeing oddly shaped hands or other body parts.

Demon face syndrome is sometimes a symptom of another rare and oddly named condition, Alice in Wonderland Syndrome (AIWS). Experts have found records of 169 cases of AIWS, which is also referred to as Todd’s syndrome or dysmetropsia.

In addition to prosopometamorphopsia, other visual distortions that are symptomatic of AIWS include:

  • Seeing people or objects as either much larger or much smaller than they really are
  • Perceiving body parts as either too large or too small
  • Sensing that things are much closer or farther away than they actually are 
  • Perceiving sounds as either louder or softer than they are
  • Feeling that time is passing much quicker or slower than it is

AIWS got its name because these symptoms are akin to some of the bizarre fictional experiences described by Lewis Carroll in his classic children’s novel, Alice in Wonderland.

What is Having Demon Face Syndrome Like?

In a March 2024 CNN article, Sharrah said that his demon face syndrome symptoms came on suddenly one afternoon while he was sitting on the couch. 

When his roommate and his roommate’s girlfriend entered the room, they appeared to have elongated eyes, scar-like lines on their faces, and ears that ended in points.

“For me the basic distortions are the same for each person, with the lines in the face, the stretching of the eyes and the mouth, and the pointy ears,” he told CNN. “But the size and shape of a person’s face or head and how they move can be different and change just how distorted they might be.”

In a May 11, 2024, article on the website Slate, Illinois resident Maggie McCart described her experience with demon face syndrome in the following terms:

  • “The skin texture on a face [that I’m looking at] can change, or their noses or eyes seem to be stretched and exaggerated in grotesque, plastic-y ways.”
  • “Sometimes a person’s face and mouth are replaced by geometric shapes – triangles, hexagons, and so on.”
  • “I’ve had faces appear to be made of potato skin, or tree bark, like the talking apple trees in Wizard of Oz.”
  • “I’ll never forget that time I looked at a manager, and he gazed back at me with – no joke – the head of a dragon, complete with matte, black skin.”

As terrifying as these examples might sound, McCart told writer Luke Winkie that she doesn’t allow the condition to cause her undue distress anymore.

“I’m used to it. I’ve made peace with it,” she said in the Slate article. “Yes, when I first saw that dragon it was truly terrifying. … But now I’m able to relax, take a deep breath, remember that it’s just my stupid brain acting up.”

What Causes Demon Face Syndrome?

Experts aren’t entirely sure what causes demon face syndrome, but they theorize that the following factors could be involved:

  • Brain injuries
  • Stroke
  • Lesions or cysts in the brain
  • Seizures
  • Migraines

Brad Duchaine, a professor of psychological and brain sciences at Dartmouth College, told Scientific American that most reports of people with demon face syndrome include references to brain damage. However, he cautioned, the limited number of patients who have received care for this condition may be preventing researchers from developing a more complete list of risk factors.

“I think that might be because that’s who’s showing up in neurological clinics,” he said, “whereas we’re hearing from people through the Internet, and very few of them are aware of any brain damage that coincided with the onset of their distortions.”

Treatment for Demon Face Syndrome

The best treatment for someone who has demon face syndrome can vary depending on what caused the onset of symptoms. 

In the same Scientific American article that we referenced in the previous section, clinical psychopathology professor Jan Dirk Blom said that tests such as magnetic resonance imaging (MRIs), electroencephalograms (EEGs), and bloodwork are necessary precursors to developing a treatment plan.

“Depending on what we find – for example, epilepsy, a brain infarction, a cerebral cyst, etc. – we apply practice-based guidelines for treatment purposes,” he said. “In other words, there is not one specific type of drug that we consider effective for all cases.”

Contact Montare Behavioral Health About Our Treatment Options

If you have been affected by hallucinations, dissociation, or other distressing perceptual distortions, Montare Behavioral Health may be able to help.

Our network of mental health treatment centers in Southern California offers a full continuum of services for adults who have been experiencing psychotic symptoms. 

If we determine that your struggles are related to a mental health concern, we can develop a customized plan to help you manage your symptoms and achieve improved quality of life. If your assessment indicates that a medical or neurological cause may be to blame, we can refer you to a trusted provider in the area. 

To learn more or to schedule a free assessment, please visit our Contact page or call us today.