This Extremely Rare Neurological Condition Makes Faces Appear Distorted or ‘Like a Demon’

For the first time, scientists have recreated what one patient suffering from prosopometamorphopsia, or PMO, sees when he looks at faces

Four panes of faces that have been distorted
These digitally edited images show how Victor Sharrah perceives faces. A. Mello et al.

One winter morning roughly three years ago, Victor Sharrah woke up and spotted his roommate walking to the bathroom. However, when Sharrah looked at his roommate’s face, he was startled to see that the man’s facial features had stretched to look like “something out of a Star Trek movie, like a demon face,” he tells the London Times’ Kaya Burgess. The corners of his mouth and eyes were pulled back, his ears were pointy and he had deep grooves in his forehead.

Nothing had actually changed about his roommate’s face—but something had shifted drastically in the way Sharrah perceived it. He was, understandably, terrified. The same thing happened when he looked at other people’s faces, too.

“I tried to explain to my roommate what I was seeing, and he thought I was nuts,” Sharrah tells CNN’s Sandee LaMotte. “Imagine waking up one morning and suddenly everybody in the world looks like a creature in a horror movie.”

Sharrah, who is now 59 and lives in Clarksville, Tennessee, was later diagnosed with prosopometamorphopsia, or PMO, an extremely rare neurological disorder that causes human faces to appear distorted. Fewer than 100 cases have been reported since 1904, and many doctors have never heard of it.

But Sharrah’s case may now help raise awareness about the mysterious condition and offer new insights into what life is like for people suffering from PMO. For the first time, researchers were able to produce a digital representation of what faces that have been warped by PMO look like to someone like Sharrah, they report this week in the journal The Lancet.

Faces only look distorted to Sharrah when he sees people in person—when he looks at faces in photographs or on computer screens, they appear completely normal. This distinction allowed researchers to use photo editing software to recreate what Sharrah was seeing.

They did so by showing Sharrah a photograph of a person’s face while that same person was standing in the room with him. As he described the differences between the photograph and the live person, researchers modified the photograph until it matched Sharrah’s description.

PMO symptoms differ greatly from person to person. Faces may appear droopy, discolored or oddly textured, and specific features may seem to have moved to different parts of the face. When looking in the mirror, a patient’s own visage might seem deformed. So, while the digitally edited images represent what Sharrah sees when he looks at human faces, they may not match what other people with PMO experience.

Still, the images are “helpful for people to understand the kinds of distortions people can see,” says Jason Barton, a neurologist at the University of British Columbia in Canada who was not involved with the paper, to Science News’ Anna Gibbs.

Doctors often mistake PMO for mental health conditions like schizophrenia or psychosis. And while there is some overlap in symptoms, one major difference is that patients with PMO “don’t think that the world is really distorted—they just realize that there is something different with their vision,” says study co-author Antônio Mello, a cognitive psychologist and neuroscientist at Dartmouth College, to NBC News’ Aria Bendix.

Many people are afraid to mention their symptoms, because “they fear others will think the distortions are a sign of a psychiatric disorder,” says study co-author Brad Duchaine, a psychologist and brain scientist at Dartmouth, in a statement. “It’s a problem that people often don’t understand.”

For many people, PMO symptoms disappear within a few days or weeks. But, for some, like Sharrah, they can persist for years.

It’s also not clear what causes PMO, though researchers suspect it results from issues in the parts of the brain that handle facial processing. Some patients have developed PMO after suffering a stroke, infection, tumor or some sort of head trauma, while others seem to develop the condition spontaneously, without any obvious explanation.

For Sharrah, two possible incidents may have led to PMO, per NBC News. Four months before his symptoms began, he had carbon monoxide poisoning. And more than a decade earlier, he suffered a severe head injury after falling backward and hitting his head on the ground.

However, Sharrah has been able to improve his symptoms with treatment, CNN reports. In his case, adjusting the color of light to a specific shade of green allows him to see faces as they truly are. Catherine Morris, a volunteer with a Facebook support group that Sharrah belongs to, discovered this wavelength of light helps Sharrah and ordered him a pair of green-tinted glasses.

“They arrived the morning he met his granddaughters,” Morris tells CNN. “He got to meet them for the first time, and they looked normal.”

Researchers hope the new paper—and a website they launched about the condition—will help doctors accurately diagnose PMO moving forward. They also hope their work helps patients with PMO feel less alone, knowing there are others like them out in the world. Since the Dartmouth team first created the PMO website in 2021, around 80 patients have gotten in touch to describe their symptoms.

“Patients correctly diagnosed with PMO are in dire need of speaking to others with this condition in order to share experiences and feel less isolated and alien,” Jan Dirk Blom, a clinical psychopathologist at Leiden University in the Netherlands who studies PMO but was not involved with the new paper, told Scientific American’s Jaimie Seaton in December.

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