713 - “Who’s Gabby?”: A Case of Somatoparaphrenia without Neglect in the Setting of a Gunshot Wound to the Head

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

BK

Bryan Ko, MD

Resident Physician
Detroit Medical Center
Detroit, Michigan, United States

Co-Author(s)

JD

John Dyke, BA

Medical Student
Michigan State University
Grand Rapids, Michigan, United States
CW

Ciara White, BS

Medical Student
Wayne State University
Madison Heights, Michigan, United States
MA

Michael Ajluni, MD

Attending Physician
Detroit Medical Center
Detroit, Michigan, United States

Submitter(s)

BK

Bryan Ko, MD

Detroit Medical Center
Detroit, Michigan, United States

Case Diagnosis: Somatoparaphrenia

Case Description: C.V. was a 17 year-old female with no significant past medical history who presented with a single gunshot wound to the forehead and Glasgow Coma Scale of 8. Imaging revealed bullet fragments in the right frontal lobe with multiple areas of intracranial hemorrhage, left midline shift, and multiple cranial/facial fractures. She underwent decompressive right-sided hemicraniectomy and bullet fragment debridement. She was admitted to inpatient rehabilitation 4 weeks later with left-sided hemiparesis, central pain and facial droop, complete right eye blindness, cognitive deficits and somatoparaphrenia. She believed her left arm was not her own and instead belonged to “Gabby”, a nurse from a previous hospital. No signs of personal nor extrapersonal neglect were present. She did exhibit some level of anosognosia toward her delusion, confabulating gruesome stories to justify how “Gabby’s arm” became attached to her body.

Discussions: Somatoparaphrenia is a subtype of asomatognosia where one delusionally misidentifies a body part and attributes it to another person. It is often associated with severe somatosensory and motor deficits, anosognosia to hemiplegia, and unilateral spatial neglect of person and extrapersonal space. Cases lacking neglect are exceedingly rare, with only one documented case lacking both types of neglect. Our patient‘s symptoms were confined to the delusional features of somatoparaphrenia, indicating symptoms of neglect are not required for its emergence. Of the ~75 documented cases in medical literature, most occur secondary to cerebrovascular accidents or neoplasms with resolution in 2-3 weeks. There are no well documented cases from a GSW and our patient showed no improvement 8 weeks post-injury.

Conclusions: We aim to expand the known mechanisms that cause somatoparaphrenia and further challenge its association with neglect. Given our patient’s lack of improvement 8 weeks post-injury despite appropriate treatment (verbal reinforcement and mirror therapy), investigation into other modalities of treatment would be of value.