Dr Sudhir Kumar diagnosed the man with prosopagnosia, also known as face blindness, a condition that can affect two out of 100 people.
Published Apr 24, 2023 | 8:30 AM ⚊ Updated Apr 24, 2023 | 8:30 AM
Hyderabad techie diagnosed with Facial Blindness, a condition in which people cannot recognise their closed family members, colleagues, their own faces. (Wikimedia Common)
Late one night when a Hyderabad techie returned home from work, he used a duplicate key to enter the house.
Abhi saw his wife in their bedroom and asked, “Who are you and what are you doing in my bedroom?”
She was shocked. Thinking that he was under the influence of alcohol, she asked, “How much did you drink?”
Strangely, the moment he heard her voice, Abhi recognised her right away.
However, the situation repeated itself with the milk vendor the next morning, as Abhi could not recognise him.
Abhi realised the problem was getting serious and that had to see a doctor when he suddenly stopped recognising some of his work colleagues.
This is not the script of a movie or a thriller novel. This is a patient who met Dr Sudhir Kumar, a consultant neurologist at Apollo Hospital in Hyderabad.
The doctor listened to Abhi’s case history and realised that the problem had a strange pattern, where he would not be able to identify the face of the person, but would get back the memory almost immediately after the person spoke a few sentences or walked in a particular manner.
“I diagnosed his condition as prosopagnosia, also known as ‘face blindness’. Though these cases are not very common, they are not rare either,” he explained to South First.
Dr Kumar explained that 45-year-old Abhi had no weakness or numbness in the arms or legs. His visual activity was also normal.
He was recently diagnosed with high blood pressure and high LDL cholesterol, for which he was on medication.
The doctor ordered an MRI of the brain to ascertain his diagnosis.
The MRI apparently showed an acute infarct (blood clot) in the right occipital lobe, affecting the right fusiform gyrus — the part of the brain that, among other things, helps people recognise faces, body, and words, and process colour information.
This finding on the MRI, said the doctor, could explain the symptoms that Abhi was experiencing.
The couple was counselled about the diagnosis and appropriate medical treatment was started.
Prosopagnosia or face blindness is a neurological disorder in which the affected person cannot put a name to a face — in person or in photographs.
However, they can easily recognise the person based on their voice, clothing, jewellery or gait.
Notable people who have been diagnosed with this disorder — for various reasons — include actor Brad Pitt, Apple co-founder Steve Wozniak, and pioneering primatologist Jane Goodall, the world’s foremost expert on the somewhat human like social and family interactions of wild chimpanzees.
The disorder has also been a plot point in several films and TV series.
Perhaps the best visual representation of what prosopagnosia could look like could be found in the American TV series Perception, which ran from 2012 to 2015.
Faces, the fourth episode of the second season, focuses on a man who has face blindness, as the protagonists of the series — a neuropsychiatrist who helps the government solve criminal cases with his expertise, and his partnering law-enforcement officer — look into an attack on him.
Dr Kumar explained that many cases of prosopagnosia remain undiagnosed due to a lack of awareness among patients as well as doctors.
The prevalence of developmental prosopagnosia (DP) — lifelong face recognition deficits — is widely reported to be 2-2.5 percent of the population, which means two out of 100 people are affected by this, explained Kumar.
He said acquired prosopagnosia occurs commonly after a stroke and traumatic brain injury. Since these cause many other neurological deficits in addition to facial blindness, not much importance is given to prosopagnosia.
Srinivas Rajendra, a Bengaluru-based businessman being treated at Vasavi Hospital for a similar condition, said he had it running in the family across generations.
“Certain techniques were taught and I needed to do a lot of specific focusing to recognise people. It is very difficult for my business, and it was diagnosed only after three generations of people had it,” Rajendra told South First.
However, doctors explained that in such cases, it need not be that all family members are affected by it, or have similar symptoms in severity and clinical features.
Doctors say that most patients don’t even know what the problem is. They struggle to explain their condition to family members who may think the patient is being rude to them by not recognising them.
However, the recognition happens as soon as they hear their voice or notice a particular hairstyle.
The symptoms of prosopagnosia can range from mild to severe, depending on the extent of the damage to the brain.
Common symptoms include difficulty recognising familiar faces, including even those of close family members, difficulty recognising emotions or expressions on faces, and relying on non-facial cues such as voice, clothing, and hairstyle to identify individuals.
Taking to Twitter, Dr Kumar, who had spoken in detail about this case study, said prosopagnosia could even result in an inability to recognise one’s own face while gazing into a mirror or while looking at one’s own photo.
He added that an abrupt onset of the inability to recognise familiar faces without impaired vision or memory could be a sign of stroke, affecting the right side of the brain.
“Some patients recover with facial recognition skill training, whereas the problem continues to persist in many,” he added.
Taking an interest in Kumar’s tweet, several people across South India wrote about their condition and were even thankful to him for tweeting about the case, as they were unaware of why they were unable to recognise faces.
Kumar explained that this condition could be clinically diagnosed on the basis of facial perception, recognition, and identification tests, and could be done by a neurologist or a neuropsychologist.
However, he added, there was no specific medicine for treating prosopagnosia.
In the Hyderabad techie’s case, he was referred for facial recognition skill training. A month after the review, he had significant improvement.
Meanwhile, neurologists say that there are treatment options to manage the symptoms.
These include, apart from cognitive training to improve face recognition skills, using compensatory strategies such as relying on non-facial cues, and using assistive technologies such as smartphone apps that help identify individuals through their voices or facial features.
