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6 The Syndromes: Doubling Patient most often has gradual onset beginning in middle to late adulthood (> 30 yrs), with the possibility of onset at any age. The frequency of episodes can vary from occasional (three to twelve per year) to, in the severest cases, constant. Duration rarely exceeds a year, though intermittent recurrences, often of greater intensity than the initial presentation , are common. Often misdiagnosed as macular degeneration. The syndrome is characterized in all cases by Doubling, or the layered and concurrent seeing of two discrete versions of a given object or person: the man’s briefcase is also an intricately woven shawl of mandibles; the sleeping child’s face is also crawling with ants; a flagpole is also a gallows . In the most acute presentations, one’s hands are also one’s hands. gay pages-2.indd 6 10/18/10 11:20 AM ...

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