Delusional misidentification syndromes are widely present in several psychiatric and neurological disorders in the geriatric population. Numerous studies witness growing evidence of organic background in different misidentification syndromes and reduplications.

The authors present a case of a patient with dementia, vascular type where clonal pluralization of the Self appeared as a secondary interpretative delusion after a hallucinatory type of autoscopic experience. the 86-year-old patient was referred to our department because he was talking continuously to his so-called ‘twin’. He considered his experience as a miracle to be investigated by a special medical staff. We discuss the distinctive characteristics of the presented case from other delusional misidentification syndromes and from other psychopathologic and neurological symptoms.

In the presented case the linear evolution and the interpretative aspect of the arising delusional misidentification phenomena were predominant. Overviewing the broad spectrum of concepts on delusional misidentification syndromes, we emphasize the importance of those approaches which enhance the disappearance of the classical functional-organic dichotomy on the double phenomenon and which try to clarify the neurocognitive background of delusional misidentifications.