Specular right-left disorientation, finger-agnosia, and asomatognosia in right hemisphere stroke.
OBJECTIVE
To search for specular disorders of body representations in right hemisphere stroke.


BACKGROUND
Mirror self-misidentification, asomatognosia, and personal confabulation are similar to body illusions or changes in sensorial or sensorimotor perceptions generated by mirror in right brain damage patients with body image disorders.


METHODS
Prospective study. Ten consecutive right-handed patients (1) performed body part naming and localization tasks and (2) were examined for asomatognosia at the acute phase of stroke, then at least 3 months after stroke, under 3 test conditions: without a mirror, with a conventional mirror, and with an inverted mirror. Video recordings of the tests were analyzed to assess performance.


RESULTS
Analysis of variance of the data confirmed that the interaction of mirror's conditions (specifically without a mirror vs. an inverted mirror) with subtest type was significant. The errors are symmetrically distributed. Asomatognosia was "reactivated" in 10 patients who experienced asomatognosia during the acute phase. No particular pattern characterized the clinical manifestations of asomatognosia.


CONCLUSIONS
A causal conflict of sensorial input is proposed. The specific symptoms observed would suggest the existence of an incomplete specular Gerstmann syndrome and/or Anton Babinski syndrome. These results emphasize the role of specular input in the generation of body representations and self-awareness.
Beis
Jean-Marie
JM
Regional Institute for Rehabilitation, University of Nancy, France. jeanmarie.beis@irr.u-nancy.fr
Paysant
Jean
J
Bret
Diana
D
Le Chapelain
Loic
L
André
Jean-Marie
JM
D000377:Agnosia / Q000175:diagnosis / Q000209:etiology*; D001828:Body Image; D001921:Brain / Q000473:pathology*; D002544:Cerebral Infarction / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012649:Self Concept; D012678:Sensation Disorders / Q000175:diagnosis / Q000209:etiology*; D012720:Severity of Illness Index