somatoparaphrenia

   Also known as personification anosognosia. The term somatoparaphrenia comes from the Greek words soma (body), para (next to, in addition), and phrèn (nerve, diaphragm, heart). It was introduced in or shortly before 1942 by the Austrian-American neuropsychiatrist Josef Gerstmann (1887-1969) to denote a disorder of the body image in which a paralyzed body part (usually the left arm or leg, or the left side of the body) is experienced as alien or as belonging to someone else. The British neurologist Macdonald Critchley (1900-1997) cites numerous examples of this condition from the literature, including the following: "Ives and Nielsen's first patient thought that his paralyzed left arm and leg 'belonged to someone else'. Zingerle's male patient had erotic sensations aroused by his own left side which he imagined belonged to a woman lying beside him. A patient with an embolism of the right middle cerebral artery remembered that in the first days following his stroke he thought his paralyzed leg belonged to the man in the next bed... One of the most extreme cases of somatoparaphrenia concerned a general paretic who sustained a left hypaes-thesia. He always lay on his right side, protesting that he had a paralysed brother recumbent beside him and that, disliking this situation, he turned his back on him. Asked to indicate this brother of his, he pointed to his powerless limbs. He would put questions to him... 'How are you?' 'Will you have a cigarette?' After telling him to lift his left arm, he explained, 'He doesn't hear... he doesn't answer... he has mental paralysis.'" Pathophysiologically, somatoparaphrenia is associated primarily with unilateral (i.e. right-sided) or bilateral lesions of the parietal lobe. Etiologi-cally, it is associated primarily with stroke. Conceptually and phenomenologically, and perhaps also pathophysiologically, this denial of ownership of one's body parts is related to the notion of the * altruistic hallucination as conceptualized by the French physician and mesmerist Charles Féré (1852-1907). Paraphrasing the words of the Austrian-American neuropsychiatrist Josef Gerstmann (1887-1969), both syndromes can be said to fall under the heading of "anosognosia which, in addition to the experience ofabsence, is associated with illusions or distortions concerning the perception of and confabulations or delusions referring to the affected limb or side".

   References

   Critchley, M. (1953). The parietal lobes. London: Edward Arnold & Co.

   Gerstmann, J. (1942). Problem of imperception of disease and of impaired body territories with organic lesions. Archives of Neurology and Psychiatry, 48, 890-913.

   Ives, E.R., Nielsen, J.M. (1937). Disturbance of body scheme: Delusion of the absence of part of body in two cases with autopsy verification of lesion. Bulletin of the Los Angeles Neurological Society, 2, 120-125.