Unawareness of “illnesses”: a case of right-sided hemiballism.

CEREBROVASCULAR disease; PATHOLOGICAL psychology; NEUROPSYCHOLOGICAL tests; BRAIN diseases; COGNITIVE (Book); NEUROPSYCHOLOGY

The Authors describe a non-demented patient who, after a left subthalamic haemorrhage causing hemiballism, was completely unaware of both neurological (i.e., dyskinesias) and non-neurological (i.e., cough) symptoms occurring after the stroke. In contrast, he was perfectly able to acknowledge pathological conditions affecting him before the brain damage. Neuropsychological assessment showed no cognitive defects, but revealed the presence of frontal behaviours (e.g., perseverations and utilization behaviours). This unusual clinical picture was ascribed to damage of frontal-subcortical circuits involved in conscious representation of current bodily states. [ABSTRACT FROM AUTHOR]

Gli Autori riportano un paziente non demente che dopo una emorragia subtalamica sinistra presentava emiballismo, anosognosia per il disturbo motorio ed una completa incapacità a riconoscere consapevolmente patologie non neurologiche, come la tosse, che si erano manifestate dopo la lesione cerebrale. Al contrario, egli era perfettamente in grado di descrivere ogni condizione patologica che lo aveva colpito prima dell’evento neurologico. La valutazione neuropsicologica, non evidenziava rilevanti disturbi congitivi, con l’eccezione di alterazioni comportamentali di natura frontale, quali perseverazioni e condotte di utilizzazione. Gli Autori riconducono questo insolito quadro clinico alla disfunzione di circuiti frontali-sottocorticali coinvolti nei processi di auto-monitoraggio e nella rappresentazione cosciente delle modificazioni che intervengono nello stato corporeo. [ABSTRACT FROM AUTHOR]

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