The Japanese journal of neuropsychology

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ArticleTitle	Anosognosia for hemiplegia: a defect in self-awareness
Language	J
AuthorList	Shinichiro Maeshima, Aiko Osawa
Affiliation	Department of Physical Medicine and Rehabilitation, Wakayama Medical University
Publication	Japanese Journal of Neuropsychology: 19 (2), 77-86, 2003
Received
Accepted
Abstract	Anosognosia is a term used by Babinski (1914) to refer to patients who did not recognize their hemiplegia. It is of interest for both pragmatic and theoretical reasons. Although many investigators have discussed about anosognosia, the responsible lesions and neuropsychological mechanisms according for this phenomenon remained unclear. In this article, we reviewed several neuroanatomical and neurological theories that have been proposed to explain this deficit. It has been suggested that lesions including anosognosia could be located in the part of the parietal lobe, diencephalon, limbic system, or brainstem. Some investigators emphasized that the anosognosia caused by lesions located in subcortical fiber or brain atrophy. The mechanisms of anosognosia are controversial. Although several mechanisms such as denial, feedback, hemispheric disconnection, or feedforward hypothesis were discussed, each hypothesis connot account for anosognosia in all patients. Thus, we suspect that anosognosia might be caused by some combination of several mechanisms that we have discussed. We also mentioned diagnostic evaluation and rehabilitation strategy for anosgnosia.
Keywords	anosognosia, anosodiaphoria