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Suppose your friend has suffered a stroke—a major one, which causes hemiplegia in which half of his body paralyzed. Despite being unable to move the left side of his body, your friend is in good spirits—he just got through a stroke and is okay! He has no clue he is paralyzed. He denies paralysis. And when you ask him to move any paralyzed body part, he claims that he is doing it just fine.
Your friend is not just paralyzed; he also has a condition called anosognosia—and he may never know that he has it.
The term anosognosia literally means “unaware of illness” and was coined by a French neurologist Joseph François Babinski in 1914. Anosognosia can be used to refer to any sort of ignorance of disease, as in hallucinations or delusions of schizophrenics and manic depressants, yet these are usually only partially impaired awareness. Full anosognosia usually accompanies blindness and especially hemiplegia – paralysis on one half of the body due to a stroke.
The cause of anosognosia is still largely unknown. Some psychologist claim that it is an extreme case of the denial defense mechanism, yet there is some physiological evidence pointing away from a purely psychological explanation. In the case of hemiplegics, anosognosia only accompanies damage to the right side of the brain, never on the left – if it was purely denial, there would be an equal chance of having anosognosia regardless of which hemisphere is damaged.
It is surprisingly difficult to get an anosognosiastic patient to recognize their own paralysis. If you ask them to do something with their paralyzed hand, for example, they will say that they can see and feel the action, despite their inactivity. You could ask them to clap and they would hopelessly wave one hand in the air—but say that nothing is wrong with their technique. When pressed about their inactivity they may make up excuses, such as that they are tired, or arthritic. Also, anosognastiac patients seem unaware of other patients’ paralysis as well – as if paralysis was not something that happened to humans.
In the worst cases, one may even forget that certain appendages are their own – most commonly their paralyzed arm. They will vehemently deny that their arm is theirs, even when it is pointed out to them that it is attached to their body.
An anosgnostic patient can be made lucid of their problems by squirting cold water into the ear on the paralyzed side of the body. Suddenly, patients will become quite aware of their own disability. However, when asked about their previous denials of paralysis, they will tell you that they had been aware of their paralysis the entire time and had never denied this fact. Afterwards, when the effects of the water wears off, they will completely forget their episode of cognizance – in fact, they will know that they were asked whether they were paralyzed, but will say that they denied it.
In some cases anosognosia eventually wears off. In other cases the person is trained to function with their disability—though they still may not be aware that they are disabled at all! Regardless, if the thought of getting anosognosia scares you, then take comfort in the fact that this condition is very rare. Besides… you will probably never know you have a problem at all.
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I don’t understand the part about the water in the ear. What does that do exactly?
To be honest, pyschologists aren’t too sure of how, either. I do not have the article on hand, but most of this article is from Vilayanur Ramachandran’s artilce “The Sound of One Hand Clapping.” I will put up a quote of his ideas later.
Generally, though, it’s believed that the cold water in the ear causes a change in the balancing system of a person, causing a shock to the nerves that are responsible for mapping the body. This causes them to be aware of their own paralysis.
Regarding the “water in the ear”…
Not related probably, but interesting nonetheless:
Actually….when trying to determine wether a person is brain dead, the physician will perform a number of tests (5 I believe…not sure).
In one of the tests, the physician will point a very thin bean of ice cold water on the ear drum of the patient. The procedure will induce instant vomiting on “Non-brain dead” patients, while a brain dead person will not respond in any way.
(Please disregard spelling errors and bad grammar…english is not my mother tongue)
Sounds to me as if Dr. Bischinger is full of snot.
I learned about this in my Cognitive Psychology course last semester. While psychologists don’t know precisely what the water does, they know that it stimulates the side of the opposite side of the brain, which controls the paralyzed half of the body. The stimulated brain function temporarily allows them to realize that they’re body is partially paralyzed.
Another interesting thing is how Ramachandran tested to make sure these people weren’t just lying to him (and knew that they’re arm was paralyzed). What he did was he created a box with a mirror diagonally placed in it. He then had the people put their head and their working arm in the box and he asked them to conduct. The mirror was positioned in such a way that it appeared to the participants that they had two functioning arms. During the whole procedure, the doctor was measuring their heart rate. Those who were aware of their paralysis had an increased heart rate when they saw both their hands conducting (even though they know it’s not really moving the mere fact that it seemed to be stimulated heart rate). Anosognosiac’s had no change in heart rate. I thought it was a pretty ingenuous way to test them. Sorry for the long post, but I’m a Psychology major :).
In an old Time Life book on psychology that my family had when I was a child, they described epileptic patients who had had their corpus callosum severed (the bridge between the left & right brain) in an attempt to control their seizures.
They could communicate with one half of the brain at a time by covering one eye and showing written messages. One half of the brain could do things like recognize “it’s cool, round, red” but not name it. The other half could name it “apple” but not describe it.
Anyway, they would tell one half of the brain (the right, I think, it was a very long time ago) to, for example, get up and walk around. Then they’d ask the other half of the brain (left if I recall correctly) why it was walking around and it ALWAYS came up with an answer such as “I wanted to get a soda” or “I felt like stretching my legs.
After I read this, I was continuously amused by my friends who always had reasons for everything they did, even though the reasons were obviously fabricated.
It’s only a flesh wound!
“The Man who Mistook his Wife for a Hat” by Oliver Sacks is an awesome read.
Did you know you could sustain retrograde blindness? That is, be rendered blind, and lose all memory of sight, so that your memories of your childhood would also be blind? Imagine suddenly never knowing you could ever see.
Brains = crazyness.
very good joke at the end
MarkTAW said: “Anyway, they would tell one half of the brain (the right, I think, it was a very long time ago) to, for example, get up and walk around. Then they’d ask the other half of the brain (left if I recall correctly) why it was walking around and it ALWAYS came up with an answer such as “I wanted to get a soda” or “I felt like stretching my legs.”
Now *that* is damn interesting (not to say the article isn’t, because it totally very much is). Does anyone know anything more about that? Never mind that I’ve missed the party, having surfed over here from a year later…Anyone?
11th!
By the way, the article and comments are incredible.
You wonder if maybe you really are crazy and won’t know it until the voices tell you?
Generally, though, it’s believed that the cold water in the ear causes a change in the balancing system of a person, causing a shock to the nerves that are responsible for mapping the body. This causes them to be aware of their own paralysis.”
I want to know the thought process that lead from “this patient is paralyzed but is unaware of his paralysis” to “I’m going to squirt cold water in his ear”… it’s not exactly the first thing that pops into your head.
misanthrope said: “I want to know the thought process that lead from “this patient is paralyzed but is unaware of his paralysis” to “I’m going to squirt cold water in his ear”… it’s not exactly the first thing that pops into your head.”
I wonder if its becuase its a test for brain death… he could have been testing if the brain responds to stimuli or something… But then, I know nothing about brains, aside from what I learned in Human Biol four years ago, and that was largely this: brains look boring. Useful things to have though, I highly recommend one
I know alot more about brains now thanks to this D.I. site! LOVE IT!
Not too long ago I whipped-up a quick story about cloning and time travel. In it I speculated about the ownership on one toe. Does it belong to the individual it was severed from, or to the clone that was cultivated from said toe.
Now I toss another mind bender into the fray. The human brain is actually not one individual persona, but a mixture of various minds interweaved into a single unit. To keep it simple, lets stay with the upper conscientious. In this we have the left and right brains communicating by the corpus callosum. If this white matter is completely severed, for a short time the two hemispheres cannot communicate. The single persona that we all exhibit to the world has been torn asunder into two very different personalities.
The persona that the outside world perceives changes in different ways depending if the person was right or left handed. For instance the very first patient to undergo this surgery was a WWII veteran who lost his ability to speak for almost 30 days.
It was found with corpus callosum severed patients that items placed in the left hand that they could demonstrate its use but could not say its name. Yet the same object then placed in the right resulted in the patient saying its name and verbally describing the use. When asked to demonstrate how to use it usually resulted in either confusion or the patient reacting unsure and not overly confident if they did use it properly. For instance a comb resulted in the left hand combing the hair with no verbal name or description, and in the right hand a proper name and description but rubbing it on the face rather than sliding it through the hair.
Also if a word was held visible only to the left eye, the patient could not read it, yet held only visible to the right and the patient could.
It was discovered that the right cerebral hemisphere was blessed with abstract geometric logic while the left cerebral hemisphere was fluent with words. Each side became specialists in various areas including memory. Because each side could communicate with the other through the corpus callosum, each became woefully deficient in certain skills. For instance the right brain was extremely word-lazy. Why worry about learning and memorizing letters, words, and written structure logic when it could just “ask” the left-brain who knew these things, the same with the left-brain when it came to physical and artistic logic.
It was discovered that over a period of time, six months to a year, both sections of brain learned the concepts that the other section was a specialists in. For instance the right-brain learned to read. It was possible for a corpus callosum severed patient to read two separate books at the same time and retain knowledge of what was read.
They also discovered that patients could become ambidextrous, or write with either hand. Now when the person was originally right handed, the writing was done with wrist and hand. The writing done with the left was performed with more shoulder and arm flexing than wrist and hand motion. Thus they discovered that the left-brain, which controls the right side of the body, is strong in logic and academics or reading, writing, and mathematics. This leaves the right brain more artistic and imitative.
It was also found that by isolating the left senses from the right, two very different people would appear. Isolating the vision and sound of each side, researchers would communicate first with the right, then the left. It was discovered that right after surgery a war would occur between the newly separate minds over who got to talk. The victor was usually the dominant mind. Or if they were right handed, the left-brain would talk, and vise-a-versa.
But like very close twins, many aspects would be the same, whereas others very different. One side was shy. One side was fluent in social events while the other more dreamy or artistic. While one side was extremely emotional the other was stoical.
In memory the person also displayed unusual patterns. Shortly after the separation, tests or discussions done to one side (the other isolated from these) were not found to be in the memory of the other side. Yet months later, the other side began to recall these memories though strict control these tests were never revealed to the other brain.
Sorry for the long narrative, but I wanted an understanding before I say this. Our personalities are actually a mix. By fully severing the corpus callosum two of these personas are isolated, allowing the meeker one to fully surface. Though over a period of time the separated mind “learns” how to communicate, though limited, through other means, perhaps through the more primitive mind situated near the hub of the brain and spinal cord.
Anyway, what we have are mental clones. Two slightly different people trapped in the body of someone else. When the corpus callosum was severed, in a sense that person died and two others were born. Thus two clones of the original person came into being, each slightly different that the original whole.
There you go, my mind bender. What are your thoughts on this one?
The Don.