Allochiria
Allochiria | |
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Allochiria is most frequently associated with a lesion of the right parietal lobe (in yellow, at top) | |
Pronunciation | |
Specialty | Neurology |
Allochiria is a
Allochiria is often confused with
Definitional criteria
Allochiria has been observed mainly in the context of neglect which is usually due to a lesion that affects the right parietal lobe.[4] In patients with allochiria, their sensibility is retained completely but the patient is not clear as to which side of the body has been touched. Their power of localization is retained but error exists to the side touched and they often refer the irritation to the corresponding part of the limb.[7] In the patients' mind there is doubt or error as to which side of the body is touched.[citation needed]
There are multiple definitions of allochiria. According to Musser, allochiria is the reference of a sensory stimulus to the corresponding location on the opposite location on the opposite side of the body.[8] Judson Bury says that a patient may refer to an impression on one side to a corresponding place on the opposite side of the body.[9] Thus, if a patient is pricked on one limb, he may say that he feels it on the other. Overall, even though different author's definition differs on points such as the type of stimulus, and the symmetry between the site of the stimulus and the seat of its localization, they all agree that an essential feature of allochiria is the deflection of a sensation to the wrong side of the body, which is true allochiria. In none of these definitions is any stress laid on the state of the patient's knowledge of a right or left side and the symptoms are seen as an error in localization.[citation needed]
Obsersteiner laid stress that there is in allochiria no defect in vertical localization but merely confusion in the patient's mind between the opposite sides of the body and come to look upon the symptom as simply any form of bad mistake in localization.[10] There is in the patient's mind doubt or error as to the side touched while sensibility including the power of localization is otherwise retained. Allochiria has been described as occurring in
Allochiria can occur in relation to any or every segment of the body. In some cases allochiria may be bilateral, and in others it may be restricted to certain regions of the body, or even only to one part of the body. Allochiria is marked to have connections with a variety of senses and sometimes only certain kinds of stimuli can arouse the appropriate feeling of one sidedness.[13]
Types
Electromotor allochiria
This is seen when there is a cross of electrical reflexes as a muscle is stimulated. Electromotor allochiria has been observed in the face, lower limbs, and upper limbs.[12] In these cases, a stimulus presented on the affected side caused contraction of the opposite facial muscles with a current so weak that the healthy facial did not react. Another example is that pressure on one forearm caused movement of the opposite forearm. The central fact is that an electrical stimulus may manifest its effect at a distant part of the nervous system. This distant part may be on the same side of the body or on the opposite side, naturally it is more often on the opposite side because the representation of corresponding contralateral[14] limbs in the spinal cord are nearer to each other than homolateral limbs.[12] This has nothing to do with the confusion of the two sides that occurs in the patients mind when allochiria is present.[citation needed]
Motor allochiria
If patient asked to carry out a movement on effect side he does so with the corresponding part of the opposite side fully under the impression that he has correctly performed the required movement.[12]
Reflex allochiria
Patients with reflex allochiria respond to a stimulation of the sole of the foot or in the inner part of the thigh as being evoked as the corresponding reflex on the opposite side only.[12]
Auditory allochiria
In cases of auditory allochiria, observations recorded that when a tuning fork was held constantly to one ear, the patient responded with a series of symptoms, including pain and deafness, in the opposite ear.[12]
Visual allochiria
In
Gustatory allochiria
In a case of gustatory allochiria, a substance placed on one side of the tongue was said to have been tasted on the opposite side. Also, touches on that side of the tongue were also referred to the opposite side. In this type of allochiria, it is difficult to see how one can in this case dissociate the reference of taste from that of touch.[12]
Alloesthesia
Alloesthesia (or allesthesia
Dyschiria
In dyschiria the failure to determine the correct side is a specific failure and is quite independent of any other failure as regards to perception of stimulus. In other words, the patient may recognize every single feature concerning a single stimulus—its precise nature, position, etc.—except the one point of its side. Evidence goes to show that there is present a mental defect of the specific feeling. Dyschiria has many forms which include achiria, allochiria, and synchiria.[12]
Achiria
Achiria is referred to as simple allochiria and is the term proposed to show the failure to regard feelings of sidedness or handedness. Achiria has sensory, motor, and introspective components. For the sensory achiria, a stimulus applied to the affected part arouses no feeling of sidedness. The stimulus is presented to the side of the body that the person with the disorder has no notion. For the motor component, if a patient is asked to carry out any movement with the limb in question he is unable to do so unless is indicated in some other way than by the use of the words right and left. Reason for this is that he has lost the knowledge of the meaning of these words either altogether or at all events when they are applied to limbs concerned. For the introspective component a patient loses memory for feeling of part of the body that the stimulus is presented and declares that though he knows he has a part he cannot feel it.[12]
Allochiria
Allochiria is when a stimuli presented on one side is constantly referred to the corresponding point of the opposite side. Allochiria has sensory, motor, and introspective manifestations. In sensory cases, a point to which they are referred on the opposite side corresponds exactly with the symmetrical point touched at fact which in itself disposes of the view that allochiria is in any way merely a disturbance of localization. For cases of motor allochiria, if a patient is asked to carry out a movement on effect side, he does so with the corresponding part of the opposite side fully under the impression that he has correctly performed the required movement. For the introspective cases the patient can appreciate a given feeling of sidedness only when the opposite limb is moved or stimulated.[12]
Synchiria
Synchiria[19] is a form of dyschiria in which a stimulus applied to one side of the body is felt on both sides. Synchiria has sensory, motor, and introspective signs. The sensory component refers to a stimulus applied to the affected part evokes two simultaneous sensations which are referred to the corresponding points on both sides of the body. The motor symptom is when a patient is asked to carry out movement on affected side he does so on both sides though in doing so he gets only the feeling of sidedness of the affected part. The introspective component shows that a patient is unable to appreciate the affected feeling of sidedness alone apart from the simultaneously appreciated feeling of the corresponding opposite side though he can appreciate it when he moves both limbs together under the impression that he is moving only the affected one.[12]
Experiences
There are many cases that patients have shown symptoms of allochiria. Allochiria in constructional tasks is commonly seen when neglect patients transpose the elements on the left side to the right side but fail to see or fix their mistakes. Some cases in which patients have shown allochiria is in copying and drawing clocks from memory. A defect of mental representations may lead the patients to transpose all the elements to the ipsilesional side in drawing tasks.[3] In these drawing and memory tasks, patients with allochiria have a tendency to place all of the hours to the right half of the clock. There are different kinds of spatial transpositions that exist in these drawing tasks in patients with allochiria.[3]
The figure shows an example of allochiria in the clock drawing of a patient with hemispatial neglect. The patient omitted the left side of objects when drawing a clock. Even though the patient could verbally express that the clock face has a left side, he or she would fail to notice that the drawing was incomplete. This implies that drawing tasks can play an important role in differentiating the specific impairment of the brain lesion, and not just saying that a patient has dementia.[20]
Diagnosis
When diagnosing allochiria, it is important to consider the
Diagnostic value
Allochiria represents a psychical
Theory
There are multiple theories that explain the outcome of allochiria. The current and most widely accepted explanation of allochiria is Hammond's Theory.
See also
- Apraxia
- Hemispatial neglect
- Synesthesia
- Hemiplegia
- Hysteria
- Agnosia
- Brain damage
References
- ^ from allos lit. 'other' and kheir lit. 'hand'
- ^ "Allochiria". Oxford English Dictionary. Retrieved 1 February 2024.
- ^ a b Halligan, P. W., Marshall, J., & Wade, D. (1992).
- ^ .
- ^ a b c d e f Meador, K. J., Allen, M. E., Adams, R. J., & Loring, D. W. (1991). ALLOCHIRIA VS ALLESTHESIA - IS THERE A MISPERCEPTION. Archives of Neurology, 48(5), 546-549.
- ^ Halligan, P. W., Marshall, J., & Wade, D. (1992). Left on the right: Allochiria in a case of left visuo-spatial neglect.Journal of Neurology, Neurosurgery, and Psychiatry, 55, 717-719. Jones, E. (1907a). The clinical significance of Allochiria.
- ^ "Allochiria". Oxford Reference. Retrieved 2024-01-29.
- ^ Young, R. R., & Benson, D. F. (1992). WHERE IS THE LESION IN ALLOCHIRIA. [Letter]. Archives of Neurology, 49(4), 348-349.
- ^ Musser. A Practical treatise on Medical Diagnosis. 5th ed., 1904, London, p. 289.
- ^ Bury, Judson. Clinical Medicine. 2nd ed. 1899, London. P. 479
- ^ Obersteiner H. On allochiria. Brain. 1882;4:153-168.
- ^ "symmetrical gangrene - Medical Definition". medical.yourdictionary.com. Archived from the original on 2010-10-23.
- ^ a b c d e f g h i j k l m n Jones E. The precise diagnostic value of allochiria. Bravis. 1907;30:490-532
- ^ .
- ^ "Answers - The Most Trusted Place for Answering Life's Questions". Answers.com.
- ^ Gonzalo-Fonrodona (2007). "Inverted or tilted perception disorder." REV NEUROL 44(3): 157-165.
- ^ "allesthesia" – via The Free Dictionary.
- ^ Stewart, TG. A clinical lecture on a case of perverted localization of sensation or allachaesthesia. BMH. 1984;1:1-4.
- ^ Mario F. Mendez, J. W. Y. C. (2009). "Epilepsy partialis continua with visual allesthesia." Journal of Neurology 256(6): 1009-1011.
- ^ "synchiria" – via The Free Dictionary.
- ^ Kim, H. Y. S. C. E. Y.-L. D. (2010). "Context-bounded Refinement Filter Algorithm: Improving Recognizer Accuracy of Handwriting in Clock Drawing Test." Visual Representations and Reasoning 53-60
- ^ Lancet, Lepore, M., Conson, M., Ferrigno, A., Grossi, D., & Trojano, L. (2004). Spatial transpositions across tasks and response modalities: Exploring representational allochiria. [Article]. Neurocase, 10(5), 386-392.
- ^ "psychical" – via The Free Dictionary.
- ^ Grossi, D., Di Cesare, G., & Trojano, L. (2004). Left on the right or viceversa: A case of "alternating" constructional allochiria. [Article]. Cortex, 40(3), 511-518.
- ^ "the definition of retrogression". Dictionary.com.
- Trojano, L., Grossi, D., &
- Kolb, B., & Whishaw, I. (1990).Fundamentals of human neuropsychology. Freeman: New York.
- Leon Y. Deouell, D. D., Donatella Scabini, Nachum Soroker, Robert T Knight (2008). "No Disillusions in Auditory Extinction: Perceiving a Melody Comprised of Unperceived Notes." Front Hum Neurosci. 1(15): 1–15.
- Pia, L., A. Folegatti, et al. (2009). "Are drawing perseverations part of the neglect syndrome?" Cortex 45(3): 293–299.
- Blom, Jan Dirk. A Dictionary of Hallucinations, Springer, December 24, 2009
- Heath, M., Maraj, A., Maddigan, M., & Binsted, G. (2009). The Antipointing Task: Vector Inversion Is Supported by a Perceptual Estimate of Visual Space. Journal of Motor Behavior, 41(5), 383–392. Retrieved from Psychology and Behavioral Sciences Collection database.