Background: In previous studies, the incidence of anosognosia for hemiparesis has varied between 17%and 58%in samples of brain damaged patients with hemipar esis. Objective: To determine whether this wide variation mi...Background: In previous studies, the incidence of anosognosia for hemiparesis has varied between 17%and 58%in samples of brain damaged patients with hemipar esis. Objective: To determine whether this wide variation might be explained by the different criteria used for diagnosing anosognosia. Methods:128 acute stroke patients with hemiparesis or hemiplegia were tested for anosognosia for hemipar esis using the anosognosia scale of Bisiach et al. Results: 94%of the patients who were rated as having “mild anosognosia"that is, they did not acknowledge th eir hemiparesis spontaneously following a general question about their complaint s-suffered from, and mentioned, other neurological deficits such as dysarthria, ptosis,or headache. However, they immediately acknowledged their paresis when t hey were asked about the strength of theirlimbs. Their other deficits clearly ha d a greater impact. These patients had significantly milder paresis than those w ho denied their disorder even when asked directly about their limbs.Conclusions: Patients who do not mention their paresis spontaneously but do so when question ed about it directly should not be diagnosed having “anosognosia. " If this mor e conservative cut off criterion is applied to the data of the present as well a s previous studies, a frequency of between 10%and 18%for anosognosia for hemip aresis is obtained in unselected samples of acute hemiparetic stroke patients. T he incidence thus seems smaller than previously assumed.展开更多
文摘Background: In previous studies, the incidence of anosognosia for hemiparesis has varied between 17%and 58%in samples of brain damaged patients with hemipar esis. Objective: To determine whether this wide variation might be explained by the different criteria used for diagnosing anosognosia. Methods:128 acute stroke patients with hemiparesis or hemiplegia were tested for anosognosia for hemipar esis using the anosognosia scale of Bisiach et al. Results: 94%of the patients who were rated as having “mild anosognosia"that is, they did not acknowledge th eir hemiparesis spontaneously following a general question about their complaint s-suffered from, and mentioned, other neurological deficits such as dysarthria, ptosis,or headache. However, they immediately acknowledged their paresis when t hey were asked about the strength of theirlimbs. Their other deficits clearly ha d a greater impact. These patients had significantly milder paresis than those w ho denied their disorder even when asked directly about their limbs.Conclusions: Patients who do not mention their paresis spontaneously but do so when question ed about it directly should not be diagnosed having “anosognosia. " If this mor e conservative cut off criterion is applied to the data of the present as well a s previous studies, a frequency of between 10%and 18%for anosognosia for hemip aresis is obtained in unselected samples of acute hemiparetic stroke patients. T he incidence thus seems smaller than previously assumed.
