Article

Anosognosia for hemiplegia (AHP), or unawareness of motor deficits contralateral
to a brain lesion, has lasting negative implications for the management and
rehabilitation of patients. A recent, bedside psychophysical intervention, namely
self-observation by video replay, lead to a lasting remission of severe AHP in an
acute stroke patient (Fotopoulou, A., Rudd, A., Holmes, P., & Kopelman, M.
(2009). Self-observation reinstates motor awareness in anosognosia for
hemiplegia. Neuropsychologia, 47, 1256-1260). This procedure has been adjusted
and applied here, as the basis of two intervention protocols administered
independently to two patients with severe AHP. The first study used multiple,
successive sessions of video-based self-observation in an acute patient,
targeting first the awareness of upper limb and subsequently lower limb
paralysis. The second study used a single session of video-based, self- and
other-observation in a patient at the chronic stage following onset. Both
protocols also involved elements of rapport building and emotional support. The
results revealed that video-based self-observation had dramatic, immediate
effects on awareness in both acute and chronic stages and it seemed to act as an
initial trigger for eventual symptom remission. Nevertheless, these effects did
not automatically generalise to all functional domains. This study provides
provisional support that video-based self-observation may be included in wider
rehabilitation programmes for the management and restoration of anosognosia.

Langue : ANGLAIS