Bogousslavsky J, Kumral E, Regli F, Assal G, Ghika J
Department of Neurology, University Hospital, Lausanne, Switzerland.
J Neurol Neurosurg Psychiatry. 1995 Apr;58(4):428-32. doi: 10.1136/jnnp.58.4.428.
Three patients developed a striking visual and motor behaviour in the acute phase of a stroke involving the territory of the right anterior parietal artery (postcentral gyrus, parts or upper and middle temporal gyri, anterior part of inferior parietal gyrus, and supramarginal gyrus). The patients concentrated on the left side of their bodies, looking at it for long periods and relentlessly rubbing, touching, pinching, pressing, lifting, and manipulating parts of the left arm, trunk, and leg with their right hand or foot. They all had severe loss of elementary sensation on the left (touch, pain, temperature, vibration, position). The behaviour was not associated with overinterest in the left hemispace apart from their own bodies. It lasted no more than a few days, disappearing when left sided sensation improved. The findings suggest an association between sensory dysfunction and this "acute hemiconcern". None of 13 patients with a mirror infarct in the left hemisphere and none of 38 patients with acute hemisensory loss due to thalamic capsular or brainstem stroke showed hemiconcern behaviour. This behaviour may result from a feeling of strangeness critically associated with hemisensory loss without hemispatial neglect, due to involvement of the right anterior parietotemporal region.
三名患者在涉及右侧顶叶前动脉供血区域（中央后回、颞上回和颞中回的部分或全部、顶下小叶前部以及缘上回）的中风急性期出现了显著的视觉和运动行为。患者专注于身体左侧，长时间注视并不断用右手或右脚摩擦、触摸、捏、按压、抬起和摆弄左臂、躯干和腿部的各个部位。他们左侧均有严重的基本感觉丧失（触觉、疼痛、温度觉、振动觉、位置觉）。除了自身身体外，这种行为与对左侧半空间的过度关注无关。该行为持续不超过几天，随着左侧感觉改善而消失。这些发现表明感觉功能障碍与这种“急性半身关注”之间存在关联。13例左侧半球镜像梗死患者以及38例因丘脑包膜或脑干中风导致急性半身感觉丧失的患者均未表现出半身关注行为。这种行为可能是由于右侧顶颞前部区域受累，导致与半身感觉丧失密切相关的陌生感，而无半侧空间忽视。
