Anosognosia: What It Is, Causes And How To Address It

From a historical point of view, the first descriptions of low disease awareness can be traced back to the 19th century. However, we must wait for the work of Babinksi (1914) to find the term anosognosia for the first time. This was used to specifically indicate the lack of knowledge of a deficit sensory.

Currently, the definition of anosognosia is as follows: condition of a person who suffers a brain injury as a result of which is not able to detect the presence or realistically assess the severity of sensory, motor, affective or cognitive deficits On the other hand, it should be noted that these deficits are evident to doctors and family members.

Anosognosia is a selective disorder For example, a hemiplegic patient may be anosognose with respect to only one of the paralyzed limbs. The study of anosognosia suggests that consciousness is not a monolithic and superordinate cognitive process with respect to the various brain functions, but, on the contrary, it could result from the integration of different modules with different domains.

People with anosognosia can manifest it in different ways. Let’s see what the types of anosognosia are:

• Verbal anosognosia: verbal denial of hemiplegia.
• Behavioral anosognosia: There is a lack of recognition of the paralyzed side in the behavior. Particular phenomena are also observed such as somatophrenia, or the conviction that one’s own paralyzed limb belongs to another person, and the personification of the paralyzed limb, or when the subject designates his or her members with diminutives and proper names.

The anosognosic patient presents certain specific features. Let’s see what the symptoms of anosognosia are:

• Inability to recognize and report your condition of illness.
• Demonstration of the firm conviction of still possessing the capabilities motor or cognitive, which he has actually lost as a result of a brain injury.
• If he compares himself with his deficits, the patient makes comparisons, that is, he offers absurd and incoherent explanations with reality of the facts.

Anosognosia must be distinguished from those cases in which there are significant deficits, or a notable and generalized disturbance, of intellectual functions. What parts of the brain does anosognosia affect? Produces parietoccipital or thalamic lesions in the non-dominant hemisphere. Consciousness deficit can manifest in the absence of specific disorders, that is, patients’ other critical abilities are intact.

Anosognosia is a very complex phenomenon, not yet clearly understood by medicine and psychology. On the one hand, it can be difficult to understand the disease. On the other hand, these relationships directly connect a high-level cognitive phenomenon, such as consciousness, with disorders that are usually organic in nature.

Let’s see what the causes of anosognosia are based on different theories:

• According to neurobiology: Some authors suggest that a copy of incoming information, i.e. a perception, is sent directly to a center of consciousness. Despite the fact that perception is not actually processed by the injured brain area, the patient would react as if it were.
• According to Antonio Damasio: patients would be prevented by brain damage from accessing current bodily inputs and would depend on representations of the state of the premorbid organism. His theory is explanatory for anosognosia and anosodiaphoria, but also for the inappropriate affectivity to the condition itself that is observed in patients.
• From the psychodynamic point of view: According to this hypothesis, one of the causes of anosognosia would be a defense mechanism that would come into play to preserve the patient. However, it does not account for hemispheric asymmetry, for which the neurological disorder with anosognosia is more often associated with right lesions and rarely with left lesions. Furthermore, it does not explain the selectivity of anosognosia.

How to cure anosognosia? Recovery of this deficit can occur spontaneously or through rehabilitation made difficult by the fact that the patient with anosognosia is less motivated to recover deficits that he does not recognize, so patients are aware of the disease and its deficits.

In other cases, anosognosia does not recover, or only superficially recovered. However, the presence of anosognosia has a negative prognostic value and may interfere with rehabilitation treatments.

To address anosognosia, individuals who work with people who may have anosognosia must be aware of the complexities involved and give appropriate therapeutic importance. The existence of a cognitive, emotional, or behavioral deficit must first be demonstrated and, only later, various measures used to estimate possible impairments of consciousness for your disorders.

Finally, it must be emphasized that the awareness of a deficit and that of the consequences associated with it can be dissociated in the patient and, therefore, must be evaluated separately for the various disorders.

This article is merely informative, at PsychologyFor we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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