ACUTE HEMICONCERN - A RIGHT ANTERIOR PARIETOTEMPORAL SYNDROME

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 gyr us). The patients concentrated on the left side of their bodies, looki ng at it for long periods and relentlessly rubbing, touching, pinching , pressing, lifting, and manipulating parts of the left arm, trunk, an d leg with their right hand or foot. They all had severe loss of eleme ntary sensation on the left (touch, pain, temperature, vibration, posi tion). The behaviour was not associated with overinterest in the left hemispace apart from their own bodies. It lasted no more than a few da ys, disappearing when left sided sensation improved. The findings sugg est an association between sensory dysfunction and this ''acute hemico ncern''. None of 13 patients with a mirror infarct in the left hemisph ere and none of 38 patients with acute hemisensory loss due to thalami c capsular or brainstem stroke showed hemiconcern behaviour. This beha viour may result from a feeling of strangeness critically associated w ith hemisensory loss without hemispatial neglect, due to involvement o f the right anterior parietotemporal region.