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Title

Four legs. Illusory reduplication of the lower limbs after bilateral parietal lobe damage

Authors
Reverdin, A.
Published in Archives of Neurology. 1997, vol. 54, no. 12, p. 1543-1547
Abstract OBJECTIVE: To report an unusual disorder of body schema and its neurologic and neuropsychological correlates. DESIGN AND METHODS: We describe a patient with a reduplicative phantom illusion of her lower limbs. Motor and sensory functions, as well as mental representation of body and space, were studied during the reduplication experience until its resolution. SETTING: Clinical neurology department in a primary care hospital. PATIENT: A 64-year-old, left-handed woman who experienced the uncontrollable and distressing feeling of having 4 legs, without delusional belief, after surgical removal of a right-predominant parasagittal parietal meningioma. This phenomenon spontaneously resolved after 2 weeks. INTERVENTION: None. MAIN OUTCOME MEASURES: Clinical neurologic examinations and standardized neuropsychological tests, with emphasis on tests assessing orientation to body parts, right-left discrimination, and mental orientation in space. RESULTS: The patient had severe weakness and proprioceptive sensory loss in both lower limbs. She had no disturbances of body schema knowledge but a striking impairment in tasks requiring mental orientation in space, particularly for right-left laterality discrimination. Resolution of the reduplication experience correlated with improvement in the affected spatial abilities, while motor, sensory, and other cognitive functioning did not significantly change. CONCLUSION: This patient's reduplicative phantom illusion might be related to the combination of the severe somatosensory loss with an underlying impaired mental representation of relative positions in space.
Keywords Brain Neoplasms/diagnosis/ surgeryDelusions/ psychologyFemaleHumansLegMagnetic Resonance ImagingMeningioma/diagnosis/ surgeryMiddle AgedNeurologic ExaminationNeuropsychological TestsParietal Lobe/pathology/ surgeryPostoperative Complications/ psychologyRemission, Spontaneous
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PMID: 9400364
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