[The Juliane Hochriehser case--a classical case of anosognosia]

Still today anosognosia as a phenomenon attracts the attention of both clinicians and researchers. Patients affected by this syndrome deny an obvious neurological dysfunction caused by a defined damage in their brains. This lack of awareness of their impairment is the most interesting feature of this syndrome. In the neuropsychiatric literature case studies have played an important role, among them four contributions by Gabriel Anton (1858-1933) at the end of the 19th century. The phenomenon described by him in these case studies was later referred to as anosognosia by Josef François Babinski (1857-1932). Recognising his achievements in the description of this phenomenon one kind of anosognosia, namely cortical blindness, is still referred to in the scientific literature as the Anton-Syndrome (also Anton Symptom). Using the recently discovered original files of 1895/96 our study substantiates one case described by Anton. The case in question is that of Juliane Hochriehser, a 69-year old dairymaid who showed anosognosia with cortical deafness due to bilateral lesion of the temporal lobes. Other cases of his are also included. The study concludes with an overview of the current state of research and the different approaches to this syndrome. Yet it is still not clear which areas and structures in the brain are responsible for the development of anosognosia. It may well be that dextral or bilateral damage of several areas of the brain plays a major role.