[Unusual disorders of body image caused by peripheral deafferentation]

Two cases are presented. One concerned a patient with anosognosia of left plexus paralysis. The other was a patient with a massive alcoholic neuropathy, with bilateral severe deafferentation, during the course of which two almost delusional phantom limbs developed, both of which sprang from the left armpit. Some degree of mental confusion, no doubt partly responsible for these body image disorders, existed in both cases. These patients form the basis for a discussion which emphasizes the importance of elevation of functional levels of multimodal association areas in the organization of awareness of the physical self. Peripheral afferent stimuli probably partly contribute to this elevation. The hypothesis of the role of right hemispheric dominance for attention to provide an explanation for negligence does not appear valid in the first case, and another hypothesis in proposed in which a left hemispheric dominance is involved in the awareness of the physical self.