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Misoplegia: a review of the literature and a case without hemiplegia
  1. T Loetscher,
  2. M Regard,
  3. P Brugger
  1. Department of Neurology, University Hospital Zurich, Zurich, Switzerland
  1. Correspondence to:
 Tobias Loetscher
 Neuropsychology Unit, Department of Neurology, University Hospital Zurich, CH-8091 Zurich, Switzerland; tobias.loetscher{at}usz.ch

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Brain damage may cause profound changes in people’s attitudes towards their own bodies. Relatively common after unilateral lesions are anosognosia and anosodiaphoria—that is, the denial of, or unconcern about, a sensorimotor hemisyndrome. Less familiar forms of altered limb perception include asomatognosia (lack of awareness of a part of the body), somatoparaphrenia (lack of ownership of a paralysed limb), the experience of supernumerary phantom limbs (reduplication of limbs on the affected side of the body), personification (nicknaming a limb and giving it an identity of its own) and misoplegia. The term misoplegia was coined by Critchley1,2 and refers to the morbid dislike or hatred of paralysed limbs in patients with hemiplegia. Minor manifestations of this condition may be restricted to verbal aggression towards a limb, but commonly misoplegia includes physical acts such as striking and beating the hemiplegic extremity.1–3 Although these verbal or physical acts of self-directed aggression are impressive, detailed case reports are rare. Apart from the anecdotal communications by Critchley1,2 and some passing notes by others, we are aware of only six published accounts. These cases and our new observation are summarised in the supplementary data available online at http://jnnp.bmjjournals.com/supplemental.

Case history

A 79-year-old ambidextrous woman had poliomyelitis with atrophia and shortening of the left leg (about 6 cm) in her early …

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