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 Critchley^1,2 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 Critchley^1,2 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 …