© 2009 American Academy of Neurology Views & Reviews Delusional misidentifications and duplicationsRight brain lesions, left brain delusionsFrom the Departments of Neurology, Psychiatry, and Neurosurgery, NYU Epilepsy Center, New York, NY. Address correspondence and reprint requests to Dr. Orrin Devinsky, Departments of Neurology, Psychiatry, and Neurosurgery, NYU Epilepsy Center, 403 E. 34th Street, 4th floor, New York, NY 10016 od4{at}nyu.edu When the delusional misidentification syndromes reduplicative paramnesia and Capgras syndromes result from neurologic disease, lesions are usually bifrontal and/or right hemispheric. The related disorders of confabulation and anosognosis share overlapping mechanisms and anatomic pathology. A dual mechanism is postulated for the delusional misidentification syndromes: negative effects from right hemisphere and frontal lobe dysfunction as well as positive effects from release (i.e., overactivity) of preserved left hemisphere areas. Negative effects of right hemisphere injury impair self-monitoring, ego boundaries, and attaching emotional valence and familiarity to stimuli. The unchecked left hemisphere unleashes a creative narrator from the monitoring of self, memory, and reality by the frontal and right hemisphere areas, leading to excessive and false explanations. Further, the left hemisphere's cognitive style of categorization, often into dual categories, leads it to invent a duplicate or impostor to resolve conflicting information. Delusions result from right hemisphere lesions. But it is the left hemisphere that is deluded.
Disclosure: The author reports no disclosures. Received July 29, 2008. Accepted in final form September 22, 2008. This article has been cited by other articles:
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
