04: The Man Who Fell Out of Bed

In this story, a man was admitted to the hospital for exhibiting signs of a “lazy left leg”. After falling asleep, the man awoke and found what he thought to be a cadaver’s left leg in bed with him. With a feeling of disgust, he tried to physically remove the strange leg from his bed. Quickly he realized it was attached to him and fell from bed along with the estranged leg. When the neurologist arrived to see what was taking place, he soon realized this man had been talking about his own leg.

The patient’s symptoms initially consisted of weakness in his left leg but grew to a more serious condition where there was complete loss of sensation in his left leg. This is typical of the neurological disorder parietal ataxic hemiparesis¹. Dr. Sacks did not diagnose what part of the brain was responsible for causing the symptoms but after some research, it has been attributed to damage to the right parietal lobe¹. The parietal lobe is responsible for the spatial awareness of your body, as well as many sensory inputs to the brain such your sense of touch¹. The corticospinal tract is commonly affected since the axons between the cerebral cortex and spinal cord cannot correctly integrate or transmit information¹. If the corticospinal tract starts on the right side of the brain it will decussate (cross over) in the myelencephalon to the opposite side of the body where it is connected to the spinal cord and then to the left leg³.

Unmentioned by Dr. Sacks was whether or not the patient was treatable. Although in other cases treatment is possible with antiepileptic drugs, which have been known to remedy symptoms within a few days¹. If untreatable some ways they may overcome their obstacles may include rehab where a combination of physical and mental exercises are used to help alleviate symptoms⁴.

This type of condition is considered rare², although lesions to the parietal lobe aren’t. These can be common among patients who have hemiparesis after having a stroke⁴. What makes this case study unique is how the patient is seemingly normal in every aspect except he was having almost hallucination-like images about his leg. He was no longer able to recognize his own leg and was very confident that the nurse has put an imposter leg on his body.

References

Gordon, N. (1999). Ataxia of parietal lobe origin. Developmental Medicine & Child Neurology, (41), 353-355. Retrieved September 17, 2015.

Yagnik, P. (1988). Result Filters. Retrieved September 17, 2015.

Bear, M., & Connors, B. (2007). Neuroscience: Exploring the brain (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Barclay‐Goddard RE, Stevenson TJ, Poluha W, Thalman L. Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke. Cochrane Database of Systematic Reviews 2011, Issue 5.

Sacks, O. (1985). The man who mistook his wife for a hat and other clinical tales. New York: Summit Books.