Knowing and not knowing: practical reflections on video based feedback as part of neuro-rehabilitation in a case of persistent anosognosia for hemiplegia

We report the case of DT, a man in his fifties who suffered a large right fronto-parietal hemorrhage, resulting in a dense left weakness and a persistent anosognosia for the resultant hemiplegia. DT engaged in several video-feedback sessions. Video feedback therapy has been successful in previously reported cases of anosognosia, resulting in immediate and lasting resolution. In the current case, similarly dramatic effects were observed, but with a subsequent recurrence of the anosognosic ideation. The present case sheds light on the interplay of neurologic and psychological mechanisms involved in anosognosia and on some of the pragmatic emotional considerations of engaging in this form of rehabilitative therapy.