A human cerebral deconnection syndrome

American Academy of Neurology Dedicated to advancing the art and science of neurology, and thereby promoting the best possible care for patients with neurological disorders A Celebration of the First 50 Years of the American Academy of Neurology Neurology 1962;12:675-685 We propose in this paper to present a patient whose clinical picture appears to us to be most simply explainable by a partial deconnection of the two cerebral hemispheres. He appears to behave as if there were 2 nearly isolated half-brains, functioning almost independently. In the early years of this century several cases were described which showed some of the phenomena that are present in our patient. Sittig1 reviews these cases in his monograph on apraxia. The earlier workers generally described these cases as showing apraxia and apractic agraphia of the left side and leftsided astereognosis and attributed these findings to lesions of the corpus callosum. In the 1940's considerable doubt was cast on the role of the corpus callosum by the extensive studies of Akelaitis2 and his co-workers on humans whose corpora callosa had been sectioned surgically (to prevent the interhemispheric spread of seizures) and who subsequently presented virtually no abnormalities. Earlier physiological work in animals also failed to show convincing disturbances. Bremer, Brihaye, and Andre-Balisaux3 have reviewed this literature. By contrast, in the last five years, the work of Sperry4 and his co-workers has convincingly proved that in animals, section of the callosum produces behavior which is most simply explained as resulting from deconnection of the 2 hemispheres. It was Sperry's work which alerted us to the possibility of deconnection syndromes in man. Our patient shows behavior similar to that described by the earlier workers. In addition we have observed several manifestations not previously mentioned. Detailed anatomical confirmation of the localization of the lesion …