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What is Quadriplegia?
to neuro-rehabilitation?
to Neuropsychoanalysis?
CNS
?
?
C6 lesion secondary to tumour resection. 53 years Divorced, 23yrs son. Hospitalized 1mth after lesion 14mth as inpatient Mechanical ventilation
Pieter Claesz
Four Hands:
Christian Salas Riquelme www.rehabilitacionneuropsicologica.com
Mrs A: the stones on my hands are bothering me CS: which ones? (looking at her hands resting on top of her stomach) Mrs A: not those ones. The ones that are lying by the side of my body. CS: how? Mrs A: that is the crazy thing. That I feel my hands in a place where I know they are not. CS: and if you close your eyes, can you think about moving those hands? Mrs A: no CS: how about the other hands, the ones you can see. How do they feel like? Mrs A: I dont feel them CS: and how do you know they are yours? Mrs A: I dont know. Maybe by looking at them I know they are mine. CS: lets do something. Could you close your eyes, please? How are your hands now? Mrs A: they are at the side of my body, holding the stones. CS: what about the other pair of hands, the ones that you would see if you open your eyes do you feel them? Mrs A: no.
Changes in the body experience have been scarcely described (virtual/physical body)
Reduplication of extremities on quadriplegia (Ohry &
Zeilig, 1989)
Sensory-motor map is transformed after amputation (Chen et al., 2002; Giumarra et al., 2007, Clarke et al., 1996,
Ramachandran et al., 1992)
CS: do you feel like your emotions have changed after your spinal cord lesion? I mean the way that you feel them or experience them? Mrs A: frankly I havent noticed anything different. I think that Im still the same person. CS: do you mean, for example, that when you feel sad now, the way you feel it is the same as before? Mrs A: yep, I think so. CS: could you describe me how you feel your body when you feel sad now? Mrs A: oh! Sadness does not go further that point (looks at the imaginary line in her chest that divides her body) CS: how? Mrs A: thats right. I feel sadness up to that point till the point I feel my body. From there below I dont feel. CS: what do you feel below that line? Mrs A: I could not say is sadness. Sometimes dont feel anything. Sometimes have sensations, as if was feeling parts of my stomach. I know is my body, and that Im stuck to it, but I dont feel it. At least as something clear.
Concluding remarks
Subjective experience after acquiring quadriplegia need to be further explored in order to comprehend the diverse challenges that adapting to such lesions imply. Emotional changes may not be only related to body-brain traffic interruption, but also to changes in how organism and environment interact. Quadriplegia cases must be considered as belonging to the neuropathologies of the self (Salas & Turnbull, 2011) These clinical observations are anecdotal evidence.
Gracias!
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