right left disorientation

1. Presented by
Seethal p.m
2nd msc psychology

2.  Gerstmann syndrome is a rare neurological disorder
consisting of a tetrad of symptoms which include
impairment in performing calculations (acalculia),
discriminating their own fingers (finger agnosia),
writing by hands (agraphia) and impairment of
distinguishing left from right (left-right disorientation)

3.  Right–left disorientation refers to the disturbances in the ability to
identify right and left in one’s own body and in that of the
examiner. It consequently includes not just linguistic but also
spatial components.
 Right –left disorientation is also observed in cases of left posterior
parietal damage and is included in the Gerstmann’s syndrome
 Left-right discrimination is a complex neuro-psychological
process involving several higher neurological functions such as
the ability to integrate sensory and visual information, language
function and memory.

4.  Right–left orientation refers to the ability to identify the
right and left sides of one's own body, and to identify the
right and left sides of a person seated opposite or in a
photo or drawing.
 Individuals with right–left disorientation often demonstrate
the sparing of other spatial concepts, such as up–down and
front–back
 Right–left disorientation may develop consequent to
broader disturbances of body schema or language
processing, but it can exist as a fairly isolated symptom

5. 1. Wolf (1973) examined the incidence of right–left
confusion in a sample of physicians and their spouses.
Results revealed that 17.5% of women and 8.8% of men
sampled admitted to “frequent” right–left confusion.
2. Harris and Gitterman (1978) assessed the frequency of
right–left confusion in a sample of 364 university faculty
members, and found greater error rates among females,
especially left-handed females.
3. Head (1926) and Bonhoeffer (1923) demonstrated that
RLD was a consequence of left hemisphere lesions with
associated aphasia, and specifically implicated the left
retro Rolandic area.

6.  McFie and Zangwill (1960) found RLD in 5 of 8 patients
with left hemisphere lesions; in contrast, none of the 21
patients with right hemisphere lesions demonstrated the
deficit.
 Ratcliff (1979) found that patients with right parietal-
temporal-occipital lesions were impaired at making right–
left judgments about inverted (upside down) figures, but
not with upright figures.
 Ratcliff (1979) summarized his findings as lending support
to the notion that the right posterior cortex was
specialized for mental rotation.

7.  Formal examination of RLD makes demands on numerous
cognitive abilities, including auditory comprehension, verbal
expression of the labels “left” and “right,” short-term memory for
the instructions, sensory discrimination, and mental rotation.
 identification of “right” and “left” may occur on one's own body,
when confronting the examiner or picture, or during a
combination of the two.

8.  RLD may be driven by primary language factors such as
comprehension deficits; anomia, which could cause confusion in
the use of the “right” and “left” labels; and deficits in auditory
retention
 TEST
1. Right- left orientation test
2. Standardized Road-Map Test of Direction Sense
3. Laterality Discrimination Test

9.  20-item test of simple and complex verbal commands to assess
right–left orientation.
 The first 12 items involve discerning right from left on the
subject's own body.
 The final eight questions necessitate right–left discrimination on
the examiner or on a model that is at least 15 inches in height.
Alternative forms of this test exist

10.  This is a test of right–left orientation in extra personal space
(Money, 1976).
 On an unmarked road map, the examiner draws a dotted pathway
and the subject is asked to tell the direction (right or left) at each
turn.

11.  The LDT (Culver, 1969) is a speeded task of laterality judgment
and spatial perception.
 The stimuli consist of 32 line drawings of body parts (16 hands, 8
feet, 4 eyes, and 4 ears).
 Subjects are shown one card at a time, and are asked to judge
whether the picture is a right or left body part