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Neuropsychiatric Manifestations of Right Hemisphere Lesions

A wide variety of neuropsychiatric syndromes are associated with right brain dysfunction, including mania, depression, psychosis, hallucinations, personality changes, anxiety, dissociative states, and altered sexual behavior. This review summarizes the anatomic relationships reported between specific neuropsychiatric syndromes and localized right brain lesions. Information is derived from individual case studies and case series. Most neuropsychiatric syndromes are found to be associated with damage to the limbic system. Disruption of body schema and interpersonal functions mediated primarily by the right hemisphere contributes to the neuropsychiatric disability associated with right hemisphere injury. Nonlesion biologic and sociocultural influences including a family history of psychiatric disorder, personal psychiatric history, and the presence of cerebral atrophy increase the vulnerability to neuropsychiatric morbidity following right brain damage. Investigation of the secondary neuropsychiatric disorders occurring with right brain dysfunction contributes to understanding the pathophysiology of idiopathic psychiatric syndromes.