A patient describes a felt change in how large a body part seems. Before revealing the answer, decide what distinguishes schemazia distortion from anosognosia.

Ask whether the patient is describing a felt mismatch in size with retained awareness that it is subjective, or whether they are unaware of, or denying, an objectively demonstrable physical deficit. Schemazia distortion differs from anosognosia, which concerns unawareness of a genuine deficit rather than a distorted sense of size — in schemazia distortion, the person usually retains insight that the distortion is a subjective sensation rather than a real physical change, and there is no underlying physical impairment being denied. Anosognosia, by contrast, is an unawareness of, or flat denial of, an objectively demonstrable deficit, most classically paralysis, often accompanied by a notable lack of emotional concern. Whether a subjective size distortion is recognised as such, or a genuine physical deficit is being denied altogether, is the key distinguishing feature.