Objective: Unilateral spatial neglect (USN) is a neuropsychological syndrome whose symptoms differ considerably between patients. Several heterogeneities and dissociations have been described between processing stages, spatial regions, reference frames, or sensory modalities. However, in clinical practice, current routine tests rarely assess the different USN subtypes. There is a real lack of practice guidance for clinicians to help them choosing the right USN assessment tools for specific USN aspects. Method: The present article is a narrative synthesis based on a systematic literature search of (a) the dissociations and heterogeneities that can appear in USN and of (b) the different clinical tools available for their assessment. Results: Several tools have been developed to better assess USN heterogeneities. This review highlights their potential relevance and advocates for their widespread use in a clinical practice context. However, it also raised the issue of the lack of standardized clinical tools for the evaluation of some USN aspects. Conclusion: While USN heterogeneities and dissociations are difficult to assess in current clinical practice, there is a real need to improve their assessment. This will allow clinicians to establish the individual USN profile of each patient not only in terms of severity but also of impaired aspects in order to provide them the rehabilitation program that suits the best their needs. Key PointsQuestion: This article aims at reviewing the dissociations and heterogeneities that can appear in unilateral spatial neglect and the different clinical tools available for its assessment. Findings: While a few tools have been developed to assess different unilateral spatial neglect aspects, some heterogeneities and/or dissociations are not considered in clinical practice. Importance: By reviewing unilateral spatial neglect assessment tools, the present article could guide clinicians during their diagnosis. Next Steps: Improving unilateral spatial neglect assessment is now critical to better understand each patient's profile and to propose individualized rehabilitation programs.
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