Hemispatial neglect: clinical features, assessment and treatment

Abstract

Hemispatial neglect is a disorder of attention which commonly follows from damage to the right side of the brain. Patients with neglect show symptoms of lateralised inattention, failing to acknowledge or report information on the left side. Neglect is a poor prognostic indicator for general functional recovery from stroke, and is associated with a range of co-morbid conditions including denial or indifference to the brain injury, hemiplegia and visual field loss. Mild to moderate cases can be over-shadowed by the more gross symptoms that accompany brain injury, however assessment and diagnosis is relatively quick and simple.Current treatment guidelines suggest that patients should be taught compensatory strategies, but these are largely ineffective. Although recent research has identified more promising treatment approaches, investigations are still preliminary. Given the prevalence and debilitating nature of neglect, there is a clear need to raise awareness and understanding of the condition amongst carers and healthcare professionals.

Current clinical practice in the screening and diagnosis of spatial neglect post-stroke: Findings from a multidisciplinary international survey

“…Relatedly, neglect may manifest alongside various comorbidities. Neglect and visual field loss often co-occur, as can hemiplegia (Gallagher et al, 2013), delirium (Boukrina & Barrett, 2017), and anosognosia (Bisiach et al, 1986;Chen & Toglia, 2019;Vocat et al, 2010). The use of neurological assessments that are not specific to neglect (see list of assessments in appendix) could be a useful approach for the detection of co-morbidities.…”

Chronological Rehabilitation Treatment Varying by Stage for Constructive Disability

“…Another method alters the behavior of a person and follows a temporal execution procedure. Since the state and changes in the environment affect the work and results, environmental adjustment during training may enhance the benefits of rehabilitation treatment [ 15 , 16 ].…”

Comprehension of Spatial Metaphors After Right Hemisphere Stroke: A Case Report

“…Briefly, hemianopia or visual field deficit is a sensory loss caused by damage to the primary visual pathways running between the optic tract and striate cortex, whereas neglect refers to inability to attend to contralesional space, due to cortical lesion (24,25). Crucially, while the boundary between the intact and blind field in hemianopia is typically perceived as a "cliff ", the visual loss in neglect is more gradual and the size of the neglected field appears to depend on the features of the scene (26).…”