Pediatric unilateral spatial neglect: A systematic review

Abstract

PURPOSE: Unilateral spatial neglect (USN), an inability to attend to one side of space or one’s body, is commonly reported in adult stroke survivors and is associated with poor outcomes. USN has been reported in pediatric survivors of stroke, but its impact is unclear. The purpose of this systematic review was to summarize and evaluate the literature regarding USN in pediatric stroke survivors. METHODS: PRISMA guidelines, Scopus, CINAHL, PubMed, and other relevant databases were searched with terms including “children”, “stroke”, and “unilateral neglect”, with the ages of participants limited from to birth to 18 years. Data were extracted from studies on the clinical presentation of pediatric USN, the assessment of this condition, treatment options, or USN recovery. RESULTS: A total of 18 articles met inclusion criteria. There were no current prevalence data available. USN presents similarly in children compared to adults. Several different USN assessments were used, however, there were little data regarding treatment options. Furthermore, the data suggest that not all children fully recover. CONCLUSION: This systematic review reveals a lack of quality research to inform the assessment and treatment of children with USN. Although the literature spans decades, there remain no guidelines for standardized assessment or treatment. Similar to adults, paper-and-pencil testing may be less able to identify USN than functional assessments. It is likely that there are children who struggle with undetected USN-related deficits years after their injuries. With a rise of pediatric stroke survivors, there is a pressing need for clinicians to be educated about USN in children, clinical presentations, assessments, and treatments.

From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy

“…Indeed, previous research showed that early brain injuries produce specific spatial cognitive deficits [205][206][207][208][209]. Unilateral brain damage in children with hemiplegic CP may disrupt the processing of visual information, resulting in unilateral spatial neglect manifested as an inability to attend, process, and report on sensory events occurring in one side of extrapersonal space [155][156][157]210,211]. For example, children with hemiplegic CP tend to draw asymmetrical pictures of the human body, often distorting the side of the picture corresponding to their own affected limb [153,212].…”

“…For example, children with hemiplegic CP tend to draw asymmetrical pictures of the human body, often distorting the side of the picture corresponding to their own affected limb [153,212]. Although spatial neglect in children with hemiplegic CP is often identified with paper-and-pencil tests, the latter might be less effective than functional assessments [211]. In general, the scarcity of quality research on spatial neglect in pediatric populations has resulted in the lack of valid assessment and treatment methods [211].…”

“…Although spatial neglect in children with hemiplegic CP is often identified with paper-and-pencil tests, the latter might be less effective than functional assessments [211]. In general, the scarcity of quality research on spatial neglect in pediatric populations has resulted in the lack of valid assessment and treatment methods [211].…”