Neglect
Neglect
Neglect is a failure to orient toward, respond to, or report novel or meaningful stimuli. If failure to respond can be attributed to concurrent sensory or motor deficits (e.g., hemiparesis, hemianopia, visuospatial deficits) neglect is not present.
Neglect can involve stimuli in the extrapersonal environment (e.g.,visual neglect) or personal space (e.g., personal neglect or asomatognosia). Neglect of contralateral hemispace may also be called unilateral spatial neglect, hemi-inattention, or hemineglect. Lesser degrees of neglect may be manifest as extinction (double simultaneous stimulation). Motor neglect may be evident as hemiakinesia, hypokinesia, or motor impersistence. Alloesthesia and allokinesia may also be features of neglect.
Neglect may be obvious (e.g., patient not dressing one side of the body), but is sometimes more subtle, in which case it may be tested for using various simple tests:
- Cancellation tests, for example, stars (unstructured array), letters (structured array)
- Figure copying, for example, Rey-Osterreith figure
- Line bisection, numbering a clock face
- Drawing from memory.
Neglect is commoner after right rather than left brain damage, usually of vascular origin. The angular gyrus and parahippocampal gyrus may be central to the development of visual neglect. Marked degrees of neglect may seriously hamper attempts at neurorehabilitation.
References
Bowen A, McKenna K, Tallis RC. Reasons for variability in the reported rate of occurrence of unilateral spatial neglect after stroke. Stroke 1999; 30: 1196-1202
Chatterjee A. Neglect: a disorder of spatial attention. In: D’Esposito M (ed.). Neurological foundations of cognitive neuroscience. Cambridge: MIT Press, 2003: 1-26
Husain M. Cognitive neuroscience of hemispatial neglect. CognitiveNeuropsychiatry 2002; 7: 195-209
Mort DJ, Malhotra P, Mannan SK et al. The anatomy of visual neglect. Brain 2003; 126: 1986-1997
Parkin AJ. Explorations in cognitive neuropsychology. Hove: Psychology Press, 1996: 90-109
Cross References
Alexia; Alloesthesia; Allokinesia; Asomatognosia; Extinction; Hemiakinesia; HypoKinesia; Impersistence
