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Hemispatial Neglect

Hemispatial Neglect . Pagah Sadat Mirzakhalili PSY 3108 A . YOU have neglect.. Imagine. You aren’t aware of your left visual field You ignore people who approach you on the left You shave ONLY the right side of your face You eat ONLY from the right side of your plate

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Hemispatial Neglect

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  1. Hemispatial Neglect Pagah Sadat Mirzakhalili PSY 3108 A

  2. YOU have neglect.. Imagine.. • You aren’t aware of your left visual field • You ignore people who approach you on the left • You shave ONLY the right side of your face • You eat ONLY from the right side of your plate • You don’t use your left limbs- even though there is no physical deficits.

  3. Worst Part is....? You have NO idea there is even anything wrong!

  4. What is Hemispatial Neglect? • Also called unilateral neglect or neglect • The failure to notice stimuli on the contralesional side • Abnormality in attention- NOT a sensory or motor disturbance • Right hemisphere, left neglect form is most common • Anosognosia – patient is unaware of their condition

  5. Classifications of Neglect

  6. MechanismS underlying neglect • Heterogeneous condition • Damage to Right inferior parietal lobe or temporo-parietal junction caused by stroke leads to most severe neglect • Damage to frontal lobe may lead to transient form of neglect

  7. MechanismS underlying neglect • Other cortical structures that may be involved: • Mid-superior temporal gyrus • Angular gyrus of the parietal lobe • Subcortical areas involved : • Right basal ganglia • Thalamus

  8. Taken from :Parton et al., 2004

  9. Diagnostic tests for Neglect • For severe forms of neglect- simple observation may be enough • For less severe forms: • “Paper and Pen” assessments: • Cancellation task • Line Bisection task • Copying task • Behavioral assessments : • Watching their normal routine ( grooming, eating, dressing) • Ecological Assessments : • Pointing to objects in the room

  10. Cancellation Task Copying Task Line Bisection Taken from :Parton et al., 2004

  11. Treatments for Neglect • Encouraging patients to direct their gaze to contralesional side • Hemianopic patching : Blocking the ipsilesional (“good”) side of vision

  12. Treatments for Neglect • Caloric Vestibular Stimulation (CVS): use of cold &/orwarm water to stimulate the semicircular canals and produce an oscillation of eyeballs- with a quick and slow phase – to shift gaze

  13. Treatments for Neglect • Trunk Rotation : shifting the body’s perceived midline more into the contralesional field • Slight improvement in neglect

  14. Treatments for Neglect • Prism Adaptation : Use of goggles with prism wedges to shift patient’s visual field horizontally

  15. Prism Adaptation study by Rossetti et al., (1990)

  16. Questions?

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