Spatial Neglect

Excerpt

Spatial neglect syndrome, a behavioral disorder, also known as unilateral or hemineglect syndrome, is a disabling condition that often presents with diagnostic difficulties even for specialists familiar with this condition. This hemineglect syndrome classically presents as non-dominant (often left-sided) spatial disorientation after a pathological event in the right cerebral hemisphere, classically the right posterior parietal cortex. Spatial neglect does not necessarily limit involvement to sensory and motor impairment, but can also affect other components like perceptual, representational, visuospatial, behavioral deficits, etc. The most challenging aspect of this illness is the frequent abnormal awareness of the patient regarding the deficit termed anosognosia and the presence of emotional dysfunction.

Neglect is a heterogeneous syndrome due to variations in the location and extent of brain damage. This interhemispheric imbalance causes the left hemisphere to become more active after the right hemisphere lesion, which results in attention diversion and eye movements towards the right side. The presence of spatial neglect indicates a severe prognosis in terms of the long-term independent functioning of the patient.

Clinicians can estimate the severity of this unilateral neglect using the Kessler Foundation Neglect Assessment Process (KF-NAP) or Conley Scale scores.