Unilateral neglect

Unilateral neglect, also known as hemispatial neglect, is a perceptual condition often resulting from a brain injury, particularly to the right hemisphere of the brain. This condition leads individuals to ignore or not be aware of one side of their body or the space around it, typically the left side. It is most commonly observed after a stroke but can also occur due to other neurological disorders.

Causes

Unilateral neglect is primarily caused by damage to the cerebral cortex, especially in areas related to attention and spatial processing. The most common cause is a stroke affecting the right parietal lobe, although it can also result from injuries to other parts of the brain, including the frontal lobe and subcortical structures. The condition underscores the brain's role in interpreting and attending to the spatial aspects of the world.

Symptoms

The main symptom of unilateral neglect is the failure to acknowledge objects or stimuli on one side of the body or space. This can manifest in several ways:

• Ignoring food on one half of a plate
• Failing to dress one side of the body
• Colliding with objects on the neglected side
• Not responding to people approaching from the neglected side

Patients with unilateral neglect may also have difficulties in representing space or understanding spatial relationships, affecting their ability to navigate their environment.

Diagnosis

Diagnosis of unilateral neglect involves clinical observation and specialized tests. These may include visual scanning tasks, drawing tasks (such as copying a picture or drawing a clock), and reading tasks. Neuropsychological assessments can help differentiate unilateral neglect from other cognitive impairments.

Treatment

Treatment for unilateral neglect is multidisciplinary, involving occupational therapy, physical therapy, and sometimes speech therapy. Techniques may include:

• Visual scanning training to encourage awareness of the neglected side
• Prism adaptation therapy, using prism glasses to shift the visual field
• Sensory stimulation, such as tactile or auditory cues, to draw attention to the neglected side

Recovery varies greatly among individuals and depends on the severity of the brain injury and the specific areas of the brain affected.

Prognosis

The prognosis for unilateral neglect can vary. Some patients experience significant improvement, especially with early and intensive rehabilitation. However, others may have persistent symptoms that continue to affect their daily lives.