Unilateral Neglect
Original Editor - Emily Wood
Lead Editors - Kathy Bueckert, Alexandra Dansereau
Definition
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Unilateral neglect is an attention disorder that arises as a result of injury to the cerebral cortex Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title (Hills, 2006). Unilateral neglect is also commonly known as contralateral neglect, hemispatial neglect, visuospatial neglect, spatial neglect, or hemi-neglect (Menon, Plummer). In unilateral neglect, patients fail to report, respond or orient to meaningful stimuli presented on the affected side (Menon). In most cases, the right parietal cortex is injured and the left side of the body and/or space is/are ignored Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. Unilateral neglect is a heterogeneous condition; different individuals may present with different symptoms. Unilateral neglect may involve various modalities, including visual, auditory, somatosensory or kinetic Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. Unilateral neglect is generally classified in one of two ways: by the modality that is affected or by the space that is affected (i.e. personal or extrapersonal space). It is important to remember that these classifications may overlap and intersect (Plummer).
Mechanism of Injury / Pathological Process
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Unilateral neglect usually results from damage to the right parietal area, often the posterior parietal cortex (Hillis, 2006). Normally, neurons in the right parietal cortex strongly attend to both the left and the right side of the space, while neurons in the left parietal cortex weakly attend to the right side of the space only (Heilman & Van Den Abell, 1980). Therefore, in right parietal lesions, attention to the right side of the space is maintained by the left parietal cortex, but attention to the left side of the space ceases. In left parietal lesions, attention is typically maintained on both sides of the space by the right parietal cortex (Heilman & Van Den Abell, 1980).
However, lesions in different cortical and subcortical areas may also lead to neglect by causing dysfunction in brain networks (Vuilleumier, 2013). Usually, unilateral neglect results from stroke; however, it may also result from traumatic brain injuries or a neoplastic disease. Neglect is most likely in cases of large right hemisphere stroke (Yang, Zhou, Chung, Li-Tsang, & Fong, 2013).
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