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Discussion of unilateral spatial inattention and a proposed new screening method for its detection

1 May 2006


Unilateral spatial inattention, also known as neglect, is a condition associated with brain injury that results in the patient being unaware of one hemifield, usually contralateral to the side of the lesion. It is commonly the result of traumatic or acquired brain injury (stroke) and it can be quite variable in its presentation and severity. Unilateral spatial inattention typically requires an extensive battery of tests to confirm its presence or absence, and thus is often not identified by individuals working with these patients. This lack of recognition often leaves unilateral spatial inattention patients underserved with their visual needs. In this paper we review some of the common definitions, causes, rates of occurrence and different manifestations of unilateral spatial inattention. We further review some of the classifications of unilateral spatial inattention as well as the more common tests used to detect and diagnose it. An area of much debate, treatment of unilateral spatial inattention, is also examined along with the clinical prognosis for unilateral spatial inattention patients. In this discussion we propose a new testing method to aid in the detection of unilateral spatial inattention. Brain injury patients commonly present with visual perceptual deficits for which The Test of Visual Perceptual Slulls non-motor is commonly administered. This test is frequently used by rehabilitation specialists and optometrists to help identify these deficits. We postulate that patients with unilateral spatial inattention will show more mistakes on those test plates where the correct answer choice falls into the neglected hemi-field. Therefore, it may be possible to uncover and diagnose unilateral spatial inattention solely by analyzing a patient's pattern of errors on the Test of Visual Perceptual Skills. If it were easier to detect unilateral spatial inattention, it would likely lead to better rehabilitative care of unilateral spatial inattention patients.


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