Neglect is a failure to orient toward, respond to, or report novel or meaningful stimuli. If failure to respond can be attributed to concurrent sensory or motor deficits (e.g., hemiparesis, hemianopia, visuospatial deficits) neglect is not present.
Neglect can involve stimuli in the extrapersonal environment (e.g.,visual neglect) or personal space (e.g., personal neglect or asomatognosia). Neglect of contralateral hemispace may also be called unilateral spatial neglect, hemi-inattention, or hemineglect. Lesser degrees of neglect may be manifest as extinction (double simultaneous stimulation). Motor neglect may be evident as hemiakinesia, hypokinesia, or motor impersistence. Alloesthesia and allokinesia may also be features of neglect.
Neglect may be obvious (e.g., patient not dressing one side of the body), but is sometimes more subtle, in which case it may be tested for using various simple tests:
- Cancellation tests, for example, stars (unstructured array), letters (structured array)
- Figure copying, for example, Rey-Osterreith figure
- Line bisection, numbering a clock face
- Drawing from memory.
Neglect is commoner after right rather than left brain damage, usually of vascular origin. The angular gyrus and parahippocampal gyrus may be central to the development of visual neglect. Marked degrees of neglect may seriously hamper attempts at neurorehabilitation.
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