Visual neglect: should we attend to it?

Abstract

Aim: To review the literature on unilateral visuospatial inattention/neglect following stroke, concentrating on the areas of the brain involved, methods of assessment and therapeutic options. Methods: A literature-based survey was conducted using relevant articles and practical experience to elicit current theories of inattention and to discover whether any evidence-based treatment strategies exist. As there are numerous testing approaches for inattention, evidence was also sought for the most appropriate and accurate assessment tool(s). Results: The star cancellation, line bisection and random shape cancellation tests appeared to be the most sensitive for detecting neglect; however, a range of tests is necessary in order to detect severity.Therapeutic options may include scanning techniques and visuo-motor cueing into the affected side, prism adaptation and limb activation to increase awareness of the affected side and reduce inhibition by the healthy hemisphere. Motor and functional recovery of stroke patients with neglect seems to be improved by targeted treatment. Conclusion: Neglect is an important predictor of poor functional recovery and therefore treatment remains a high priority. However, more research is needed to better define which treatment options are the most effective.

Keywords

• Neglect
• Scanning training
• Visual inattention
• Visuo-motor cueing