Unilateral Spatial Neglect (unilateral + spatial_neglect)

Distribution by Scientific Domains

Selected Abstracts

Postictal But Not Interictal Hemispatial Neglect in Patients with Seizures of Lateralized Onset

EPILEPSIA, Issue 12 2006
Olga Prilipko
Summary:,Purpose: Unilateral spatial neglect, defined as a failure to report, respond, or orient to stimuli that are presented contralaterally, has been widely documented after brain damage to right, and to a lesser degree, left frontotemporoparietal networks. Group studies involving patients with seizures with a lateralized focus have demonstrated transient dysfunctions in memory and language; however, so far, only two case reports have described transient neglect after an epileptic seizure. Methods: To assess the existence and consistency of this phenomenon, we evaluated 33 epilepsy patients on a line-bisection task in interictal and postictal states as compared with an age- and sex-matched control group. Results: Spatial neglect, as determined by this test, was found in the postictal but not interictal examination in patients with right parietal epileptic foci and was maximal for the left-positioned lines, whereas no neglect was found in other groups. Conclusions: Our findings indicate that patients with right parietal foci can present a transient neglect phenomenon on the line-bisection task in the postictal period, even in the absence of overt clinical neglect signs. These findings might be useful in establishing the laterality and even localization of epileptic foci based on the postictal neuropsychological evaluation. [source]

EFNS guidelines on cognitive rehabilitation: report of an EFNS task force

Members of the Task Force on Cognitive Rehabilitation
Disorders of language, spatial perception, attention, memory, calculation and praxis are a frequent consequence of acquired brain damage [in particular, stroke and traumatic brain injury (TBI)] and a major determinant of disability. The rehabilitation of aphasia and, more recently, of other cognitive disorders is an important area of neurological rehabilitation. We report here a review of the available evidence about effectiveness of cognitive rehabilitation. Given the limited number and generally low quality of randomized clinical trials (RCTs) in this area of therapeutic intervention, the Task Force considered, besides the available Cochrane reviews, evidence of lower classes which was critically analysed until a consensus was reached. In particular, we considered evidence from small group or single cases studies including an appropriate statistical evaluation of effect sizes. The general conclusion is that there is evidence to award a grade A, B or C recommendation to some forms of cognitive rehabilitation in patients with neuropsychological deficits in the post-acute stage after a focal brain lesion (stroke, TBI). These include aphasia therapy, rehabilitation of unilateral spatial neglect (ULN), attentional training in the post-acute stage after TBI, the use of electronic memory aids in memory disorders, and the treatment of apraxia with compensatory strategies. There is clearly a need for adequately designed studies in this area, which should take into account specific problems such as patient heterogeneity and treatment standardization. [source]

Design and testing of a virtual environment to train stroke patients with unilateral spatial neglect to cross a street safely

Health Studies, Professor Patrice L. (Tamar) Weiss Faculty of Social Welfare
Abstract Virtual reality (VR) entails the use of advanced technologies, including computers and various multimedia peripherals, to produce a simulated (that is, virtual) environment that users perceive as comparable to real world objects and events. In recent years, virtual reality technologies have begun to be used as an assessment and treatment tool in occupational therapy, in part because of the ability to create environments that provide patients with opportunities to engage in meaningful, purposeful tasks that are related to real-life interests and activities. The objective of this study was to determine the suitability and feasibility of using a PC-based, nonimmersive, VR system (that is, a system in which the user has a reduced sense of actual presence in and control over the simulated environment) for training individuals with unilateral spatial neglect to cross streets in a safe and vigilant manner. A virtual environment, consisting of a typical city street, was programmed using Superscape'sTM 3D-Webmaster, a 3D web-authoring tool. Twelve subjects, aged 55 to 75 years, participated in the initial feasibility study and, to date, a further eight subjects have participated in the intervention study. Six of the initial subjects and all eight of the intervention subjects had sustained a right hemispheric stroke at least 6 weeks prior to the study. The remaining subjects were healthy age-matched adults who were independently mobile and had no difficulty in crossing streets. The results show that this virtual environment was suitable in both its cognitive and motor demands for the targeted population and indicate that the virtual reality training is likely to prove beneficial to people who have difficulty with crossing streets. The generalizability of these results, and recommendations regarding the use of virtual reality as an occupational therapy intervention, must be substantiated by further studies using a range of VR platforms with people with different cognitive and motor disabilities. Copyright 2003 Whurr Publishers Ltd. [source]

Using the knowledge to action process model to incite clinical change,

Anita Petzold BSc
Abstract Introduction Knowledge translation (KT) has only recently emerged in the field of rehabilitation with attention on creating effective KT interventions to increase clinicians' knowledge and use of evidence-based practice (EBP). The uptake of EBP is a complex process that can be facilitated by the use of the Knowledge to Action Process model. This model provides a sequence of phases for researchers and clinicians to follow in order to optimize KT across various fields of practice. Methods In this article we use an example from a series of national studies in stroke rehabilitation to demonstrate how the Knowledge to Action Process model is being used to increase the use of best practices in the management of a very prevalent poststroke impairment, unilateral spatial neglect. Results The series of research projects and actions described herein each address a specific phase of the model. The reader is introduced to a specific example with the goal of generalizing the process to his or her own domain of interest. Gaps in our research agenda are also highlighted and future initiatives to complete the process are described. Discussion It is important that KT is maximized in health care to improve patient outcomes. As demonstrated here, the Knowledge to Action Process model provides an excellent guide for clinicians, managers, and researchers who wish to incite change in patient care. [source]

So near yet so far: Neglect in far or near space depends on tool use

Alan J. Pegna PhD
The study of unilateral spatial neglect has shown that space can be dissociated on a peripersonal versus extrapersonal basis. We report a novel type of dissociation based on tool use in a patient suffering from left neglect. Line bisection was carried out in near and far space, using a stick and a laser pointer. A rightward bias was always found for the former, but not for the latter. Neglect thus appears to be contingent not only on distance, but also on the motor action required by the task. [source]