Right Hemisphere Syndrome (RHS) or Dysfunction (RHD) Flashcards
Until the mid 1800s, neuroanatomists believed that the human brain was functionally and physically _____
symmetrical
Behavioral and cognitive symptoms of right-hemisphere BI: characterized as…
- self absorbed
- insensitive to others; preoccupied with self
- oblivious to social conventions
- unconcerned/unaware/ inattentive about physical and mental impairments
- verbose
- tangential
- rambling in speech
- insensitive to the meaning of abstract or implied material
- unable to grasp the overall significance or meaning of complex events
Some adults with RH BI are characterized as behaviorally passive, meaning…
They are:
- unresponsive to social/environmental stimuli
- short utterances that lack emotional inflection (dysprosody)
- can be passive, emotionally flat and having problems with attention (for more than a few seconds)
- present with left hemi-spatial neglect
Why might patients with RH BI have trouble in therapy?
- they don’t think they need it (poor/reduced awareness and/or defensitivity)
Why is there a poor understanding of diversity within this population? (group studies)
Group studies of adults with RH BI:
- report results for heterogeneous groups lacking disclosure of the location/severity of BI
- report the average performance of groups
- do not include a control group
- include disproportionately large numbers of participants with frontal lobe injuries
- RH adults with posterior lesions (no paralysis) and are discharged EARLY from hospital
Describe neglect
affected individuals fail to respond to stimuli on the side of the body opposite the side of the BI
T/F Neglect may be caused by BI in L or R hemisphere, but is more frequent, severe, and persistent following R hemisphere BI
true
T/F Although neglect will present in injuries in several regions of R hemisphere, most common/severe after R temporal lobe injury
false; right PARIETAL lobe injury
Neglect occasionally results after _____ injury
subcortical (thalamus & basal ganglia)
Sometimes concomitant with partial or completely blind in the ____ visual field (L or R)
left
T/F Neglect usually improves or resolves days/weeks after the BI
true
RH adults with left neglect may not respond to…
touch on L side of body, or attend to visual or auditory stimuli in L-sided space
Freebie: these individuals may… (reading)
- fail to include words on L side of page when reading
- produce neglect-related errors when reading single words as well as text (reading ‘mistake’ as ‘take’)
- leave out left half of compound words (‘blackboard’ as ‘board’)
- substitute/add letters to make word (reading ‘chain’ as ‘train’ or ‘fearless’ as ‘careless’)
- longer words are more likely to be read incorrectly than are shorter words
Freebie continued: these individuals may… (writing)
- use only R side of the paper when writing words/sentences
- often their writing slants upward from left to right
- omit letters/words when writing (especially at the beginning of the word)
- may add extra lines and strokes to printed letters (page 399)
- bump into objects on the L whether walking or in a wheelchair
- attend to only R-side of pockets, drawers, cupboards
Freebie: Myers (1999) common signs of left neglect
- diminished/poor awareness of deficits
- diminished/lack of participation in rehab
Name the proposed theories to explain neglect (4)
- Representational
- Arousal
- Attentional engagement
- Attentional disengagement
Representational theories
Neglect is caused by disturbed mental representation of external space
Arousal theories
R-hemisphere injured persons are less responsive to stimuli in neglected space
Attentional engagement theories
Individuals w/ neglect have difficulty shifting attention to stimuli in neglected space
Attentional disengagement theories
Stimuli in non-neglected space capture and hold the person’s attention, preventing him/her from shifting attention to stimuli on neglected side
What is anosognosia?
- denial of illness
- ranges from mild to profound
What is a constructional impairment?
inability to draw or copy geometric designs
Freebie
adults with RH BIs:
- respond quickly and impulsively
- make frequent errors
- try to correct by adding more lines to drawings or by aimlessly rearranging stick or block designs
- leave out details (or everything) on L side
- drawings look fragmented, disorganized, and crowded
- displaced to R side of page
What is a topographic impairment?
denotes a condition in which the affected person has difficulty orienting to extra personal space (difficulty following familiar routines, reading maps, giving directions)
