W12: Neglect (Perceptual Cognitive)

Question 1

Perceptual-Cognitive Definition

Answer 1

Inability to process and interpret sensory information (perceptual) and inability to process, sort, retrieve and interpret information (cognitive)”

Question 2

Can also present as:
- Agnosia (Perceptual-cognitive)
- Apraxia
- Others eg Pusher syndrome

Please define the above

Answer 2

Agnosia: stimulus is recognised, but not able to be interpreted (meaning)

Pusher syndrome: a clinical disorder following brain damage in which patients actively push away from the non-hemiparetic side (ie non-affected side), leading to a loss of balance” –> Burke Lateropulsion Scale

Question 3

Define neglect

Answer 3

Failure to respond to meaningful stimuli presented to the side opposite a brain lesion

Question 4

What must you distinguish neglect from?

Answer 4

Decreased vision & proprioception

Question 5

True or False: (L) neglect from a (R) brain lesion is more common than (R) neglect from a (L) brain lesion

Answer 5

True

Question 6

What is neglect associated with?

Answer 6

Associated with ↓ independence in ADLs and mobility, ↑ length of hospital stay

Question 7

What is neglect associated with ie where are the lesions?

Answer 7

Chiefly associated with lesions to the (R) parietal lobe

Question 8

Classifications of neglect: Modality vs distribution

Answer 8

Modality: Sensory, motor, representational/imagery

Distribution: Personal, peripersonal, extrapersonal

Question 9

Modality: Sensory neglect

Answer 9

Known as visual, auditory or tactile neglect (failure to respond to any of these stimuli)

eg in the case of visual neglect they may not notice you until you say hello

Question 10

Inattention vs extinction

Answer 10

Failure to respond to sensory stimuli on side of body or space only when both sides are stimulated

Question 11

Modality: Motor neglect

Answer 11

• Failure to move in response to a stimulus despite being aware of stimulus
• e.g. bumping into door frame on neglect side

Question 12

Modality: Representational/imagery

Answer 12

• Ignorance of the contralesional half of internally generated images (mental representations or visualizations of a task, action or environment)

eg If asked to visualize a familiar room, they might only describe or “see” objects on the right side of that room in their mental image, completely ignoring or being unaware of the objects on the left side.

Question 13

Distribution: Personal

Answer 13

• Failure to acknowledge side of body
• EG dress only one side of the body, comb only one side of hair, shave only one side of face

Question 14

Distribution of neglect: Peripersonal

Answer 14

• Peripersonal
• Failure to acknowledge stimuli in the Peripersonal space around individual eg eating from only one side of plate

Explained further:
Peripersonal space refers to the area immediately surrounding a person, within arm’s reach, where they can interact with objects and stimuli. It is essentially the space within which we can easily reach out and touch things.

Peripersonal neglect, therefore, is a condition where a person fails to acknowledge or respond to stimuli located in this immediate surrounding space on one side of their body.

Question 15

Distribution of neglect: extrapersonal

Answer 15

• Failure to acknowledge stimuli in the extra personal space around individual, e.g. bumping into door frame on neglect side

Question 16

Weak recommendation for neglect

Answer 16

• Cognitive rehabilitation (WR)
• Mirror therapy (WR)
• Teach them strategies eg visual scanning, give cues to draw attention to affected side,