Neglect and Related Disorders
Abstract Neglect is the failure to report, respond, or orient to novel or meaningful stimuli presented to the side opposite a brain lesion, when this failure cannot be attributed to either sensory or motor defects (Heilman, 1979). Neglect may be spatial or personal. Spatial neglect may occur in three reference frames: body centered, environmentally centered, and object centered. One may be inattentive to stimuli in space or on the person (attentional or sensory neglect) and one may fail to act in a portion of space, in a spatial direction, or to use a portion of one’s body (intentional or motor neglect). Many specific disorders have been described, distinguished by their presumed underlying mechanisms, the distribution of the abnormal behavior, and the means of eliciting the behavior. Different behavioral manifestations may occur at different times, and in some patients certain manifestations are never seen. The major behavioral manifestations that we will discuss in this chapter include (1) inattention or sensory neglect, (2) extinction to simultaneous stimuli, (3) motor neglect, (4) spatial neglect, (5) personal neglect, (6) allesthesia and allokinesia, and (7) anosognosia (unawareness of illness). The first section of this chapter will define specific disorders and describe clinical tests that may be used to assess them.