The Incidence of Neglect Phenomena and Related Disorders in Patients with an Acute Right or Left Hemisphere Stroke

TLDR

Neglect phenomena are typically linked to right‑hemisphere damage, but language deficits may mask them in left‑hemisphere stroke patients. We studied 171 consecutive acute hemispheric stroke patients (69 right, 102 left) at 2–3 days post‑stroke using a standardized, validated test battery to detect a wide variety of neglect phenomena and related disorders. Among assessable patients, visual neglect was present in 82 % of right‑hemisphere and 65 % of left‑hemisphere strokes, hemi‑inattention in 70 % and 49 %, tactile extinction in 65 % and 35 %, allesthesia in 57 % and 11 %, visual extinction in 23 % and 2 %, anosognosia in 28 % and 5 %, anosodiaphoria in 27 % and 2 %, and non‑belonging in 36 % and 29 %, with visual neglect occurring more commonly after left‑hemisphere stroke than previously reported.

Abstract

We studied 171 consecutive patients with an acute hemispheric stroke (69 right hemisphere, 102 left), at 2–3 days post-stroke. A standardized test battery, previously validated in patients with acute stroke, was used to detect a wide variety of neglect phenomena and related disorders. Visual neglect was found in 82% of assessable right hemisphere patients and 65% of left hemisphere patients. Hemi-inattention was found in 70% of right and 49% of left hemisphere strokes. Tactile extinction was found in 65% of right and 35% of left hemisphere patients; allaesthesia in 57% (right), and 11% (left); visual extinction in 23% (right) 2% (left). Anosognosia was found in 28% (right), and 5% (left); anosodiaphoria in 27% (right), and 2% (left); non-belonging in 36% (right) and 29% (left). Visual neglect occurred more commonly in left hemisphere stroke than previously reported. Although neglect phenomena and related disorders were associated with right hemisphere damage, it is possible that language difficulties obscured their presence in some patients with a left hemisphere stroke.