Neglect test Some of the neglect tests. File:Letter search neglect test.Letter search neglect test File:Letter search neglect test result.Letter search neglect test result File:Line cancellation neglect test.Line cancellation neglect test File:Line cancellation neglect test result.Line cancellation neglect test result File:AllochiriaClock.The Allochiria phenomena might be revealed by the request to draw a clock. File:Neglect LINE BISECTION test.The patients has to mark the half of the line. In order to assess not only the type but also the severity of neglect, doctors employ a variety of tests, most of which are carried out at the patient's bedside. Perhaps one of the most-used and quickest is the line bisection. In this test, a line a few inches long is drawn on a piece of paper and the patient is then asked to dissect the line at the midpoint. Patients exhibiting, for example, left-sided neglect will exhibit a rightward deviation of the line's true midpoint. Another widely used test is the line cancellation test. Here, a patient is presented with a piece of paper that has various lines scattered across it and is asked to mark each of the lines. Patients who exhibit left-sided neglect will completely ignore all lines on the left side of the paper. Visual neglect can also be assessed by having the patient draw a copy of a picture with which they are presented. If the patient is asked to draw a complex picture they may neglect the entire contralesional side of the picture. If asked to draw an individual object, the patient will not draw the contralesional side of that object. A patient may also be asked to read a page out of a book. The patient will be unable to orient their eyes to the left margin and will begin reading the page from the center. Presenting a single word to a patient will result in the patient either reading only the ipsilesional part of the word or replacing the part they cannot see with a logical substitute. For example, if they are presented with the word "peanut", they may read "nut" or say "walnut". Varieties Neglect is a heterogenous disorder that manifests itself radically differently in different patients. No single mechanism can account for these different manifestations. A vast array of impaired mechanisms are found in neglect. These mechanisms alone would not cause neglect. The complexity of attention alone—just one of several mechanisms that may interact—has generated multiple competing hypothetical explanations of neglect. So it is not surprising that it has proven difficult to assign particular presentations of neglect to specific neuroanatomical loci. Despite such limitations, we may loosely describe unilateral neglect with four overlapping variables: type, range, axis, and orientation. Type Types of<unk>  are broadly divided into disorders of input and disorders of output. The neglect of input, or "inattention", includes ignoring contralesional sights, sounds, smells, or tactile stimuli. Surprisingly, this inattention can even apply to imagined stimuli. In what's termed "representational neglect", patients may ignore the left side of memories, dreams, and hallucinations. Output neglect includes motor and pre-motor deficits. A patient with motor neglect does not use a contralesional limb despite the neuromuscular ability to do so. One with pre-motor neglect, or directional hypokinesia, can move unaffected limbs ably in ipsilateral space but have difficulty directing them into contralesional space. Thus a patient with pre-motor neglect may struggle to grasp an object on the left side even when using the unaffected right arm. Range<unk>  can have a wide range in terms of what the patient neglects. The first range of neglect, commonly referred to as "egocentric" neglect, is found in patients who neglect their own body or personal space. These patients tend to neglect the opposite side of their lesion, based on the midline of the body, head, or retina. For example, in a gap detection test, subjects with egocentric<unk>  on the right side often make errors on the far right side of the page, as they are neglecting the space in their right visual field. The next range of neglect is "allocentric" neglect, where individuals neglect either their peri-personal or extrapersonal space. Peri-personal space refers to the space within the patient's normal reach, whereas extrapersonal space refers to the objects/environment beyond the body's current contact or reaching ability. Patients with allocentric neglect tend to neglect the contralesional side of individual items, regardless of where they appear with respect to the viewer. For example, In the same gap detection test mentioned above, subjects with allocentric<unk>  on the right side will make errors on all areas of the page, specifically neglecting the right side of each individual item. This differentiation is significant because the majority of assessment measures test only for neglect within the reaching, or peri-personal, range. But a patient who passes a standard paper-and-pencil test of neglect may nonetheless ignore a left arm or not notice distant objects on the left side of the room. In cases of somatoparaphrenia, which may be caused by personal neglect, patients deny ownership of contralesional limbs. Sacks (1985) described a patient who fell out of bed after pushing out what he perceived to be the severed leg of a cadaver that the staff had hidden under his blanket. Patients may say things like, "I don't know whose hand that is, but they'd better get my ring off!" or, "This is a fake arm someone put on me. I sent my daughter to find my real one." Axis Most tests for neglect look for rightward or leftward errors. But patients may also neglect stimuli on one side of a horizontal or radial axis. For example, when asked to circle all the stars on a printed page, they may locate targets on both the left and right sides of the page while ignoring those across the top or bottom. In a recent study, researchers asked patients with left neglect to project their midline with a neon bulb and found that they tended to point it straight ahead but position it rightward of their true midline. This shift may account for the success of therapeutic prism glasses, which shift left visual space toward the right. By shifting visual input, they seem to correct the mind's sense of midline. The result is not only the amelioration of visual neglect, but also of tactile, motor, and even representational neglect. Orientation An important question in studies of neglect has been: "left of what?" That is to say, what frame of reference does a subject adopt when neglecting the left half of his or her visual, auditory, or tactile field? The answer has proven complex. It turns out that subjects may neglect objects to the left of their own midline (egocentric neglect) or may instead see all the objects in a room but neglect the left half of each individual object (allocentric neglect). These two broad categories may be further subdivided. Patients with egocentric neglect may ignore the stimuli leftward of their trunks, their heads, or their retinae. Those with allocentric neglect may neglect the true left of a presented object, or may first correct in their mind's eye a slanted or inverted object and then neglect the side then interpreted as being on the left. So, for example, if patients are presented with an upside-down photograph of a face, they may mentally flip the object right side up and then neglect the left side of the adjusted image. In another example, if patients are presented with a barbell, patients will more significantly neglect the left side of the barbell, as expected with right temporal lobe lesion. If the barbell is rotated such that the left side is now on the right side, patients will more significantly neglect the left side of the object, even though it is now on the right side of space. This also occurs with slanted or mirror-image presentations. A patient looking at a mirror image of a map of the World may neglect to see the Western Hemisphere despite their inverted placement onto the right side of the map. Various neuropsychological research studies have considered the role of frame of reference in<unk> , offering new evidence to support both allocentric and egocentric neglect. To begin, one study conducted by Dongyun Li, Hans-Otto Karnath, and Christopher Rorden examined whether allocentric neglect varies with egocentric position. This experimental design consisted of testing eleven right hemispheric stroke patients. Five of these patients showed spatial neglect on their contralesional side, while the remaining six patients showed no spatial neglect. During the study, the patients were presented with two arrays of seven triangles. The first array ran from southwest to northeast (SW-NE) and the second array ran from southeast to northwest (SE-NW). In a portion of the experimental trials, the middle triangle in the array contained a gap along one side. Participants were tested on their ability to perceive the presence of this gap, and were instructed to press one response button if the gap was present and a second response button if the gap
Hemispatial neglect
Hemimotor neglect
Visuospatial dysgnosia
Integrative agnosia
Autotopagnosia
Finger agnosia
Metamorphopsia
Receptive aphasia