DOCSLIB.ORG

Chapter 13: Rehabilitation of Unilateral Spatial Neglect

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Chapter 13: Rehabilitation of Unilateral Spatial Neglect Chapter 13: Rehabilitation of unilateral spatial neglect Abstract This review examines the treatment of perceptual disorders following stroke focusing primarily on unilateral spatial neglect. Unilateral spatial neglect is reported in about 25% of stroke patients referred for rehabilitation and is more commonly associated with right parietal lesions. Unilateral spatial neglect has been reported to have a negative impact on functional recovery, length of rehabilitation stay, and need for assistance after discharge. In general, rehabilitation interventions to improve neglect may be classified into a) those which attempt to increase the stroke patient's awareness of or attention to the neglected space or b) those which focus on the remediation of deficits of position sense or body orientation. Interventions of the first type included in the present review are: visual scanning retraining, arousal or activation strategies and feedback to increase awareness of neglect behaviours. Identified interventions that attempt to improve neglect by targeting deficits associated with position sense and spatial representation include the use of prisms, eyepatching and hemispatial glasses, caloric stimulation, optokinetic stimulation, TENS and neck vibration. The use of dopaminergic medication therapy and music therapy is also discussed. Marcus Saikaley, BSc Jerome Iruthayarajah, MSc Katherine Salter, PhD Janet Donais, OT Robert Teasell, MD Chapter 13: Neglect Rehabilitation Table of contents Modified Sackett Scale ....................................................................................... 4 New to the 19th edition of the Evidence-based Review of Stroke Rehabilitation ....................................................................................................... 5 Outcome Measure Definitions ............................................................................ 7 Visuospatial Processing & Neglect ............................................................................... 7 Learning & Memory .................................................................................................... 14 Global Cognition ......................................................................................................... 14 Motor Rehabilitation .................................................................................................... 15 Stroke Severity ........................................................................................................... 17 Activities of Daily Living .............................................................................................. 18 Defining Neglect ................................................................................................ 19 Incidence of Neglect ................................................................................................... 19 Anatomical substrates of Neglect ............................................................................... 20 Spontaneous recovery and neglect ............................................................................ 21 The impact of Neglect Post-Stroke ............................................................................. 21 Screening and Assessments for Neglect .................................................................... 22 Behavioural therapy-based Intervention......................................................... 24 Visual Scanning Training ............................................................................................ 24 Computer-Based Rehabilitation .................................................................................. 29 Limb Activation ........................................................................................................... 32 Visuomotor Feedback Strategies ................................................................................ 36 Prism Adaptation Treatment ....................................................................................... 39 Eye-Patching and Hemispatial Glasses ...................................................................... 43 Trunk Rotation Therapy .............................................................................................. 48 Stimulation Interventions ................................................................................. 51 Neck Muscle Vibration ................................................................................................ 51 Transcutaneous Electrical Nerve Stimulation ............................................................. 53 Repetitive Transcranial Magnetic Stimulation ............................................................. 56 Theta Burst Stimulation .............................................................................................. 59 Transcranial Direct Current Stimulation ...................................................................... 62 Galvanic Vestibular Stimulation .................................................................................. 64 Optokinetic Stimulation ............................................................................................... 67 Pharmacological Interventions ........................................................................ 71 Dopaminergic Medication Therapy ............................................................................. 71 Acetylcholinesterase Inhibitor Therapy ....................................................................... 73 Nicotine Therapy ........................................................................................................ 75 Guanfacine ................................................................................................................. 77 References ......................................................................................................... 79 Key points The literature is mixed regarding visual scanning training for improving neglect. Visual scanning training may not be beneficial for improving activities of daily living. Computer-based and virtual reality therapies may not be beneficial for improving neglect, or activities of daily living. Limb activation may not be beneficial for improving neglect. Mirror training may be beneficial for improving neglect. The literature is mixed regarding prism adaptation training for improving neglect. Eye patching and hemispatial glasses may not be beneficial for neglect, stroke severity, motor rehabilitation or activities of daily living. Galvanic vestibular stimulation (GVS) may not be beneficial for improving neglect. There does not appear to be a difference in efficacy between left or right GVS, and high or low volume GVS. The literature is mixed regarding optokinetic stimulation training for improving neglect. The literature is mixed concerning trunk rotation therapy for improving neglect and activities of daily living. The literature is mixed concerning visual exploration with neck muscle vibration for improving activities of daily living. TENS may be beneficial for improving neglect. The literature is mixed regarding rTMS for improving motor rehabilitation. rTMS may not be beneficial for improving activities of daily living. TBS may be beneficial for improving neglect. tDCS may be beneficial for improving neglect. Dopaminergic medication may not be beneficial for improving neglect, learning and memory, and motor rehabilitation. The literature is mixed concerning rivastigmine therapy for improving neglect. Nicotine may be beneficial for improving neglect. The literature is mixed regarding guanfacine for improving neglect. Modified Sackett Scale Level of Study design Description evidence Level 1a Randomized More than 1 higher quality RCT (PEDro score ≥6). controlled trial (RCT) Level 1b RCT 1 higher quality RCT (PEDro score ≥6). Level 2 RCT Lower quality RCT (PEDro score <6). Prospective PCT (not randomized). controlled trial (PCT) Cohort Prospective longitudinal study using at least 2 similar groups with one exposed to a particular condition. Level 3 Case Control A retrospective study comparing conditions, including historical cohorts. Level 4 Pre-Post A prospective trial with a baseline measure, intervention, and a post-test using a single group of subjects. Post-test A prospective post-test with two or more groups (intervention followed by post-test and no re-test or baseline measurement) using a single group of subjects Case Series A retrospective study usually collecting variables from a chart review. Level 5 Observational Study using cross-sectional analysis to interpret relations. Expert opinion without explicit critical appraisal, or based on physiology, biomechanics or "first principles". Case Report Pre-post or case series involving one subject. New to the 19th edition of the Evidence-based Review of Stroke Rehabilitation 1) PICO conclusion statements This edition of Chapter 13: Neglect rehabilitation interventions synthesizes study results from only randomized controlled trials (RCTs), all levels of evidence (LoE) and conclusion statements are now presented in the Population Intervention Comparator Outcome (PICO) format. For example: New to these statements is also the use of colours where the levels of evidence are written. Red statements like above, indicate that the majority of study results when grouped together show no significant differences between intervention and comparator groups. Green statements indicate that the majority of study results when grouped together show a significant between group difference in
Load more

Recommended publications
  • Non-Ketotic Hyperglycaemia and the Hemichorea- Hemiballismus
    This open-access article is distributed under ARTICLE Creative Commons licence CC-BY-NC 4.0. Non-ketotic hyperglycaemia and the hemichorea- hemiballismus syndrome – a rare paediatric presentation M P K Hauptfleisch, MB BCh, MMed Paeds, FCPaed (SA), Cert Paed Neuro (SA); J L Rodda, MB BCh, FCPaed (SA) Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa and Chris Hani Baragwanath Academic Hospital, Johannesburg, Africa Corresponding author: M P K Hauptfleisch ([email protected]) Hemichorea-hemiballismus may be due to non-ketotic hyperglycaemia, but this condition has rarely been described in paediatrics. We describe the case of a 13-year-old girl with newly diagnosed type 1 diabetes and acute onset of left-sided choreoathetoid movements. Neuroimaging revealed an area of hyperintensity in the right basal ganglia. Her blood glucose level at the time was 19 mmol/L, and there was no ketonuria. The hemiballismus improved with risperidone and glycaemic control. Repeat neuroimaging 4 months later showed complete resolution of the hyperintensities seen. S Afr J Child Health 2018;12(4):134-136. DOI:10.7196/SAJCH.2018.v12i4.1535 Non-ketotic hyperglycaemic hemichorea-hemiballismus (NKHHC) is a rare, reversible condition, with the clinical and radiological signs usually resolving within 6 months, following correction of hyperglycaemia.[1] The condition has previously been described as specifically affecting the elderly, with very few cases described in children and adolescents.[2] We describe a paediatric patient presenting with the classic clinical and radiological findings of NKHHC. Case A 13-year-old female presented to hospital with severe cramps in her left hand.
    [Show full text]
  • Upper Extremity Function in Persons with Tetraplegia: Relationships
    Neurorehabilitation and Research Articles Neural Repair Volume 23 Number 5 June 2009 413-421 © 2009 The Author(s) 10.1177/1545968308331143 Upper Extremity Function in Persons with http://nnr.sagepub.com Tetraplegia: Relationships Between Strength, Capacity, and the Spinal Cord Independence Measure Claudia Rudhe, OT, MSc, and Hubertus J. A. van Hedel, PT, PhD Objective. To quantify the relationship between the Spinal Cord Independence Measure III (SCIM III), arm and hand muscle strength, and hand function tests in persons with tetraplegia. Methods. A total of 29 individuals with tetraplegia (motor level between cervical 4 and thoracic 1; sensory-motor complete and incomplete) participated. The total score, category scores, and separate items of the SCIM III were compared to the upper extremity motor score (UEMS), an extended manual muscle test (MMT) for 11 upper extremity muscles, and 6 functional capacity tests of the hand. Spearman’s correlation coefficients (rs) and regression analyses were performed. Results. The SCIM III sum score correlated well with the sum scores of the 3 tests (rs ≥ .76). The SCIM III self-care category correlated better with the tests (rs ≥ .80) compared to the other categories (rs ≤ .72). The SCIM III self-care item “grooming” highly correlated with muscle strength and hand capacity items (rs ≥ .80). A combination of hand muscle tests and the key grasping task explained over 90% of the variability in the self-care category scores. Conclusions. The SCIM III self-care category reflects upper extremity performance as it contains especially useful and valid items that relate to upper extremity function and capacity tests.
    [Show full text]
  • Four Effective and Feasible Interventions for Hemi-Inattention
    University of Puget Sound Sound Ideas School of Occupational Master's Capstone Projects Occupational Therapy, School of 5-2016 Four Effective and Feasible Interventions for Hemi- inattention Post CVA: Systematic Review and Collaboration for Knowledge Translation in an Inpatient Rehab Setting. Elizabeth Armbrust University of Puget Sound Domonique Herrin University of Puget Sound Christi Lewallen University of Puget Sound Karin Van Duzer University of Puget Sound Follow this and additional works at: http://soundideas.pugetsound.edu/ot_capstone Part of the Occupational Therapy Commons Recommended Citation Armbrust, Elizabeth; Herrin, Domonique; Lewallen, Christi; and Van Duzer, Karin, "Four Effective and Feasible Interventions for Hemi-inattention Post CVA: Systematic Review and Collaboration for Knowledge Translation in an Inpatient Rehab Setting." (2016). School of Occupational Master's Capstone Projects. 4. http://soundideas.pugetsound.edu/ot_capstone/4 This Article is brought to you for free and open access by the Occupational Therapy, School of at Sound Ideas. It has been accepted for inclusion in School of Occupational Master's Capstone Projects by an authorized administrator of Sound Ideas. For more information, please contact [email protected]. INTERVENTIONS FOR HEMI-INATTENTION IN INPATIENT REHAB Four Effective and Feasible Interventions for Hemi-inattention Post CVA: Systematic Review and Collaboration for Knowledge Translation in an Inpatient Rehab Setting. May 2016 This evidence project, submitted by Elizabeth Armbrust,
    [Show full text]
  • Susceptibility to Size Visual Illusions in a Non-Primate Mammal (Equus Caballus)
    animals Brief Report Susceptibility to Size Visual Illusions in a Non-Primate Mammal (Equus caballus) Anansi Cappellato 1, Maria Elena Miletto Petrazzini 2, Angelo Bisazza 1,3, Marco Dadda 1 and Christian Agrillo 1,3,* 1 Department of General Psychology, University of Padova, 35131 Padova, Italy; [email protected] (A.C.); [email protected] (A.B.); [email protected] (M.D.) 2 Department of Biomedical Sciences, University of Padova, Via Bassi 58, 35131 Padova, Italy; [email protected] 3 Padua Neuroscience Center, University of Padova, Via Orus 2, 35131 Padova, Italy * Correspondence: [email protected] Received: 30 July 2020; Accepted: 13 September 2020; Published: 17 September 2020 Simple Summary: Visual illusions are commonly used by researchers as non-invasive tools to investigate the perceptual mechanisms underlying vision among animals. The assumption is that, if a species perceives the illusion like humans do, they probably share the same perceptual mechanisms. Here, we investigated whether horses are susceptible to the Muller-Lyer illusion, a size illusion in which two same-sized lines appear to be different in length because of the spatial arrangements of arrowheads presented at the two ends of the lines. Horses showed a human-like perception of this illusion, meaning that they may display similar perceptual mechanisms underlying the size estimation of objects. Abstract: The perception of different size illusions is believed to be determined by size-scaling mechanisms that lead individuals to extrapolate inappropriate 3D information from 2D stimuli. The Muller-Lyer illusion represents one of the most investigated size illusions. Studies on non-human primates showed a human-like perception of this illusory pattern.
    [Show full text]
  • ICD-10 Backs
    Qualifying Dx Codes for Java Backs, Java Decaf Back, & Custom Back ICD-10 Description ICD-10 Description Paraplegia (paraparesis) and quadriplegia B91 Sequelae of poliomyelitis G82.20 - G82.54 (quadriparesis) E75.00 - E75.19 GM2 Gangliosidosis - Other gangliosidosis G83.10 - G83.14 Monoplegia of lower limb Other specified disorders of the brain - E75.23 Krabbe disease G93.89 - G94 Other disorders of the brain in diseases classified elsewhere E75.25 Metachromatic leukodystrophy G95.0 Syringomyelia and syringobulbia Acute infarction of spinal code (embolic) E75.29 Other sphingolipidosis G95.11 (nonembolic) E75.4 Neuronal ceroid lipofuscinosis G95.19 Other vascular myelopathies Myelopathy in diseases classified F84.2 Rett's Syndrome G99.2 elsewhere Monoplegia of lower limb following G04.1 Tropical spastic paraplegia I69.041 - I69.049 nontraumatic subarachnoid hemorrhage Hemiplegia and hemiparesis following G04.89 Other Myelitis I69.051 - I69.059 nontraumatic subarachnoid hemorrhage Monoplegia of lower limb following G10 Huntington's disease I69.141 - I69.149 nontraumatic intracerebral hemorrhage Congenital nonprogressive ataxia - Hemiplegia and hemiparesis following G11.0 - G11.9 I69.151 - I69.159 Hereditary ataxia, unspecified nontraumatic intracerebral hemorrhage Infantile spinal muscular atrophy, type 1 Monoplegia of lower limb following other G12.0 I69.241 - I69.249 (Werdnig-Hoffman) nontraumatic intracranial hemorrhage Hemiplegia and hemiparesis following G12.1 Other inherited spinal muscular atrophy I69.251 - I69.259 other nontraumatic
    [Show full text]
  • Traumatic Hemiparesis Associated with Type III Klippel-Feil Syndrome
    online ML Comm www.jkns.or.kr J Korean Neurosurg Soc 42 : 145-148, 2007 Case Report Traumatic Hemiparesis Associated with Jin-Kyu Park, M.D. Type III Klippel-Feil Syndrome Han-Yong Huh, M.D. Kyeong-Sik Ryu, M.D. Chun-Kun Park, M.D. Klippel-Feil Syndrome (KFS) is a complex congenital syndrome of osseous and visceral anomalies. It is mainly associated with multi-level cervical spine fusion with hypermobile normal segments. Therefore, a patient with KFS can be at risk of severe neurological symptoms even after a minor trauma. We report a patient with type III KFS who developed a hemiparesis after a minor trauma and was successfully managed with operation. KEY WORDS : Hemiparesis·Klippel-Feil Syndrome·Trauma. INTRODUCTION Department of Neurosurgery In 1912, Klippel and Feil first described a syndrome that consisted of a clinical triad of short Kangnam St. Mary’s Hospital The Catholic University of Korea neck, limitation in head and neck movements and low posterior hairline. Currently, this Seoul, Korea syndrome called Klippel-Feil syndrome (KFS) is referred to a congenital fusion of two or more vertebrae7). Multi-level fused cervical vertebrae may become symptomatic during the rapid growth of adolescence or in adult life by the entrapment of the brain and/or the spinal cord. The classification of KFS is based on the site and extent of the cervical fusion9). Type I is applied to patients with an extensive cervical and upper thoracic spinal fusion. Type II refers to patients with one or two interspace fusions, often associated with hemivertebrae and occipitio- atlantal fusions.
    [Show full text]
  • Reach and Palmar Grasp in Tetraplegics with Neuromuscular Electrical Stimulation
    REACH AND PALMAR GRASP IN TETRAPLEGICS WITH NEUROMUSCULAR ELECTRICAL STIMULATION ALCANCE E PREENSÃO PALMAR EM TETRAPLÉGICOS COM ESTIMULAÇÃO ELÉTRICA NEUROMUSCULAR ORIGINAL ARTICLE ARTIGO ORIGINAL ALCANCE Y PRENSIÓN PALMAR EN TETRAPLÉJICOS CON ESTIMULACIÓN ELÉCTRICA NEUROMUSCULAR ARTÍCULO ORIGINAL Enio Walker Azevedo Cacho1 ABSTRACT (Physiotherapist) Roberta de Oliveira Cacho1 Objective: To evaluate the movement strategies of quadriplegics, assisted by neuromuscular electrical stimulation, (Physiotherapist) on reach and palmar grasp using objects of different weights. Methods: It was a prospective clinical trial. Four chronic Rodrigo Lício Ortolan2 quadriplegics (C5-C6), with injuries of traumatic origin, were recruited and all of them had their reach and palmar grasp (Electrical Engineer) movement captured by four infrared cameras and six retro-reflective markers attached to the trunk and right arm, as- 1 Núbia Maria Freire Vieira Lima sisted or not by neuromuscular electrical stimulation to the triceps, extensor carpi radialis longus, extensor digitorum (Physiotherapist) communis, flexor digitorum superficialis, opponens pollicis and lumbricals. It was measured by a Neurological and Edson Meneses da Silva Filho1 (Physiotherapist) Functional Classification of Spinal Cord Injuries of the American Spinal Injury Association, Functional Independence Alberto Cliquet Jr3,4 Measure and kinematic variables. Results: The patients were able to reach and execute palmar grasp in all cylinders (Electronics Engineer) using the stimulation sequences assisted by neuromuscular electrical stimulation. The quadriplegics produced lower peak velocity, a shorter time of movement and reduction in movement segmentation, when assisted by neuromuscular 1. Universidade Federal do Rio electrical stimulation. Conclusion: This study showed that reach and palmar grasp movement assisted by neuromuscular Grande do Norte, Faculdade de Ciências de Saúde do Trairi, electrical stimulation was able to produce motor patterns more similar to healthy subjects.
    [Show full text]
  • Vision Biological Vision and Image Processing
    Vision Stefano Ferrari Universit`adegli Studi di Milano [email protected] Methods for Image processing academic year 2016–2017 Biological vision and image processing I The human visual perception results from a chain of processing tasks, often cooperating with other perceptual activities. I Image processing is a discipline (mainly) based on mathematical and statistical concepts, with constraints imposed by the image acquisition technology. I The study of the human vision is useful for more than one reason: I the output of some processes is targeted for the vision of a human user; I the operation of the organs devoted to the acquisition and perception of images can inspire the development of similar artificial devices; moreover, the performance of image processing algorithms have to be compared; I some known mulfunctioning of the biological apparatus do not affect the image processing devices. Stefano Ferrari| Methods for Image processing| a.a. 2016/17 1 . Eye I cornea I sclera I pupil I iris I lens I choroid I retina I fovea I blind spot Blind spot: close the left eye, sta- re to the cross, come closer to the screen till the spot disappears. Distribution of the receptors on the retina On the retina, two kinds of receptors can be found: I cones; I rods. I Cones: I about 7 millions; I perception of details and rapid changes; I sensitive to colors; I sensitive in high illuminance conditions (photopic vision). I Rods: I about 100 millions; I provide a large scale vision; I sensitive in low illuminance conditions (scotopic vision). Stefano Ferrari| Methods for Image processing| a.a.
    [Show full text]
  • Hemiballismus: /Etiology and Surgical Treatment by Russell Meyers, Donald B
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.13.2.115 on 1 May 1950. Downloaded from J. Neurol. Neurosurg. Psychiat., 1950, 13, 115. HEMIBALLISMUS: /ETIOLOGY AND SURGICAL TREATMENT BY RUSSELL MEYERS, DONALD B. SWEENEY, and JESS T. SCHWIDDE From the Division of Neurosurgery, State University of Iowa, College ofMedicine, Iowa City, Iowa Hemiballismus is a relatively uncommon hyper- 1949; Whittier). A few instances are on record in kinesia characterized by vigorous, extensive, and which the disorder has run an extended chronic rapidly executed, non-patterned, seemingly pur- course (Touche, 1901 ; Marcus and Sjogren, 1938), poseless movements involving one side of the body. while in one case reported by Lea-Plaza and Uiberall The movements are almost unceasing during the (1945) the abnormal movements are said to have waking state and, as with other hyperkinesias con- ceased spontaneously after seven weeks. Hemi- sidered to be of extrapyramidal origin, they cease ballismus has also been known to cease following during sleep. the supervention of a haemorrhagic ictus. Clinical Aspects Terminology.-There appears to be among writers on this subject no agreement regarding the precise Cases are on record (Whittier, 1947) in which the Protected by copyright. abnormal movements have been confined to a single features of the clinical phenomena to which the limb (" monoballismus ") or to both limbs of both term hemiballismus may properly be applied. sides (" biballismus ") (Martin and Alcock, 1934; Various authors have credited Kussmaul and Fischer von Santha, 1932). In a majority of recorded (1911) with introducing the term hemiballismus to instances, however, the face, neck, and trunk as well signify the flinging or flipping character of the limb as the limbs appear to have been involved.
    [Show full text]
  • 26 Aphasia, Memory Loss, Hemispatial Neglect, Frontal Syndromes and Other Cerebral Disorders - - 8/4/17 12:21 PM )
    1 Aphasia, Memory Loss, 26 Hemispatial Neglect, Frontal Syndromes and Other Cerebral Disorders M.-Marsel Mesulam CHAPTER The cerebral cortex of the human brain contains ~20 billion neurons spread over an area of 2.5 m2. The primary sensory and motor areas constitute 10% of the cerebral cortex. The rest is subsumed by modality- 26 selective, heteromodal, paralimbic, and limbic areas collectively known as the association cortex (Fig. 26-1). The association cortex mediates the Aphasia, Memory Hemispatial Neglect, Frontal Syndromes and Other Cerebral Disorders Loss, integrative processes that subserve cognition, emotion, and comport- ment. A systematic testing of these mental functions is necessary for the effective clinical assessment of the association cortex and its dis- eases. According to current thinking, there are no centers for “hearing words,” “perceiving space,” or “storing memories.” Cognitive and behavioral functions (domains) are coordinated by intersecting large-s- cale neural networks that contain interconnected cortical and subcortical components. Five anatomically defined large-scale networks are most relevant to clinical practice: (1) a perisylvian network for language, (2) a parietofrontal network for spatial orientation, (3) an occipitotemporal network for face and object recognition, (4) a limbic network for explicit episodic memory, and (5) a prefrontal network for the executive con- trol of cognition and comportment. Investigations based on functional imaging have also identified a default mode network, which becomes activated when the person is not engaged in a specific task requiring attention to external events. The clinical consequences of damage to this network are not yet fully defined. THE LEFT PERISYLVIAN NETWORK FOR LANGUAGE AND APHASIAS The production and comprehension of words and sentences is depen- FIGURE 26-1 Lateral (top) and medial (bottom) views of the cerebral dent on the integrity of a distributed network located along the peri- hemispheres.
    [Show full text]
  • Absence of Hemispatial Neglect Following Right Hemispherectomy in a 7-Year-Old Girl with Neonatal Stroke
    Neurology Asia 2017; 22(2) : 149 – 154 CASE REPORTS Absence of hemispatial neglect following right hemispherectomy in a 7-year-old girl with neonatal stroke *1Jiqing Qiu PhD, *2Yu Cui MD, 3Lichao Sun MD, 1Bin QiPhD, 1Zhanpeng Zhu PhD *JQ Qiu and Y Cui contributed equally to this work Departments of 1Neurosurgery, 2Otolaryngology and 3Emergency Medicine, The First Hospital of Jilin University, Changchun, Jilin, China Abstract Neonatal stroke leads to cognitive deficits that may include hemispatial neglect. Hemispatial neglect is a syndrome after stroke that patients fail to be aware of stimuli on the side of space and body opposite a brain lesion. We report here a 7-year-old girl who suffered neonatal right brain stroke and underwent right hemispherectomy due to refractory epilepsy. Post-surgical observation of the child’s behavior and tests did not show any signs of hemispatial neglect. We concluded the spatial attention function of the child with neonatal stroke might be transferred to the contralateral side during early childhood. Key words: Epilepsy; hemispatial neglect; hemispherectomy; neonatal stroke; child. INTRODUCTION CASE REPORT Approximately one in every 4,000 newborns suffer The patient was a 7-year-old right-handed girl. from neonatal stroke, with a high mortalityrate.1-3 She was delivered with normal body weight. The survivors may develop varying degrees Gestation and delivery were uneventful. There of hemiparesis and low intelligence quotient was no family history of epilepsy. She had coma (IQ). Children with neonatal stroke, especially a few days after birth and was diagnosed with children with hemiplegia, have a high risk of neonatal stroke (Figure 1A-D).
    [Show full text]
  • BJNN Neglect Article Pre-Proof.Pdf
    Kent Academic Repository Full text document (pdf) Citation for published version Gallagher, Maria and Wilkinson, David T. and Sakel, Mohamed (2013) Hemispatial Neglect: Clinical Features, Assessment and Treatment. British Journal of Neuroscience Nursing, 9 (6). pp. 273-277. ISSN 1747-0307. DOI https://doi.org/10.12968/bjnn.2013.9.6.273 Link to record in KAR https://kar.kent.ac.uk/37678/ Document Version UNSPECIFIED Copyright & reuse Content in the Kent Academic Repository is made available for research purposes. Unless otherwise stated all content is protected by copyright and in the absence of an open licence (eg Creative Commons), permissions for further reuse of content should be sought from the publisher, author or other copyright holder. Versions of research The version in the Kent Academic Repository may differ from the final published version. Users are advised to check http://kar.kent.ac.uk for the status of the paper. Users should always cite the published version of record. Enquiries For any further enquiries regarding the licence status of this document, please contact: [email protected] If you believe this document infringes copyright then please contact the KAR admin team with the take-down information provided at http://kar.kent.ac.uk/contact.html 1 Hemispatial Neglect: Clinical Features, Assessment and Treatment Maria Gallagher1, David Wilkinson1 & Mohamed Sakel2 1School of Psychology, University of Kent, UK. 2East Kent Neuro-Rehabilitation Service, East Kent Hospitals University NHS Foundation Trust, UK. Correspondence and request for reprints to: Dr. David Wilkinson, School of Psychology, University of Kent, Canterbury, Kent, CT2 7NP, UK. Email: [email protected].
    [Show full text]