Hemineglect. Part 1. The nature of hemineglect and its clinical assessment in stroke patients: an overview

Hemineglect is an attentional disorder with quoted incidence varying widely between studies, from 10% to as high as 82% during the acute phase post-stroke. Neglect is typically transitory and only persists in a more chronic fashion in a minority of patients. The precise relationship between the presence of neglect and reduced functional ability is not entirely clear, however, there is evidence of an association. Neglect is commonly assessed clinically using a variety of ‘pencil and paper’ tests; most of these primarily assess perceptual forms of neglect. Other tests are described which are considered to differentiate personal from extrapersonal, and motor from perceptual forms of the disorder. Due to the multi-modal nature of neglect, a battery of tests rather than a single test may, in addition to being more sensitive, enable assessment of different forms of neglect. Tests that have demonstrated validity, sensitivity, and published cut-off scores are suggested for use by therapists in the clinical situation.