Cognitive symptoms related to attention
Aurora Lassaletta, Ruth Clarke in The Invisible Brain Injury, 2019
My desire to know more about what is happening to me makes me more observant. One day, I heard someone in my paddle tennis class say that she has good vision in both eyes, but she doesn’t register what she sees on the left. That fact stayed in my mind and I recalled it as I sat down to a family meal and realised that for the last few years I had been quickly choosing the same seat. The same thing happened the next day when I was looking for a place to sit in my mindfulness workshop: I realised that I always look for a place on the same side of the room and I need to see the teacher from the same side. Suddenly, it all started to add up and I understood that, although to a lesser extent, it is also much easier for me to process information that comes from the right. It also happens at conferences and concerts, and when one of my children comes to show or tell me something. This discovery is making everyday and social situations much easier. Hemineglect is the difficulty in registering stimuli that appear in one visual field, usually the left. It can also affect other sensory modalities, such as hearing or touch. People who display hemineglect have no physical changes (loss of vision, for example) to explain it, yet they are unable to pay attention to what is happening on that side. As such, in its most severe form, they might ask for bread at mealtime when it is already on the table but on their affected side, or apply make-up to only one half of their face (Benedet, 2002).
Nervous system
David Sturgeon in Introduction to Anatomy and Physiology for Healthcare Students, 2018
The second major region of the parietal lobe is the sensory association area situated between the primary sensory cortex and the occipital lobe (Figure 12.10). This interprets and evaluates sensory information received from the primary sensory cortex and other areas of the brain in order to generate meaningful patterns of recognition and awareness. For example, when you are rummaging around at the bottom of a bag trying to locate your car keys, the sensory association area draws upon past sensory experience in order to make sense of the various objects that your fingers come into contact with (coins, sweet-wrappers, crumbs, etc.). Damage to this area (e.g. following a stroke) can result in a neurological condition known as hemispatial neglect where individuals effectively ignore or disregard people, sounds and objects on one side of their visual field (hemi = half). Those who suffer from this condition are usually unaware of this fact and may bump into things on their neglected side or shave/apply make-up to one side of their face only.
Alex at the Oliver Zangwill Centre
Alex Jelly, Adel Helmy, Barbara A. Wilson in Life After a Rare Brain Tumour and Supplementary Motor Area Syndrome, 2019
What is SMA Syndrome? Although this syndrome has been described by Adel Helmy in Chapter 11, a few extra words are probably advisable here. SMA Syndrome occurs following damage to the supplementary motor area; such damage frequently appears after surgery to remove tumours (Bannur & Rajshekhar, 2000). Characteristics of the syndrome include reduction of spontaneous movements and difficulty in performing voluntary motor acts to command. This happens despite muscle tone in the limbs being maintained or increased (ibid.). Speech deficits may or may not be seen. Bannur and Rajshekhar (2000) describe six patients who underwent surgery for removal of a tumour in the SMA and say that as well as “a severe impairment of volitional movements, the salient features of the deficits in this syndrome are hemineglect and dyspraxia or apraxia involving the contralateral limbs” (p. 204). All of the patients in this study went on to regain their lost functions, as did six of eight patients reported by Ibe et al. (2016). Alex, too, regained speech and voluntary control of her limbs. The return of these functions can be seen in the reports of those who worked with her as described in the previous chapter. Another common consequence of frontal lobe damage, however, is difficulty with executive functioning.
Successful return to professional work after neglect, extinction, and spatial misperception – Three long-term case studies
Published in Neuropsychological Rehabilitation, 2021
Spatial neglect is defined as the inability to respond to sensory stimuli in the contralesional hemispace or – body – of a neurological patient (Husain, 2008; Kerkhoff, 2001). In addition to visual, auditory, or tactile neglect, motor neglect often co-occurs as a reduced use of contralesional extremities, i.e., during reaching, standing, or walking. Moreover, neglect patients show a lack of insight into their left-sided sensory and motor deficits, termed anosognosia or unawareness. Both neglect and anosognosia are a major source of long-term disability and associated with an adverse rehabilitation outcome (Jehkonen et al., 2006a, 2006b) and longer hospital stays (Kalra et al., 1997). Moreover, left hemineglect is frequently associated with left hemianopia, which is often difficult to disentangle (pseudo-hemianopia, Nyffeler et al., 2017). The presence of hemianopia reflects larger lesions and predicts chronic neglect as well as severe neglect dyslexia (Ptak et al., 2012). Furthermore, spatial-perceptual disorders are often associated with neglect due to lesion proximity or overlap (Reinhart et al., 2016), as well as hemiparesis/hemiplegia and hemianaesthesia or hypaesthesia. All these associated deficits reduce the functional effects of rehabilitation and worsen the overall outcome.
Right and left-sided infective endocarditis in an IV drug abuser
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Maryam Nemati, Kristine Galang, Syung Min Jung
On arrival, the patient had a low-grade temperature of 37.8 C, heart rate of 90 beats per minute, respiratory rate of 18 breaths per minute, and blood pressure of 121/70 mmHg. He was awake, alert, and in mild distress. He had no JVD or cervical lymphadenopathy. On lung exam, he had faint bibasilar crackles. On heart exam, he had normal S1, S2, regular rate, and rhythm with a crescendo decrescendo systolic murmur 4/6 loudest over the tricuspid area. His abdomen was soft, not distended, and non-tender. Although the patient stated that his vision was intact, he was found to have left-sided hemineglect. He had normal strength and range of motion in extremities. He didn’t have any edema or tenderness. Skin exam was notable for track marks around the right knee, but he had no Janeway lesions or Osler’s nodes.
Scale for contraversive pushing in stroke patients: pusher behavior vs Thalamic astasia differential diagnosis and psychometric properties
Published in Topics in Stroke Rehabilitation, 2022
Juan Nicolás Cuenca Zaldivar, María Caballero Nahúm, Isabel Alcalá-Zamora Marcó, Rocío Conde Rodríguez, Marta Díaz López, Alexandra Manzano Carvajal, Ana María Olmedo Carrillejo, Esther Monge Pereira, Álvaro Monroy Acevedo
In people with PB, the appearance of sensory-motor deficits in their affected lower limb is common (14% of cases),5 delaying their recovery. The combination of this behavior and hemineglect, which is commonly observed in patients with right-hemisphere brain injuries, can lengthen rehabilitation time by up to 60–70%.5 It can take between three weeks6 and six months7 longer to reach the same recovery levels as stroke survivors without PB. The presence of PB is usually taken as a negative predictor of recovery time, but not with respect to functional improvement.6 It has been observed that PB decreases progressively, especially from the sixth week post-stroke. In general, these patients require a longer period of rehabilitation and hospital stay than patients without PB, yet they reach similar recovery levels.7
Related Knowledge Centers
- Acquired Brain Injury
- Cerebral Hemisphere
- Delusion
- Neuropsychology
- Parietal Lobe
- Visual Perception
- Stroke
- Stimulus
- Visual Field
- Somatoparaphrenia