Unilateral neglect in children

What causes Unilateral neglect?

Unilateral neglect is a neuropsychological condition that comes as after effect of brain damage in a stroke or traumatic brain injury. Damage to the hemisphere of the brain is sustained, a deficit in attention to and awareness of one side of the field of vision is observed.

The affected child will experience the inability to process and perceive stimuli on one side of the body or environment, where that inability is not due to lack of sensation. Unilateral neglect is commonly contralateral to the damaged hemisphere. However, instances of neglect on the same side as the lesion have been reported.

Effects of Right Brain Injury on Visual Neglect and Perception in Children

The child with a brain injury on the right side can neglect the left side visual field. In these instances, they may neglect to take food from the left half of their plate. Frequent collision with objects or structures such as doorframes on the side being neglected is observed.

Neglect may also affect the memory and recall perception e.g. if the child asked to draw an object, he will draw half of the object. This is due to a perceptive deficit of memory.

Some forms of neglect may also be very mild in a condition “Extinction”. The competition from the same side lesion impedes the perception of the contralesional stimulus.

How to treat Unilateral Neglect?
  • Treatment consists of finding ways to bring the child’s attention towards the neglected side.  For the left side, this usually happens incrementally, by going just a few degrees past midline and progressing from there.
  • Rehabilitation is teamwork with Physical therapists, Neuro-psychologist, Optometrist, Occupational Therapist, and Speech and Language Pathologist.
  • Caloric stimulation treatment, Prismatic adaption are the treatment for visual performance.
  • Constraint-Induced Therapy (CIT) appears to be an effective long term treatment for improving neglect.
  • Optokinetic stimulation is effective in improving position sense, motor skills, body orientation and perceptual neglect on a short – term basis.
  • Trunk rotation therapies also found results in improving postural and balance deficits in patients.
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