Recovery from unilateral neglect after right-hemisphere stroke.
OBJECTIVE
To show the recovery process for different forms of unilateral neglect (UN)--including personal neglect and neglect of far space--in relationship to impairment, disability, cognition and mood.


METHODS
Patients were tested at 2-4 weeks, at 6 months and at 1 year. We used the Behaviour Inattention Test and a test for personal neglect. We also used the NIH Stroke Scale, the Functional Independence Measure (FIM), the Mini-Mental State Evaluation and the Geriatric Depression Scale.


RESULTS
Peripersonal neglect diminishes within 6 months, but complete recovery occurred in only 13%. The prognosis for personal neglect and neglect of far space is better, with a recovery ratio at 6 months of 52% and 46%, respective. The correlations between UN and FIM are high. A few patients deteriorate in the absence of recurrent stroke.


CONCLUSIONS
For clinical purposes, it is practical to postpone UN evaluation until a couple of weeks after a stroke. Many of the patients who then have UN are likely to retain their UN, although many will improve. Patients with UN should receive special attention in the rehabilitation phase, as well as at discharge. One explanation of the worsening of UN seen in some patients, may be continuing cerebral atherosclerosis.
Appelros
P
P
Department of Neurology, Orebro University Hospital, Sweden. peter.appelros@orebroll.se
Nydevik
I
I
Karlsson
G M
GM
Thorwalls
A
A
Seiger
A
A
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000377:Agnosia / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D003071:Cognition / Q000502:physiology; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D013028:Space Perception / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation