Left Neglected – What is spatial neglect?

doctor reviewing brain scans

A new novel about brain injury was just released last month. Left Neglected is a fictional story about a traumatic brain injury patient who develops a bizarre, but relatively common, neurological syndrome called spatial neglect. The author, Lisa Genova, earned a doctorate in neuroscience from Harvard, and brings her deep understanding of brain injury to life in her main character, Sarah.

Sarah is a busy professional who has a car accident while distracted by her Blackberry. She wakes up in the hospital and soon realizes that half her world is missing. Genova describes the long, frustrating rehabilitation process, the insurance woes, and the major life changes that Sarah must face after her brain injury.

But what is spatial neglect? It is considered to be an attention disorder in which the brain is unaware of, and therefore "neglects," one side of everything. This can include one side of the body, a room, a plate, a picture-everything. It is not that the patient can't see; their vision is normal, and they can often acknowledge the missing side when their head is forced in that direction.

Spatial neglect is associated with damage to the parietal lobe of the brain, and is commonly found in stroke as well as traumatic brain injury patients. Parietal damage that results in spatial neglect usually occurs on the right side of the brain causing the brain to ignore the left side of the environment (as in Genova's patient who has left spatial neglect).

Rehabilitation of neglect may include using prism adaptation to distort the patient's view of the real world and therefore force their attention to the left. Another rehabilitation method may include using adaptive search strategies to remind the patient to constantly look to their left. In Left Neglected, Sarah uses an adaptive strategy by putting all her jewelry on her left hand, in the hope that the sparkle would draw her attention to her neglected hand and remind her to use it.

In most cases of spatial neglect, there is at least partial recovery of attention to the neglected side after about six months. Even with partial recovery, however, activities of daily living and the potential to return to work are greatly compromised. TBI patients with spatial neglect will most likely require long-term support from their families, as well as rehabilitation professionals.

Genova L. Left Neglected. Gallery. (January 2011).