Signs of Left Neglect

Left neglect is one of the odder symptoms of a brain injury.  Briefly, left neglect is an attention deficit in which a patient’s brain essentially tells the patient to ignore the left side of the world.  It is almost as if the left side of the world does not exist.  It is most commonly observed when a patient ignores items in the left visual field (even when visual acuity is perfect) but can also involve hearing and sensation on the left side.  Left neglect is due to an injury to the right side of the brain.  Different techniques, such as practicing scanning skills, are used to manage left neglect.  For more general information on left neglect, please see these previous posts on the topic:

What is Left Neglect?

Left Neglect vs. Field Cut

What I would like to do with this post is to give a few signs that rehabilitation professionals commonly observe with cases of left neglect.  Below is a list of these common left neglect signs:

1. The patient only eats food on the right side of the plate and does not notice the food on the left side of the plate.  Often the patient will complain that he or she is not being fed enough because the patient believes that he or she is only being fed half-sized portions since the food on the left is ignored.

2. The patient bumps against objects with the left side of the body or wheelchair.  For instance, the patient may bump on the left side of a door frame as he or she attempts to exit a room.  Typically, patients who are just beginning to understand their left neglect and have not become proficient in scanning techniques will have bruises on the left arm or leg.  Staff often have to monitor patients in wheelchairs who have left neglect to ensure that the patients’ arms do not fall down and get caught in the wheels of the wheelchairs.

3. The patient does not face people on their left, even when talking with these people.  Many times, the patient may begin the conversation face to face but slowly their head drifts to the right during the conversation.

4. The patient only shaves the right side of the face, only washes the right side of the face or only puts make-up on the right side  of the face.

5. The patient misses words on the left side of the page.  Often a patient will complain that the reading material he or she is given does not make sense because the patient does not realize that he or she is only reading words on the right side of the page.

6. The patient is unable to find rooms located on the left side of a hallway.  Sometimes a patient will claim that a room has “moved” or “disappeared” since the patient cannot find the room.

7. The patient will start all activities on the right side and not make it to the left. For instance, a patient may play Connect 4 and always place their chips on the right side of the game.  Similarly, the patient may squeeze all of his or her writing on the right side of the page while the left side of the page is blank.  The patient will often draw the right side of a picture.

8. The patient complains that he or she is losing hearing in their left ear even though an audiological test shows no hearing loss.

9. In extreme cases, a patient may not recognize their left arm or leg as being their own body part.  When the patient sees their arm or leg but does not recognize it, he or she may make a complaint such as that a stranger is in their bed with them.

I hope this post helps everyone understand some of the more common signs of left neglect that rehabilitation professionals commonly observe!

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