J Neurol Neurosurg Psychiatry 67:35-38 doi:10.1136/jnnp.67.1.35
  • Paper

Ipsilesional neglect: behavioural and anatomical features

  1. M Kima,
  2. D L Nac,
  3. G M Kimc,
  4. J C Adaird,
  5. K H Leec,
  6. K M Heilmana,b
  1. aDepartment of Neurology, University of Florida College of Medicine, FL, USA, bNeurology Service, Department of Veterans Affairs Medical Center, Gainesville, FL, USA, cDepartment of Neurology, Samsung Medical Center, Seoul, Korea, dDepartment of Neurology, University of New Mexico, and the Neurology Service, Department of Veterans Affairs Medical Center, Albuquerque, NM, USA
  1. Dr Kenneth M Heilman, Department of Neurology, University of Florida College of Medicine, PO Box 100236, Gainesville, FL 32610–0236, USA. Telephone 001 352 392 3491; fax 001 352 393 6893; email heilman{at}
  • Received 6 February 1998
  • Revised 5 January 1999
  • Accepted 28 January 1999


OBJECTIVE To learn more about the behavioural and anatomical features of ipsilesional neglect.

METHODS Thirty consecutive patients with spatial neglect were tested on cancellation and line bisection tasks. To learn if patients with ipsilesional neglect demonstrate the sensory-attentional or motor-intentional type of neglect, a video apparatus was used that dissociates these determinants.

RESULTS Five patients showed evidence of ipsilesional neglect. This phenomenon was seen only on the line bisection task. All patients with ipsilesional neglect had lesions involving frontal-subcortical regions. Although ipsilesional neglect evolved from early in three of five cases, the other patients displayed ipsilesional neglect without initial contralateral neglect, suggesting that ipsilesional neglect cannot be fully attributed to a compensatory strategy. The results of the tests that used the video apparatus indicate that right sided frontal or subcortical injury may induce contralateral attentional or intentional “approach” behaviours.

CONCLUSIONS Ipsilesional neglect is most often associated with frontal-subcortical lesions, cannot be entirely attributed to a compensatory strategy, and may be induced by an attentional bias, an intentional bias, or both.


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