Table 1 Subject details
Description of symptomsAge (y)Time since stroke (months)Bells cancellation score*Line bisection score (mm rightward)Personal neglect score†Tactile neglect (N/Y)Combined motor neglect score
Family noticed lack of movement on left side during daily activities532020N41.4
Difficulty walking due to “leaving left leg behind”. Finding arm hanging in uncomfortable positions and not being involved in activity particularly mobile phone use and eating670.5240N53.7
Absolutely no spontaneous activity in left arm unless prompted. Also great difficulty walking and wheelchair use dangerous as forgets to use one arm. Anosognosic6115152 (left side)Y99.8
Difficulty with two handed activity, particularly eating and failure to move left hand noted by physiotherapist691030N22.8
Clumsiness reported by patient and friend. Limited spontaneous movement of hand noticed when writing661000N123.8
Complete failure to use the left hand except when prompted7826180Y16.1
Tended to avoid using left hand except when prompted. Difficulty with make-up/washing reported by patient3620−20N20.7
  • Motor neglect was assesses by uni- and bimanual motor neglect scores (summed to give the combined motor neglect score) to reflect the difference between the number of left and right handed movements in each condition: ((R − L) × 100) / (R + L) where R = number of right hand movements and L  = number of left hand movements. Fist opening is defined as >90° movement of the long axis of the second phalanx).

  • Non-motor neglect patients: performance range on combined motor neglect score −17 to 6.69 (average −1.71, SD 8.96); mean age 53.5 (range 44–71 years), none had significant weakness. It is important to note that there has been confusion in the literature about the term motor neglect, with some authors using it to describe other movement deficits following stroke, including directional impairments with the ipsilesional limb. However, many investigators now use the diagnostic label “motor neglect” to refer to the syndrome described here of underuse of the contralesional limb.

  • *Bells cancellation score (number of right-sided – left-sided cancellations).

  • †Personal neglect—modified Fluff test20 (eight post-it notes attached to the patient’s body while blindfolded; the patient was required to remove all post-it notes; score reflects number missed).