Denial and neglect of hemiparesis in right-sided apoplectic lesions

Abstract

In a prospective investigation of 55 consecutively selected patients with right-sided apoplectic lesions, denial and neglect of hemiparesis was registered in a standardized way using fixed criteria. The patients were all fully conscious and could cooperate in a detailed investigation. About half of the patients had denial and neglect of hemiparesis (1/4 denial, 1/5 neglect). The syndrome(s) of denial/neglect was not related to sensory defects or defects in the sense of position. Denial of hemiparesis was related to extent of lesion, neglect of hemiparesis was not. Both syndromes were related to age of patients. The resemblance between denial and neglect of hemiparesis is pointed out. The 2 phenomena could be seen as 1 syndrome released by right-side brain lesions, the difference being a matter of degree. Cognitive factors in denial/neglect are thought upon as factors that can be seen in right-sided lesions together with paresis, visual defects, but apparently not necessarily associated with the named defects.