Leftward deviation of eyes in human face drawing: A new diagnostic measure for left unilateral spatial neglect

Abstract

Objectives Patients with left unilateral spatial neglect draw a human face more satisfactorily than other objects. The aim of the present study is to examine the features of face drawings by patients with neglect and to establish their meaning in the diagnosis of neglect. Methods Sixty-four right-handed patients with a right hemisphere stroke underwent the conventional test of the Behavioural Inattention Test (BIT) and showed left unilateral spatial neglect in one or more of the subtests. From the "drawing a man or woman" subtest, 64 samples of face drawing, in which both eyes were placed, were obtained. The percentage deviation of the location of the eyes in the face outline was calculated for 46 face drawings without discontinuity of the outline or severe distortion of the construction. The percentage deviation of the location of the eyes was compared among the patients with neglect, right-hemisphere damaged patients without neglect, and healthy control subjects. Results The patients with neglect placed the eyes with greater leftward deviation in the face outline compared with the other two groups. The percentage deviation of the eyes was, however, not associated with neglect severity scored with the BIT conventional test. Forty-three percent of the patients with neglect located the eyes leftward beyond the normal range obtained from the performance of the healthy subjects, while none of the patients without neglect showed such abnormal leftward deviation. Conclusions The leftward deviation of the eyes in the face drawing suggests the presence but not the severity of left unilateral spatial neglect.