Rehabilitative management of post-stroke visuospatial inattention

Abstract

Purpose : Visuospatial inattention or sensory neglect is a common impairment following cerebrovascular accident and is thought to negatively impact on functional recovery and longterm outcome. This review examines various rehabilitative interventions available for the management of visuospatial inattention and the literature that supports their efficacy. Method : Medical literature review. Results : Therapies geared toward improved visual scanning and 'retraining' of patients to attend to the neglected field are the mainstay of current therapy. While some studies support their efficacy, others have reported limited benefit. Newer approaches that may be efficacious include eye patching techniques, use of video feedback during therapy, training in visual imagery, and pharmacologic therapy with dopamine agonists. Protocols using vestibular, somatosensory and optokinetic stimulation have each been shown to produce transient improvements in neglect. However, therapeutic applications for these techniques have not been studied. Conclusions : A number of approaches toward the rehabilitation of post-stroke neglect are described in the literature. Further research is needed to better define which techniques may prove most beneficial.