Assessment of unilateral neglect
Assessment of unilateral neglect
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DOI：
10.1093/ptj/83.8.732
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发表时间：
2003-08-01
期刊：
影响因子：
3.2
通讯作者：
Dunai, J
中科院分区：
文献类型：
--
作者：
Plummer, P;Morris, ME;Dunai, J
单侧忽略（ULN）（或“忽略”）是卒中患者常见的行为综合征。据报道，右侧大脑半球卒中后ULN的发生率差异很大，从10%（1）到82%（2）不等，左侧大脑半球卒中后从15%（3）到65%（2）不等。卒中后ULN发生率报道不一致的原因包括受试者选择标准、病变部位以及评估的性质和时间（4）。对已发表数据的系统综述支持了右侧脑损伤后ULN发生频率高于左侧脑损伤的临床印象（4）。单侧忽略的特征是对大脑病变对侧呈现的人或物体未报告或未作出反应。如果反应缺失可由感觉或运动缺陷来解释，则不被视为忽略（5）。患者可能有一种类型的忽略或多种忽略行为组合（6）。由于ULN有多种临床表现，没有单一的测试可用于识别所有患者的这种障碍，单一测试也无法对忽略行为提供全面诊断（7）。一些作者（7,8）建议对忽略的评估应包括一组测试。为确保足够的敏感性，该测试组应包括针对所有类型忽略的测量方法（9）。本次更新的目的是：（1）阐明不同类型的忽略，作为理解ULN测试和测量的基础；（2）综述ULN判定的有效性和可靠性；（3）就物理治疗师使用这些测试提出建议。鉴于本文的范围——这是对忽略评估的一次更新——仅讨论ULN的主要测试。关于ULN的病理生理学和类型的广泛讨论，我们建议读者参考近期关于这些主题的综述文章（10,11）。
Unilateral neglect (ULN) (or "neglect") is a common behavioral syndrome in patients following stroke. The reported incidence of ULN varies widely from 10%(1) to 82%(2) following right-hemisphere stroke and from 15%(3) to 65%(2) following left-hemisphere stroke. Reasons for the variability in the published rates of occurrence of ULN after stroke include subject selection criteria, lesion site, and the nature and timing of the assessment.(4) The clinical impression that ULN occurs more frequently following right brain damage than left brain damage has been supported in a systematic review of published data.(4) Unilateral neglect is characterized by the failure to report or respond to people or objects presented to the side opposite a brain lesion. If the failure to respond can be accounted for by either sensory or motor deficits, it is not considered to be neglect.(5) Patients may have one type of neglect or a combination of neglect behaviors.(6) Because ULN has a wide variety of clinical presentations, no single test can be used to identify the disorder in all patients, nor will a single test provide a comprehensive diagnosis of neglect behavior.(7) Some authors(7,8) have recommended that assessment of neglect include a test battery. To ensure sufficient sensitivity, the battery should include measures for all types of neglect.(9)The purposes of this update are: (1) to clarify the different types of neglect, as a basis for understanding the tests and measures of ULN, (2) to review the validity and reliability of determinations of ULN, and (3) to make recommendations regarding the use of these tests by physical therapists. Given the scope of this article-which is an update of the assessment of neglect-only the major tests for ULN are discussed. For an extensive discussion of the pathophysiology and types of ULN, we refer readers to recent review articles on these topics.(10,11).