How to Reverse Hemineglect in Stroke Patients

How to Reverse Hemineglect in Stroke Patients

If you approach a stroke survivor on their right side and they do not notice you, they may have left side neglect (a.k.a. hemineglect).

Similarly, a stroke survivor who does not notice the left side of their environment may have right side neglect.

Understanding Hemineglect After Stroke

Hemineglect is a post-stroke side effect that impairs the patient’s awareness of the body and environment on the affected side.

This is an attention issue that’s also known as unilateral neglect.

Like most stroke side effects, this condition can be treated through rehabilitation.

Before we dig into treatment, you should understand the difference between right- and left-side neglect.

Right Side Neglect vs Left Side Neglect

Hemineglect coincides with the location of the stroke.

When one side of the brain is affected, the survivor with hemineglect will be unaware of the opposite side of the body and environment.

Here are specific examples:

What is left side neglect?

When someone has hemineglect after a stroke in the right hemisphere, they will not notice you when approached from their left side.

This patient may show other sights of hemineglect by only eating the right side of their plate (i.e. neglecting the left side).

Hemineglect seems to occur more frequently after right-sided strokes.

What is right side neglect?

When a stroke affects the left hemisphere of the brain, the patient with hemineglect may not notice the right side of their environment.

Patients with right-sided neglect may be unresponsive when approached from their right side.

What Does Hemineglect Look Like?

It’s important to note that hemineglect is not a vision problem. Patients with hemineglect can see their affected side just fine.

Rather, hemineglect is an attention problem.

Here are some symptoms of hemineglect:

  • Does not notice half of an object
  • Unaware of the environment on the affected side
  • Does not notice people who approach from the affected side
  • Failure to take care of the affected side of the body

If someone with hemineglect is asked to fill in the numbers on a clock, they’ll do something like this:

left side neglect drawing

Image from Journal of Neurology

Unilateral neglect can coincide with other stroke side effects, so it’s important to work closely with your physiatrist for correct diagnosis.

Treatment for Hemineglect

Sometimes hemineglect goes away on its own – also known as spontaneous recovery.

Other times, you need to participate in rehabilitation.

Treatment for hemineglect requires training the brain to notice the affected side again.

This training is achieved through repetitive practice, which activates neuroplasticity and rewires the brain.

(If you’re unfamiliar, you should read up on why neuroplasticity is the #1 concept for stroke recovery.)

Now that you know that repetitive practice can help reverse hemineglect, what exactly should you practice?

Awareness Training

hemineglect and unilateral neglect

Stroke patients with hemineglect need to practice paying attention to their affected side.

As you practice this, the brain will learn to pay attention and respond to stimuli on the affected side.

Here are some clever ways to treat hemineglect:

  • Place objects on your neglected side, like television remotes and nightstands. This will help train you to look for objects on that side.
  • Have a caregiver or family member guide your affected hand through tasks as you complete them, also bringing more awareness and movement into your neglected side.
  • Have friends and family members sit on your neglected side when they talk to you so that you learn to look in that direction.

By training yourself to attend to your neglected side, you will slowly improve your awareness.

As a result, you will reduce your hemineglect.

Overcoming Hemineglect / Unilateral Neglect

Hemineglect occurs when stroke affects one side of the brain, impairing the patient’s ability to be aware of the opposite side of the body and environment.

Like most stroke side effects, you can often reverse this condition by retraining the brain through repetitive practice.

By frequently turning toward your affected side, for example, your brain will learn to notice stimuli on that side.

With good repetition, the brain will rewire itself and your hemineglect will subside.