Hello steemians, today I am going to write on something concerning our health.
Lol! This sunglass isn't for fashionate use, so don't say is a kind of swaag!
Stroke as one of the leading cause of death affects about fifteen million people world wide, of the fifteen million people five million died from the stroke, another five million spent their lives with disabilities resulting from stroke and the other five million fully recovered and regained their functional independence.
Some stroke survivors, especially those who sustained middle cerebral artery stroke present with a syndrome called spatial neglect, hemineglect, visual hemineglect, attention neglect among other synonyms. This syndrome occurs in stroke survivors when the two attentional networks are disrupted in brain.
These two attentional networks are ventral and dorsal attentional networks located in the frontal and parietotemporal region in the brain. Spatial hemineglect is more common in right brain damage than in left brain damage.
PRESENTATIONS
Usually patients with this syndrome have some peculiar presentations or symptoms among which are as follow:
For example, in this my patient with left spatial hemineglect.
Gaze deviation towards the right.
Collision with objects placed on left side.
Shaving one side of the face.
Wearing the right trouser leg only while wearing a pair of trouser .
Eating food only from the right side of his plate and so on.
Bedside Diagnosis
There are some simple ways to diagnose this condition at bedside using pencil and paper tests such as:
a) line bisection test
Here the patient is unable to equally bisect the 20cm line drawn on paper, instead he located the middle of the line far toward his right, because his left hemispace is shifted to the right side.
b) clock drawing test
c) picture copying test
d) star cancellation test
Other clinical outcome measures used in the diagnosis and evaluation include:
a) Catherine Bergego Scale (CBS).
b) Behavioral inattention test (BIT).
Differential diagnosis
A clinical condition which is mimicking spatial hemineglect is hemianopia. It happens when there is lesion along the optic nerve precisely at the optic chiasm.
MANAGEMENT/INTERVENTIONS
___,,_____________________
Researches have established some interventions to help these patients to explore the neglected hemispace. Some interventions include:
- Hemianopic patching**
It is done by constructing a patching by using a sunglasses. In the the case of my patient, in the right eye of the sunglasses I perforated the temporal side and nasal side of the left eye of the sunglass. Hence, the patient will only see through the left hemispace because the right side is opaqued.
Visual scanning training
Vibration technique using TENS Unit.
Trunk rotation training.
Magnetic transcranial stimulation.
PROGNOSIS
Patients with neglect syndrome often exhibit another syndrome called anosognosia which is the denial of the neglect behaviors by the patients, this hinders administering interventions to these patients. Therefore, neglect syndrome is a poor prognostic indicator for functional recovery, especially when the syndrome persists more than three month post stroke.
CONCLUSION
It is very important to stress the emphasis on managaing the neglect syndrome in stroke survivors first or in combination with managing hemiplegias.
All pictures are either prepared or taken with my hot4 infinix phone