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Räumlicher Neglect

Spatial neglect

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Zusammenfassung

Unter dem Begriff (Hemi-)Neglect werden Symptome zusammengefasst, die mit (halbseitiger) Vernachlässigung des extra-, peri- und/oder personalen Raums einhergehen und nicht primär durch Störungen der Sensorik oder Motorik bedingt sind. Patienten mit Neglect haben Schwierigkeiten, ihre Aufmerksamkeit in die vernachlässigte kontraläsionale Raumhälfte zu wenden und auf visuelle, akustische oder somatosensorische Reize adäquat zu reagieren. Hemi-Neglect wird am häufigsten nach rechtshemisphärischen Läsionen, insbesondere des rechten inferioren Parietalkortex und des rechten temporoparietalen Übergangskortex beobachtet. Da eine adäquate Wahrnehmung und räumliche Repräsentation unseres Körpers und des uns umgebenden Raums notwendige Voraussetzungen für nahezu alle Aktivitäten des täglichen Lebens sind, führt Neglect zu einer Einschränkung der aktiven Teilnahme am Alltag und den Rehabilitationsprogrammen und ist deswegen mit einer schlechten funktionellen Prognose und einer stärkeren sozialen Beeinträchtigung assoziiert. Neue neuropsychologische und pharmakologische Therapieansätze versprechen, dass Neglect in Zukunft zielgerichteter behandelt werden kann.

Summary

Unilateral spatial (hemi-)neglect or (hemi-)inattention are clinical terms used to describe a number of different clinical symptoms which have in common the patient’s failure to attend to, respond adequately to, or orient voluntarily to people or objects in the contralesional space. Unilateral spatial neglect is most often observed following brain lesions affecting the right hemisphere, and in particular the right inferior parietal cortex (angular and supramarginal gyrus) and right temporoparietal junction. Importantly, the term hemineglect cannot be meaningfully used if the target behavior is explained by primary sensory or motor deficits only. Typically the patient’s deficit is supramodal: patients with hemineglect fail to respond to novel or meaningful stimuli irrespective of whether they are presented in the visual, auditory, and somesthetic (somatosensory) domain. As adequate perception and spatial representation of both the body and the outside world are mandatory for almost all activities of daily living, hemineglect is known to limit the degree of active participation in rehabilitation programs and is thus commonly associated with poor functional recovery and less successful social reintegration. A number of new promising behavioral and pharmacological treatments may help to ameliorate neglect in the future.

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Authors and Affiliations

  1. Neurologische Klinik, Universitätsklinikum RWTH Aachen

    G. R. Fink

  2. Institut für Medizin, Forschungszentrum Jülich

    G. R. Fink

  3. Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus und Universität Lübeck

    W. Heide

  4. Neurologische Klinik, Allgemeines Krankenhaus, Celle

    W. Heide

  5. Neurologische Klinik, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen

    G. R. Fink

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Correspondence to G. R. Fink.

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Fink, G.R., Heide, W. Räumlicher Neglect . Nervenarzt 75, 389–410 (2004). https://doi.org/10.1007/s00115-004-1698-3

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