Right half-field eye patching may not be an effective approach for chronic hemispatial neglect – a two-case investigation

Abstract

Right half-field eye-patched glasses intervention was performed in two chronic stroke patients with unilateral spatial neglect. Eye movement on the neglect side, the center of gravity as an index of the internal midline bias, neglect sign tests, and the regional cerebral blood flow (rCBF) were measured before and after intervention. The improvement of eye movement was not shown clearly after intervention. The center of gravity shifted significantly to the right and backward. Letter and star cancellation tests were improved in both the cases. Line bisection test showed improvement in one patient. However, line cancellation and line bisection tests were worsened in the other. The rCBF was not changed after intervention. This case study suggests that right half-field eye patching might not be an effective intervention.

Post‐stroke visual midline shift syndrome

“…While a number of signs and symptoms have been attributed to visual midline shift syndrome, there appears to be some consensus around the signs/symptoms of poor posture and imbalance, which have been reported by several authors . Additional signs/symptoms noted were: bumping into objects, drifting while walking, feeling unsteady or not ‘grounded’, inaccurate reaching/poor eye–hand co‐ordination, dizziness and a sense of being out of synchronisation …”

“…Finally, a tactile sensor scan system has also been used to measure centre of gravity and infer midline representation …”

“…These include caloric vestibular stimulation, contralateral neck muscle vibration, visual exploration, trunk rotation, prism adaptation and prescribed yoked prism . Occluding the ipsilesional half of spectacles was not beneficial …”