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Abstract: Unilateral neglect (UN) is a disorder associated primarily with right-brain damage; it causes individuals to behave as if the contralesional half of their world has become unimportant or has simply ceased to exist. This is the first known case study to describe and measure UN caused by an infectious process, meningoencephalitis. The patient was immune compromised as a result of antirejection drugs following a kidney and pancreas transplant, as well as from a baseline vulnerability common to patients with hemodialysis. She was reassessed serially during hemodialysis treatments over 12 months and demonstrated improvement in some measures of UN but not in others. UN is a recognized nursing diagnosis and can be assessed, treated, and researched by nurses. Neuroscience nurses need to better understand and investigate UN to improve their own practice and the practice of other specialties.
Unilateral Neglect
Unilateral neglect (UN) is a disorder that causes individuals with brain damage to behave as if one half of their world-the half contralateral to the damage-has become unimportant or ceased to exist (Mesulam, 2000). It is not a sensory or motor disorder of seeing, hearing, or moving, but instead is a disinclination to look, detect, explore, or interact with the contralesional world (Mesulam). Affected patients may fix their head or gaze to one side; dress, groom, and protect only one side of their body; eat food from only one side of the plate; ignore or collide with people and objects on the neglected side; and even deny ownership of their own contralesional limbs (Parton, Malhotra, & Husain, 2004; Robertson & Halligan, 1999).
UN is a heterogeneous syndrome with several subtypes, and it is possible that many distinct disorders have been inaccurately lumped together under this single label (Halligan & Marshall, 1994). There is a growing consensus that no single mechanism accounts for the full range of signs and symptoms (Buxbaum, 2006; Danckert & Ferber, 2006; Manly, 2002; Stone, Halligan, Marshall, & Greenwood, 1998). It appears that impairments of several different pathways converge to result in UN, each of which could exist singly without causing it (Parton et al., 2004). Also, it has been difficult to assign any particular variations of UN to specific neuroanatomical loci (Buxbaum). However, UN appears to be more common,...