TABLE 6-2.

Key Components of Aiming Spatial Neglect

Symptom	Abnormality (after right brain damage)	Finding (after right brain damage)
Motor extinction	Difficulty moving both sides of the body at the same time, with the left body failing to move properly when the right body is activated	Patient raises only the right arm when asked to raise both arms; however, strength tested to confrontation is good in both arms
Directional hypokinesia	Problems moving leftward with the eyes, head, limbs, or axial body; not accounted for by paralysis alone	Patient sits, stands, and moves with rightward rotation; veering while ambulating can cause collisions
Hemispatial hypokinesia	Smaller or weaker movements in left space as compared with right space	The patient’s grip with either hand is weaker to the left of the body than it is with the hand positioned in the right body space
Limb hypokinesia	Smaller or weaker movements by the left hand, arm, and even leg compared with the right limbs; not accounted for by paralysis alone	Similar to motor extinction, except that spontaneous left arm movements are weak or small even when that limb moves in isolation; however, strength tested to confrontation is good in both arms; patient may “forget” arm and leave it in an unsafe position
Defective motor response inhibition	Stimulus-evoked responses in a leftward direction or with the left body; cannot be inhibited by goal-oriented, conscious intention although the right body can be inhibited	Patient cannot inhibit leftward glances or cannot inhibit grasp or reach (leftward or with left hand or arm) while walking, during transfers, or during complex activities (eg, using power equipment); can interfere with safety