Visual neglect and extinction: a new test.

A new computerized test for visual neglect and extinction was developed and evaluated by testing twenty-five patients with right-hemisphere cerebrovascular accidents. The test consisted of a series of unilateral or bilateral lights on a semicircular array to which the subject responded by pushing a button. A computer controlled the sequence of stimuli and stored the responses. Results of the computer test were compared to conventional occupational therapy and beside clinical tests. Extinction was present in 16 subjects on the computerized test, and in 11 on the clinical test. Neglect was present in 13 subjects on the computerized test, in seven subjects on the occupational therapy test, and in five subjects on the clinical test. The computerized test was more sensitive than the other tests. On both computerized and clinical testing, all subjects with left-sided neglect also had left-sided extinction, but not all subjects with extinction had neglect. Neglect may represent a more severe manifestation of an underlying perceptual defect that produces both neglect and extinction.