Abstract Details

Title Cerebellar Allocentric and Action-Intentional Spatial Neglect

Topic Behavioral Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 003

Objective

Background Each cerebellar hemisphere has extensive connections with the contralateral cerebral cortex. Contralesional hemispatial neglect is most often associated with lesions of the right posterior temporo-parietal cortex. Less commonly contralateral and ipsilateral neglect are induced by lesions of the frontal lobe. Whereas body-centered (egocentric) ipsilesional (left sided) neglect has been reported with unilateral (left) cerebellar lesions, left sided object centered (allocentric) neglect with a leftward action-ipsilateral bias has not.

Design/Methods A 61 year old right handed woman who presented 8 months after suffering a hemorrhagic stroke of her left cerebellum with complaints of emotional lability and difficulty walking, including frequently bumping into things on her left side, was tested for neglect.

Results In addition to ocular dysmetria and left sided limb ataxia, when this woman attempted to draw a clock she accurately drew a circle but her number placement was distorted outward on the left side. The same pattern was observed when she attempted to draw a circle composed of small triangles. Her line bisection was normal but on an allocentric task of open triangle cancellation, she primarily neglected the triangles with a left side opening.

Conclusions The patient's clock drawing and figure drawing errors have been previous described in a patient with cortical dysfunction and this action-intentional neglect is thought to be a form of an action-intentional grasp induced by frontal dysfunction. Alternatively, right hemisphere dysfunction could cause a deficit in global attention, and when performing a focal attentional task of placing and writing clock numbers, she became unaware of the global form on the left side.

Authors/Disclosures
Nicholas Milano, MD (Medical University of South Carolina) PRESENTER	Dr. Milano has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Jackson kelly.
Kenneth M. Heilman, MD, FAAN (Univ. of Florida, Dept. of Neurology)	Dr. Heilman has received publishing royalties from a publication relating to health care.
Ettore Beghi, MD, FAAN	No disclosure on file

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