Perceptual impairments

Unilateral neglect

• inability to register and integrate stimuli and perceptions from one side of the body and the environment or heispace (spatial neglect of the area surrounding one side of the body) which is not due to sensory loss

• Lesion area- inferior- posterior regions of the right parietal lobe

• Referred to as unilateral spatial neglect, hemi-inattention, hemineglect and unilateral visual inattention

• Always affects the left side of the body

• Patient w. unilateral neglect seems to ignore the left side of the body and stimuli occurring in the left personal space

Anosognosia

• lack of awareness, or denial of a paretic extremity as belonging to the person, or lack of insight concerning or denial or paralysis and disability

Somatoagnosia

• Impairment in body scheme is a lack of awareness of the body structure and the relationship of body parts to oneself or to others

• Also referred to as Autotopagnosia or simply body agnosia

• Difficulty following instructions that require distinguishing body parts and may be unable to imitate mvmts of the therapist

• May have difficulty performing transfer activities bc they do not perceive the meaning of terms related to body parts

• Difficulty dressing

• Hard time participating in exercises that requires some body parts to be moved in relation to other body parts

• Lesion ares: dominant parietal lobe

Right- Left discrimination

• inability to identify right and left sides of one’s body or that of the examiner

• Inability to execute mvmts in response to verbal commands that include the terms right and left

• often unable to imitate mvmts

Finger agnosia

• Inability to identify the fingers of one’s old hand or of the hands of the examiner

• Characterized by difficulty in naming the fingers on command, identifying which finger was touched, and by some definitions, mimicking finger mvmts

Figure- ground discrimination

• Inability to visually distinguish a figure from the background in which it is embedded

• Patient has difficulty ignoring irrelevant visual stimuli and cannot select the appropriate cue to which to respond

  • may lead to distractibility, resulting in a shortened attention span, frustration, and decreased independent and safe functioning

Form discrimination

• Impairment in form discrimination is the inability to perceive or attend to subtle differences in form and shape

• Patient is likely to confuse objects of similar shape or not to recognize an object placed in an unusual position

• Patient may confuse pen with a toothbrush, a vase with a water pitcher etc.

Spatial relations

• inability to perceive the relationship of one object in space to another object or to oneself

  • this may lead to, or compound, problems in constructional tasks and dressing

• Crossing the midline may be a problem for patients with spatial relations deficits

• Spatial relations skills are required to manage most ADL

Position in Space

• Inability to perceive and to interpret spatial concepts such as up, down, under, over, in, out, in front of, and behind

Topographical disorientation

• Difficulty in understanding and remembering the relationship of one location to another

  • As a result, the patient is unable to get from one place to another without a map

Depth and distance perception

• Experiences inaccurate judgment of direction, distance, and depth

Vertical disorientation

• Refers to a distorted perception of what vertical

• Displacement of the vertical position can contribute to disturbance of motor performance, both in posture and in gait

Visual agnosia

• most common form

• Inability to recognize familiar objects despite normal function of the eyes and optic tracts

• Simultanagnosia (Balint’s syndrome)

  • Inability to perceive a visual stimulus as a whole

  • Pt. perceives an entire array one part at a time

• Prosopagnosia

  • Inability to recognize familiar faces

• Color agnosia

  • Inability to recognize colors; It is not color blindness

  • Pt. is unable to identify or name colors on command, although color chips can be correctly paired

Simultanagnosia (Balint’s syndrome)

• Inability to perceive a visual stimulus as a whole

• Pt. perceives an entire array one part at a time

Prosopagnosia

• Inability to recognize familiar faces

Color agnosia

• Inability to recognize colors; It is not color blindness

• Pt. is unable to identify or name colors on command, although color chips can be correctly paired

Auditory agnosia

• Inability to recognize nonspeech sounds or to discriminate b/t them

Tactile agnosia or astereognosis

• inability to recognize forms by handling them, although tactile, proprioceptive, and thermal sensations may be intact

Ideomotor apraxia

• Breakdown b/t concepts and performance

• There is a disconnection b/t the idea of a mvmt and its motor execution

• Able to carry out habitual tasks automatically and describe how they are done, but is unable to imitate gestures or perform on command

Ideational apraxia

• Is a failure in the conceptualization of the task

• Inability to perform a purposeful motor act, either automatically or on command, because the patient no longer understands the overall concept of the act, cannot retain the idea of the task, or cannot formulate the motor patterns required