Right Hemisphere Syndrome Flashcards Preview

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Flashcards in Right Hemisphere Syndrome Deck (14):
1

What are some features of the right hesmisphere?

Less localized than Left hemisphere
Responsible for

  • Arousal
  • Orientation to space and time
  • Attention
  • Emotion
  • Prosody
  • Facial Expression
  • Affect
  • Body Language
  • Visuo-Spatial Skills
  • Music
  • Gestalt Processing
     

2

Describe arousal, or level of awareness. Why arousal important? What should it be addressed as first? 

  • Patients with decrease level of alertness have difficulty maintain arousal level
  • Alertness is fundamental for all other skills
  • Should be addressed as a safety issue first.
  • Patient may require frequent breaks from task, therapy
  • Likely to improve early, but  if it doesn’t is a poor prognostic indicator
     

3

What are communicative defecits of right hemisphere syndrome?

  • Facial Expressions
  • Prosodic Deficits
  • Inferencing Deficits
  • Discourse Deficits

4

Describe the deficit with facial expressions and body language. What do they have difficulty comprehending? What may be absent? How may they be perceived?

  • Difficulty comprehending emotion and meaning conveyed by the face and body
  • Difficulty using appropriate expressions and gestures
  • Facial expressions and gestures may be absent
  • Flat affect is very common
  • May be perceived as apathetic, indifferent or disengaged
     

5

Describe the prosodic deficits of right hemisphere syndrome. What is it similar to? What is it characteried by?

  • Impaired ability to both understand meaning  and convey meaning through intonation.
  • Changes in prosody similar to depression, but not caused by it.
  • Speech pattern characterized by:
    • Monotone or decreased pitch variation
    • Stress marked by increased loudness instead of change in pitch
    • Slowed rate of speech 

6

Describe inferencing deficits in right hemisphere syndrome. What do hese difficulties extend to?

  • Difficulty understanding implied meaning
  • Difficulty drawing conclusions from given information
  • May make inferences, but they may be inaccurate
  • Extends to difficulties with humor and abstract language

7

Describe the discourse deficits in right hemisphere syndrome. What is perseverated? What does the output sound like? 

  • Perseveration on topics/ ideas
  • Poor organization of information
  • Poor cohesion
  • Difficulty recognizing relevant and irrelevant information
  • Tangential output
  • Difficulty grasping the ‘big picture’ and tone of conversations

 

In describing cookie theft picture:

Well, this is a scene in a house. It looks like a fine spring day. The window is open. I guess it’s not Minnesota, or the flies and mosquitoes would be coming in. Outside I see a tree and another window. Looks like the neighbors have their windows closed. There’s a woman near the window wearing what appears to be an inexpensive pair of shoes. She’s holding something that looks like a plate. On the counter there, there’s a hat and two caps that look like they would fit on a child’s head. The woman is looking out the window, and the water’s on, and it’s running on the floor. Looks like she needs to call the plumber. (Clinician: Is there anything over on this side of the picture?) Well, I see two people….children…a boy and a girl. The boy is getting cookies from the cupboard and the girl is laughing and waving. There’s also a stool.  Perhaps the boy is stealing cookies and perhaps the girl….or the stool is going to fall. There’s a window beside the cookie jar, but it doesn’t have any curtains. 

8

What are the four visuospatial and visuoperceptual defecits in right hemisphere syndrome?

  • Prosopagnosia
  • Body Neglect
  • Spatial Neglect
  • Spatial Orientation and Constructional Deficits
     

9

Describe prosopagnosia. What can the person not do? How do they compensate for this defecit?

  • Also called “Face blindness”
  • Patient cannot recognize famous or familiar faces
  • Will compensate by identifying other unique features for people they encounter often (hair, clothes)
  • May be able to identify using verbally described features (big nose, bushy mustache, etc.)
     

10

Describe attentional body neglect. What does the patient not respond to? 

•  Patient does not attend to one half of the body
•  May not respond to sensory input from that side except auditory.
•  May not use a limb even though there is no hemiparesis
•  In an extreme case will refuse to acknowledge one half of their own body
 

11

Describe attentional spatial neglect. What does the person not attend to? 

Spatial Neglect

  • Patient doesn’t attend to things in the environment on one side of the body
  • Eye gaze is to the right
  • When asked to point to the left may point straight ahead
  • May only shave half their face, put make-up only on the right, or eat only food on the right

12

Describe the spatial orientation and construction deficits in right hemisphere syndrome. What do they have difficulty with?

  • May get lost in familiar places
  • Will have difficulty with maps
  • Difficulty thinking in 3-dementions
  • Difficulty judging dimensions (depth, length height, etc)
  • May have difficulty mental or physically manipulating objects in space (eg. to put on glasses)
     

13

Describe anosagnosia. Is it similar to Wernicke's?

  • “Denial of deficit”
  • Presents differently than Anosagnosia seen in Wernicke’s aphasia
  • Presents as total lack of awareness of deficits
  • When you explain a deficit to them, they may seem puzzled or surprised. 

14

Describe confabulation

  • Patient give plausible but untrue information
  • Patient is completely convinced of the accuracy of the information