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Neglect is a failure to respond or orient to stimuli in one part of space not due to a sensory or a motor deficit. [1] Neglect occurs in multiple spatial dimensions, [2,3] suggesting a three-dimensional attentional system in humans, based on the orthogonal axes (horizontal, vertical, and radial). [1] Heilman and Howell [4] reported a patient with horizontal neglect on line bisection tasks, manifest during focal seizures. There are no reports of radial neglect, as evidenced by radial deviation on a line bisection task in relation to seizures.
Case report.
A 46-year-old right-handed man presented with frequent simple partial seizures. In 1969, he developed generalized seizures that persisted until diagnosis and debulking of a grade II right temporoparietal astrocytoma in 1980. After surgery, seizures were very infrequent. He was admitted in November 1993 to the Royal University Hospital, complaining of frequent flashing lights in the left visual field lasting 90 seconds, sometimes associated with brightly colored visual hallucinations of people and objects in the same hemifield. These episodes had gradually increased in frequency over 4 days, until they were occurring 12 times per hour on the day of admission. There was no impairment of consciousness. His medications were phenobarbital and phenytoin, which he had been taking continuously since 1969.
On examination he was alert, cooperative, and oriented. He had a left homonymous hemianopia. Cranial nerves were otherwise normal. Strength, reflexes, and sensation were normal. The patient only described objects on the right side …
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