Search patterns and neglect: a case study

An irregular and unsystematic search pattern may contribute to unilateral neglect. We examined the sequence of cancellations performed by a patient with unilateral neglect and found that she followed a systematic and stereotypic vertical search pattern. To overcome this vertical search pattern, foils were placed in rows. These foils induced slightly more horizontal movements, but did not alter her neglect. In another attempt to overcome her vertical search and tendency to cancel on the right, she was explicitly instructed to cancel targets alternating to and from the right and left sides of the array. This strategy overcame her vertical search, but, instead of modifying the severity of her neglect, this task only changed its spatial distribution. The altered spatial distribution of neglect is difficult to reconcile with current theories of neglect. We suggest that this patient demonstrates a limited capacity to sequentially be aware of or act upon stimuli.