Wheel-chair driving improvement following visuo-manual prism adaptation

Prism adaptation has been used for several years to improve several aspects of unilateral neglect. Parameters ranging from the classical neuropsychological tests to mental imagery or to tactile extinction have been successfully ameliorated following a brief period of adaptation to wedge prisms shifting the visual field to the right. However the potential therapeutic implications of this technique depend on the investigation of more functional and ecological parameters. Here we describe a patient with left hemiplegia and unilateral neglect who was impaired during wheel-chair navigation in the clinical unit. Following a brief adaptation period, this patient showed a sudden improvement of wheel-chair driving as well as of classical tests. The potential implications of prism adaptation for the rehabilitation of unilateral neglect are highlighted by the long duration of improvement obtained after a single adaptation session.