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Visual Extinction – Neglect Variant — SCE Neurology MCQ

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ModerateCerebrovascular DiseaseVisual Extinction – Neglect VariantSCE Neurology

A 55-year-old woman with a right MCA stroke has persistent left visual inattention (extinction) — she can see objects in the left visual field when tested alone but misses the left object when objects are presented bilaterally simultaneously. Her formal visual fields are full. What is this phenomenon?

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Correct answer: B — Visual extinction — a form of neglect where contralateral stimuli are only missed during bilateral simultaneous stimulation

Visual extinction is a mild form of hemispatial neglect where the patient detects single stimuli in the left visual field normally but consistently misses the left stimulus during bilateral simultaneous presentation. It reflects a right hemisphere attentional bias — when competing stimuli are presented, the right hemisphere's attentional deficit causes the contralateral (left) stimulus to be 'extinguished'. It is commonly found on formal neurological testing and has functional implications for daily activities in cluttered visual environments. A: Full visual fields excludes hemianopia. C: The patient can see — cortical blindness is excluded. D: There is a neurological basis. E: The pattern is consistent and has a neuroanatomical explanation.

Reference: RCP Stroke Guidelines; Clinical Neuroanatomy