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Neglect after stroke — DGM MCQ

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HardStroke and rehabilitationNeglect after strokeDGM

An 84-year-old woman after a right middle cerebral artery stroke eats food from one side of the plate and ignores her left arm. Visual fields are difficult to test but she denies the limb belongs to her. Strength is reduced on the left. Current medicines include clopidogrel. What is the most likely diagnosis?

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Correct answer: C — Left hemispatial neglect

Ignoring the left side and lack of awareness of the limb after right hemispheric stroke suggest hemispatial neglect. Hemianopia alone does not explain personal neglect, delirium tremens needs withdrawal features, functional visual loss lacks the stroke context, and neuropathy is peripheral. Neglect has major implications for rehabilitation and safety.

Reference: NICE NG236