Visual Extinction - Treatment

Treatment

Without any sort of treatment, visual extinction usually worsens in severity of symptoms or remains completely stagnant. Simple exercises, such as reading and copying tasks, can be useful in treating the symptoms and increasing brain activity, though the damaged area can never be completely healed since the dead brain cells do not regenerate. An individual should keep up with exercises designed to maintain or improve function in order to create the best chance of improvement and/or maintenance at his or her current state.

Treatment methods for patients who suffer from visual extinction generally involve use and training of an individual's vision. A doctor may instruct a patient to scan rows of lights in different ways in an attempt to regenerate function. Some light boards do exist that are used specifically to aid this task. Other methods exist that are designed to force the patient to focus on multiple stimuli at the same time. These cueing and scanning methods do yield results, but they are not consistent across all patients. In successful cases, generally forty hours of retraining the patients' vision were necessary as well as some additional work done at home with similar exercises.

Other computer scanning methods of treatment were shown to be effective with specialized equipment designed specifically for scanning and cueing exercises to force patients to focus on multiple stimuli simultaneously. Again, the results of these methods were not consistent, but in laboratory settings rehabilitation was successful. Of the individuals who recovered some function, not all maintained the function they recovered, losing it after about five months.

In another, single-stimulus rehabilitatory approach, the patient is shown a computer screen with a box in each corner and a fixation cross at the center. When a stimulus appears in any of the boxes, the patient is instructed to indicate seeing it as quickly as possible. This task is eased somewhat by an indicating icon before the stimulus – either an arrow that points to the box the stimulus is most likely (but not guaranteed) to be in, or a cross to indicate that the stimulus could appear in any box. Following thirty hour-long sessions, patients demonstrated a significant decrease in both extinction and hemispatial neglect.

In patients whose brain damage was in the right hemisphere, left limb activation (LLA) was another treatment that proved effective. The theory behind this method of treatment is that any use of the damaged side of the brain will enhance all functions related to the damaged hemisphere and that use of the opposite (healthy) side will only cause further impairment. LLA therefore is merely the concentrated use of the left side of the body in patients whose damage is in the right hemisphere (since the right hemisphere controls the left side of the body). This forces the patient to exercise spatial awareness using the damaged side of the brain, increasing activity around the lesion. While generally a treatment used for visual neglect (a different but related neurological disorder), LLA still increases brain activity around damaged area in patients with visual extinction and generates improvement in some patients. The reason this treatment does not work in some cases of visual extinction is that damage can be on either side of the brain as opposed to in visual neglect where the damage is always on the right.