Whereas visual and somatosensory forms of neglect are commonly recognized by clinicians, auditory
neglect is often not assessed and therefore neglected. The auditory cortical processing system can
be functionally classified into 2 distinct pathways. These 2 distinct functional pathways deal with
recognition of sound (“what” pathway) and the directional attributes of the sound
(“where” pathway). Lesions of higher auditory pathways produce distinct clinical
features. Clinical bedside evaluation of auditory neglect is often difficult because of coexisting
neurological deficits and the binaural nature of auditory inputs. In addition, auditory neglect and
auditory extinction may show varying degrees of overlap, which makes the assessment even harder.
Shielding one ear from the other as well as separating the ear from space is therefore critical for
accurate assessment of auditory neglect. This can be achieved by use of specialized auditory tests
(dichotic tasks and sound localization tests) for accurate interpretation of deficits. Herein, we
have reviewed auditory neglect with an emphasis on the functional anatomy, clinical evaluation, and
basic principles of specialized auditory tests.
Sankalp Gokhale, Sourabh Lahoti, Louis R. Caplan. The Neglected NeglectAuditory Neglect. JAMA Neurol. 2013;70(8):1065–1069. doi:10.1001/jamaneurol.2013.155