Dr Bloch raises a good point. There is the possibility of a bias in case selection when patients with right and left hemisphere lesions are compared on one or another performance. Some patients with severe receptive language disorder either fail to grasp nonverbal pantomimed (as well as verbal) instructions or they apparently forget the instructions in the course of task performance. This also may occur with nonaphasic patients with massive right hemisphere disease and with demented patients. In our study, five nonaphasic patients with right hemisphere lesions were excluded from the study because they failed to respond appropriately to the easy practice items preceding the test.Of the 48 patients with left hemisphere disease, nine had anterior lesions of whom six were aphasic, 20 had posterior lesions of whom 14 were aphasic, and 19 patients had lesions that either could not be confidently localized or extended into both the anterior
Benton AL, Varney NR, Hamsher KD. Visuospatial Judgment-Reply. Arch Neurol. 1979;36(1):59. doi:10.1001/archneur.1979.00500370089030
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