Spatial neglect is a frequent, disabling syndrome and is associated with a poor rehabilitation outcome. Return to work seems almost impossible and has not been reported so far. Here, three cases with extensive right-hemisphere lesions after stroke are reported, who all showed residual left visuospatial neglect, left visual extinction on double simultaneous stimulation (DSS), and marked spatial-perceptual deficits. After early inpatient rehabilitation all three patients received specific, successive neuropsychological therapy as outpatients in four domains: (1) Optokinetic stimulation with pursuit eye movements and saccadic eye-movement training to reduce left-sided neglect and improve visual exploration; (2) Anti-extinction training to reduce left-sided visual extinction; (3) Spatial-perceptual feedback training to improve spatial-perceptual disorders and visuoconstruction; and (4) Job-related visual and cognitive treatments. All three cases were treated in sequential single-subject baseline designs. Significant improvements were obtained in all treated domains during therapy, which persisted at follow up. After a period of graded vocational re-integration, all three patients worked successfully in their prior job, two part-time (50%), one full-time (100%). These results show that return to professional (paid) work is possible despite initially severe neglect, hemianopia, visual extinction, and spatial-perceptual disorders after stroke.

中文翻译：

---

在被忽视、灭绝和空间误解之后成功重返专业工作——三个长期案例研究

空间忽视是一种常见的致残综合征，并与较差的康复结果有关。重返工作岗位似乎几乎是不可能的，而且到目前为止还没有报道。在这里，报告了 3 例中风后右半球广泛病变的病例，均显示残留的左侧视觉空间忽视、双重同时刺激 (DSS) 时左侧视觉消退和明显的空间感知缺陷。在早期住院康复后，所有 3 名患者均在四个领域作为门诊患者接受了特定的连续神经心理治疗：（1）通过追踪眼球运动和扫视运动训练的视动刺激，以减少左侧忽视并改善视觉探索；（2）防消光训练，减少左侧视觉消退；（3）空间感知反馈训练，改善空间感知障碍和视觉建设；(4) 与工作相关的视觉和认知治疗。所有三个病例都在连续的单受试者基线设计中进行治疗。在治疗期间，所有治疗领域都获得了显着改善，并在随访中持续存在。经过一段时间的分级职业重新整合，所有三名患者都成功地完成了之前的工作，两名兼职（50%），一名全职（100%）。这些结果表明，尽管最初严重忽视、偏盲、视力消退和中风后的空间感知障碍，但仍有可能重返专业（有偿）工作。在治疗期间，所有治疗领域都获得了显着改善，并在随访中持续存在。经过一段时间的分级职业重新整合，所有三名患者都成功地完成了之前的工作，两名兼职（50%），一名全职（100%）。这些结果表明，尽管最初严重忽视、偏盲、视力消退和中风后的空间感知障碍，但仍有可能重返专业（有偿）工作。在治疗期间，所有治疗领域都获得了显着改善，并在随访中持续存在。经过一段时间的分级职业重新整合，所有三名患者都成功地完成了之前的工作，两名兼职（50%），一名全职（100%）。这些结果表明，尽管最初严重忽视、偏盲、视力消退和中风后的空间感知障碍，但仍有可能重返专业（有偿）工作。