Screening tests are not enough to detect hemineglect.

Objective: To verify the sensitivity of the conventional subtests of the Behavioral Inattention Test (BIT) in the diagnosis of hemineglect after stroke.

Method: One hundred and two patients with cerebral infarct or hemorrhage were prospectively evaluated. In 22, hemineglect was diagnosed using standard BIT criteria. The frequency of hemineglect using 6 commonly used screening subtests of this battery was assessed.

Results: Hemineglect would not be recognized in 10 patients if they were only screened using the line crossing test; this would be the case in 2 patients with the letter cancellation test; and in 4 patient with the line bisection test. Three patients would not be diagnosed even if both line crossing and line bisection tests were used.

Conclusion: Hemineglect may not be recognized with single screening tests commonly used. The use of a standard battery is recommended to improve diagnostic sensitivity in individuals with various subtypes of hemineglect.