Extinction (Double simultaneous stimuli)
Examination Technique:

1. Tactile (sensory)

• with eyes open demonstrate to the patient that you will touch them on the left side, the right side or both.
  
  
• this should only be done if the patient can perceive a unilateral stimulus (i.e. if there is loss of pain and temperature or light touch on one side, there would be no point assessing extinction).
  
  
• have the patient close their eyes and as you deliver a gentle touch, report whether they feel it on the left side, right side or both sides.

2. Visual extinction

• wiggle a finger in the left, right or both visual fields and ask the patient to report where they see it.

3. Auditory extinction

• snap your fingers on the left, right or both sides and have the patient report where they hear the stimulus.
  
  
• when testing for extinction, it is important to deliver bilateral stimuli simultaneously with no time lag in between.