顶叶出血后Pusher综合征的康复1例报道

doi:10.3969/j.issn.1006-9771.2021.05.016

Abstract

Abstract: Objective

To explore the features and rehabilitation of Pusher syndrome (PS).

Methods

A female patient was reported and the literatures were reviewed.

Results

The patient presented moderate ipsilateral, deep sensory disturbance, left spatial neglect and disuse. White matter degeneration was found. After four-week rehabilitation, the score of Scale for Contraversive Pushing decreased from 2.5 to 0.75, and her hand function recovered to assistant hand.

Conclusion

The degeneration of white matter develops rapidly in PS patient, while the recovery of motor function is relatively slow, and need longer and comprehensive rehabilitation, especially the exercise therapy and somatosensory stimulation.

Key words: stroke, Pusher syndrome, perception, posture control, balance, unilateral spatial neglect

CLC Number:

R743.34

Xiao-xia DU,Jing-jie HE,Yu-fan LIN,Xiao-ling WANG. Features and Rehabilitation of Pusher Syndrome after Parietal Lobe Hemorrhage: A Case Report[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(5): 615-620.

Figures/Tables 2

References 30

1	網本和. Pusher現象の評価とアプローチ (脳卒中 : 高次脳機能障害) [J]. 理学療法学, 1996, 23: 118-121.
	KAZU A. Evaluation and therapeutic approach in patients with Pusher sign (section stroke) [J]. Jpn Phys Ther Assoc, 1996, 23: 118-121.
2	刘四维,关敏,张静,等. 倾斜综合征的研究进展[J]. 华西医学, 2019, 34(11): 115-120.
	LIU S W, GUAN M, ZHANG J, et al. Progress in research on pusher syndrome [J]. West Chin Med J, 2019, 34(11): 115-120.
3	KATZ N, ITZKOVICH M, AVERBUCH S, et al. Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery for brain-injured patients: reliability and validity [J]. Am J Occup Ther, 1989, 43(3): 184-192.
4	BABYAR S R, PETERSON M G, BOHANNON R, et al. Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature [J]. Clin Rehabil, 2009, 23(7): 639-650.
5	PEDERSEN P M, WANDEL A, JØRGENSEN H S, et al. Ipsilateral pushing in stroke: incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study [J]. Arch Phys Med Rehabil, 1996, 77(1): 25-28.
6	KARNATH H O, BROETZ D. Understanding and treating "pusher syndrome" [J]. Phys Ther, 2003, 83(12): 1119-1125.
7	DAVIES P M, ZINN W M, BRUHWILLER D J. Steps to Follow: A Guide to the Treatment of Adult Hemiplegia [M]. Heidelberg: Springer-Verlag, 1985: 266-284.
8	KARNATH H O, BRÖTZ D, GÖTZ A. Clinical symptoms, origin, and therapy of the "pusher syndrome" [J]. Der Nervenarzt, 2001, 72(2): 86-92.
9	PONTELLI T E, PONTES-NETO O M, COLAFÊMINA J F, et al. Posture control in Pusher syndrome: influence of lateral semicircular canals [J]. Braz J Otorhinolaryngol, 2005, 71(4): 448-452.
10	DIETERICH M, BRANDT T. Perception of verticality and vestibular disorders of balance and falls [J]. Front Neurol, 2019, 10: 172.
11	尾崎新平,草場正彦,植田耕造,他. 半側空間無視に加えpusher症候群を呈し,直流前庭電気刺激が効果的であった一症例[C]. 千葉:Congress of the Japanese Physical Therapy Association, 2017.
	OZAKI S, KUSABA M, UEDA K, et al. A case of unilatera spatial neglect and pusher syndrome in which DC vestibular electrical stimulation was effective [C]. Chiba: Congress of the Japanese Physical Therapy Association, 2017.
12	SAEYS W, HERSSENS N, VERWULGEN S, et al. Sensory information and the perception of verticality in post-stroke patients. Another point of view in sensory reweighting strategies [J]. PLoS One, 2018, 13(6): e0199098.
13	JANG S H, LEE H D. Recovery of an injured medial lemniscus with concurrent recovery of pusher syndrome in a stroke patient: a case report [J]. Medicine (Baltimore), 2018, 97(22): e10963.
14	HONORÉ J, SAJ A, BERNATI T, et al. The pusher syndrome reverses the orienting bias caused by spatial neglect [J]. Neuropsychologia, 2009, 47(3): 634-638.
15	TAKASE M, SHIRAI M, MATSUSHITA H, et al. The severity of unilateral spatial neglect was positively correlated with that of Pusher syndrome [J]. Ann Phys Rehabil, 2018, 61: e35.
16	CHEN X W, LIN C H, ZHENG H, et al. A Chinese patient with pusher syndrome and unilateral spatial neglect syndrome [J]. Can J Neurol Sci, 2014, 41(4): 493-497.
17	ABE H, KONDO T, OOUCHIDA Y, et al. Prevalence and length of recovery of pusher syndrome based on cerebral hemispheric lesion side in patients with acute stroke [J]. Stroke, 2012, 43(6): 1654-1656.
18	DIETERICH M, BRANDT T. Global orientation in space and the lateralization of brain functions [J]. Curr Opin Neurol, 2018, 31(1): 96-104.
19	BRANDT T, DIETERICH M. Does the vestibular system determine the lateralization of brain functions? [J]. J Neurol, 2015, 262(1): 214-215.
20	袁雯静,刘世文. 脑卒中Pusher综合征的临床研究进展[J]. 中国康复医学杂志, 2007, 22(4): 373-376.
	YUAN W J, LIU S W. Chin J Rehabil Med, 2007, 22(4): 373-376.
21	PATRICIA D M. Steps to follow [J]. Physiotherapy, 2000, 8: 443-444.
22	KARNATH H O, BRÖTZ D. Instructions for the Clinical Scale for Contraversive Pushing (SCP) [J]. Neurorehabil Neural Repair, 2007, 21(4): 370-371.
23	KOTER R, REGAN S, CLARK C, et al. Clinical outcome measures for lateropulsion poststroke: an updated systematic review [J]. J Neurol Phys Ther, 2017, 41(3): 145-155.
24	LAGERQVIST J, SKARGREN E. Pusher syndrome: reliability, validity and sensitivity to change of a classification instrument [J]. Adv Physiother, 2009, 8(4): 154-160.
25	YANG Y R, CHEN Y H, CHANG H C, et al. Effects of interactive visual feedback training on post-stroke pusher syndrome: a pilot randomized controlled study [J]. Clin Rehabil, 2015, 29(10): 987-993.
26	王丹丹,林坚,刘晓林,等. 视觉反馈结合核心稳定训练对脑卒中Pusher综合征患者的影响 [J]. 中国康复医学杂志, 2016, 31(4): 426-429.
	WANG D D, LIN J, LIU X L, et al. Effects of visual feedback and core stability training program on post-stroke Pusher syndrome: a pilot randomized controlled study [J]. Chin J Rehabil Med, 2016, 31(4): 426-429.
27	叶正茂,万新炉,苏久龙,等. 躯干强化训练对脑卒中Pusher综合征患者平衡与步行能力的影响[J]. 中华物理医学与康复杂志, 2011, 33(6): 440-442.
	YE Z M, WAN X L, SU J L, et al. The effect of intensive trunk training on the balance and walking ability of stroke patients with Pusher syndrome [J]. Chin J Phys Med Rehabil, 2011, 33(6): 440-442.
28	黄林鹏,周开斌,梁天佳,等. 前庭康复治疗对脑卒中Pusher综合征患者躯干控制及平衡功能的影响[J]. 广西医科大学学报, 2019(7): 1164-1167.
	HUANG L P, ZHOU K B, LIANG T J, et al. The effects of vestibular rehabilitation trunk control and balancing capacity in stroke patients with Pusher syndrome [J]. J Guangxi Med Univ, 2019(7): 1164-1167.
29	高晓艳,夏彩秋,谷艳,等. 强化平衡功能康复治疗对急性期脑卒中Pusher综合征的疗效研究[J]. 神经损伤与功能重建, 2011, 6(4): 265-268.
	GAO X Y, XIA C Q, GU Y, et al. Effects of rehabilitation of enhancing balancing capabilities on patients with pusher syndrome [J]. Neural Injury Func Reconstruc, 2011, 6(4): 265-268.
30	PARDO V, GALEN S. Treatment interventions for pusher syndrome: a case series [J]. NeuroRehabilitation, 2019, 44(1): 131-140.

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Features and Rehabilitation of Pusher Syndrome after Parietal Lobe Hemorrhage: A Case Report

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