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pusher syndrome

Suzanne R Babyar, Margaret G E Peterson, Michael Reding
BACKGROUND: Comparing cohorts with similar functional and motor status at admission to inpatient rehabilitation may delineate demographics or impairments associated with recovery from lateropulsion, also known as "pusher syndrome," after stroke based on lesion side. The aim of this case-control study was to determine how demographics and severity of stroke impairments at admission to inpatient rehabilitation distinguish patients who recover from lateropulsion from those who do not. METHODS: Patients with admission motor Functional Independence Measure (FIM) scores less than 31 and contralesional lower extremity Fugl-Meyer motor scores less than 19 out of 34 were included...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Anderson Castro Mundim, Clarissa Cardoso dos Santos Couto Paz, Emerson Fachin-Martins
Since the first Broca publications issued from 1970s, lateralized functions in the human brain have urged the researchers to postulate hypothesis based in the right-left asymmetries and, according to some theories, the lateralization of the voluntary motor control could represent a solution to avoid redundant process optimizing space and time. Supported by this idea, the clinicians and researchers tend to concept that the chronic hemiplegic stroke patients learn to use predominantly the non-affected hemibody after stroke in which is more convenient to execute their daily life activities, modifying their natural preference in some cases...
November 2015: Medical Hypotheses
Julian Conrad, Bernhard Baier, Marianne Dieterich
Most of our knowledge concerning central vestibular pathways is derived from animal studies while evidence of the functional importance and localization of these pathways in humans is less well defined. The termination of these pathways at the thalamic level in humans is even less known. In this review we summarize the findings concerning the central subcortical vestibular pathways in humans and the role of these structures in the central vestibular system with regard to anatomical localization and function...
2014: Journal of Vestibular Research: Equilibrium & Orientation
Yea-Ru Yang, Yi-Hua Chen, Heng-Chih Chang, Rai-Chi Chan, Shun-Hwa Wei, Ray-Yau Wang
OBJECTIVE: We investigated the effects of a computer-generated interactive visual feedback training program on the recovery from pusher syndrome in stroke patients. DESIGN: Assessor-blinded, pilot randomized controlled study. PARTICIPANTS: A total of 12 stroke patients with pusher syndrome were randomly assigned to either the experimental group (N = 7, computer-generated interactive visual feedback training) or control group (N = 5, mirror visual feedback training)...
October 2015: Clinical Rehabilitation
Ferco H Berger, Koenraad H Nieboer, Gerard S Goh, Antonio Pinto, Mariano Scaglione
To avoid detection at border crossings or airport customs, drug trafficking is increasingly performed by intra-corporeal concealment. Body packers may ingest packets of varying size and containing varying drugs (mostly cocaine, heroin and cannabis) mixed with other compounds, while body pushers will insert packets in the rectum or vaginal cavity. Body packing may lead to potential life-threatening complications with acute overdose syndromes after packet rupture and intestinal obstruction with possible ensuing bowel rupture being the most significant complications...
January 2015: La Radiologia Medica
Xiao-Wei Chen, Cheng-He Lin, Hua Zheng, Zhen-Lan Lin
OBJECTIVE: To observe clinical manifestations, behavioral characteristics, and effects of rehabilitation on a patient with pusher syndrome and unilateral spatial neglect caused by right thalamic hemorrhage. METHODS: Assessment of pusher syndrome was made by the Scale for Contraversive pushing (SCP), and unilateral spatial neglect syndrome was diagnosed using line cancellation, letter and star cancellation, line bisection tests and copy and continuation of graphic sequence test...
July 2014: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Arindam Dutta, Sanjay Chugh, Alakananda Banerjee, Anirban Dutta
BACKGROUND: Non-invasive brain stimulation (NIBS) is a promising tool for facilitating motor function. NIBS therapy in conjunction with training using postural feedback may facilitate physical rehabilitation following posture disorders (e.g., Pusher Syndrome). OBJECTIVES: The objectives of this study were, 1) to develop a low-cost point-of-care-testing (POCT) system for standing posture, 2) to investigate the effects of anodal tDCS on functional reach tasks using the POCT system...
2014: NeuroRehabilitation
Jong Hwa Lee, Sang Beom Kim, Kyeong Woo Lee, Ji Yeong Lee
OBJECTIVE: To investigate the somatosensory findings of pusher syndrome in stroke patients. METHODS: Twelve pusher patients and twelve non-pusher patients were enrolled in this study. Inclusion criteria were unilateral stroke, sufficient cognitive abilities to understand and follow instructions, and no visual problem. Patients were evaluated for pusher syndrome using a standardized scale for contraversive pushing. Somatosensory finding was assessed by the Cumulative Somatosensory Impairment Index (CSII) and somatosensory evoked potentials (SEPs) at 1 and 14 weeks after the stroke onset...
February 2013: Annals of Rehabilitation Medicine
Alexander A Tarnutzer, Dominik Straumann
Herein, we summarize articles in the field of neuro-otology published in the Journal of Neurology over the last year. Topics included acute and chronic vertigo as well as auditory and ocular motor disorders. Characteristic lesion locations in Pusher syndrome are reported and the usefulness of bedside ocular motor tests in vertebrobasilar stroke is revisited. Probing the vestibular system and its value in predicting the outcome in vegetative state is discussed. Several articles address new diagnostic and therapeutic approaches in different disorders associated with chronic vestibular, auditory or gait deficits...
November 2012: Journal of Neurology
Hiroaki Abe, Takeo Kondo, Yutaka Oouchida, Yoshimi Suzukamo, Satoru Fujiwara, Shin-Ichi Izumi
BACKGROUND AND PURPOSE: The aim of this study was to determine if side of cerebral hemisphere lesion affects the prevalence and time course of pushing behavior (PB) after stroke. METHODS: A total of 1660 patients with acute stroke were investigated. PB was assessed using the standardized Scale for Contraversive Pushing. Risk ratios were used to evaluate the differences in the prevalence of PB between right cerebral hemisphere-damaged (RCD) and left cerebral hemisphere-damaged (LCD) patients...
June 2012: Stroke; a Journal of Cerebral Circulation
Toshihiko Matsumoto, Shigeru Ozaki, Ohji Kobayashi, Kiyoshi Wada
PURPOSE: The purpose of the present study was to examine the current situation regarding sedative (mainly benzodiazepines)-related disorder in Japan and the clinical characteristics of Japanese patients with this disorder. SUBJECTS: Subjects were 671 drug-related disorder patients diagnosed according to the ICD-10 classification as "F1: mental and behavioural disorders due to psychoactive substance use," who abused psychoactive substances other than alcohol. Of all the psychiatric hospitals in Japan between September and October 2010, these drug-related disorder patients had consecutively consulted or were admitted to 153 psychiatric hospitals...
2011: Seishin Shinkeigaku Zasshi, Psychiatria et Neurologia Japonica
Taiza Elaine Grespan Santos-Pontelli, Octavio Marques Pontes-Neto, Draulio Barros de Araujo, Antonio Carlos dos Santos, João Pereira Leite
Pusher behavior (PB) is a disorder of postural control affecting patients with encephalic lesions. This study has aimed to identify the brain substrates that are critical for the occurrence of PB, to analyze the influence of the midline shift (MS) and hemorrhagic stroke volume (HSV) on the severity and prognosis of the PB. We identified 31 pusher patients of a neurological unit, mean age 67.4 ± 11.89, 61.3% male. Additional neurological and functional examinations were assessed. Neuroimaging workup included measurement of the MS, the HSV in patients with hemorrhagic stroke, the analysis of the vascular territory, etiology and side of the lesion...
December 2011: Arquivos de Neuro-psiquiatria
Ellen Clark, Keith D Hill, T David Punt
OBJECTIVES: To analyze responsiveness to change of 2 outcome measures in the lateropulsion population after stroke. Lateropulsion describes an atypical balance problem after stroke where patients actively push themselves toward their paretic side. Secondary aims were to measure the incidence of lateropulsion and evaluate the site of the brain most commonly involved in lateropulsion. DESIGN: Stroke patients were screened for lateropulsion on admission to rehabilitation...
January 2012: Archives of Physical Medicine and Rehabilitation
Bernhard Baier, Jelena Janzen, Wibke Müller-Forell, Marcel Fechir, Notger Müller, Marianne Dieterich
Unilateral stroke can lead to a disorder of postural balance that manifests as a pushing away toward the contralesional side. It is called "pusher syndrome" (PS). The aims of this study were first to assess the anatomical cortical regions that induce PS and second to clarify whether tilt of the subjective visual vertical (SVV)--a sign of vestibular otolith dysfunction--is associated with PS. Sixty-six patients with acute unilateral strokes (28 left-sided lesions, 38 right-sided lesions) were tested for PS, for tilts of the SVV, for hemineglect and for the anatomical lesion site by magnetic resonance imaging (MRI)-based voxelwise lesion-behavior mapping analysis...
February 2012: Journal of Neurology
Matteo Paci, Giovanni Matulli, Nicola Megna, Marco Baccini, Stefano Baldassi
Pusher behaviour (PB) reflects some misrepresentation of verticality. However, its neural mechanisms are still unclear. The aim of this pilot study is to assess the perception of the subjective visual vertical in patients with PB using an orientation discrimination task relying on a psychophysical forced-choice procedure. A sample of eight patients with post-stroke hemiplegia, three of whom with (PB+ group) and five without (PB- group) a clear PB, and 10 matched healthy subjects, was selected. All participants were assessed with an orientation discrimination task based on the objective Two-Alternatives Forced Choice (2AFC) procedure, in which observers are forced to report whether an oriented stimulus that was tilted off-vertical by a varying amount (but never vertical) was tilted clockwise or counterclockwise from vertical...
August 2011: Neuropsychological Rehabilitation
Stefanie Cardoen, Patrick Santens
"Pusher syndrome" is classically described as a disorder of body orientation in the coronal plane. Although it mainly occurs in stroke patients, non-stroke causes have been described. Pusher behaviour is characterized by a tilt towards the contralesional paretic side and a resistance to external attempts to rectify. It may occur with or without hemispatial neglect, which in itself may be the cause of a usually ipsilesional shift of attention and body orientation in the axial plane. In this report we describe two patients with a marked disturbance of body orientation in the sagittal plane with imbalance, posterior tilt and an active resistance to forward pulling or pushing...
May 2010: Clinical Neurology and Neurosurgery
Luca Francesco Ticini, Uwe Klose, Thomas Nägele, Hans-Otto Karnath
Brain damage may induce a dysfunction of upright body position termed "pusher syndrome". Patients with such disorder suffer from an alteration of their sense of body verticality. They experience their body as oriented upright when actually tilted nearly 20 degrees to the ipsilesional side. Pusher syndrome typically is associated with posterior thalamic stroke; less frequently with extra-thalamic lesions. This argued for a fundamental role of these structures in our control of upright body posture. Here we investigated whether such patients may show additional functional or metabolic abnormalities outside the areas of brain lesion...
2009: PloS One
Suzanne R Babyar, Margaret G E Peterson, Richard Bohannon, Dominic Pérennou, Michael Reding
OBJECTIVE: To examine the clinimetric properties and clinical applicability of published tools for 'quantifying' the degree of lateropulsion or pusher syndrome following stroke. DATA SOURCES: Search through electronic databases (MEDLINE, EMBASE, CINAHL, Science Citation Index) with the terms lateropulsion, pushing, pusher syndrome, validity, reliability, internal consistency, responsiveness, sensitivity, specificity, posture and stroke. Databases were searched from their inception to October 2008...
July 2009: Clinical Rehabilitation
Jacques Honoré, Arnaud Saj, Thérèse Bernati, Marc Rousseaux
Spatial neglect can be accompanied by a pusher syndrome (PS) which is characterized by a postural deviation towards the contralesional side. In this study, the representation of the body orientation in the horizontal plane was evaluated in neglect patients with and without PS. The participants had to align a luminous rod with the straight ahead direction, a method allowing the measure of both horizontal components of subjective straight ahead, i.e. lateral shift and yaw rotation. Eighteen patients with a lesion of the right hemisphere were compared with ten healthy participants...
February 2009: Neuropsychologia
Matteo Paci, Marco Baccini, Lucio A Rinaldi
Despite an increasing interest by researchers and clinicians, the pusher behaviour (PB) is still a poorly understood disorder, exhibited by some stroke patients, who push with their non-affected limbs towards the contralesional side and resist attempts at correction of their tilted posture. This review is aimed at critically summarizing findings on controversial issues regarding PB, namely correlation with neglect, neural correlates and underlying mechanisms. There is a growing agreement that PB reflects some misrepresentation of verticality...
2009: Disability and Rehabilitation
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