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Pusher syndrome

Pusher syndrome

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Pusher syndrome

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  1. Pusher syndrome Reporter:9419201張語竹 Advisor:蕭世芬老師 Date:2010/01/16

  2. Outline • Introduction • What’s pusher syndrome • Prevalence • Localization of Lesions • Clinical manifestation • Mechanism underlying pusher behavior • SVV and SPV • Assessment • SCP • Clinical implication • Prognosis • Summary

  3. Introduction • What’s pusher syndrome? • Synonym • Ipsilateral pushing • Contraversive pushing behavior • Prevalence • 10% in stroke patients • R’t brain damage • Localization of Lesions

  4. Clinical manifestation • Postural behavior • Motor performance • Sensation • Perception

  5. Mechanism underlying pusher behavior • PB reflects some misrepresentation of verticality • Perception of our orientation relative to the vertical and horizontal coordinates of the earth is determined by • Visual information • Somesthesic information • Vestibular information(gravity receptors) • SVV and SPV

  6. Assessment • SCP

  7. Clinical implication • Visual cue (SVV) • Moving lower trunk on stabilized upper trunk (SPV) • Motor relearning approach • TENS( sensory manipulation)

  8. Prognosis

  9. Summary

  10. Karnath HO, Broetz D. Understanding and treating "pusher syndrome". Phys Ther. Dec 2003;83(12):1119-1125. • P.M. Davies, Steps to Follow, A Guide to the Treatment ofAdult Hemiplegia, Springer, New York, 1985 • PM D. Steps To Follow: The Comprehensive Treatment Of Patients With Hemiplegia: Springer Berlin Heidelberg; 2000:403-428. • Paci M, Baccini M, Rinaldi LA. Pusher behaviour: a critical review of controversial issues. Disabil Rehabil. 2009;31(4):249-258. • 陳至淳.台灣老年醫學雜誌2006;2(1):42-52 • Wang H-C, Meng L-F. 中風病患伴隨推倒症候群之相關現象. 臺灣復健醫學雜誌. 2005 33(1):39-46. • Sharpe JA. What's up, doc? Altered perception of the haptic, postural, and visual vertical. Neurology. Nov 11 2003;61(9):1172-1173.