RSS-Feed abonnieren
DOI: 10.1055/s-0031-1277115
Pusher-Symptomatik: Zusammenfassung der aktuellen Erkenntnisse
Publikationsverlauf
Publikationsdatum:
06. Juni 2011 (online)
Zusammenfassung
Als Pusher-Symptomatik bezeichnet man das erstaunliche Verhalten mancher Patienten, nach einer Hirnläsion, sich aktiv mithilfe der nicht gelähmten Extremitäten zu ihrer gelähmten Seite hin zu drücken. Dieses Verhalten wurde überwiegend nach Schlaganfällen, aber auch nach anderen Hirnläsionen beobachtet und beschrieben. In der Literatur finden sich leider immer noch unterschiedliche Definitionen, obwohl die Symptomatik charakteristisch und stereotyp auftritt. Mehrere Untersuchungsverfahren und wenige Behandlungsansätze wurden bislang beschrieben und untersucht. Dieser Artikel bietet einen Überblick über den aktuellen Kenntnisstand zu Definition, Untersuchung, Prävalenz, Ursachen, Analyse der betroffenen Hirnregionen, Behandlung und Prognose der Pusher-Symptomatik.
Literatur
- 01 Babyar S R, Peterson M G, Bohannon R W et al.. Clinical examination tools for lateropulsion or pusher syndrome following stroke: a systematic review of the literature. Clin Rehabil. 2009; 23 639-650
- 02 Baccini M, Paci M, Rinaldi L A. The scale for contraversive pushing: A reliability and validity study. Neurorehabil Neural Repair. 2006; 20 468-472
- 03 Beevor C E. Remarks on paralysis of the movements of the trunk in hemiplegia. Br Med J. 1909; 881-885
- 04 Bisdorff A R, Wolsley C J, Anastasopoulos D et al.. The perception of body verticality (subjective postural vertical) in peripheral and central vestibular disorders. Brain. 1996; 119 1523-1534
- 05 Bjerver K, Silfverskiöld B P. Lateropulsion and imbalance in Wallenberg's syndrome. Acta Neurol Scand. 1968; 44 91-100
- 06 Bohannon R W. Correction of recalcitrant lateropulsion through motor learning. Physical Therapy Case Reports. 1998; 1 157-159
- 07 Bohannon R W. Pusher syndrome. Phys Ther. 2004; 84 580-581 author reply 582–583
- 08 Broetz D, Karnath H O. New aspects for the physiotherapy of pushing behaviour. NeuroRehabilitation. 2005; 20 133-138
- 09 Broetz D, Johannsen L, Karnath H O. Time course of ”pusher syndrome” under visual feedback treatment. Physiother Res Int. 2004; 9 138-143
- 10 Brötz D. Schlaganfallrehabilitation; zielgerichtete aktive Physiotherapie. Zeitschrift für Physiotherapeuten, Krankengymnasten. 2011; im Druck
- 11 Brunnstrom S. Movement therapy in hemiplegia. A neurophysiological approach. Harper & Row; New York; 1970
- 12 Danells C J, Black S E, Gladstone D J et al.. Poststroke "pushing": natural history and relationship to motor and functional recovery. Stroke. 2004; 35 2873-2878
- 13 D'Aquila M A, Smith T, Organ D et al.. Validation of a lateropulsion scale for patients recovering from stroke. Clin Rehabil. 2004; 18 102-109
- 14 Davies P M. Steps to follow. A guide to the treatment of adult hemiplegia. Springer; New York; 1985
- 15 Davies P M. Steps to follow. A guide to the treatment of adult hemiplegia. Springer; New York; 2000
- 16 Dettmann M A, Linder M T, Sepic S B. Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient. Am J Phys Med. 1987; 66 77-90
- 17 Dieterich M, Brandt T. Wallenberg's syndrome: lateropulsion, cyclorotation, and subjective visual vertical in thirty-six patients. Ann Neurol. 1992; 31 399-408
- 18 Johannsen L, Broetz D, Karnath H O. Leg orientation as a clinical sign for pusher syndrome. BMC Neurol. 2006a; 6 30
- 19 Johannsen L, Brötz D, Nägele T et al.. "Pusher syndrome" following cortical lesions that spare the thalamus. J Neurol. 2006b; 253 455-463
- 20 Johannsen L, Fruhmann Berger M, Karnath H-O.. Subjective visual vertical (SVV) determined in a representative sample of 15 patients with pusher syndrome. Journal of Neurology. 2006c; 253 1367-1369
- 21 Karnath H O, Ferber S, Dichgans J. The origin of contraversive pushing: Evidence for a second graviceptive system in humans. Neurology. 2000a; 55 1298-1304
- 22 Karnath H O, Ferber S, Dichgans J. The neural representation of postural control in humans. Proc Natl Acad Sci USA. 2000b; 97 13931-13936
- 23 Karnath H O, Brötz D, Götz A. Klinik, Ursache und Therapie der Pusher-Symptomatik. Nervenarzt. 2001; 72 86-92
- 24 Karnath H O, Johannsen L, Broetz D et al.. Prognosis of contraversive pushing. J Neurol. 2002; 249 1250-1253
- 25 Karnath H O, Brötz D. Understanding and treating ”pusher syndrome”. Physical Therapy. 2003; 83 1119-1125
- 26 Karnath H O, Johannsen L, Brötz D. Posterior thalamic hemorrhage induces "pusher syndrome". Neurology. 2005; 64 1014-1019
- 27 Karnath H O. Pusher syndrome – a frequent but little-known disturbance of body orientation perception. Journal of Neurology. 2007a; 254 415-424
- 28 Karnath H O, Brötz D. Instructions for the Clinical Scale for Contraversive Pushing (SCP). Neurorehabil Neural Repair. 2007b; 21 370-371
- 29 Lafosse C, Kerckhofs E, Troch M et al.. Contraversive pushing and inattention of the contralesional hemispace. J Clin Exp Neuropsychol. 2005; 27 460-484
- 30 Lagerqvist J, Skargren E. Pusher syndrome: Reliability, validity and sensitivity to change of a classification instrument. Advances in Physiotherapy. 2006; 8 154-160
- 31 Masdeu J C, Gorelick P B. Thalamic astasia: inability to stand after unilateral thalamic lesions. Ann Neurol. 1988; 23 596-603
- 32 Paci M, Baccini M, Rinaldi L M. Pusher behavior: A critical review of controversial issues. Disability and Rehabilitation. 2009; 31 249-258
- 33 Pedersen P M, Wandel A, Jorgensen H S et al.. Ipsilateral pushing in stroke: incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study. Arch Phys Med Rehabil. 1996; 77 25-28
- 34 Pérennou D A, Mazibrada G, Chauvineau V et al.. Lateropulsion, pushing and verticality perception in hemisphere stroke: a causal relationship?. Brain. 2008; 131 2401-2413
- 35 Pontelli T E, Pontes-Neto O M, Colafemina J F et al.. Posture control in Pusher syndrome: influence of lateral semicircular canals. Rev Bras Otorrinolaringol (Engl Ed). 2005; 71 448-452
- 36 Premoselli S, Cesana L, Cerri C. Pusher syndrome in stroke: clinical, neuropsychological, and neurophysiological investigation. Eur Med Phys. 2001; 37 143-151
- 37 Santos-Pontelli T E, Pontes-Neto O M, Colafemina J F et al.. Contraversive pushing in non-stroke patients. J Neurol. 2004; 251 1324-1348
- 38 Ticini L F, Klose U, Nägele T et al.. Perfusion imaging in pusher syndrome to investigate the neural substrates involved in controlling upright body position. PLoS ONE. 2009; 4 e5737
Doris Brötz
Poststraße 2–4
72072 Tübingen
eMail: info@broetz-physiotherapie.de
Prof. Dr. Dr. Hans-Otto Karnath
Zentrum für Neurologie
Sektion Neuropsychologie
Universität Tübingen
Hoppe-Seyler-Str. 3, 72076 Tübingen
eMail: karnath@uni-tuebingen.de