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Journal articles on the topic 'Lateropulsion'

Author: Grafiati

Published: 5 November 2024

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1

Delva, Iryna, Olga Oksak, and Mykhaylo Delva. "TIME COURSE AND PREDICTORS OF RECOVERY FROM LATEROPULSION AFTER HEMISPHERIC STROKE (PROSPECTIVE STUDY)." Eastern Ukrainian Medical Journal 12, no. 1 (2024): 174–82. http://dx.doi.org/10.21272/eumj.2024;12(1):174-182.

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Introduction. In recent years, considerable attention has been paid to the abnormality of body verticality perception in stroke patients. Most often, misperception of body verticality is manifested in the form of lateropulsion and repulsion syndrome. Objective: to study the timing of recovery from lateropulsion (pusher syndrome) and to determine the predictors of lateropulsion resolution in patients with hemispheric strokes. Material and methods. We included in the study patients with hemispheric strokes occurring within the last month. 61 patients were diagnosed with lateropulsion and 9 patients with pusher syndrome, according to the Scale for Contraversive Pushing. After initial examination, patients were subsequently invited for a weekly examination until the body's verticality was normalized. Results. Recovery time from pusher syndrome was significantly longer – 9.0 (95% confidence interval: 7.1–10.4) weeks compared to recovery time from lateropulsion – 5.9 (95% confidence interval: 5.5–6.3) weeks. Among all the studied factors, only spatial hemineglect was a significant independent predictor of a much longer resolution time of lateropulsion (hazard ratio 2.36; 95% confidence interval: 1.20–4.27). The mean duration of lateropulsion in patients with spatial hemineglect was 6.3 (95% confidence interval: 5.8–6.8) weeks, whereas in patients without spatial hemineglect, it was 4.8 (95% confidence interval: 4.3–5.4) weeks. In a subgroup of patients without spatial hemineglect, higher Fazekas scale values were a significant independent predictor of longer resolution time of lateropulsion (hazard ratio 2.38; confidence interval 95%: 1.25–4.48). Conclusions. After hemispheric strokes recovery time from pusher syndrome is much longer than recovery from lateropulsion. Recovery time from lateropulsion is determined by spatial hemineglect and leukoaraiosis severity.

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Lee, Kyoung Bo, Sang Won Yoo, Eun Kyu Ji, Woo Seop Hwang, Yeun Jie Yoo, Mi-Jeong Yoon, Bo Young Hong, and Seong Hoon Lim. "Is Lateropulsion Really Related with a Specific Lesion of the Brain?" Brain Sciences 11, no. 3 (March 10, 2021): 354. http://dx.doi.org/10.3390/brainsci11030354.

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Lateropulsion (pusher syndrome) is an important barrier to standing and gait after stroke. Although several studies have attempted to elucidate the relationship between brain lesions and lateropulsion, the effects of specific brain lesions on the development of lateropulsion remain unclear. Thus, the present study investigated the effects of stroke lesion location and size on lateropulsion in right hemisphere stroke patients. The present retrospective cross-sectional observational study assessed 50 right hemisphere stroke patients. Lateropulsion was diagnosed and evaluated using the Scale for Contraversive Pushing (SCP). Voxel-based lesion symptom mapping (VLSM) analysis with 3T-MRI was used to identify the culprit lesion for SCP. We also performed VLSM controlling for lesion volume as a nuisance covariate, in a multivariate model that also controlled for other factors contributing to pusher behavior. VLSM, combined with statistical non-parametric mapping (SnPM), identified the specific region with SCP. Lesion size was associated with lateropulsion. The precentral gyrus, postcentral gyrus, inferior frontal gyrus, insula and subgyral parietal lobe of the right hemisphere seemed to be associated with the lateropulsion; however, after adjusting for lesion volume as a nuisance covariate, no lesion areas were associated with the SCP scores. The size of the right hemisphere lesion was the only factor most strongly associated with lateropulsion in patients with stroke. These results may be useful for planning rehabilitation strategies of restoring vertical posture and understanding the pathophysiology of lateropulsion in stroke patients.

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Dai, Shenhao, Céline Piscicelli, Emmanuelle Clarac, Monica Baciu, Marc Hommel, and Dominic Pérennou. "Lateropulsion After Hemispheric Stroke." Neurology 96, no. 17 (March 15, 2021): e2160-e2171. http://dx.doi.org/10.1212/wnl.0000000000011826.

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ObjectiveTo test the hypothesis that lateropulsion is an entity expressing an impaired body orientation with respect to gravity in relation to a biased graviception and spatial neglect.MethodsData from the DOBRAS cohort (ClinicalTrials.gov: NCT03203109) were collected 30 days after a first hemisphere stroke. Lateral body tilt, pushing, and resistance were assessed with the Scale for Contraversive Pushing.ResultsAmong 220 individuals, 72% were upright and 28% showed lateropulsion (tilters [14%] less severe than pushers [14%]). The 3 signs had very high factor loadings (>0.90) on a same dimension, demonstrating that lateropulsion was effectively an entity comprising body tilt (cardinal sign), pushing, and resistance. The factorial analyses also showed that lateropulsion was inseparable from the visual vertical (VV), a criterion referring to vertical orientation (graviception). Contralesional VV biases were frequent (44%), with a magnitude related to lateropulsion severity: upright −0.6° (−2.9; 2.4), tilters −2.9° (−7; 0.8), and pushers −12.3° (−15.4; −8.5). Ipsilesional VV biases were less frequent and milder (p < 0.001). They did not deal with graviception, 84% being found in upright individuals. Multivariate, factorial, contingency, and prediction analyses congruently showed strong similarities between lateropulsion and spatial neglect, the latter encompassing the former.ConclusionsLateropulsion (pusher syndrome) is a trinity constituted by body tilt, pushing, and resistance. It is a way to adjust the body orientation in the roll plane to a wrong reference of verticality. Referring to straight above, lateropulsion might correspond to a form of spatial neglect (referring to straight ahead), which would advocate for 3D maps in the human brain involving the internal model of verticality.

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Gomez-Risquet, Maria, Anja Hochsprung, Eleonora Magni, and Carlos Luque-Moreno. "Feedback Interventions in Motor Recovery of Lateropulsion after Stroke: A Literature Review and Case Series." Brain Sciences 14, no. 7 (July 5, 2024): 682. http://dx.doi.org/10.3390/brainsci14070682.

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Lateropulsion is a post-stroke phenomenon marked by an active push of the body across the midline towards the more affected side and/or a resistance of the weight shift towards the less affected side. Within the mechanisms of treatment, feedback systems have been shown to be effective. The aim of the present study was to create a body of knowledge by performing a literature review on the use of feedback mechanisms in the treatment of lateropulsion and to report two cases of lateropulsion patients who had undergone feedback-based treatment. Methods: The review was performed across five different databases (Embase, Medline/PubMed, Scopus, Web of Science, and PEDro) up to February 2024, and haptic feedback intervention was incorporated into the case series (with lateropulsion and ambulation capacity as the main variables). Results: In total, 211 records were identified and 6 studies were included after the review of the literature. The most used feedback modality was visual feedback. In the case series, positive results were observed from the intervention, particularly in the recovery of lateropulsion and balance, as well as in the improvement of gait for one patient. Patients demonstrated good adherence to the intervention protocol without adverse effects. Conclusions: Visual feedback is the most commonly used feedback modality in lateropulsion patients but other mechanisms such as haptic feedback also are feasible and should be taken into account. Larger sample sizes, extended follow-up periods, and the isolation of feedback mechanisms must be established to clarify evidence.

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Dai, Shenhao, Camille Lemaire, Céline Piscicelli, and Dominic Pérennou. "Lateropulsion Prevalence After Stroke." Neurology 98, no. 15 (February 21, 2022): e1574-e1584. http://dx.doi.org/10.1212/wnl.0000000000200010.

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Background and ObjectivesLateropulsion is a deficit of active body orientation with respect to gravity in the frontal plane, mostly observed after a stroke. It magnifies mobility limitations and represents an emerging target in rehabilitation. Efforts to design specific interventional studies require some basic knowledge of epidemiology, which is insufficient today because many studies have focused on a few severe forms in individuals called pushers. The objectives of this study were to bridge this gap.MethodsWe systematically searched MEDLINE, EMBASE, CINAHL, and Cochrane Clinical Trials up to 31 May 2021 for original research reporting a prevalence or incidence of poststroke lateropulsion. We followed MOOSE and PRISMA guidelines. Eligibility for inclusion, data extraction, and study quality (Joanna Briggs Institute guidelines) were evaluated by 2 reviewers who used a standardized protocol (PROSPERO; CRD42020175037). A random-effects meta-analysis was used to obtain the pooled prevalence, whose heterogeneity was investigated by subgroup analysis (stroke locations and poststroke phases) and metaregression.ResultsWe identified 22 studies (5,125 individuals; mean age 68.5 years; 42.6% female; assessed 24 days, on average, after stroke), most published after 2000. The studies' quality was adequate, with only 8 (36.4%) showing risk of bias. The pooled lateropulsion prevalence was 55.1% (95% CI 35.9–74.2) and was consistent across assessment tools. After supratentorial stroke, lateropulsion prevalence was 41% (95% CI 33.5–48.5), and only 12.5% (95% CI 9.2–15.9) in individuals with severe lateropulsion, called pushers. Metaregression did not reveal any effect of age, sex, geographic region, publication year, or study quality. Lateropulsion prevalence progressively decreased from 52.8% (95% CI 40.7–65) in the acute phase to 37% (95% CI 26.3–47.7) in the early subacute phase and 22.8% (95% CI 0–46.3) in the late subacute phase. The ratio of right to left hemispheric stroke with lateropulsion increased as a function of time: 1.7 in the acute phase to 7.7 in the late subacute phase. After infratentorial stroke, lateropulsion prevalence was very high, reaching 83.2% (95% CI 63.9–100.3).DiscussionPoststroke lateropulsion prevalence is high, which appeals for its systematic detection to guide early interventions. Uprightness is predominantly controlled from the right hemisphere.

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Komiyama, Atsushi. "Isolated Body Lateropulsion." Equilibrium Research 79, no. 6 (December 31, 2020): 566–68. http://dx.doi.org/10.3757/jser.79.566.

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7

Dai, Shenhao, and Dominic Pérennou. "Renaissance of “lateropulsion”." Annals of Physical and Rehabilitation Medicine 64, no. 6 (November 2021): 101595. http://dx.doi.org/10.1016/j.rehab.2021.101595.

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Gillespie, Jaime, Katelyn D. Bosteder, Radha Morar, Molly Trammell, Simon Driver, and Chad Swank. "Physical therapist burden delivering gait training for a patient with lateropulsion after stroke during inpatient rehabilitation: a single-case design." International Journal of Therapy and Rehabilitation 31, no. 10 (October 2, 2024): 1–11. http://dx.doi.org/10.12968/ijtr.2024.0075.

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Background/Aims Gait training for patients with lateropulsion after stroke improves outcomes (eg reduced lateropulsion and improved function) but can be burdensome on the physical therapist. This study describes the physical therapist burden and performance of a patient with moderate lateropulsion during three gait training approaches during inpatient rehabilitation. Methods A physical therapist delivered gait training (one session each of overground robotic exoskeleton, overground supported walking, and body weight-supported treadmill training) for a patient with lateropulsion (scoring 8 out of 17 on the Burke Lateropulsion Scale). Outcomes were physiological burden (heart rate, metabolic equivalents, respiratory exchange ratio and energy expenditure), which were measured via a wearable metabolic system and perceptual burden (National Aeronautics and Space Administration Task Load Index) on the physical therapist. Patient performance (step count, time walking, time spent upright and time in moderate-to-vigorous intensity) was recorded. Results During overground robotic exoskeleton gait training, the physical therapist's physiological metrics included an average heart rate of 116 beats per minute (minimum–maximum: 98–127, time in moderate-to-vigorous intensity was 0%), average metabolic equivalents of 3.2 (minimum–maximum: 1.7–4.3), a respiratory exchange ratio of 0.79 (minimum–maximum: 0.70–0.93), an energy expenditure of 228 kcal/hour and a perceptual burden of 33.3. The patient walked 228 steps, spent 15.4 minutes upright, 8.7 minutes walking and achieved 0% in moderate-to-vigorous intensity. During overground supported walking, the physical therapist's metrics included an average heart rate of 145 beats per minute (minimum–maximum: 113–164, time in moderate-to-vigorous intensity was 87%), average metabolic equivalents of 4.7 (minimum–maximum: 2.7–6.0), a respiratory exchange ratio of 0.96 (minimum–maximum: 0.81–1.16), an energy expenditure of 343 kcal/hour and a perceptual burden of 60.8. The patient walked 588 steps, spent 19.6 minutes upright, 10.5 minutes walking and achieved 38% in moderate-to-vigorous intensity. During body weight-supported treadmill training, the physical therapist's metrics included an average heart rate of 112 beats per minute (minimum–maximum: 69–137, time in moderate-to-vigorous intensity was 34%), average metabolic equivalents of 3.9 (minimum–maximum: 3.2–4.4), a respiratory exchange ratio of 0.89 (minimum–maximum: 0.82–0.95), an energy expenditure of 281 kcal/hour and a perceptual burden of 32.5. The patient walked 682 steps, spent 16.0 minutes upright, 10.0 minutes walking and achieved 0% in moderate-to-vigorous intensity. Conclusions As concordance between physical therapist burden and patient gait performance was low in this study, future efforts to identify gait training approaches that minimise therapist burden while maximising outcomes for the patient with lateropulsion are necessary for the health of both. Implications for practice Physical therapists may consider advanced technology use such as overground robotic exoskeletons to reduce the burden during the provision of gait training for patients with lateropulsion. Gait training performance of patients with lateropulsion may vary across different gait training approaches with low correspondence to therapist burden.

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Islam, Niaz, Gordon T. Plant, and James F. Acheson. "Saccadic lateropulsion or ipsipulsion." Acta Ophthalmologica 86, no. 6 (August 26, 2008): 688–89. http://dx.doi.org/10.1111/j.1600-0420.2007.01040.x.

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Naoi, Tameto, Yuko Nakamura, Tomoaki Kameda, Ayako Ando, and Tadataka Kawakami. "Imaging of ocular lateropulsion." Neurology and Clinical Neuroscience 4, no. 1 (August 6, 2015): 37. http://dx.doi.org/10.1111/ncn3.12019.

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Kim, Yeong-Sang, Hyeonjun Woo, Jin-Ah Oh, and Su-Hyeon Jeong. "Korean Medicine Treatment with Scalp Acupuncture for Diplopia and Lateropulsion in a Patient with Lateral Medullary Infarction: A Case Report." Journal of Korean Medicine 45, no. 3 (September 1, 2024): 211–23. http://dx.doi.org/10.13048/jkm.24050.

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Background: This case study aimed to report the efficacy of scalp acupuncture in a patient with diplopia or lateropulsion and lateral medullary infarction.Case report: A 41-year-old woman with lateral medullary infarctions presented with symptoms of left-sided diplopia, left lateropulsion, headache, dizziness, and right-sided dysesthesia for 8 months. She received daily Korean medicine treatments, including scalp acupuncture. During the treatment period, various assessments were conducted, including the symptom score, visual analog scale (VAS), diplopia questionnaire (DQ), eyeball movement, dizziness handicap inventory (DHI), Korean version of the berg balance scale (K-BBS), activities-specific balance confidence scale (ABC), vestibular disorders activities of daily living scale (VADL), and the EuroQol five-dimension index (EQ-5D index). The patient’s symptom score, VAS, DQ, DHI, and VADL scores decreased, while K-BBS, ABC, and EQ-5D scores increased. Additionally, eyeball movements improved after Korean medicine treatment including scalp acupuncture.Conclusions: The observed improvements suggest that Korean medicine treatment including scalp acupuncture can effectively alleviate diplopia and lateropulsion in patients with lateral medullary infarction.

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Yamaoka, Yumiko, Sadahiro Kishishita, Yohei Takayama, and Seiji Okubo. "A Report of a Case Involving Body Lateropulsion with Numbness of the Ipsilesional Fingers Caused by a Small Infarction in the Dorsal Part of the Middle Medulla." Case Reports in Neurology 10, no. 1 (February 15, 2018): 54–59. http://dx.doi.org/10.1159/000486892.

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Based on the complexity of functional anatomy, a small infarction in the medulla can produce various types of clinical symptoms or signs depending on the location of this infarction. We describe the case of a 46-year-old man who presented with sudden onset of body lateropulsion to the left side and numbness of the ipsilateral fingers. 3-tesla diffusion-weighted magnetic resonance imaging with a section thickness of 2 mm revealed a small infarction in the dorsal part of the left middle medulla. To our knowledge, this is the first case report describing vestibular dysfunction apparent upon otoelectrophysiological examination but without vestibular symptoms or signs except for body lateropulsion.

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Kim, J. S., S. Y. Moon, S. H. Park, B. W. Yoon, and J. K. Roh. "Ocular lateropulsion in Wallenberg syndrome." Neurology 62, no. 12 (June 21, 2004): 2287. http://dx.doi.org/10.1212/wnl.62.12.2287.

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Dai, S., E. Clarac, A. Odin, A. Kistner, A. Chrispin, P. Davoine, M. Jaeger, C. Piscicelli, and D. Pérennou. "Lateropulsion syndrome or Pusher syndrome?" Annals of Physical and Rehabilitation Medicine 61 (July 2018): e64. http://dx.doi.org/10.1016/j.rehab.2018.05.141.

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Babyar, Suzanne R., Anna Smeragliuolo, Fatimah M. Albazron, David Putrino, Michael Reding, and Aaron D. Boes. "Lesion Localization of Poststroke Lateropulsion." Stroke 50, no. 5 (May 2019): 1067–73. http://dx.doi.org/10.1161/strokeaha.118.023445.

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Komiyama, Atsushi. "Body Lateropulsion and Pusher Behavior." Equilibrium Research 82, no. 1 (February 28, 2023): 3–15. http://dx.doi.org/10.3757/jser.82.3.

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Baehring, J. M., M. Phipps, and G. Wollmann. "ROSTRAL MIDBRAIN INFARCTION PRODUCING ISOLATED LATEROPULSION." Neurology 70, no. 8 (February 19, 2008): 655–56. http://dx.doi.org/10.1212/01.wnl.0000280459.05326.af.

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Dai, Shenhao, Céline Piscicelli, Emmanuelle Clarac, Anaïs Odin, Andrea Kistner, Anne Chrispin, Patrice Davoine, Marie Jaeger, and Dominic Pérennou. "Syndrome Pusher ou plutôt syndrome Lateropulsion ?" Neurophysiologie Clinique 48, no. 6 (December 2018): 326. http://dx.doi.org/10.1016/j.neucli.2018.10.039.

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Koter, Ryan, Sara Regan, Caitlin Clark, Vicki Huang, Melissa Mosley, Erin Wyant, Chad Cook, and Jeffrey Hoder. "Clinical Outcome Measures for Lateropulsion Poststroke." Journal of Neurologic Physical Therapy 41, no. 3 (July 2017): 145–55. http://dx.doi.org/10.1097/npt.0000000000000194.

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Delva, I. I., and O. M. Oksak. "IMPAIRED VERTICALITY PERCEPTION AND POSTURAL BALANCE AT 1 MONTH AFTER HEMISPHERIC STROKE." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 23, no. 2.1 (May 23, 2023): 13–17. http://dx.doi.org/10.31718/2077-1096.23.2.1.13.

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Introduction. In some patients with hemispheric strokes the internal model of verticality is shifted to the opposite side, so patients actively tilt the body axis in the opposite direction from the affected hemisphere. Disturbances of verticality perception are associated with worse functional conditions and slower dynamics of their recovery, with the need for longer rehabilitation treatment, etc. Objective: to investigate the relationships between impaired perception of verticality and indicators of postural balance during the 1st month after hemispheric strokes. Material and methods. There were examined 205 patients with hemispheric strokes that occurred during the last month. The Scale for Contraversive Pushing was used to assess the orientation of the body axis in relation to the force of gravity in the frontal plane. For evaluating of static and dynamic balance we used Berg Balance Scale, Postural Assessment Scale for Stroke, Trunk Impairment Scale, Test Timed Up and Go. Results. Depending on the presence (absence) of verticality perception disorders it had been revealed significant differences in postural balance scales and tests. Severity of verticality perception impairment was associated with significant changes in postural balance: patients with pushing syndrome had reliably worse indicators of postural balance compared to patients with lateropulsion. Moreover, even minimal lateropulsion was associated with significant deterioration of postural balance indicators, compared to normal perception of verticality. In addition, increasing severity of lateropulsion was associated with significant deterioration of postural balance indicators, regardless of spatial hemineglect and hemiparesis severity. Conclusions. 1. Impaired verticality perception in the recovery period of hemispheric strokes was associated with reliable negative changes in postural balance status. 2. Increasing severity of verticality perception disorders corresponded to a reliable deterioration of postural balance indicators.

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Mon, Yusuke, Takenori Yamaguchi, Yoichiro Hashimoto, and Mamiko Satomi. "Ocular lateropulsion. Its symptomatology and MRI findings." Nosotchu 11, no. 5 (1989): 586–91. http://dx.doi.org/10.3995/jstroke.11.586.

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Takamatsu, A., K. Sakajiri, and E. Nitta. "Examination of body lateropulsion in cerebral infarction." Journal of the Neurological Sciences 381 (October 2017): 1102–3. http://dx.doi.org/10.1016/j.jns.2017.08.3113.

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Akdal, Gülden, Matthew J. Thurtell, and G. Michael Halmagyi. "Isolated Lateropulsion in Acute Lateral Medullary Infarction." Archives of Neurology 64, no. 10 (October 1, 2007): 1542. http://dx.doi.org/10.1001/archneur.64.10.1542.

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Delva, I. I., O. M. Oksak, and M. Yu Delva. "IMPAIRED VERTICALITY PERCEPTION IN PATIENTS WITH HEMISPHERIC STROKES: PREVALENCE, ASSOCIATED FACTORS (CROSS-SECTIONAL STUDY)." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 22, no. 3-4 (November 29, 2022): 42–46. http://dx.doi.org/10.31718/2077-1096.22.3.4.42.

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Introduction. In recent decades, among the causes of post-stroke postural balance disorders, a lot of attention has been paid to disorders of verticality perception. Impairments of verticality perception have different forms: from lateropulsion to pushing syndrome. Aim: to study the prevalence of verticality perception impairments during the 1st month after strokes and to determine the factors associated with this phenomenon. Material and methods. 205 patients with hemispheric strokes that occurred during the last month were examined. The Scale for Contraversive Pushing scale was used to assess the orientation of the body axis in relation to the force of gravity in the frontal plane. We determined socio-demographic factors, clinical and neurological characteristics, cognitive and psycho-emotional characteristics, neuroimaging parameters. Impaired verticality perception was diagnosed in 70 patients (34,2%): lateropulsion – in 61 (29,8%), pushing syndrome – in 9 patients (4,4%). No associations were found between impaired vertical perception and age, gender of patients, level of paresis, presence of apraxias and aphasias, NIHSS scale scores, modified Rankin scale scores, stroke type (ischemic/hemorrhagic), cognitive, anxiety and depressive disorders, fatigue, localization of cerebral infarction, level of leukoaraiosis, morphometric indicators of external and internal cerebral atrophy. On the other hand, patients with impaired verticality perception had significantly more often paresis (in case of lateropulsion - in 96.7%, in pushing syndrome - in 100%, in patients with normal verticality perception - in 75.6%), spatial hemineglect (70.5 %, 88.% and 17.8%, respectively), non-lacunar subtype of ischemic stroke (91.8%, 100% and 73.4%, respectively), lesions of the right hemisphere (73.8%, 77.7% and 57.0%, respectively), also they had significantly larger volumes of cerebral infarctions (20.3 (13.4-28.9) cm3, 24.1 (12.9-27.2) cm3 and 15.8 (8.5 -23.3) cm3, respectively). Conclusions. During the first month after stroke, impaired verticality perception is a common phenomenon associated with certain clinical and neuroimaging characteristics.

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Li, Hui, Na Wei, Lu Zhang, Xiuli Liu, and Jingzhe Han. "Body lateropulsion as the primary manifestation of medulla oblongata infarction: a case report." Journal of International Medical Research 48, no. 11 (November 2020): 030006052097077. http://dx.doi.org/10.1177/0300060520970773.

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Background Isolated body lateropulsion is a possible predominant manifestation of medulla oblongata infarction, and can occur without vestibular and cerebellar symptoms. However, it is relatively rare and challenging to diagnose. Case presentation A 67-year-old woman was admitted to the Harris International Peace Hospital complaining mainly of instability when standing and walking for the previous 8 hours. Based on the neural localization and multiple head magnetic resonance imaging (MRI) examinations, a diagnosis of cerebral infarction (vertebrobasilar system) was made. Consequently, the patient was managed using therapy aimed at preventing platelet aggregation, lowering plasma lipids, stabilizing plaques, protecting mitochondria, and improving circulation and brain function. The patient’s gait improved and she was discharged after 14 days because she was able to walk unaided. The patient was followed up for 6 months and had no noticeable undesirable side effects or signs of neurological deficits. Conclusion The possibility of lateral medulla oblongata infarction should be considered when patients present with isolated body lateropulsion, without other signs or symptoms of brainstem damage.

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Matsuda, Masazumi, Sachiko Kamada, Satoshi Okawa, Masashiro Sugawara, and Hirohide Ohnishi. "Acute onset lateropulsion strongly suggests a medullary infarction." Nosotchu 35, no. 3 (2013): 195–99. http://dx.doi.org/10.3995/jstroke.35.195.

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Ueda, Kunihiro, Akiko Seto, Tatsuo Mano, and Tatsushi Toda. "Isolated Body Lateropulsion in Supplementary Motor Area Infarction." Internal Medicine 59, no. 23 (December 1, 2020): 3113–14. http://dx.doi.org/10.2169/internalmedicine.5320-20.

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Pérennou, D. A., G. Mazibrada, V. Chauvineau, R. Greenwood, M. A. Gresty, J. Rothwell, and A. M. Bronstein. "5.26 Lateropulsion, pushing and verticality perception: Acausal relationship?" Gait & Posture 21 (June 2005): S29—S30. http://dx.doi.org/10.1016/s0966-6362(05)80101-8.

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Pérennou, D., V. Chauvineau, C. Reymond, J. P. Micallef, J. Pélissier, C. Benaim, and J. Barra. "Improving verticality perception reduces lateropulsion after hemisphere stroke." Annals of Physical and Rehabilitation Medicine 55 (October 2012): e12. http://dx.doi.org/10.1016/j.rehab.2012.07.031.

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Shan, Din-E., Vinchi Wang, and Jen-Tser Chen. "Isolated lateropulsion of the trunk in cerebellar infarct." Clinical Neurology and Neurosurgery 97, no. 2 (May 1995): 195–98. http://dx.doi.org/10.1016/0303-8467(95)00026-g.

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31

Crevits, L., and H. vander Eecken. "Clinical analysis of ocular lateropulsion in wallenberg's syndrome." Clinical Neurology and Neurosurgery 87, no. 1 (January 1985): 69. http://dx.doi.org/10.1016/0303-8467(85)90081-2.

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Nakamura, Koichiro, Suguru Kadowaki, Nozomu Matsuda, and Yoshikazu Ugawa. "Isolated Lateropulsion Caused by a Paramedian Midbrain Infarction." Internal Medicine 50, no. 17 (2011): 1863. http://dx.doi.org/10.2169/internalmedicine.50.5391.

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Brandt, Thomas, and Marianne Dieterich. "Perceived Vertical and Lateropulsion: Clinical Syndromes, Localization, and Prognosis." Neurorehabilitation and Neural Repair 14, no. 1 (March 2000): 1–12. http://dx.doi.org/10.1177/154596830001400101.

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We present a clinical classification of central vestibular syndromes according to the three major planes of action of the vestibulo-ocular reflex: yaw, roll, and pitch. The plane-specific syndromes are determined by ocular motor, postural, and percep tual signs. Yaw plane signs are horizontal nystagmus, past pointing, rotational and lat eral body falls, deviation of perceived straight-ahead to the left or right. Roll plane signs are torsional nystagmus, skew deviation, ocular torsion, tilts of head, body, and perceived vertical in a clockwise or counterclockwise direction. Pitch plane signs are upbeat/downbeat nystagmus, forward/backward tilts and falls, deviations of the per ceived horizon. The thus defined vestibular syndromes allow a precise topographic analysis of brainstem lesions according to their level and side. Special emphasis is placed on the vestibular roll plane syndromes of ocular tilt reaction, lateropulsion in Wallenberg's syndrome, thalamic and cortical astasia and their association with roll plane tilt of perceived vertical. Recovery is based on a functionally significant central compensation of a vestibular tone imbalance, the mechanism of which is largely un known. Physical therapy may facilitate this central compensation, but this has not yet been proven in prospective studies. Key Words: Visual vertical—Lateropulsion— Vestibulo-ocular reflex—Central vestibular syndromes.

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34

Pape, A. E., G. Karabin, N. Schenke, T. Duning, and H. Hildebrandt. "Eine Pilotstudie zur Behandlung der kontraversiven Lateropulsion (»Pusher-Syndrom«) durch Prismenadaption." Neurologie & Rehabilitation 29, no. 02 (2023): 100–106. http://dx.doi.org/10.14624/nr2302003.

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Zusammenfassung Hintergrund: Patienten mit unilateralen Hirnschäden zeigen häufig eine kontraversive Lateropulsion (»pusher syndrome«, PS). Prismenadaption (PA) führt zu einer Neuausrichtung des propriozeptiven und visuellen Koordinatensystems und könnte daher eine wirksame Behandlungsoption für das PS sein. Methode: Das Studiendesign bestand aus einer Serie von Einzelfallinterventionen (n=14) mit vor- und nachheriger Baseline Messung. Patienten in einem subakuten Zustand nach einem zerebrovaskulären Ereignis der rechten Hemisphäre und mit einem mindestens moderatem PS (gemessen anhand der Klinischen Skala für Contraversive PusherSymptomatik (SCP) und einer Abweichung der Sitzbalance zwischen der linken und rechten Körperhälfte von mindestens 10 Prozent) wurden eingeschlossen. Die quantitativ gemessene Veränderung der Gleichgewichtsverteilung beim Sitzen war der primäre Outcome Parameter. Nach drei Baseline-Messungen im Abstand von drei Tagen (Tage 1, 4, 7) folgten die Interventionssitzungen mit PA im Abstand von drei Tagen (Tage 10, 13, 16). Nach 14 Tagen (Tag 30) wurde eine Folgemessung durchgeführt. Wir erhoben auch den Kraftgrad, den Frührehabilitation Barthel-Index (FRBI) und die Functional Independence Measure (FIM) am Tag 1 und zum Zeitpunkt der Nachfolgeuntersuchung. Die Lokalisation der Läsion wurde manuell in den MRIcron-Standard-Hirnatlas übertragen. Ergebnisse: Jede PA-Intervention verbesserte das Sitzgleichgewicht signifikant, was auf eine sofortige Wirkung von PA auf PS hindeutet. Die PA-Effekte nahmen jedoch über den Zeitraum von drei Tagen teilweise wieder ab, und, wie die Baseline-Phase zeigte, es trat eine signifikante Erholung auch unabhängig von PA auf. Die Patienten verbesserten sich auch in der SCP, dem FRBI, der FIM und der Muskelkraft. Aufgrund der generell hohen Remission kann nicht geschlossen werden, dass letztere Verbesserungen mit den PA-Interventionen zusammenhingen. Die Patienten zeigten überlappende Läsionen im rechten Putamen, im präzentralen Gyrus und in der Corona radiata. Schlussfolgerung: PA führte zu einer kurzfristigen Verbesserung der kontraversiven Lateropulsion, die aber womöglich als Nacheffekt der PA zu interpretieren ist. Es bleibt damit unklar, ob sie sich auch nachhaltig auf die Erholung vom PS auswirkt Schlüsselwörter: Schlaganfallrehabilitation, Prismenadaption, Pusher-Syndrom, Lateropulsion, Sitzbalance

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35

Nolan, Jessica, Angela Jacques, Erin Godecke, Hiroaki Abe, Suzanne Babyar, Jeannine Bergmann, Melissa Birnbaum, et al. "Post-stroke lateropulsion terminology: pushing for agreement amongst experts." Annals of Physical and Rehabilitation Medicine 65, no. 6 (November 2022): 101684. http://dx.doi.org/10.1016/j.rehab.2022.101684.

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36

Lim, Seong Hoon, Kyoung Bo Lee, and Bo Young Hong. "Is lateropulsion really related with specific lesion of brain?" Journal of the Neurological Sciences 429 (October 2021): 118585. http://dx.doi.org/10.1016/j.jns.2021.118585.

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37

JAHN, K. "Lateropulsion in Wallenberg's Syndrome Decreases with Increasing Locomotion Speed." Annals of the New York Academy of Sciences 1004, no. 1 (October 1, 2003): 521–23. http://dx.doi.org/10.1196/annals.1303.066.

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38

Crevits, L., and H. Eecken. "Ocular lateropulsion in Wallenberg's syndrome: A prospective clinical study." Acta Neurologica Scandinavica 65, no. 3 (January 29, 2009): 219–22. http://dx.doi.org/10.1111/j.1600-0404.1982.tb03080.x.

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39

Pollak, L., C. Klein, J. Schiffer, and M. J. Rabey. "Persistent ocular lateropulsion in Wallenberg's syndrome responsive to phenytoin." Neuro-Ophthalmology 18, no. 2 (January 1997): 91–94. http://dx.doi.org/10.3109/01658109709044124.

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40

Thomke, F., J. J. Marx, G. D. Iannetti, G. Cruccu, S. Fitzek, P. P. Urban, P. Stoeter, M. Dieterich, and H. C. Hopf. "A topodiagnostic investigation on body lateropulsion in medullary infarcts." Neurology 64, no. 4 (February 22, 2005): 716–18. http://dx.doi.org/10.1212/01.wnl.0000152040.27264.1a.

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41

Okamura, Madoka, Keisuke Suzuki, Tomoko Komagamine, Toshiki Nakamura, Hidehiro Takekawa, Yohei Asakawa, Akiko Kawasaki, Masanari Yamamoto, and Koichi Hirata. "Isolated Body Lateropulsion in a Patient with Pontine Infarction." Journal of Stroke and Cerebrovascular Diseases 22, no. 7 (October 2013): e247-e249. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2012.11.008.

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42

Nakazato, Yoshihiko, Naotoshi Tamura, Kei Ikeda, and Toshimasa Yamamoto. "Isolated body lateropulsion caused by lower lateral medullary infarction." eNeurologicalSci 7 (June 2017): 25–26. http://dx.doi.org/10.1016/j.ensci.2017.03.004.

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43

Tilikete, Caroline, Marc Hermier, Denis Pelisson, and Alain Vighetto. "Saccadic lateropulsion and upbeat nystagmus: Disorders of caudal medulla." Annals of Neurology 52, no. 5 (October 24, 2002): 658–62. http://dx.doi.org/10.1002/ana.10342.

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44

Chen, Ko-Ting, Sheng-Yao Huang, Yi-Jye Chen, and Ying-Yun Chen. "Primary Graviceptive System and Astasia: A Case Report and Literature Review." Brain Sciences 13, no. 10 (September 26, 2023): 1371. http://dx.doi.org/10.3390/brainsci13101371.

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Astasia refers to the inability to maintain upright posture during standing, despite having full motor strength. Impairment of the vestibulocerebellar pathway, graviceptive system, and cingulate motor area have been proposed to be related to astasia. However, the responsible neural pathways remain unclear. We hypothesize that there is a common neural network behind astasia. To test the hypothesis, we reviewed all reported cases with astasia, including ours, and focused on the correlation between anatomical destruction and symptom presentation. A total of 26, including ours, non-psychogenic astasia patients were identified in the English literature. Seventy-three percent of them were associated with other neurologic symptoms and sixty-two percent of reported lesions were on the right side. Contralateral lateropulsion was very common, followed by retropulsion, when describing astasia. Infarction (54%) was the most reported cause. The thalamus (65%) was the most reported location. Infarctions were the fastest to recover (mean: 10.6 days), while lesions at the brainstem needed a longer time (mean: 61.6 days). By combining the character of lateropulsion in astasia and the presentation of an interrupted graviceptive system, we concluded that the primary graviceptive system may be the common neural network behind astasia. Future studies on astasia should focus on the pathological changes in the perception of verticality in the visual world and the body.

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MAEDA, Kengo, Michiko SAIKYO, Atsushi MUKOSE, Hirotaka TOMIMATSU, and Hitoshi YASUDA. "Lateropulsion Due to a Lesion of the Dorsal Spinocerebellar Tract." Internal Medicine 44, no. 12 (2005): 1295–97. http://dx.doi.org/10.2169/internalmedicine.44.1295.

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Babyar, S., and M. Reding. "Recovery from lateropulsion: The role of lesion side and impairments." Neurologie & Rehabilitation 25, S1 (2019): 46–48. http://dx.doi.org/10.14624/nr1904009.

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Bier, J. C., E. J. Bartholome, P. Fery, M. Vokaer, L. Pollak, and K. Galuyot. "OCULAR LATEROPULSION FROM A BRAINSTEM STROKE CAN COMPENSATE FOR HEMIANOPIA." Neurology 69, no. 6 (August 6, 2007): 616–17. http://dx.doi.org/10.1212/01.wnl.0000278873.00520.30.

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Zhang, She-Qing, Ming-Yuan Liu, Xiao-Long Ma, and Hui-Min Zheng. "Ocular and Truncal Lateropulsion Associated with Caudal Lateral Medullary Infarction." CNS Neuroscience & Therapeutics 18, no. 2 (February 2012): 182–84. http://dx.doi.org/10.1111/j.1755-5949.2011.00284.x.

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Ohtsuka, Kenji, Masahiro Sawa, Seiji Matsuda, Alejandra Uno, and Makoto Takeda. "Nonvisual Eye Position Control in a Patient with Ocular Lateropulsion." Ophthalmologica 197, no. 2 (1988): 85–89. http://dx.doi.org/10.1159/000309925.

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50

Kim, S. H., J. Cho, J. H. Cho, S. W. Han, S. M. Kim, S. C. Park, and J. H. Heo. "Isolated Lateropulsion by a Lesion of the Dorsal Spinocerebellar Tract." Cerebrovascular Diseases 18, no. 4 (2004): 344–45. http://dx.doi.org/10.1159/000080978.

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