ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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Pusher Sendromu: İnme Hastalarında Nadir Olmayan Ancak Sık Gözden Kaçan Bir Fenomen: Literatür Derlemesi ve Tipik Bir Olgunun Sunumu
Pusher Syndrome: Not a Rare, But a Little-known Phenomenon in Stroke Survivors: A Review of the Literature with Report of a Typical Case
Received Date : 12 Jan 2023
Accepted Date : 05 Apr 2023
Available Online : 07 Apr 2023
Doi: 10.31609/jpmrs.2023-95402 - Makale Dili: EN
J PMR Sci. 2023;26(3):360-7
ÖZET
Pusher sendromu (PS), bazı inme hastalarında vücudun aktif olarak hemiplejik tarafa doğru itilmesi ve eğilmesi ile karakterize, anormal bir postüral reaksiyondur. Kesin etiyolojisi bilinmemektedir. Ancak yer çekimi hissi ve dikeylik algısına ilişkin nöral bağlantıların bozulması sorumlu tutulmaktadır. Bu hastalar, hemiplejik tarafta yeterli motor aktiviteye sahip olsalar bile denge, transfer, hareketlilik ve fonksiyonelliği bozan postüral instabiliteye sahiptir. Bununla birlikte, akut bakım ve rehabilitasyonda, özellikle ağrı veya diğer motor ve bilişsel problemlerle uğraşırken PS gözden kaçabilir. Bu yazıda, PS’nin patofizyolojik temeli, tanısal yaklaşımları ve rehabilitasyon girişimleri ile ilgili güncel literatür bir vaka örneği üzerinden tartışılacaktır.
ABSTRACT
Pusher syndrome (PS) is an abnormal postural reaction characterized by actively pushing and tilting the body to the hemiplegic side in some stroke patients. Its exact etiology is unknown. However, the disruption of the neural network that processes gravitational sensation and verticality perception is accused for PS. These patients have postural instability that impairs balance, transfer, mobility, and functionality, even if they have adequate motor activity on the hemiplegic side. However, PS may be overlooked in acute care and rehabilitation, especially when dealing with pain or other motor and cognitive problems. In this paper, the current literature on the pathophysiological basis, diagnostic approaches, and rehabilitation interventions of PS will be discussed through a case example.
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