PMID- 15592727
OWN - NLM
STAT- MEDLINE
DCOM- 20050314
LR  - 20181113
IS  - 0340-5354 (Print)
IS  - 0340-5354 (Linking)
VI  - 251
IP  - 11
DP  - 2004 Nov
TI  - Contraversive pushing in non-stroke patients.
PG  - 1324-8
AB  - BACKGROUND: Pusher syndrome is a disorder of postural control observed in 
      patients with right or left brain damage associated with hemiparesis. Those 
      patients show a peculiar behavior of actively pushing away from the 
      nonhemiparetic side and resisting against passive correction, with a tendency to 
      fall toward the paralyzed side. Thus far this phenomenon has been exclusively 
      associated with stroke patients. OBJECTIVE: We investigate the occurrence, 
      imaging features and clinical evolution of pusher behavior in patients with acute 
      encephalic lesions at a tertiary emergency hospital. METHODS: Pusher patients 
      were identified from 530 inpatients during a 1 year period. Patients were 
      evaluated using a standardized Scale for Contraversive Pushing (SCP), 
      neurological examination, assessment of neuropsychological symptoms, activities 
      of daily living function and neuroimaging studies. RESULTS: We found eight 
      patients (1.5%) with severe contraversive pushing, three female and five male. 
      Age at symptoms onset ranged from 48 to 80 years (mean 65.4). All patients had 
      scores equal or above 1.5 in each tested parameter of the SCP. Six patients (75 
      %) had right-hemisphere brain damage. A stroke etiology was found in four 
      patients. The other four patients had non-stroke etiology (three traumatic, one 
      metastatic tumor). Stroke patients showed complete recovery of pusher behavior at 
      a mean duration of 15.3 weeks. In patients with brain trauma, pushing behavior 
      was completely resolved in a mean time of 5 weeks. CONCLUSIONS: The results 
      demonstrate that contraversive pushing may also occur in patients with non-stroke 
      neurological lesions and suggest that resolution of symptoms may vary according 
      to the underlying etiology.
FAU - Santos-Pontelli, Taiza E G
AU  - Santos-Pontelli TE
AD  - Dept. of Neurology, University of Sao Paulo, School of Medicine at Ribeirao 
      Preto, Campus Universitario, Ribeirao Preto, CEP 14049-900, Brazil.
FAU - Pontes-Neto, Octavio M
AU  - Pontes-Neto OM
FAU - Colafemina, Jose Fernando
AU  - Colafemina JF
FAU - de Araujo, Draulio B
AU  - de Araujo DB
FAU - Santos, Antonio Carlos
AU  - Santos AC
FAU - Leite, Joao P
AU  - Leite JP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - J Neurol
JT  - Journal of neurology
JID - 0423161
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Brain/pathology
MH  - Cerebrovascular Disorders/pathology/*physiopathology
MH  - Female
MH  - Functional Laterality/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neurologic Examination
MH  - Neuropsychological Tests
MH  - Paresis/pathology/*physiopathology
MH  - *Posture
MH  - Syndrome
MH  - Tomography, X-Ray Computed/methods
EDAT- 2004/12/14 09:00
MHDA- 2005/03/15 09:00
CRDT- 2004/12/14 09:00
PHST- 2004/02/12 00:00 [received]
PHST- 2004/05/03 00:00 [revised]
PHST- 2004/05/06 00:00 [accepted]
PHST- 2004/12/14 09:00 [pubmed]
PHST- 2005/03/15 09:00 [medline]
PHST- 2004/12/14 09:00 [entrez]
AID - 10.1007/s00415-004-0532-y [doi]
PST - ppublish
SO  - J Neurol. 2004 Nov;251(11):1324-8. doi: 10.1007/s00415-004-0532-y.