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.
We report a sequential neuroimaging study in a 48-years-old man with a history of chronic hypertension and lacunar strokes involving the ventral lateral posterior nucleus of the thalamus. The patient developed mild hemiparesis and severe contraversive pushing behavior after an acute hemorrhage affecting the right thalamus. Following standard motor physiotherapy, the pusher behavior completely resolved 3 months after the onset and, at that time, he had a Barthel Index of 85, although mild left hemiparesis was still present. This case report illustrates that pushing behavior itself may be severely incapacitating, may occur with only mild hemiparesis and affected patients may have dramatic functional improvement (Barthel Index 0 to 85) after resolution pushing behavior without recovery of hemiparesis.
Introdução: A possibilidade de correlacionar aspectos do comportamento auditivo (habilidades auditivas) a fenômenos fisiológicos observáveis (potencial cognitivo -P300) tem despertado o interesse dos profissionais interessados no estudo das disfunções auditivas. Porém, os métodos de análise do P300 e interpretação dos resultados ainda não estão padronizados e devem ser explorados e discutidos visando maior segurança para aplicação clínica e científica. Objetivo: Este estudo investigou a estabilidade na análise e interpretação do P300 auditivo seguindo um conjunto de regras (critério) pré-determinadas. Forma de estudo: Clínico prospectivo. Material e método: Traçados de P300 de crianças e adolescentes saudáveis foram analisados, em 2 momentos diferentes, seguindo as mesmas regras para a identificação e marcação das ondas N1, P2, N2 e P3. As medidas de latência da onda P300 foram submetidas a análises qualitativa e quantitativa. A análise qualitativa investigou os tipos de erros cometidos pelo examinador no uso do critério de determinação do P300 (5,9% do total de 560 medidas obtidas). A análise quantitativa investigou a variabilidade da medida da latência do P300 atribuível ao examinador. Resultado: Os resultados mostraram que não houve diferença significante entre as análises inter e intraexaminador, tendo sido encontradas correlações significantes entre as medidas de latência, indicando boa fidedignidade no teste-reteste e alta concordância entre os examinadores no modo como analisaram os traçados das ondas. Conclusão: O critério usado neste estudo demonstrou ser útil na determinação do P300, podendo ser sugerido com segurança para uso clínico e científico.
OBJECTIVE:The aim of this study was to evaluate the multisegmental static postural balance of active eutrophic and obese elderly women using a three-dimensional system under different sensory conditions.METHODS:A cross-sectional study was conducted on 31 elderly women (16 eutrophic and 15 obese) aged 65 to 75 years. The following anthropometric measurements were obtained: weight, height, waist and hip circumference, and handgrip strength. The physical activity level was evaluated using the International Physical Activity Questionnaire. Body composition was measured using the deuterium oxide dilution technique. The Polhemus® Patriot (three-dimensional) equipment was used to measure the parameters of postural balance along the anteroposterior and laterolateral axes. The data acquisition involved one trial of 60 s to test the limit of stability and four trials of 90 s each under the following conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; and (4) eyes closed, unstable surface.RESULTS:For the limit of stability, significant differences were observed in the maximum anteroposterior and laterolateral displacement (p<0.01) and in the parameter maximum anteroposterior displacement in the eyes closed stable surface condition (p<0.01) and maximum anteroposterior and laterolateral displacement in the eyes open unstable surface (p<0.01 and p = 0.03) and eyes closed unstable surface (p<0.01 and p<0.01) conditions. CONCLUSIONS:Obese elderly women exhibited a lower stability limit (lower sway area) compared with eutrophic women, leaving them more vulnerable to falls.
OBJECTIVE:The aim of this study was to assess the subjective visual vertical in patients with bilateral vestibular dysfunction and to propose a new method to analyze subjective visual vertical data in these patients.METHODS:Static subjective visual vertical tests were performed in 40 subjects split into two groups. Group A consisted of 20 healthy volunteers, and Group B consisted of 20 patients with bilateral vestibular dysfunction. Each patient performed six measurements of the subjective visual vertical test, and the mean values were calculated and analyzed.RESULTS:Analyses of the numerical values of subjective visual vertical deviations (the conventional method of analysis) showed that the mean deviation was 0.326±1.13° in Group A and 0.301±1.87° in Group B. However, by analyzing the absolute values of the subjective visual vertical (the new method of analysis proposed), the mean deviation became 1.35±0.48° in Group A and 2.152±0.93° in Group B. The difference in subjective visual vertical deviations between groups was statistically significant (p<0.05) only when the absolute values and the range of deviations were considered.CONCLUSION:An analysis of the absolute values of the subjective visual vertical more accurately reflected the visual vertical misperception in patients with bilateral vestibular dysfunction.
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