Hypercompensation in hemiplegia: l Pusher syndrome
Keywords:
pusher, stroke, Phisioterapy, posture, perception of vertical.Abstract
The pusher syndrome is a behaviour characterized by a constant push from the patient's unaffected side to the affected, resisting any attempt of passive correction. It is found on 10 % of patients who suffered a cerebrovascular accident and this incidence increases in case of right hemisphere damage.
he area of the brain more significantly affected is the posterior thalamus, with implication of the posterior crus of the internal capsule. Recent studies indicate an alteration of the perception of the verticality of the trunk as origin of the behavior. Pusher patients feel their trunk is orientated 18 degrees towards the side of the brain damage. Several measurement scales have been created, being the Scale of Controversies Pushing of Karnath the most commonly used. Pusher symptoms have a negative impact on time of recovery; however, they tend to disappear after 6 months of onset. Treatment must be orientated not only to a motor functional recover of the affected side, but to both sides from a motor and sensitive approach.
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