轻偏瘫
轻偏瘫 | |
---|---|
类型 | 局部麻痹[*]、瘫痪、中枢神经系统疾病、疾病 |
分类和外部资源 | |
医学专科 | 神经学 |
ICD-10 | G81.9 |
ICD-9-CM | 342.9, 094.89, 438.2 |
MeSH | D006429 |
轻偏瘫(英语:Hemi-paresis)是人体左右某一侧出现的麻痹、瘫痪的症状,最严重时将导致偏瘫(英语:Hemi-plegia),或称半身不遂,即半个身体的完全麻痹。这两种症状的成因有很多,既有先天原因也有中风等后天原因。[1]
症状
不同程度的偏瘫会对人体功能产生不同的影响,除去肢体麻痹等必然发生的症状之外,也有一些看似无关,但实际上也是因为大脑受损而造成的问题。[1]
动作技能丧失
患者通常因肢体麻痹而难以保持平衡,日常行为如穿衣吃饭等都会因而受到影响,从而导致运动失调。而纯运动性轻偏瘫,即脸、胳膊和腿的轻偏瘫则是最常见的轻偏瘫。[1]
倾斜综合症
倾斜综合征指的是患者主动向未发生偏瘫发生的体侧倾斜的症状,这与大多数中风者的情况相反,不过都导致患者失去姿势平衡。[2]其产生可能与丘脑或大脑右半球的功能有关。[3][4]
在急中风和轻偏瘫患者中,出现倾斜综合征的患者占10.4%。这种症状可以纠正,但要花去很长的时间。[5]倾斜综合征常与空间疏忽一词混淆,实际有些研究显示空间疏忽也会导致倾斜综合征。[2]但另外一些研究显示空间疏忽绝大多数情况闲置出现在右半球受损的患者身上,而倾斜综合征则亦见于左半球受损的患者。[6]
病因
轻偏瘫或偏瘫的最常见病因是中风,其中在中风影响到皮层脊髓束时更容易发生偏瘫。此外成因还包括脊髓损伤、脊髓半切综合征、外伤性脑损伤和其他脑部疾病。在成人身上,外伤、出血、糖尿病、高血压和癌症有时也会导致轻偏瘫或偏瘫。[7][8]
治疗
治疗轻偏瘫或偏瘫的办法与治疗中风和脑损伤的方法一样,[1]理疗师协助病人康复的过程中扮演着重要角色。这些治疗方法重在提高患者的身体麻痹部分的运动能力。具体来说,可使用强制性使用运动疗法、[9]镜像疗法等。[10]这些疗法一定要持久才容易起效。[11][12]
预后
除非病因本身不断加剧,轻偏瘫或偏瘫的症状并不会日益加剧。但由于运动困难可能产生有氧适能下降、肌肉痉挛、褥疮、压力溃疡和血栓形成等问题。[13] 很少有人能在极短的时间内康复,实际上许多人都只能恢复部分的身体机能。因此也要注意鼓励他们运动并协助其融入社会。[13]
参考文献
- ^ 1.0 1.1 1.2 1.3 Hemiparesis - Types, Treatment, Facts and Information. Disabled World. [2020-12-19]. (原始内容存档于2023-02-20) (美国英语).
- ^ 2.0 2.1 Karnath, Hans-Otto; Broetz, Doris. Understanding and treating "pusher syndrome". Physical Therapy. 2003-12, 83 (12): 1119–1125 [2020-12-19]. ISSN 0031-9023. PMID 14640870. (原始内容存档于2020-08-21).
- ^ Karnath, H. O.; Ferber, S.; Dichgans, J. The origin of contraversive pushing: evidence for a second graviceptive system in humans. Neurology. 2000-11-14, 55 (9): 1298–1304 [2020-12-19]. ISSN 0028-3878. PMID 11087771. doi:10.1212/wnl.55.9.1298. (原始内容存档于2020-08-20).
- ^ Karnath, Hans-Otto; Ferber, Susanne; Dichgans, Johannes. The neural representation of postural control in humans. Proceedings of the National Academy of Sciences of the United States of America. 2000-12-05, 97 (25): 13931–13936. ISSN 0027-8424. PMC 17678 . PMID 11087818. doi:10.1073/pnas.240279997.
- ^ Pedersen, P. M.; Wandel, A.; Jørgensen, H. S.; Nakayama, H.; Raaschou, H. O.; Olsen, T. S. Ipsilateral pushing in stroke: incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The Copenhagen Stroke Study. Archives of Physical Medicine and Rehabilitation. 1996-01, 77 (1): 25–28 [2020-12-19]. ISSN 0003-9993. PMID 8554469. doi:10.1016/s0003-9993(96)90215-4. (原始内容存档于2020-11-23).
- ^ Davies, P.M. Steps to follow: A guide to the treatment of adult hemiplegia : Based on the concept of K. and B. Bobath. New York: Springer-Verlag. 1985.
- ^ What is hemiplegia? | HemiHelp: for children and young people with hemiplegia (hemiparesis). HemiHelp. [2013-03-08]. (原始内容存档于2013-03-05).
- ^ Sleep paralysis, parasomnia, sleep apnea, sleep eat, parasomnias, paresthesias, dysesthesias, obstructive sleep apnea, REM, Stage 1, Sinemet narcolepsy, insomnia, cataplexy, benzodiazepines, opioids, sleepiness, sleep walking, daytime sleepiness, upper airway, CPAP, hypoxemia, UVVP, uvula, Somnoplasty, obesity, airway obstruction, EEG, electroencephalogram, Klonopine, night terrors, bruxism, parasomnias, EMG, Epworth Sleepiness Scale, BiPAP, sleep efficiency, Lawrence Martin, M.D. Lakesidepress.com. [2013-03-08]. (原始内容存档于2017-05-13).
- ^ Sterr, Annette; Freivogel, Susanna. Motor-improvement following intensive training in low-functioning chronic hemiparesis. Neurology. 2003-09-23, 61 (6): 842–844 [2020-12-19]. ISSN 1526-632X. PMID 14504336. doi:10.1212/wnl.61.6.842. (原始内容存档于2020-08-21).
- ^ Dohle, Christian; Püllen, Judith; Nakaten, Antje; Küst, Jutta; Rietz, Christian; Karbe, Hans. Mirror therapy promotes recovery from severe hemiparesis: a randomized controlled trial. Neurorehabilitation and Neural Repair. 2009-03, 23 (3): 209–217 [2020-12-19]. ISSN 1545-9683. PMID 19074686. doi:10.1177/1545968308324786. (原始内容存档于2020-11-15).
- ^ Stroke in Physical Rehabilitation 2007,第746页
- ^ Patten, Carolynn; Lexell, Jan; Brown, Heather E. Weakness and strength training in persons with poststroke hemiplegia: rationale, method, and efficacy. Journal of Rehabilitation Research and Development. 2004-05, 41 (3A): 293–312 [2020-12-19]. ISSN 1938-1352. PMID 15543447. doi:10.1682/jrrd.2004.03.0293. (原始内容存档于2020-08-21).
- ^ 13.0 13.1 Hemiplegia (Hemiparalysis). Healthopedia.com. 2009-04-06 [2013-03-08]. (原始内容存档于2012-11-24).