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| Hemineglect common in hemiparetic stroke patients |
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07 March 2006
German research has revealed a high incidence of hemineglect among patients who have hemiparesis after acute stroke. Hemineglect is characterised by impaired use of one side of the body, and may appear similar to hemiplegia, the investigators explain in the journal Cerebrovascular Diseases. However, unlike stroke patients with hemiplegia, those who have hemineglect retain motor output function, but nevertheless have difficulty in generating spontaneous limb movements.
Noting that the effect of hemineglect on post-stroke recovery is still unclear, Dr E Siekierka-Kleiser and colleagues from Heinrich Heine University in Düsseldorf studied 52 patients with acute hemiparetic stroke. Of these patients, 19 were able to move the affected limbs on strong command or painful stimuli, indicating hemineglect, rather than hemiplegia. These individuals were more severely affected by hemiparesis, with an average European Stroke Scale motor subscore of 21, compared with 13 in the group without hemineglect. In addition, they had significantly larger lesions than patients who did not have hemineglect.
During 7 days of follow-up, 14 of the patients with hemineglect showed only a slight improvement in their condition. However, the other five patients made an almost complete recovery, which correlated with the return of spontaneous movement of their affected side. In contrast, no variations in the rate of stroke recovery were observed among patients without hemineglect. As these observations were made within the first 7 days after symptom onset, the team suggests that hemineglect may not affect the final outcome in stroke patients.
"Motor hemineglect seems to aggravate hemiparesis and may even mimic hemiplegia," the investigators conclude. They therefore stress the importance of determining whether stroke patients with hemiparesis can move their affected limbs upon strong command or painful stimuli.
Reference:
Cerebrovasc Dis 2006; 21 (5-6): 307-314.
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