格斯特曼综合征及其康复治疗:2例报告(英文)  

Gerstmann syndrome and its rehabilitation: report of two cases

作　　者：余桂军[1] 周玲[1] 谢莲红[1] 倪冬艳[1] 任传成[1] 

机构地区：[1]复旦大学附属上海市第五人民医院神经内科,上海市200240

出　　处：《中国临床康复》2004年第22期4605-4607,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:格斯特曼综合征(Gerstmannsyndrome,GS)临床少见,其康复治疗的临床研究报道较少,发病机制仍不清楚。目的:探讨GS的发病机制、临床特点及康复治疗。设计:以诊断为依据的回顾性分析。地点和对象:2003-04/2003-08复旦大学附属上海市第五人民医院住院治疗的2例GS患者。干预:采用常规治疗方法,一氧化碳中毒患者加用高压氧治疗。按GS四主征及失读、命名性失语给以康复治疗,时间3个月。主要观察指标:GS四主征及失读、命名性失语的评分情况。结果:GS多为脑血管病、肿瘤等所致,本文1例患者由一氧化碳中毒引起更为罕见,但头颅MRI显示大脑顶枕区有病灶,可能为缺氧所致。GS的四主征由于损害大脑顶枕区与身体、手指和数字空间定位独特性缺陷有关,但很少单独存在。GS的康复治疗有效,左右失认、手指失认相对恢复较好。结论:GS的病因、发病机制及康复治疗研究有十分重要意义。BACKGROUND:Gerstmann syndrome(GS),whose pathogenesis remains unknown,is clinic ally rare and currently few reports are available to address its rehabilitation. OBJECTIVE:To explore the pathogenesis,clinical features and rehabilitation of GS. DESIGN:A retrospective clinical study on the basis of diagnosis. SETTING and SUBJECTS:Two patients diagnosed as having GS were studied,who were hospitalized from April to August in 2003 in Shanghai Fifth People's Hospital affiliated to Fudan University. INTERVENTION:Routine therapeutic regimen was adopted,and one of the patients w ith CO poisoning also received hyperbaric oxygen therapy. Both of the two patien ts received rehabilitative training for 3 months for the 4 major symptoms of GS, alexia and nominal aphasia. MAIN OUTCOME MEASURES:The patients were scored for the 4 major symptoms,alexia and nominal aphasia. RESULTS:GS was most often caused by cerebrovascular disease and neoplasms,but GS caused by CO poisoning, as was the case with one of the patients,was rare.Sku ll magnetic resonance imaging(MRI) of this patient identified parietal-occipita l lesions, which suggested the involvement of hypoxia in the pathogenesis of GS. The 4 major symptoms of GS were considered to involve parietal-occipital impair ment that was responsible for spatial orientation defects of the body, finger an d figures,which often appeared with one another.Rehabilitative training proved t o be effective,especially for left-right disorientation and finger agnosia. CONCLUSION:Researches on the etiology,pathogenesis and rehabilitation can be o f great significance for patients with GS.

关 键 词：格斯特曼综合征 一氧化碳中毒 脑梗塞 康复 

分 类 号：R74[医药卫生—神经病学与精神病学]