BRAIN and NERVE－神経研究の進歩68巻3号

2016年03月発行

総説

Isolated body lateropulsionの神経解剖学

著者： 中里良彦¹ 田村直俊¹ 池田桂¹ 田中愛¹ 山元敏正¹

所属機関： ¹埼玉医科大学神経内科

ページ範囲：P.263 - P.270

文献概要

Isolated body lateropulsion（iBL）とは，脳梗塞急性期に前庭症状や小脳症状などの神経症候を伴わず，体軸の一側への傾斜と転倒傾向のみが臨床症候として認められることである。iBLは脊髄小脳路，外側前庭脊髄路，前庭視床路，歯状核赤核視床路，視床皮質路のいずれの経路がどこで障害されても生じる可能性がある。本稿では，延髄，橋，中脳，小脳，視床，大脳において，どの病巣部位でiBLが生じるかを概説する。

参考文献

1)Dieterich M, Brandt T: Wallenberg's syndrome: lateropulsion, cyclorotation, and subjective visual vertical in thirty-six patients. Ann Neurol 31: 399-408, 1992

2)荒木信夫: 延髄外側症候群. 神経内科47: 349-358, 1997

3)Shan DE, Wang V, Chen JT: Isolated lateropulsion of the trunk in cerebellar infarct. Clin Neurol Neurosurg 97: 195-198, 1995

4)後藤　昇: 脊髄小脳路. 脊椎脊髄1: 250-252, 1988

5)Smith MC: The anatomy of the spino-cerebellar fibers in man. Ⅰ. The course of the fibers in the spinal cord and brain stem. J Comp Neurol 108: 285-352, 1957

6)Smith MC: The anatomy of the spino-cerebellar fibers in man. Ⅱ. The distribution of the fibers in the cerebellum. J Comp Neurol 117: 329-354, 1961

7)Zwergal A, Büttner-Ennever J, Brandt T, Strupp M: An ipsilateral vestibulothalamic tract adjacent to the medial lemniscus in humans. Brain 131: 2928-2935, 2008

8)Yi HA, Kim HA, Lee H, Baloh RW: Body lateropulsion as an isolated or predominant symptom of a pontine infarction. J Neurol Neurosurg Psychiatry 78: 372-374, 2007

9)Dieterich M, Brandt T: Thalamic infarctions: differential effects on vestibular function in the roll plane (35 patients). Neurology 43: 1732-1740, 1993

10)斉木臣二, 吉岡　亮, 山谷洋子, 金本真澄, 廣瀬源二郎: 視床梗塞により視床性失立症を呈した2症例. 臨床神経40: 383-387, 2000

11)Thömke F, Marx JJ, Iannetti GD, Cruccu G, Fitzek S, et al: A topodiagnostic investigation on body lateropulsion in medullary infarcts. Neurology 64: 716-718, 2005

12)Eggers C, Fink GR, Möller-Hartmann W, Nowak DA: Correlation of anatomy and function in medulla oblongata infarction. Eur J Neurol 16: 201-204, 2009

13)Lee H, Sohn CH: Axial lateropulsion as a sole manifestation of lateral medullary infarction: a clinical variant related to rostral-dorsolateral lesion. Neurol Res 24: 773-774, 2002

14)Kim SH, Cho J, Cho JH, Han SW, Kim SM, et al: Isolated lateropulsion by a lesion of the dorsal spinocerebellar tract. Cerebrovasc Dis 18: 344-345, 2004

15)Arai M: Ipsilateral axial lateropulsion as an initial symptom of vertebral artery occlusion. J Neurol Neurosurg Psychiatry. 75: 1648, 2004

16)Nowak DA, Topka HR: The clinical variability of Wallenberg's syndrome. The anatomical correlate of ipsilateral axial lateropulsion. J Neurol 253: 507-511, 2005

17)Maeda K, Saikyo M, Mukose A, Tomimatsu H, Yasuda H: Lateropulsion due to a lesion of the dorsal spinocerebellar tract. Intern Med 44: 1295-1297, 2005

18)Akdal G, Thurtell MJ, Halmagyi GM: Isolated lateropulsion in acute lateral medullary infarction. Arch Neurol 64: 1542-1543, 2007

19)Kim HJ, Kwon HM, Huh YE, Oh MY, Lee YS: Ipsilateral axial lateropulsion as an initial symptom of lateral medullary infarction: a case report. J Clin Neurol 3: 197-199, 2007

20)和田裕子, 高橋竜一, 柳原千枝, 西村　洋: Body lateropulsionを主症状とした橋病変の血管障害例の検討—延髄外側病変例との比較. Brain Nerve 61: 72-76, 2009

21)阿部浩明: 脳機能を考慮した理学療法思考プロセス—Isolated lateropulsionを呈した症例. 脳科学とリハビリテーション11: 11-22, 2011

22)津田浩昌, 久保田　和, 田中こずえ, 岸田修二: Isolated body lateropulsionを呈した延髄外側梗塞. 神経内科74: 436-437, 2011

23)西平崇人, 鈴木圭輔, 竹川英宏, 中村利生, 岩崎晶夫, 他: Truncal lateropulsionと半身の胸髄レベル以下の温痛覚障害を呈した延髄外側梗塞の45歳男性例. 臨床神経54: 819-823, 2014

24)中里良彦, 田村直俊, 島津邦男: 延髄梗塞は男性が女性の3.3倍多い. 神経内科52: 460-462, 2000

25)Okamura M, Suzuki K, Komagamine T, Nakamura T, Takekawa H, et al: Isolated body lateropulsion in a patient with pontine infarction. J Stroke Cerebrovasc Dis 22: e247-e249, 2013

26)津田浩昌, 高　沙羅, 田中こずえ: Body lateropulsionと三叉神経領域の温度覚・痛覚障害を呈した橋梗塞. 脳卒中35: 213-215, 2013

27)Bertholon P, Michel D, Convers P, Antoine JC, Barral FG: Isolated body lateropulsion caused by a lesion of the cerebellar peduncles. J Neurol Neurosurg Psychiatry 60: 356-357, 1996

28)Felice KJ, Keilson GR, Schwartz WJ: ‘Rubral' gait ataxia. Neurology 40: 1004-1005, 1990

29)Karimi M, Razavi M, Fattal D: Rubral lateropulsion due to vertebral artery dissection in a patient with Klippel-Feil syndrome. Arch Neurol 61: 583-535, 2004

30)Baehring JM, Phipps M, Wollmann G: Rostral midbrain infarction producing isolated lateropulsion. Neurology 70: 655-656, 2008

31)Lee H: Body lateropulsion as a presenting symptom of rostral paramedian midbrain syndrome. Eur Neurol 60: 101-103, 2008

32)Nakamura K, Kadowaki S, Matsuda N, Ugawa Y: Isolated lateropulsion caused by a paramedian midbrain infarction. Intern Med 50: 1863, 2011

33)Muley SA, Bushara KO: Isolated gait ataxia due to cerebellar vermis infarct. Arch Neurol 61: 1461, 2004

34)Lee H: Isolated body lateropulsion caused by a lesion of the rostral vermis. J Neurol Sci 249: 172-174, 2006

35)Solomon DH, Barohn RJ, Bazan C, Grissom J: The thalamic ataxia syndrome. Neurology 44: 810-814, 1994

36)Melo TP, Bogousslavsky J, Moulin T, Nader J, Regli F: Thalamic ataxia. J Neurol 239: 331-337, 1992

37)Masdeu JC, Gorelick PB: Thalamic astasia: inability to stand after unilateral thalamic lesions. Ann Neurol 23: 596-603, 1988

38)Dieterich M, Brandt T, Thalamic infarctions: differential effects on vestibular function in the roll plane (35 patients). Neurology 43: 1732-1740, 1993

39)Lee PH, Lee JH, Joo US: Thalamic infarct presenting with thalamic astasia. Eur J Neurol 12: 317-319, 2005

40)Elwischger K, Rommer P, Prayer D, Mueller C, Auff E, et al: Thalamic astasia from isolated centromedian thalamic infarction. Neurology 78: 146-147, 2012

41)三隅洋平, 西田泰斗, 荒木淑郎: 片側視床外側の小梗塞により失立症のみを呈した1症例. 臨床神経46: 649-651, 2006

42)Davies PM: Steps to Follow: A Guide to the Treatment of Adult Hemiplegia. Springer Verlag Telos, New York, 1985

43)Karnath HO: Pusher syndrome--a frequent but little-known disturbance of body orientation perception. J Neurol 254: 415-424, 2007

44)Kataoka H, Sugie K, Kohara N, Ueno S: Novel representation of astasia associated with posterior cingulate infarction. Stroke 37: e3-e5, 2006

45)Satow T, Komuro T, Kobayashi A: Caudal cingulate infarction manifesting astasia. Case Rep Neurol 6: 14-17, 2014

46)Wada Y, Nishimura Y: Isolated astasia in acute infarction of the supplementary-motor area. BMJ Case Rep, 2010［doi: 10.1136/bcr.01.2010.2618］

47)松田雅純, 鎌田幸子, 大川　聡, 菅原正伯, 大西洋英: Body lateropulsionを主訴とした脳梗塞5症例の臨床像の検討. 脳卒中35: 195-199, 2013