Brain Neurorehabil.  2014 Sep;7(2):105-110. 10.12786/bn.2014.7.2.105.

Rehabilitation for Brainstem Lesion: Non-Motor Symptoms

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Korea. ideale1@snu.ac.kr

Abstract

The brainstem is a compact, stalklike structure. It carries nearly all information between the brain and the remainder of body. It is a corridor to all major sensory, motor, cerebellar, cranial nerve pathways but it is not simply a conduit for information. It has numerous nuclei of the cranial nerves. Therefore, when a patient has a lesion in the brainstem, he or she will demonstrate a variety of symptoms regarding level of consciousness, motor control, muscle tone, posture, vegetative function and other essential function. Here, we will discuss about the non-motor symptoms caused by the brainstem lesions and the strategy for the rehabilitation.

Keyword

balance; brainstem; consciousness; sensory function; swallowing

MeSH Terms

Brain
Brain Stem*
Consciousness
Cranial Nerves
Deglutition
Humans
Posture
Rehabilitation*
Sensation

Figure

  • Fig. 1 The maximum lesion overlap was in the center of pontine tegmentum for brainstem coma subjects with fatal hyperthermia.

  • Fig. 2 Overlay lesion plots of the poststroke patients as concerned with affective depression (A) and apathetic depression (B).

  • Fig. 3 The central pattent generator of swallowing.

  • Fig. 4 The cortico-ponto-cerebellar pathway.

  • Fig. 5 The anatomical structures correlated of balance problem in the dorsolateral medulla oblongata syndrome.


Reference

1. Ciurleo R, Bramanti P, Calabrò RS. Pharmacotherapy for Disorders of Consciousness: Are 'Awakening'Drugs Really a Possibility? Drugs. 2013; 73:1849–1862.
2. Machado C, Estevez M, Redriguez R, Perez-Nellar J. Wakefulness and loss of awareness: Brain and brainstem interaction in the vegetative state. Neurology. 2010; 75:751–752.
Article
3. Parvizi J, Damasio AR. Neuroanatomical correlates of brainstem coma. Brain. 2003; 126:1524–1536.
Article
4. Zuccoli G, Santa Cruz D, Bertolini M, Rovira A, Gallucci M, Carollo C, Pipitone N. MR imaging findings in 56 patients with Wernicke encephalopathy: nonalcoholics may differ from alcoholics. AJNR Am J Neuroradiol. 2009; 30:171–176.
Article
5. Zuccoli G, Pipitone N. Neuroimaging findings in acute Wernicke's encephalopathy: review of the literature. AJR Am J Roentgenol. 2009; 192:501–508.
Article
6. Thibaut A, Bruno M-A, Ledoux D, Demertzi A, Laureys S. tDCS in patients with disorders of consciousness Sham-controlled randomized double-blind study. Neurology. 2014; 82:1112–1118.
Article
7. van Zandvoort M, de Haan E, van Gijn J, Kappelle LJ. Cognitive functioning in patients with a small infarct in the brainstem. J Int Neuropsychol Soc. 2003; 9:490–494.
Article
8. Murakami T, Hama S, Yamashita H, Onoda K, Kobayashi M, Kanazawa J, Yamawaki S, Kurisu K. Neuroanatomic pathways associated with poststroke affective and apathetic depression. Am J Geriatr Psychiatry. 2013; 21:840–847.
Article
9. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clin Neurophysiol. 2003; 114:2226–2244.
Article
10. Ishibashi A, Fujishima I. Lesion of the nucleus solitarius leads to impaired laryngeal sensation in bulbar palsy patients. J Stroke Cerebrovasc Dis. 2012; 21:174–180.
Article
11. Prosperini L, Kouleridou A, Petsas N, Leonardi L, Tona F, Pantano P, Pozzilli C. The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis. J Neurol Sci. 2011; 304:55–60.
Article
12. Lu J, Liu H, Zhang M, Wang D, Cao Y, Ma Q, Rong D, Wang X, Buckner RL, Li K. Focal pontine lesions provide evidence that intrinsic functional connectivity reflects polysynaptic anatomical pathways. J Neurosci. 2011; 31:15065–15071.
Article
13. Eggers C, Fink G, Möller-Hartmann W, Nowak D. Correlation of anatomy and function in medulla oblongata infarction. Eur J Neurol. 2009; 16:201–204.
Article
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