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[脑视觉感知障碍的治疗]

[Therapy for cerebral visual perception disturbances].

作者信息

Kerkhoff G, Oppenländer K, Finke K, Bublak P

机构信息

Arbeitseinheit Klinische Neuropsychologie, Universität des Saarlandes, Gebäude A.1.7., 66123 Saarbrücken.

出版信息

Nervenarzt. 2007 Apr;78(4):457-69; quiz 470. doi: 10.1007/s00115-006-2235-3.

Abstract

Cerebral visual disorders are frequent after brain damage (20-40%). Among them, homonymous field defects and associated reading and visual exploration disorders, reduced visual acuity, contrast sensitivity and light/dark adaptation, fusional disorders, visuospatial deficits, multimodal hemineglect, and Balint-Holmes syndrome are the most common. Prototypical symptoms are the omission of obstacles and hemianopic alexia in visual field disorders, blurred vision in reduced acuity and/or contrast sensitivity or impaired fusion, blinding in impaired light adaptation and dark vision in impaired dark adaptation, and impaired action and orientation in visuospatial deficits. Neglect is characterized by omissions of stimuli on the contralesional side in space or the body. Patients with Balint-Holmes syndrome show severe spatial and attentional deficits. Systematic treatments can be categorized as restitution, compensation, and substitution approaches. Hemineglect can be ameliorated by novel, more effective treatment approaches, whereas only initial stages of treatment are available for Balint-Holmes syndrome.

摘要

脑损伤后常出现脑性视觉障碍(20%-40%)。其中,同侧视野缺损及相关的阅读和视觉探索障碍、视力下降、对比敏感度和光/暗适应降低、融合障碍、视觉空间缺陷、多模式半侧空间忽视以及巴林特-霍姆斯综合征最为常见。典型症状包括视野障碍时遗漏障碍物和偏盲性失读症、视力和/或对比敏感度降低或融合受损时视力模糊、光适应受损时失明以及暗适应受损时暗视觉障碍,以及视觉空间缺陷时动作和定向受损。忽视的特征是在空间或身体的对侧遗漏刺激。巴林特-霍姆斯综合征患者表现出严重的空间和注意力缺陷。系统治疗可分为恢复、补偿和替代方法。新型、更有效的治疗方法可改善半侧空间忽视,而巴林特-霍姆斯综合征仅处于治疗初期阶段。

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