Klingner Carsten M, Witte Otto W
Hans-Berger Department of Neurology, Jena University Hospital, Jena, Germany; Biomagnetic Center, Hans-Berger Department of Neurology, Jena University Hospital, Jena, Germany.
Hans-Berger Department of Neurology, Jena University Hospital, Jena, Germany.
Handb Clin Neurol. 2018;151:185-206. doi: 10.1016/B978-0-444-63622-5.00009-7.
The analysis and interpretation of somatosensory information are performed by a complex network of brain areas located mainly in the parietal cortex. Somatosensory deficits are therefore a common impairment following lesions of the parietal lobe. This chapter summarizes the clinical presentation, examination, prognosis, and therapy of sensory deficits, along with current knowledge about the anatomy and function of the somatosensory system. We start by reviewing how somatosensory signals are transmitted to and processed by the parietal lobe, along with the anatomic and functional features of the somatosensory system. In this context, we highlight the importance of the thalamus for processing somatosensory information in the parietal lobe. We discuss typical patterns of somatosensory deficits, their clinical examination, and how they can be differentiated through a careful neurologic examination that allows the investigator to deduce the location and size of the underlying lesion. In the context of adaption and rehabilitation of somatosensory functions, we delineate the importance of somatosensory information for motor performance and the prognostic evaluation of somatosensory deficits. Finally, we review current rehabilitation approaches for directing cortical reorganization in the appropriate direction and highlight some challenging questions that are unexplored in the field.
躯体感觉信息的分析与解读由主要位于顶叶皮质的复杂脑区网络执行。因此，躯体感觉缺陷是顶叶病变后常见的损伤。本章总结了感觉缺陷的临床表现、检查、预后和治疗，以及有关躯体感觉系统解剖和功能的当前知识。我们首先回顾躯体感觉信号如何传输至顶叶并由其进行处理，以及躯体感觉系统的解剖和功能特征。在此背景下，我们强调丘脑在处理顶叶躯体感觉信息方面的重要性。我们讨论躯体感觉缺陷的典型模式、其临床检查，以及如何通过仔细的神经系统检查进行区分，该检查可使研究者推断潜在病变的位置和大小。在躯体感觉功能的适应和康复方面，我们阐述了躯体感觉信息对运动表现的重要性以及躯体感觉缺陷的预后评估。最后，我们回顾当前引导皮质朝着适当方向重组的康复方法，并强调该领域中一些尚未探索的具有挑战性的问题。
