Isolated body lateropulsionの神経解剖学

Neuroanatomy of Isolated Body Lateropulsion

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。

Abstract

Axial body lateropulsion, a phenomenon where the body is pulled toward the side of the lesion, with tendency of falling down, is the well-known transient feature of lateral medullary syndrome. In some cases, axial body lateropulsion occurs without vestibular and cerebellar symptoms (isolated body lateropulsion:［iBL］). Patients with iBL have a lesion located in the spinocerebellar tract, descending lateral vestibulospinal tract, vestibulo-thalamic pathway, dentatorubrothalamic pathway, or thalamocortical fascicle. This review deals with the anatomic basis and clinical significance of iBL.

(Received July 10, 2015; Accepted September 30, 2015; Published March 1, 2016)