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Distinguishing Motor Weakness From Impaired Spatial Awareness: A Helping Hand!

机译：从空间意识受损中分辨出运动能力的弱点：伸出援助之手！

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Our patient, aged 73 years, had background peripheral neuropathy of unknown cause, stable for several years, which caused some difficulty in walking on uneven ground. He attended for a teaching session but now staggered in, a new development. He had apparent weakness of his right arm, but there was difficulty in distinguishing motor weakness from impaired spatial awareness suggestive of parietal lobe dysfunction. With the patient seated, eyes closed, and left arm outstretched, S.A.R. lifted the patient’s right arm and asked him to indicate when both were level. This confirmed motor weakness. Urgent computed tomographic scan confirmed left subdural haematoma and its urgent evacuation rapidly resolved the patient’s symptoms. Intrigued by our patient’s case, we explored further and learnt that in rehabilitation medicine, the awareness of limb position is commonly viewed in terms of joint position sense. We present recent literature evidence indicating that the underlying mechanisms are more subtle.
机译：我们的患者年龄73岁，患有未知原因的背景周围神经病，可以稳定数年，这导致在不平坦的地面上行走有些困难。他参加了一次教学会议，但现在却步履蹒跚，有了新的发展。他的右臂明显无力，但是很难将运动无力与提示顶叶功能障碍的空间意识受损区分开。患者坐下，闭上眼睛，伸出左臂，S.A.R。抬起病人的右臂，让他指出两人何时处于水平状态。这证实了运动无力。紧急计算​​机断层扫描可以确认左硬膜下血肿，紧急撤离可以迅速缓解患者的症状。由患者的病情引起的兴趣，我们进行了进一步的探索，并了解到，在康复医学中，通常从关节位置的角度来看待肢体位置的意识。我们目前的文献证据表明潜在的机制更加微妙。

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