Background/Objectives: Anosognosia for hemiplegia (AHP) is a multifaceted syndrome in which stroke survivors fail to recognize motor impairments. Although AHP has significant clinical implications, rehabilitation strategies have remained fragmented and underexplored. This systematic review aimed to critically evaluate rehabilitation interventions for AHP published between 2006 and 2025, categorize intervention types, and assess clinical outcomes to inform future research and practice. Methods: A structured search was conducted in the PubMed and PsycINFO databases on 31 March 2025, using predefined keywords related to stroke, anosognosia, and rehabilitation. The eligible studies included randomized controlled trials, case–control studies, and case studies. Following title, abstract, and full-text screening, nine studies focusing on rehabilitation interventions for AHP were selected and analyzed. Results: The interventions reviewed included sensorimotor recalibration techniques, neuromodulatory approaches, error-based cognitive training, and self-observation in video replay strategies. Interventions emphasizing motor intention monitoring, error correction, and self-observation were more consistently associated with durable improvements in motor awareness than neglect-based spatial interventions were. However, many studies were limited by small sample sizes and a lack of standardized outcome measures. Assessment methodologies vary widely, highlighting the need for multidimensional theory-driven evaluation tools. Conclusions: Effective rehabilitation for AHP requires strategies targeting disrupted self-monitoring and agency mechanisms, rather than spatial realignment alone. The video self-observation and error-based learning paradigms show particular promise. Future research should focus on controlled trials, longitudinal tracking, and the integration of individualized, mechanism-specific rehabilitation models to optimize outcomes for stroke survivors with AHP.
31 August 2024 in Journal of Electrodiagnosis and Neuromuscular Diseases
This case report discusses a rare instance of herpes zoster infection presenting with radiculoplexopathy, exhibiting both preganglionic and postganglionic features. A 62-year-old male patient experienced sudden right upper limb weakness following a recent herpes zoster diagnosis. A nerve conduction study, electromyography, and magnetic resonance imaging revealed a right brachial plexopathy involving the upper trunk and posterior cord, accompanied by lesions in the middle to lower cervical roots. Even after several months, the patient’s recovery remained limited, indicating the significance of this case as a reference for clinical progression in instances of both preganglionic and postganglionic neuropathy. This case emphasizes the role of electrophysiological evaluation in zoster-associated paresis to predict disease progression and improve patient management.
Introduction: The purpose of this study was to investigate neural patterns within the gluteus maximus (Gmax) muscle to identify optimal EMG placement and injection sites for botulinum toxin and other injectable agents. Methods: This study used 10 fixed and 1 non-fixed adult Korean cadavers. Intramuscular arborization patterns were confirmed in the cranial, middle, and caudal segments of 20 Gmax muscles using Sihler staining. Ultrasound images were obtained from one cadaver, and blue dye was injected using ultrasound guidance to confirm the results. Results: The intramuscular innervation pattern of the Gmax was mostly in the middle part of this muscle. The nerve endings of the Gmax are mainly located in the 40–70% range in the cranial segment, the 30–60% range in the middle segment, and the 40–70% range in the caudal segment. Discussion: Addressing the spasticity of the gluteus maximus requires precise, site-specific botulinum toxin injections. The use of EMG and other injection therapies should be guided by the findings of this study. We propose that these specific sites, which correspond to areas with the densest nerve branches, are the safest and most efficient locations for both botulinum toxin injections and EMG procedures.