Posterior pusher syndrome: A report of two cases

"Pusher syndrome" is classically described as a disorder of body orientation in the coronal plane. Although it mainly occurs in stroke patients, non-stroke causes have been described. Pusher behaviour is characterized by a tilt towards the contralesional paretic side and a resistance to external attempts to rectify. It may occur with or without hemispatial neglect, which in itself may be the cause of a usually ipsilesional shift of attention and body orientation in the axial plane. In this report we describe two patients with a marked disturbance of body orientation in the sagittal plane with imbalance, posterior tilt and an active resistance to forward pulling or pushing. By analogy we propose the term "posterior pusher" syndrome for the clinical picture.