1/34. Somatosensory extinction for meaningful objects in a patient with right hemispheric stroke.Implicit, high level processing of extinguished objects has often been described in the visual modality. In the tactile domain, however, research on this topic is meagre and it is still uncertain whether processing of tactually presented stimuli can be affected by the same attentional disorders as visual stimuli. In this paper we describe a patient, ENM, with visual neglect and light touch extinction who, in a naming task of objects presented in the tactile modality, simultaneously to both hands, showed extinction for left hand objects. He was, nevertheless, able to make above chance Same/Different judgements on the two stimuli. We also tested two neurologically intact subjects who performed the test wearing a ski-glove on the left hand to impair the recognition of left hand objects. In these subjects, Same/Different judgements were at chance level when recognition rate was as low as that found in patient ENM. This happened when either the objects, although sharing the same name were different in shape (conditions Same-Different) or when the two objects were different with respect to the category name but were actually physically similar (conditions Different-Similar). However, when the objects were either identical or completely different, i.e., in a condition where judgement could be based simply on the physical analysis of the object shape (condition Same Identical and Different Dissimilar), their Same/Different judgements were above chance, despite the tactual deficit. Our conclusion was that patient ENM showed implicit recognition of left hand objects, at least in the Same Different and in the Different-Similar conditions, whereas, in the same conditions, normal subjects with an artificial sensory impairment did not. Our results also show that Same/Different judgements may be, in some conditions, less demanding than naming tasks, as suggested by Farah et al. Furthermore, patient ENM performed the test both with uncrossed and crossed hands. We found that extinction always affected the hand contralateral to the brain damage, although there was a tendency for a decrement of the ipsilesional hand performance in the crossed condition. We discuss these findings with reference to the most recent theories on the existence of a body centered spatial frame of reference.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/34. Neurofibromatosis, stroke and basilar impression. Case report.Neurofibromatosis type 1 (NF1) can virtually affect any organ, presenting most frequently with "cafe au lait" spots and neurofibromas. Vasculopathy is a known complication of NF1, but cerebrovascular disease is rare. We report the case of a 51-year-old man admitted to the hospital with a history of stroke four months before admission. On physical examination, he presented various "cafe au lait" spots and cutaneous neurofibromas. neurologic examination demonstrated right-sided facial paralysis, right-sided hemiplegia, and aphasia. Computed tomography scan of head showed hypodense areas in the basal ganglia and centrum semiovale. Radiographs of cranium and cervical spine showed basilar impression. angiography revealed complete occlusion of both vertebral and left internal carotid arteries, and partial stenosis of the right internal carotid artery. A large network of collateral vessels was present (moyamoya syndrome). It is an uncommon case of occlusive cerebrovascular disease associated with NF1, since most cases described in the literature are in young people, and tend to spare the posterior cerebral circulation. Basilar impression associated with this case may be considered a pure coincidence, but rare cases of basilar impression and NF1 have been described.- - - - - - - - - - ranking = 1.594607624388keywords = physical examination, physical (Clic here for more details about this article) |
3/34. gait analysis in stroke patients to assess treatments of foot-drop.By using the combined, computerized analysis of stroboscopic photography, pattern recognition devices, electromyography and foot switch outputs, gait patterns were studied in 15 stroke patients with foot-drop. Three patients were treated with a peroneal nerve stimulator for five weeks; six received intensive physical therapy; and six received both physical therapy and biofeedback training three times a week for five weeks. Each patient was examined at initial visit and after five weeks. Based upon case evaluations, both the patients with the stimulator treatment and those with biofeedback training showed and maintained improvement of gait pattern following the treatment period. This result suggests that the biofeedback and peroneal-stimulator technique may have a common mechanism that should be exploited in the rehabilitation of stroke patients.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/34. The art of perimetry.There is no single method of perimetric examination which is applicable to all types of visual field defects. Perimetry is a subjective psychophysical sensory examination. It is not an exact science unless one includes the objective measurement of visual evoked response in the optic cortex. Until such a method becomes clinically available it will be necessary for the perimetrist to determine which techniques to use in a given case and to apply these techniques with sympathetic understanding. This is the art of perimetry.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
5/34. Hemiparesis in hiv infection. rehabilitation approach.persons with acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (hiv) infection demonstrate a wide array of central nervous system impairments and may be at a significantly increased risk for cerebrovascular disease. Cerebrovascular disease can be the first manifestation of hiv infection and may be associated with a treatable etiology. Anticipating more referrals for hiv-related physical disability, we detail the rehabilitation management of three persons with hiv infection and hemiparesis. Onset of hemiparesis ranged from just before to 24 months after an AIDS-defining illness. No specific underlying etiology was identified in two of three patients, consistent with previous observations. rehabilitation interventions included lower and upper extremity orthoses, assistive devices to aid gait and activities of daily living, therapeutic exercise and use of antispasticity medication. All patients made at least mild, temporary gains in functional status. survival ranged from 3 to >6 months from initial contact with rehabilitation services. Neurologic and nonneurologic considerations in the rehabilitation of persons with hiv infection are discussed. We conclude that selected individuals with hiv infection and hemiparesis can benefit from rehabilitation intervention. hiv infection should be considered in any young adult presenting with stroke.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
6/34. phenol block for hip flexor muscle spasticity under ultrasonic monitoring.Hip flexor spasticity, which is often associated with central nervous system (CNS) diseases, is a major impediment in rehabilitation. In order to cope with this problem, lumbar nerve blocking techniques developed by Meelhuysen and major and minor psoas muscle blocking techniques developed by Awad have been used in combination with physical therapies. Based on these techniques, we conducted major and minor psoas muscle phenol block (motor point block or intramuscular nerve block) under ultrasonic monitoring. phenol block was conducted in nine patients with cerebral infarction (13 blocking procedures) and three with spinal cord injuries (six blocking procedures) while keeping them in a lateral position with the operation side upside. The beginning of the femoral nerves and part of the lumbar artery were visualized by ultrasound in some patients. As a result of the improvement of hip flexor spasticity, the range of hip joint motion (determined by the Mundale technique, prone hip extension and Thomas test) improved shortly after blocking. When physical therapy was conducted after blocking, improvement of skin care management was observed in eight cases, ability to keep in a stable sitting position in nine, improvement of a standing posture in three, increases in the ability to walk in two and alleviation of pain in three. Although nerve block is reported to result in hematoma, decreases in muscle force, pain, cystic/rectal disorders and hypogonadism, we have observed no such complication in our patients.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/34. The role of occupational therapy in rehabilitating stroke patients.The role of the occupational therapist is outlined. An overview of occupational therapy evaluation and treatment is discussed. The goal of rehabilitation is aimed at helping the patient achieve the highest level of independence of which he is physically capable. A case report is presented.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
8/34. hepatic encephalopathy mimicking stroke. A case report.This case demonstrates focal neurologic deficit mimicking stroke with underlying hepatic encephalopathy. Unilateral weakness in patients with hepatic encephalopathy has not been previously described in the English language literature. A 46-yr-old white woman was admitted to an acute care hospital for left shoulder manipulation, underwent general anesthesia and appeared to have had a right cerebrovascular accident. At transfer to the rehabilitation hospital, in addition to the left hemiparesis, there were inconsistencies in the neurologic examination and signs of cognitive impairment and liver failure. The patient's response to an intensive, multidisciplinary inpatient rehabilitation program along with treatment of the liver dysfunction led to resolution of left-sided weakness and flapping tremor with independence in ambulation and activities of daily living. Relevant literature is reviewed. A thorough history and physical examination with liver function assessment should always be performed in patients with cerebrovascular accident and unusual recovery.- - - - - - - - - - ranking = 1.594607624388keywords = physical examination, physical (Clic here for more details about this article) |
9/34. Interaction of neuropsychological and psychological factors in two cases of "space phobia".Recent theories of psychological disorders are beginning to break down the traditional dichotomy between mental and physical processes. The present paper reports on two cases of space phobia in which this is especially apparent. Neuropsychological assessment indicated subtle disturbance in visuospatial functioning. The emotional response to this dysfunction appeared, however, to be somewhat excessive given the subtlety of the deficit. This is seen as a psychological reaction to a neuropsychological dysfunction.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
10/34. Perceptual and conceptual mechanisms in neglect dyslexia. Two contrasting case studies.The contribution of peripheral, data-driven effects is contrasted with conceptual, 'top-down' effects to the reading performance of 2 subjects with neglect dyslexia following a single right hemisphere lesion. Several tasks were administered, manipulating the physical, lexical or morphemic properties of the stimuli in an attempt to establish whether the attentional deficit disrupts reading at an early or late stage of processing. Both subjects were impaired at detecting elementary stimulus features on the left side of the display but were even more impaired at identifying conjoined features. One subject's performance was influenced by structural manipulations which altered the low-level representation of the stimulus. The other was less affected by structural changes of the stimuli but was influenced by the lexical and morphemic status of the words. This apparent double dissociation is interpreted as arising from a graded attentional deficit at a single locus, early in the reading process where low-level information is detected. When the deficit is not severe sufficient information may be picked up and may interact with higher order lexical knowledge to offset partially the peripheral malfunction. For a severe attentional deficit, top-down knowledge is not engaged as insufficient information is processed on the left-hand side. This hybrid view of attention provides insight into the mechanisms underlying neglect dyslexia and bears on the role of attention in normal visual processing.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
| | Next -> |