1/5. Use of antecedent control to improve the outcome of rehabilitation for a client with frontal lobe injury and intolerance for auditory and tactile stimuli.KM, a single 23-year-old male, sustained a severe traumatic brain injury in a motor vehicle accident. Aggressive and uncooperative behaviour, resulting from the client's cognitive deficits and hypersensitivity to stimuli, made him unmanageable in a subacute rehabilitation setting. Minimizing sources of agitation reduced the client's outbursts and facilitated the completion of functional tasks, such as bathing and dressing. Modifying his environment also increased the client's participation in social and leisure activities. These changes improved the outcome of the client's rehabilitation.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/5. Organophosphate-induced delayed neuropathy: case report.Organophosphate induced delayed neuropathy (OPIDN) is an uncommon clinical condition. It occurs in association with the ingestion of great amounts of organophosphate after the stimulation of cholinergic receptor. The clinical picture is characterized by a distal paresis in lower limbs associated with sensitive symptoms. Electrodiagnostic studies show a motor axonal neuropathy. Involvement of the central nervous system may occur. We describe a 39 years-old female patient who developed hyperesthesia associated with lower limbs paresis, fourteen days after she had ingested a dichlorvos-based insecticide. Electrophysiological study was characterized by an axonal polyneuropathy pattern. Pyramidal tract dysfunction was observed later in upper limbs. Considering that both peripheral and central nervous systems are involved we believe that the more appropriated term would be organophosphate induced delayed neuropathy (OPIDN) instead of organophosphate induced delayed polyneuropathy (OPIDP).- - - - - - - - - - ranking = 58.166361414916keywords = central nervous system, nervous system (Clic here for more details about this article) |
3/5. Thermal and tactile sensory deficits and allodynia in a nerve-injured patient: a multimodal psychophysical and functional magnetic resonance imaging study.OBJECTIVE: A case study was conducted to examine a patient with chronic neuropathic pain of the right foot following peripheral nerve injury and characterize associated sensory abnormalities. methods: Multimodal psychophysical examination of the patient's affected and nonaffected foot included thermal sensibility, dynamic touch, and directional sensibility. In addition, we used functional magnetic resonance imaging to study cortical representation of brush-evoked allodynia. RESULTS: Detailed psychophysical examination revealed substantial deficits in warm, cool, and tactile perception on the injured foot. These findings indicated severe dysfunction of perceptual processes mediated by A beta, A delta, and C fibers. Despite reduced tactile perception, light touch evoked a deep burning pain in the foot. Functional magnetic resonance imaging during brushing of the patient's injured foot showed that tactile allodynia led to activation of several cortical regions including secondary somatosensory cortex, anterior and posterior insular cortex, and anterior cingulate cortex. Brushing of the patient's nonaffected foot led to fewer activated regions. DISCUSSION: The profound sensory disturbances suggest a possible deafferentation type of tactile allodynia mediated by changes within the central nervous system, such as a disruption of normal tactile or thermal inhibition of nociception. The functional magnetic resonance imaging data suggest that tactile allodynia is represented in similar brain regions as experimental pain.- - - - - - - - - - ranking = 30.083180707458keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
4/5. Impaired blood pressure response to norepinephrine in a case of insulin-dependent diabetes mellitus--improvement with a beta-adrenergic antagonist.A case of juvenile-onset insulin-dependent diabetes mellitus in a 30-year-old male patient is reported. He was admitted to the hospital because of severe diabetic neuropathy, predominantly in the lower extremities. Signs of autonomic neuropathy were not evident but the patient had severe orthostatic hypotension. Circulating catecholamine concentrations were normal; however, the blood pressure response to infused norepinephrine was reduced ten-fold compared to a group of normals. An improvement of the blood pressure response to sympathomimetic drugs was accomplished during the simultaneous administration of propranolol, a beta-receptor blocking agent. The present data suggest a possible defect of the adrenergic receptor system in response to sympathomimetic drugs while the release of catecholamines and the function of the parasympathetic nervous system appears to be intact. Treatment with beta-blocking agents such as propranolol as an adjunct to sympathomimetics seems to be a promising approach which might deserve further consideration in similar cases.- - - - - - - - - - ranking = 8.0153229231208keywords = nervous system (Clic here for more details about this article) |
5/5. strychnine poisoning: natural course of a nonfatal case.A rare case of suicidal strychnine poisoning that resolved naturally without treatment is presented. The patient first complained of chest pain, which was originally thought to be caused by a dissecting aneurysm; however, nystagmus, dysesthesia, spastic paraplesia, and hyperreactivity to stimuli shortly developed. diagnosis was difficult because the patient did not disclose the drinking of strychnine or the suicidal intent, and no abnormal signs were seen in the various central nervous system examinations. The natural course was observed without treatment because the patient's circulatory and respiratory condition was good. movement disturbances in the upper extremities disappeared after 2 days, nystagmus in 3 days, and dysesthesia and spastic paraplesia in 4 days. The patient was able to stand on the fourth day and walk on the seventh. He was discharged on day 10 without any detectable ill effects.- - - - - - - - - - ranking = 29.083180707458keywords = central nervous system, nervous system (Clic here for more details about this article) |