1/12. Focal polymicrogyria in mother and son.This 9-year-old boy was admitted at the age of 2 with a diagnosis of congenital hemiparesis while the rest of physical and neurological examination was normal. His score in the Wechsler intelligence scale was 80. Right fronto-parietal cortical dysplasia with hemisphere atrophy was evident by computerized tomography scanning and magnetic resonance imaging. The latter, also disclosed abnormal thick cortex which was interpreted as polymicrogyria or pachygyria. karyotype was normal. He had a hemifacial motor seizure at the age of 7. At the age of 8 frequent atonic or inhibitory seizures were presented. Asymmetric bilateral spike discharges with high voltage in the right hemisphere during the EEG recording were found. His mother, a 35-year-old woman (Full scale; adult intelligence scale: 85) also had congenital hemiparesis. She never had seizures and her EEG was normal. magnetic resonance imaging disclosed right fronto-parietal cortical dysplasia with ipsilateral hemisphere atrophy. karyotype was normal. Our cases should be interpreted as a familial presentation of the anomaly, probably with autosomal-dominant transmission.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/12. Chordoid meningioma.Chordoid meningioma is a relatively rare variant that is often associated with peritumoral lymphoplasmacellular infiltration causing Castleman syndrome (CS). We present a 44-year-old woman with chordoid meningioma not associated with CS. The patient presented with epilepsy and right hemiparesis (Todd's palsy) on admission. The radiological findings revealed an extraaxial mass lesion in the premotor cortex. They were compatible with a preoperative diagnosis of meningioma. No physical abnormalities related to CS were detected. A left frontal craniotomy was performed. The tumor surface was gelatinous, and it was totally resected with the attached dura mater (Simpson grade I). The patient had an uneventful recovery, and her seizures subsided. The pathological findings of the specimens revealed nests and cords of spindle and epithelioid cells with abundant myxoid matrix, mimicking the features of chordoma. On the basis of radiological, immunohistochemical, and electron microscopic findings, chordoid meningioma was verified, and a review of the literature was performed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/12. Modified constraint-induced therapy in subacute stroke: a case report.OBJECTIVE: To determine the efficacy of a modified constraint-induced therapy (CIT) protocol administered to a patient with subacute stroke. DESIGN: Multiple-baseline, before-after trial. SETTING: Subacute outpatient clinic. PATIENT: A 68-year-old woman who had a left anterior cerebral artery infarct 5 months before study entry and who exhibited learned nonuse of the affected upper limb. INTERVENTION: Thirty minutes of structured physical therapy and 30 minutes of occupational therapy 3 times a week for 10 weeks, each session emphasizing affected arm use. During the same period, her unaffected arm and hand were restrained 5d/wk during 5 hours initially identified as a time of frequent use. MAIN OUTCOME MEASURES: The Fugl-Meyer Assessment of Motor Recovery (FMA), Action research Arm Test (ARA), Wolf Motor Function Test (WMFT), and motor activity Log (MAL). RESULTS: The patient exhibited substantial improvements on the FMA and ARA. She also improved on the WMFT in her ability to perform tasks and in the time taken to complete the tasks. Amount and quality of arm use also improved, as measured by the MAL. CONCLUSIONS: Modified CIT may be an efficacious method of improving function and use of the affected arms of patients with learned nonuse.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/12. Late onset seizures, hemiparesis and blindness in hemolytic uremic syndrome.Neurologic complications of hemolytic uremic syndrome, including seizures, usually occur early during the acute phase of the illness. We report a3-year-old girl with classic diarrhea-associated hemolytic uremic syndrome who developed late onset seizures, hemiparesis and transient blindness on the 17th hospital day, at which time her recovery was characterized by improvement in her blood pressure, serum electrolytes, renal function, hematocrit and platelet count. A CT and MR revealed brainstem and posterior parietal and occipital infarct/edema. The association of these radiologic findings within the posterior distribution along with visual loss and seizures are unique to posterior reversible encephalopathy syndrome. Within 7 days, she regained motor function and vision and had no further seizure activity. At 6 months follow-up, physical examination revealed normal motor function and vision and a repeat MR showed near resolution of the previous findings with minimal occipital lobe gliosis. This case report describes the uncommon finding of late onset seizures occurring during the recovery phase of hemolytic uremic syndrome with MR findings consistent with posterior reversible encephalopathy syndrome.- - - - - - - - - - ranking = 2.3342167081317keywords = physical examination, physical (Clic here for more details about this article) |
5/12. Simulation of bilateral movement training through mirror reflection: a case report demonstrating an occupational therapy technique for hemiparesis.In rehabilitation for hemiparesis, one of the goals of an occupational therapist is to practice upper extremity tasks with the recovering individual. The practice is intended to strengthen muscles and refine movements. It also provides examples for the recovering body and brain as they attempt to reestablish the now delicate cognitive and neural connections mediating voluntary behavior. However, the paresis significantly limits the movement sequence possibilities that may be physically practiced. We outline a method for using simulation of movement, which is intended to provide a means for experiencing a range of smooth and controlled movements completed by a paretic limb. The simulation provides a compelling perceptual experience of bilateral motion beyond the current capabilities of the affected limb. The benefits of this technique after a 3-week course of the simulation practice are exemplified by the presented case study that reveals improved function as demonstrated by increases in Fugl-Meyer scores and faster movement speeds as demonstrated by decreased movement times for the Jebsen test of hand function.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/12. Ossification of the transverse atlantal ligament associated with fluorosis: a report of two cases and review of the literature.STUDY DESIGN: Two cases of ossification of the transverse atlantal ligament (OTAL) are reported, and the literature is reviewed. OBJECTIVE: To report two cases of OTAL, which share fluorosis as a possible etiologic link. SUMMARY OF BACKGROUND DATA: OTAL, a rare phenomenon, may cause upper cervical canal stenosis and spastic quadriparesis. However, the incidence, etiology, and the best therapeutic options are currently unclear. methods: Two cases are reported. Included are pertinent history, physical examination, radiographic evaluation, nonsurgical interventions, and outcomes. The available literature is also reviewed. RESULTS: On systemic examination, these two cases were found to have ossification of many ligaments and interosseous membranes, i.e., the atlantal transverse ligament, posterior longitudinal ligament, and interosseous membranes of ribs, forearm, and leg. These findings were coupled with a history of high fluoride intake and dental fluorosis; the diagnosis of fluorosis was made. After 2 weeks of treatment with halo ring traction, and protection and stabilization with a hard cervical collar, the clinical symptoms significantly improved. CONCLUSION: The incidence of OTAL may be not as rare as has been thought. Although the complete etiology of OTAL is not known, fluorosis may be one of the etiologic factors related to OTAL, as well as the ossification of other ligaments and interosseous membranes. Nonsurgical treatment may be safe and effective.- - - - - - - - - - ranking = 2.3342167081317keywords = physical examination, physical (Clic here for more details about this article) |
7/12. The efficacy of combined physical and mental practice in the learning of a foot-sequence task after stroke: a case report.OBJECTIVE: To investigate the effect of mental practice on the learning of a sequential task for the lower limb in a patient with a hemiparesis resulting from a stroke. DESIGN: A single-case study. SETTING: research laboratory of a university-affiliated rehabilitation center. PATIENT: A right-handed 38-year-old man who had suffered a left hemorrhagic subcortical stroke 4 months prior. INTERVENTION: The patient practiced a serial response time task with the lower limb in 3 distinct training phases over a period of 5 weeks: 2 weeks of physical practice, 1 week of combined physical and mental practice, and then 2 weeks of mental practice alone. MAIN OUTCOME MEASURES: Performance on the task measured through errors and response times. Imagery abilities measured through questionnaires. RESULTS: The patient's average response time improved significantly during the 1st 5 days of physical practice (26%) but then failed to show further improvement during the following week of physical practice. The combination of mental and physical practice during the 3rd week yielded additional improvement (10.3%), whereas the following 2 weeks of mental practice resulted in a marginal increase in performance (2.2%). CONCLUSION: The findings show that mental practice, when combined with physical practice, can improve the performance of a sequential motor skill in people who had a stroke, and suggest that mental practice could play a role in the retention of newly acquired abilities.- - - - - - - - - - ranking = 10keywords = physical (Clic here for more details about this article) |
8/12. A home program of sensory and neuromuscular electrical stimulation with upper-limb task practice in a patient 5 years after a stroke.BACKGROUND AND PURPOSE: This case report describes a person with upper-extremity (UE) hemiparesis who participated in a home program that included sensory amplitude electrical stimulation (SES) to his involved arm and performance of task-specific exercises with the assistance of neuromuscular electrical stimulation (NMES). CASE DESCRIPTION: The patient was a 67-year-old man with stable sensory and motor deficits 5 years after a stroke. Sensory amplitude electrical stimulation was delivered for 2 hours per day. A daily, 15-minute course of NMES was used to help him perform UE tasks. This home program was carried out for 18 weeks and included 6 physical therapist home visits. OUTCOMES: The patient's UE score on the stroke rehabilitation Assessment of movement (STREAM) improved from 10/20 to 17/20. The score on the Action research Arm Test (ARAT) improved from 27/57 to 42/57. The patient reported that he was now able to button buttons, use a knife and fork, and tie simple fishing knots. DISCUSSION: A home program combining SES and NMES may be an effective method to increase UE function even 5 years after a stroke.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/12. Hereditary neuropathy with liability to pressure palsies in childhood: report of a case and a brief review.We present a 10-year-old female diagnosed having hereditary neuropathy with liability to pressure palsies (HNPP). She had suffered from acute, recurrent monoplegic episodes affecting both the sciatic nerves and the left brachial plexus since the age of 7 years. The paresis seemed to be triggered by hiking and athletic training. Electrophysiological studies showed a conduction block in the proximal portions of affected nerves. The FISH method disclosed a deletion of the peripheral myelin protein 22 gene. This school child having HNPP is considered to be susceptible to the influence of abundant physical training, rather than minor trauma or compression at sites of entrapment of peripheral nerves.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/12. Atypical presentation of sinus histiocytosis with massive lymphadenopathy as an epidural spinal cord tumor: a case presentation and literature review.Sinus histiocytosis with massive lymphadenopathy is a benign lymphoproliferative disorder growing in frequency as awareness of the disease increases. Also known as Rosai-Dorfman disease, it typically presents as painless cervical lymphadenopathy with fever and malaise. A review of the literature reveals approximately 400 cases of extranodal involvement and approximately 44 cases of central nervous system involvement. Less than 10 of the reported central nervous system tumors have presented as an epidural spinal cord tumor. The authors describe the case of a 29-year-old woman with progressive paraplegia and leg pain. magnetic resonance imaging of the thoracic spine revealed a tumor mass from T5 to T9. The tumor was resected, and the spinal column was stabilized with pedicle screw fixation and fusion. Postoperative treatment was initiated with radiation and physical rehabilitation. The following is a case report with literature review of the entity.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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