Monolimb Paralysis after Laparoscopic Appendectomy Due to Conversion Disorder / 가정의학회지

Limb paralysis can develop for various reasons. We found a 13-year-old patient who became paralyzed in her lower extremities after laparoscopic appendectomy. Some tests, including electrodiagnostic studies and magnetic resonance imaging, were performed to evaluate the cause of lower limb paralysis. None of the tests yielded definite abnormal findings. We subsequently decided to explore the possibility of psychological problems. The patient was treated with simultaneous rehabilitation and psychological counseling. Paralysis of the patient's lower extremity improved gradually and the patient returned to normal life. Our findings indicate that psychological problems can be related to limb paralysis without organ damage in patients who have undergone laparoscopic surgical procedures.

Medical and Functional Status of Adults with Cerebral Palsy

OBJECTIVE: The purpose of this study is to survey the health and functional status of adult cerebral palsy. METHOD: This study included 47 patients who have cerebral palsy between the ages of 20 and 45 years. We evaluated the functional status by the interview and questionnaire, the medical status including a detailed medical history, with emphasis on the musculoskeletal system. RESULTS: 1) In the functional status, the number of non-functional ambulator increased from ten cases (21.3%) to fourteen cases (29.8%) in proportion to the incidence of fracture. 2) In the medical status, thirty-seven cases (78.8%) had more than one musculoskeletal complaint. Twenty-three cases (48.9%) had gastric discomfort, twenty-five cases (53.2%) had dental caries and thirty cases (63.9%) had speech disturbance. 3) Only eleven cases (23.4%) had undergone the comprehensive rehabilitation. CONCLUSION: To prevent and minimize the physical disabilities and musculoskeletal complications of adult cerebral palsy, we need more active medical intervention, active research on the methodology and comprehensive rehabilitation.

The Effect of Functional Electrical Stimulation on Hemiplegic Shoulder Subluxation

OBJECTIVE: The purpose of this study is to evaluate the effect of functional electrical stimulation (FES) on hemiplegic shoulder subluxation in post-acute stroke patients. METHOD: Forty-four patients who had shoulder subluxation as a consequence of their first stroke were included and randomly assigned to either a control group (22 subjects) or a study group (22 subjects). Patients in both groups received physiotherapy and used an arm sling. The study group received, FES therapy to shoulder muscles (supraspinatus and posterior deltoid) for 30 minutes, five days a week for 6 weeks. The effect of FES therapy was evaluated by assessment of the severity of subluxation using radiologic measurements before and after treatment. RESULTS: 1) The severity of subluxation was significantly increased after 6 weeks (p0.05). 2) In the group of patients with early treatment (onset duration, less than 6 months), the control group showed a significant increase in subluxation (p<0.05), but the study group showed significantly reduced (p<0.05) shoulder subluxation after treatment period. 3) In the group of patients with mild shoulder subluxation before treatment (less than 1 finger breadth), the control group showed a significant increase in subluxation (p<0.05), but the study group showed significantly reduced (p<0.05) shoulder subluxation after treatment period. CONCLUSION: The FES therapy is effective in preventing and reducing the severity of hemiplegic shoulder subluxation in post-acute stroke patients, especially if duration since stroke onset was less than six months and the severity of subluxation before treatment was mild.