RESUMO
Previous reports in the literature concerning cerebrovascular accident have illustrated cases of post-stroke tremor. Treatments of these studies have varied. Trials of levo-dopa have been reported in two such cases. This case study reports on a case of a patient with a left thalamic, left superior cerebellar artery infarction with a lacunar infarction in the basal ganglia. The patient developed a violent tremor/movement disorder which was unresponsive to haloperidol. With this failure, and with the evidence of a basal ganglion lesion, levo-dopa/carbi-dopa was introduced as an intervention. The amplitude of the tremor was dramatically reduced, with protective devices removed, and with complete cessation of the tremor at rest. The medication was withdrawn and reintroduced with a reduction and subsequent resolution of the symptoms. A discussion of the previous studies of movement disorder with cerebrovascular accident is included.
Assuntos
Antiparkinsonianos/uso terapêutico , Gânglios da Base/patologia , Carbidopa/uso terapêutico , Levodopa/uso terapêutico , Transtornos dos Movimentos/tratamento farmacológico , Acidente Vascular Cerebral/patologia , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Combinada , Feminino , Humanos , Transtornos dos Movimentos/etiologia , Transtornos dos Movimentos/patologia , Acidente Vascular Cerebral/complicações , Resultado do Tratamento , Tremor/tratamento farmacológicoRESUMO
OBJECTIVES: To test the ability of patients with brain injury to use a patient locator and minder (PLAM) system to assist in their adherence to therapy schedules. PARTICIPANTS: Five patients with acquired brain injury who were inpatients on an acute rehabilitation floor of a rehabilitation hospital. MEASURES: The number of human prompts necessary to direct a patient to, and ensure arrival at, a scheduled therapy destination and the proportion of therapy sessions requiring no prompting was measured both before and after the introduction of the PLAM system. RESULTS: With the PLAM system, the average number of human prompts dropped by more than 50%, and the number of sessions requiring no prompting increased from 7% to 44%. CONCLUSION: The PLAM system described in this article seems feasible and useful for patients with acquired brain injury in assisting them with arrival at their therapy destinations without the assistance of staff.
