Magnetic resonance imaging and degree of disability in multiple sclerosis.

Sixteen patients with multiple sclerosis were evaluated by magnetic resonance imaging (MRI) to determine if number of brain lesions correlated with the amount of functional disability, as described by the Incapacity Status Scale contained in the Minimal Record of Disability. Although no correlation existed, the statistical analysis did indicate a trend toward correlation, which warrants a study with a larger number of subjects.

Multiple sclerosis and rehabilitation outcome.

This paper reviewed the outcome for people with severe multiple sclerosis admitted to an inpatient rehabilitation center. Data was gathered on admission, at discharge, and at three months postdischarge. Over a four-year period 28 patients received care comprising a total of 33 patient admissions. Seventy-three percent of the cases were women, ages 23 to 69. Sixty-one percent were admitted from acute care medical services. On admission, 18% ambulated independently, by discharge 76% could do so. Fifteen cases changed from dependent to independent status in stair climbing by discharge. Less dramatic improvements were noted for activities of daily living categories. In general, individuals who stayed at the center longer were initially more dependent and made greater relative gains. More patients with multiple admissions were married, and they tended either to be employed or to have at least partial homemaking responsibilities.

Rehabilitation of patients with end-stage renal failure after lower extremity amputation.

Four patients with end-stage renal failure on maintenance hemodialysis and one patient with near end-stage renal failure received inpatient rehabilitation following lower extremity amputation. All were prosthetically restored. Three of the patients had bilateral below-knee amputations and were ambulatory at the time of discharge, including the patient with near end-stage renal failure who was on maintenance hemodialysis at follow-up. One unilateral below-knee amputee was also ambulatory at discharge. The other unilateral below-knee amputee had an ulcer on the other foot and used a pylon for transfers only. To assess the prevalence of patients on maintenance hemodialysis with lower extremity amputations, a survey of 310 patients at four dialysis units was performed. Of the 310 patients 2.9 percent had at least one amputated lower extremity and 1.0 percent had bilateral lower extremity amputations. Preliminary data and the potential for functional results following prosthetic restoration suggest the need for further research concerning prosthetic restoration in the lower extremity amputee with end-stage renal failure.

Transverse myelopathy in systemic lupus erythematosus.

There have been 28 reported cases of transverse myelopathy associated with systemic lupus erythematosus. In a 6-month period, the authors saw 2 new cases. Both of these patients were young women (29 and 31 years old) who had received a diagnosis of systemic lupus erythematosus prior to the onset of the transverse myelopathy. The case histories of the 2 patients are reported in detail and the findings are compared with those of previously reported cases. The rehabilitation program and outcome are described. Systemic lupus erythematosus should be considered in the differential diagnosis of transverse myelopathy because there may be many unsuspected cases.