Acute Flaccid Myelitis in an Adult.

INTRODUCTION: Acute flaccid myelitis (AFM) is a condition causing acute onset flaccid limb weakness primarily in children. Correlations with specific viral illnesses have been found, however, specific pathogenesis remains unknown. CASE REPORT: A 21-year-old female individual presented with progressive weakness provoking multiple falls, severe fatigue, headaches, and body aches after an upper respiratory illness. Deep tendon reflexes were absent, and cerebrospinal fluid analysis was remarkable for lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging revealed T2 hyperintensity extending from C1-T2 predominantly involving the anterior horns. Weakness continued to increase before subtly improving over the course of a 10-day hospital stay. Functional improvements had been achieved by the patient at 1-year follow-up with intensive physical therapy. CONCLUSIONS: AFM should be included in the differential for the presentation of acute weakness in adults and pediatric patients. As the incidence of AFM continues to rise, awareness of the condition and prompt obtainment of specimens in suspected patients is crucial to aid in the investigation.

Feasibility of Home-Based Neurologic Music Therapy for Behavioral and Psychological Symptoms of Dementia: A Pilot Study.

Family caregivers often feel ill-equipped to handle bothersome behavioral and psychological symptoms of dementia, such as agitation, apathy, and sleep disturbances, leading to increased caregiver distress and nursing home placement for people with dementia. Therapies for such symptoms are currently limited and non-pharmacological options are preferred, given potential side effects of medications. Neurologic music therapy (NMT) could provide an additional treatment option for managing behavioral and psychological symptoms for community-dwelling people with dementia and their caregivers. This pilot study sought to evaluate the feasibility, acceptability, and effectiveness of home-based NMT for behavioral and psychological symptoms of dementia. Eighteen persons with dementia-caregiver dyads were enrolled to receive one-hour weekly sessions of home-based NMT for 6 weeks. Demographic, quality of life, neuropsychiatric symptom, and caregiver burden and self-efficacy information was collected at baseline, 6 weeks, and 12 weeks. Seven dyads (38.9%) withdrew from therapy before completing all sessions; these participants had higher Neuropsychiatric Inventory scores and were of older age at baseline. For those who completed therapy, neuropsychiatric symptom scores improved at 6 weeks, an effect that was sustained at 12 weeks. No other outcome measures changed significantly after therapy. Initiating NMT too late in the course of dementia, when behavioral symptoms are already present, may be impractical for people with dementia and increase caregiver stress, even when provided within the home. Introducing and incorporating the principles of NMT earlier in the course of dementia could allow for increased comfort and benefit for people with dementia and their caregivers.