RESUMO
The identification and management of neurological deficit are each essential for stroke rehabilitation. Management of the two most commonly encountered deficits, hemiplegia and communication disorder, is discussed. An eleven point Stroke Rehabilitation Outcome plan forms a good basis for discussion with relatives about what to expect.
Assuntos
Transtornos Cerebrovasculares/reabilitação , Atividades Cotidianas , Feminino , Humanos , Masculino , PosturaRESUMO
A 27-year-old woman is described who suffered an acute left hemiplegia at the age of three years and 20 years later she noted the onset of unilateral left limb dystonic movements. Her cranial CT scan showed an area of low density, consistent with longstanding infarction, in the right lentiform nucleus. Cerebral angiography demonstrated aneurysmal dilatation of the terminal portion of the right internal carotid artery, minor irregularity of the lenticulostriate branches of the right middle cerebral artery (suggestive of Moya Moya disease) and occlusion of the right anterior cerebral artery. The dystonic movements improved with levodopa therapy. Clinico-radiological correlation in this case supports recent evidence for a disruption of pathways between the caudate nucleus, lentiform nucleus and thalamus in the pathophysiology of hemidystonia.
Assuntos
Angiografia Cerebral , Distonia/etiologia , Hemiplegia/complicações , Tomografia Computadorizada por Raios X , Adulto , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/diagnóstico por imagem , Corpo Estriado/fisiopatologia , Distonia/tratamento farmacológico , Distonia/fisiopatologia , Feminino , Hemiplegia/diagnóstico por imagem , Humanos , Levodopa/uso terapêutico , Vias Neurais/fisiopatologia , Tálamo/fisiopatologia , Fatores de TempoAssuntos
Doenças Desmielinizantes/fisiopatologia , Oftalmoplegia/fisiopatologia , Idoso , Doenças dos Gânglios da Base/fisiopatologia , Paralisia Bulbar Progressiva/tratamento farmacológico , Paralisia Bulbar Progressiva/fisiopatologia , Doenças Desmielinizantes/tratamento farmacológico , Di-Hidroxifenilalanina/uso terapêutico , Eletroencefalografia , Eletromiografia , Eletroculografia , Movimentos Oculares , Pálpebras/fisiopatologia , Feminino , Humanos , Masculino , Processos Mentais , Pessoa de Meia-Idade , Doenças Musculares/fisiopatologia , Condução Nervosa , Oftalmoplegia/tratamento farmacológico , Reflexo , Distúrbios da Fala/fisiopatologia , SíndromeRESUMO
Physiotherapy has traditionally been concerned with muscle function. In dealing with patients with neurological disorders it may not be enough to have a thorough grasp of muscular innervation and musculoskeletal problems. We are all aware of the importance of the higher centres as manifested by motivation, courage, intelligence, the capacity to relax and so forth. This is the same for all patients. However, the perceptual problems which are unique to some neurological conditions may undermine the best efforts of a physiotherapist not familiar with them. The patient is the last person likely to be able to point out these problems because agnosia or unawareness is part of the picture. So the physiotherapist who hopes to succeed in this area must have expertise in methods of examination outside the traditional ones.
