RESUMO
The natural history of idiopathic abducens nerve paresis and the role of conservative management such as vision training during the recovery process is not well documented in the literature to the best of our knowledge. This case report presents the natural recovery process of idiopathic abducens nerve paresis in a young adult and the role of vision therapy in the recovery process (AU)
Hasta la fecha, la historia natural de la paresia idopática del nervio abducens y la función de un tratamiento conservador como la terapia visual durante el proceso de recuperación no se hallan bien documentadas en la literatura. Este informe de un caso presenta el proceso de recuperación natural de la paresia idiopática del nervio abducens en un adulto joven, así como la función de la terapia visual en el proceso de recuperación (AU)
Assuntos
Humanos , Masculino , Adulto , Doenças do Nervo Abducente/terapia , Paresia/terapia , Doenças do Nervo Abducente/reabilitação , Diplopia/terapia , Resultado do Tratamento , Terapia por ExercícioRESUMO
The natural history of idiopathic abducens nerve paresis and the role of conservative management such as vision training during the recovery process is not well documented in the literature to the best of our knowledge. This case report presents the natural recovery process of idiopathic abducens nerve paresis in a young adult and the role of vision therapy in the recovery process.
Assuntos
Doenças do Nervo Abducente/terapia , Paresia/terapia , Doenças do Nervo Abducente/reabilitação , Adulto , Diplopia/terapia , Terapia por Exercício , Humanos , Masculino , Resultado do TratamentoRESUMO
Posterior Fossa Syndrome (PFS) is a constellation of neurological, behavioural and psychological symptoms occurring in pediatric patients following surgical resection of posterior fossa brain tumours. The clinical presentation of PFS typically includes cerebellar mutism, bulbar dysfunction, ataxia, cranial nerve palsies, flaccid hemiparesis and emotional lability. The intent of this paper is to (a) provide an overview of PFS, (b) explore the case of a 16-year-old adolescent who presented with PFS following surgical resection of a fourth ventricle medulloblastoma, (c) reveal the complexity of her discharge, and (d) describe a discharge management framework used by the authors to guide the discharge process from a general pediatric unit in a tertiary care hospital.
Assuntos
Doenças do Nervo Abducente/etiologia , Ataxia/etiologia , Neoplasias do Ventrículo Cerebral/cirurgia , Meduloblastoma/cirurgia , Mutismo/etiologia , Alta do Paciente , Doenças do Nervo Abducente/reabilitação , Adolescente , Ataxia/reabilitação , Neoplasias do Ventrículo Cerebral/complicações , Neoplasias do Ventrículo Cerebral/diagnóstico , Fossa Craniana Posterior , Craniotomia/efeitos adversos , Transtornos de Deglutição/etiologia , Feminino , Quarto Ventrículo , Humanos , Hidrocefalia/etiologia , Laminectomia/efeitos adversos , Meduloblastoma/complicações , Meduloblastoma/diagnóstico , Hipotonia Muscular/etiologia , Mutismo/reabilitação , Planejamento de Assistência ao Paciente , Enfermagem Pediátrica , SíndromeRESUMO
Botulinum Toxin as a medical therapy was introduced by Dr Alan Scott more than 20 years ago. The first clinical applications of Botulinum Toxin type A (BT-A) were for the treatment of strabismus and for periocular spasms. Botulinum Toxin type A is often effective in small to moderate angle convergent strabismus (esotropia) of any cause, and may be an alternative to surgery in these cases. Botulinum Toxin type A may have a role in acute or chronic fourth and sixth nerve palsy, childhood strabismus and thyroid eye disease. The use of BT-A for strabismus varies enormously in different cities and countries for no apparent reason. Botulinum Toxin type A may be particularly useful in situations where strabismus surgery is undesirable. This may be in elderly patients unfit for general anaesthesia, when the clinical condition is evolving or unstable, or if surgery has not been successful. Botulinum Toxin type A can give temporary symptomatic relief in many instances of bothersome diplopia irrespective of the cause. Ptosis and acquired vertical deviations are the commonest complications encountered. Vision-threatening complications are rare. Repeated use of BT-A is safe.