NeuroRehabilitation
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NeuroRehabilitation · Jan 2005
ReviewAutonomic nervous system dysfunction in lightning and electrical injuries.
Autonomic nervous system (ANS) dysfunction is a serious complication of lightning and electrical trauma (L/ET). The ANS regulates the normal vegetative functioning of many organ systems. When ANS is compromised after lightning and electric trauma, patients are vulnerable to serious medical problems. ⋯ The syndrome consists of limb paralysis, sensory symptoms, pallor, coolness and absent pulses. Release of excessive catecholamines is said to be responsible for these findings. Fortunately, the condition is transient.
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Lightning is responsible for a wide spectrum of neurologic complications. Many of the persistent symptoms require long-term neurorehabilitation. The lightning-related neurologic conditions are divided into four categories. ⋯ Category III contains delayed neurologic syndromes. Category IV encompasses neurologic lesions that are not directly activated by the lightning strike but are the result of trauma secondary to falls or blasts effects. The sensible course for individuals at risk is to learn and follow lightning safety recommendations.
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NeuroRehabilitation · Jan 2005
ReviewTreatment of agitation following traumatic brain injury: a review of the literature.
Agitation, restlessness, and aggression are frequent neurobehavioural sequelae in the early stages of recovery from traumatic brain injury (TBI). These behavioural symptoms disrupt patient care and impede rehabilitation efforts. ⋯ This article will assess the evidence for the use of selected alkylphenols, benzodiazepines, estrogens, antiandrogens, neuroleptics/antipsychotics, antidepressants, anti-Parkinsonian agents, antipsychotics, anticonvulsants, lithium carbonate, buspirone, beta-blockers, and psychostimulants in agitated TBI survivors. Review of the literature suggests that there is limited evidence to accurately guide clinicians in the management of this patient population.
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NeuroRehabilitation · Jan 2005
ReviewNeurorehabilitation of cerebral disorders following lightning and electrical trauma.
The most devastating casualties in lightning and electrical trauma patients are the result of lesions of the nervous system, and especially lesions of the brain. The brain injuries can be divided into three categories: global dysfunction; focal brain injuries; and behavioral-cognitive sequelae without gross physical signs. Lightning injuries are usually the result of outdoor sports and leisure activities. ⋯ Rehabilitation planning should begin early after the incident and often needs to be continued for a long time. The goal of the rehabilitation team is to maximize functional return in patients with deficits related to brain lesions. The neurorehabilitation team includes the neurorehabilitation physician, physical therapists, occupational therapists, psychologists, speech therapists, and case managers.
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NeuroRehabilitation · Jan 2005
ReviewNeurorehabilitation of spinal cord injuries following lightning and electrical trauma.
While spinal cord injuries caused by lightning strike or electrical shock are rare, their clinical manifestations pose unique challenges to the clinician who must anticipate the interaction of multiple system involvement with the altered physiology of spinal cord injury. Spinal cord damage may be secondary to the direct effects of electrical current passing through neural tissue producing immediate or delayed impairment. ⋯ In addition to effects on the spinal cord, electrical trauma may result in injury to the brain, peripheral nervous system, musculoskeletal system, skin, and cardiovascular system. This article will review the neurorehabilitation approach to this rare and challenging group of patients.