NeuroRehabilitation
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NeuroRehabilitation · Jan 2012
Case ReportsA case of anti-NMDAR (N-methyl-D-aspartate receptor) encephalitis: a rehabilitation perspective.
Anti-NMDAR (N-Methyl-D-Aspartate Receptor) Encephalitis is a rare occurring autoimmune disease that is mediated by antibodies against the NR1 subunit of the NMDA receptor. While this condition has a known predilection for young females with ovarian tumors, heightened awareness has led to increasing recognition of this condition in other population groups as well. Afflicted patients typically evolve through a multi-staged course of neurological, behavioral, cognitive and physical deficits. ⋯ As the recovery of patients with anti-NMDAR encephalitis is often protracted, the role of the rehabilitation is important particularly beyond its acute stages. We describe a case of anti-NMDAR encephalitis in a 17-year-old girl who presented to our rehabilitation centre for management in the gradual recovery phase of her condition. This case illustrates the multiple challenges faced in the rehabilitation of such a patient.
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NeuroRehabilitation · Jan 2012
Case ReportsRecovery of assisted overground stepping in a patient with chronic motor complete spinal cord injury: a case report.
Clinical studies have shown that after incomplete spinal cord lesions at the thoracic level, patients can develop functional gait patterns through gait training. To date, however, training has been ineffective in producing gait in patients with clinically motor complete spinal cord lesions. ⋯ Even after a motor complete lesion with some preservation of sensory pathways, the spinal cord may be able to retain some of its locomotor function through intensive gait rehabilitation.
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NeuroRehabilitation · Jan 2012
ReviewCentral sensitization as a component of post-deployment syndrome.
Many service members and veterans report chronic unexplained symptoms such as pain, fatigue and memory complaints, which have most recently been characterized as post-deployment syndrome (PDS). Chronic widespread pain is a component of this syndrome, producing significant disability and considerable health care costs. ⋯ Here, we provide support for PDS as a consequence of pain and sensory amplification secondary to neuroplastic changes within the central nervous system, a phenomenon often termed central sensitization. We also discuss how factors such as stress and genetics may promote chronic widespread pain in veterans and service members who develop PDS.
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NeuroRehabilitation · Jan 2012
ReviewPediatric traumatic brain injury: neuroimaging and neurorehabilitation outcome.
Brain injury in the pediatric patient not only occurs in an immature brain, but potentially influences all subsequent brain and neurodevelopmental maturation. This presents unique challenges in neuroimaging the developing central nervous system, which is reviewed herein. ⋯ Pediatric neuroimaging findings of TBI are discussed in terms of techniques that can assess underlying neural networks and provide information about neuroplasticity of recovery. Neuroimaging methods also provide insights into the complexities of brain injury, cognitive and neurobehavioral recovery, and how multimodality contemporary neuroimaging methods best demonstrate underlying neuropathology that affects outcome.
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NeuroRehabilitation · Jan 2012
ReviewDecompressive craniectomy in pediatric traumatic brain injury: a review of the literature.
Pediatric traumatic brain injury accounts for approximately 37,000 hospitalizations and 2,685 deaths in the United State annually. The 2003 guidelines consolidated and summarized the body of literature on this subject. Among the material covered was the role of surgical management of elevated intracranial pressure. Here we review the guideline recommendations, recent literature on the topic, and important recent results in the adult population. ⋯ Based on the only randomized trial in children and the abundance of smaller studies, it is our belief that decompressive craniectomy does provide a benefit in terms of the management of intracranial hypertension and overall outcome in children.