Temporomandibular joint (TMJ) dislocations, which occur as a result of an excess of muscle activity/ spasticity in the protractor masticatory muscles, were defined as neurogenic dislocations of the TMJ. We report a case of a 36-year-old woman with sequelae of haemorrhagic stroke, which developed recurrent episodes of TMJ dislocation, interfering with the rehabilitation program and her well-being/quality of life. Conservative measures were implemented but 2 months later, TMJ dislocation episodes continued (2-3 daily). Then, type A botulinum toxin (BTX-A) injections were applied to both lateral pterygoid muscles, and these episodes ceased to happen for more than seven months. While conservative treatment is often not sufficient, surgical procedures are invasive and involve more risk, BTX-A injections, were an effective treatment option during for a longer than expected period of time.

No abstract

Introduction: Multiple Sclerosis (MS) is a complex immune-mediated disease that causes demyelination and degeneration within the brain and spinal cord. This may result in muscle weakness, abnormal tone, visual disturbances, decreased sensation, tremor/ataxia, bladder, bowel and sexual dysfunction, fatigue and impaired ambulation. Those symptoms cause disability and have a huge impact on quality of life (QoL). Methods:Literature review about the evidence assessing the rehabilitation interventions for maintaining functional capacity and reducing risk of losing important abilities and independence. Databases of Cochrane Library/Pubmed/Medline were searched, from 2004-2016 with the keywords "Physical therapy", "rehabilitation", "multiple sclerosis", "review". Results and Discussion:Physical exercise is safe and should be encouraged. Even though rehabilitation has no direct influence on disease progression, studies have shown that this intervention reduces the limitations, and helps to maintain QoL. Timing and setting of rehabilitation interventions should be selected individually. Benefits are generally higher in earlier phases of MS. A multidisciplinary approach, is the basic concept of any rehabilitation program. The main impairments that need to be specifically managed are spasticity, cognitive impairment, motor, sensory and visual deficits, fatigue and bladder/ bowel dysfunction. Ambulation difficulties should be addressed to improve efficacy, efficiency and to reduce falls. Compensation through appropriate prescription of assistive devices, bracing, and/or wheelchairs will help improve safety. Cognitive training can improve memory span, working memory and immediate visual memory. New promising rehabilitation techniques may also be useful: impairment-oriented training, electromyogram-triggered neuromuscular stimulation, and robotic interactive therapies. Conclusion:Rehabilitation has significant impact on achieving and maintaining QoL as well as on improving independence in patients with MS. A multidisciplinary and multimodal approach is the recommended model for neurorehabilitation interventions.Keywords: Multiple sclerosis, Rehabilitation, Physical therapy, Quality of Life. AbstractRehabilitation in multiple sclerosis 2 ARC Publishing

No abstract

No abstract