Introduction. Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion.(1) As a result of the injury, the functions performed by the spinal cord are interrupted at the distal level of the injury. SCI causes serious disability among patients.(2) The treatment and rehabilitation period is long, expensive and exhausting in SCI. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI.(3) Material and method. Having the patient’s consent and The Teaching Emergency Hospital “Bagdasar-Arseni” Ethics Committee’s approval, a 48 years old patient, complete tetraplegic with intense and refractory spasticity and frequency of spasm with presacral pressure sores (successfully operated) post traumatic spinal cord injury. The patient was functionally assessed using the following scales: : Glasgow Outcome Scale Extended, Modified Rankin Scale, Modified Ashworth, Penn Spasm Frequency Scale Functional Independence Measure, FAC International Scale, Quality of Life Assessment. Conclusions. Spasticity is a common secondary impairment after SCI characterized by hypertonus, increased intermittent or sustained involuntary somatic reflexes (hyperreflexia), clonus and painful muscle spasms. Severe spasticity may contribute to increased functional impairment, contractures, ulcers, posture disorders and pain. Treatment should start as soon as possible to prevent such negative effects. Keywords: tetraplegia, spinal cord injury, spasticity, pressure sores, traumatism, rehabilitation,
Introduction: Neurofibromatosis - type 1 (NF1) and type 2 (NF2) - are genetic disorders of the nervous system that can affect the growth and development of nerve cell tissue and so can determine severe or rather permanent sequels. NF2 implies usually multiple tumors on the cranial and spinal nerves and it is less common than NF1. The most frequent symptom of NF2 is hearing progressive loss, as a consequence of auditory nerves affection and appears at early ages or at twenties. The evolution of a patient with NF2 depends on the number and location of tumors and some of them might develop a life-threatening or disabling condition. With a prompt diagnosis and an appropriate therapy it can be improved the patient prognosis and QOL. Materials and Methods: This paper presents the case of a 43-year-old patient, with personal antecedents of hearing dysfunction, diagnosed in 2013 with neurofibromatosis that was hospitalized at the IV Neurosurgery Clinic of TEHBA in January 2019 and suffered a re-intervention for removal of the spinal cord tumor (psammomatous meningioma) and with spinal cord decompression. In our clinic, the patient was admitted for incomplete AIS/Frankel C paraplegia, he had initially followed a complex nursing program and subsequently a rehabilitation adequate program. The patient was assessed functionally using the following scales: AIS / Frankel, modified Ashworth, Functional Independence Measure (FIM), Life Quality Assessment (QOL), FAC International Scale, Independence Assessment Scale in Daily Activities (ADL / IADL), Walking Scale for Spinal Cord Injury (WISCI). Results: The paraclinical assessments (cerebral and spinal cord MRI) detect multiple cerebral tumors and micro-nodules adjacent to the lumbar spinal roots, which, associated with the bilateral acoustic neurinoma (diagnosed in 2013), contributed to the suspicion of the NF2 diagnosis. The patient had two admissions in our clinic division, benefited from a complex neuro-muscular rehabilitation program, having a favourable evolution, with an increase in the evaluated scales scores, now performing walking with a support from another person in walking frame, as well as sphincter re-education, with the neurogenic bladder remission. Conclusions: Even if there is no cure for neurofibromatosis and no standard treatment, it is important to promptly diagnose such a rare disease and to give an adequate treatment (AINS or other analgesic drugs, surgery, chemotherapy or radiation –when it’s needed, or psychotherapy) for controlling symptoms and also a personalized rehabilitation program (including nursing measures) enhancing including patient's quality of life. Key words: paraplegia, neurofibromatosis, neuro-muscular rehabilitation,
Introduction: gout is a chronic inflammatory arthropathy produced by depositing crystals of monosodium uric acid (in joints and tissues) following an anomaly (genetics or acquired) in the purine metabolism (1,2). The manifestations of the disease are: hyperuricemia, recurrent episodes of acute arthritis, the presence of tophi, chronic kidney disease, urinary lithiasis(2). Stroke represents„ the rapid development of localized or global clinical signs of cerebral dysfunction with symptoms exceeding 24 hours, leading to death, without any other cause, except for vascular origin”. (3) Materials and Methods: with the permission of the THEBA Ethics Commission ( no.17464/14.06.2019), we will present the clinical case of a 57-year-old patient admitted to the TEHBA Neuromuscular Recovery Clinic presenting a right hemiplegia and mixed aphasia after an ischemic stroke in the territory of the left middle cerebral artery, on the background of complex polypathology (monstrous gout arthropathy, chronic smoking, arterial hypertension, myocardial infarction with coronary artery stenosis, chronic kidney disease). Results: the patient did in our clinic a neuro-muscular recovery treatment, adapted to his needs,which consisted of kinetotherapy and speech therapy and received appropriate medical treatment. The clinical evolution of the patient was slowly favorable, with improvement in language disorders and motor control of paralyzed limbs. Conclusions: the case of this patient has several particularities. This is a patient with a vicious life style, with a severe arthropathy, with severe cardio-vascular sufferers, hospitalized for recovering neuro-muscular deficits after an ischemic stroke. Despite limited prognosis, the patient has improved ADL and the quality of life after recovery treatment. Key words: stroke, hemiplegia, poly-pathologic, ischemic,
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