No abstract

Focal dystonia (FD) can develop after thalamic lesions. Abnormal somatic sensations were argued to be responsible for FD. Our patient experienced FD-like movement disorders, agraphesthesia, and a reduced sense of shear force on the skin and pressure to deep tissues of the right upper limb following a small infarction in the left posterolateral thalamus. FD-like symptoms improved while the skin was being pulled or the deep tissue was being pushed in a manner proportional to the strength of muscle contractions. Therefore, the lack of these sensations was suggested to be related to FD-like symptoms.

[Purpose] To clarify the factors behind a case who had strong anxiety about returning home despite being largely independent in daily living behavior. [Subjects and Methods] A patient with Wallenberg syndrome due to medullary infarction of the pons, in addition to general physical therapy evaluations was evaluated weekly over about 150 days from hospital admission to discharge with the 10m walk test (1), and for feelings of self-efficacy (2), anxiety and depression (3), and condition-characteristic anxiety (4).[Results] Negative correlations were found between the 10m walk test and anxiety/state anxiety, and between feelings of self-efficacy and items 3 and 4, and a positive correlation was found between the 10m walk test and self-efficacy. In addition, the activities of daily living that the subject could perform increased with prolongation of the single leg standing time.[Conclusion] The results suggest that when cases don't show enough improvement in physical and psychological abilities for discharge from hospital, it may be necessary to devise interventions focusing on psychological aspects and vestibular function.