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PT 7326 Neuroanatomy Case Study - Wikispaces：Pt 7326神经解剖学案例研究——Wikispaces
S S Case Study IV Joni Williamson Sean Hester Examination Mrs. Jenkins 29 y/o female Lives with her husband and 1 small child Stay at home mom MOI: unknown PT needed due to limited mobility PMH: ED visit 2 days ago, sent home on Vicodin, recently recovered from flu Right hand dominant Examination Physical Examination: AO x 3 Vitals elevated due to obvious pain Peripheral pulses intact Appears well-nourished and stated age Altered facial expressions Examination Neurologic Examination: Cranial nerves intact Short term memory deficits found Neurological Exam Motor Systems: R UE – STR 2/5 with spasticity L UE – STR 4/5 with normal tone R LE – STR 2-/5 with spasticity L LE – STR 4/5 with normal tone DTR: R – hyperreflexia L - WNL Neurological Exam Sensation: Light touch test: Pain elicited with dull (non-noxious) stimulus Further sensory is contraindicated due to hypersensitivity of pain. Pathology THALAMIC SYNDROME- from a CVA to the posterior cerebral artery. Thalamic pain due to spinothalamic, VPL/VPM damage Contralateral hemiparesis due to interuption of the corticospinal tract Emotional/behavioral issues- due to motor involvement in the face Choreaathetoid movements Evaluation: Disablement Model Pathology- Thalamic Syndrome Impairment- Decrease strength of R UE and R LE Functional Limitation- pt is unable to ambulate Disablity-pt can’t ambulate at home to take care of her child Prognosis The overall prognosis for this patient is fair. The strength in the UE and LE can be increased, but the ultimate success depends on the ability to control the pain that will be everlasting. Intervention Pain control Gate training Strength training Stretching ROM Pt and caregiver education Aquatic Therapy Interventions There is no surgical treatment for this syndrome. A multidisciplinary approach will be needed to treat the patient. Pain medications (prescribed and NSAIDS) have been used to manage the pain as best as possible. In some cases medicinal marijuana is prescri
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