Interesting Case

Hi guys,
Well, here we are on our last blog, and our last clinic.

My last week was an interesting one, where I was given one more new patient to see.

He is middle aged aboringinal man who sufferred a bilateral cerebellar infarct 3/12 ago, and has just been admitted with a R MCA. He is dysarthric, and is not accustomed to our lifestyle and therefore feels very apprehensive regarding what we want to do with him.

The learning experience for me is that, at uni, we learn the treatment for different infarcts, not a combination of them.

this man is extremely ataxic in his R UL, R LL, and trunk. To add to this he has L hemiparesis, with very little movement in his L UL and L LL (gowland 2 and 3 respectively).

His sitting balance requires close S/V when he uses his R UL for support, and a 1 mod A with no UL support, as he is very ataxic through his trunk.

Now, this is where your comments/ideas will help. I have decided to address his ataxia issues (trunk and R UL) prior to addressing his hemiparesis primarily. My reasoning is this: I feel that without a decent stable base to move from, he will not be able to move properly. I have given him some bed exercises regarding his L limbs to assist in rehab, but have focused primarily on his sitting balance and ataxic imparments.

I could go on and on about this patient, as i did find his case and culture background very interesting, and unfortunately I will not get to continue with his rehab.

He was progressing well, and we had started standing balance ex with him.

Good luck for the PCR's guys, we all will be FINE!