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Rehabilitation Practice and Science

Translated Title

脊髓萎縮症之診斷及治療︰一病例報告

Abstract

This is a case of a 64-year-old male with difficulty in ambulation for 40 years. Physical examination revealed a defect in vibration and positional sense over the lower extremities. Muscle power of the upper extremities was normal. The lower extremities could still resist force, but there was a little atrophic change in the quadriceps muscle and weakness over the iliopsoas muscle.Laboratory data were all negative, including CSF, routine blood, urine and stool specimens. However, MRI revealed hypertrophy of the ligamentum flavum with spinal cord compression. CT with myelogram revealed T2-T10 spinal cord atrophy. SSEP revealed T-myelopathy. EMG revealed upper motor neuron disease. The etiology is related to spinal cord compression over T10-T12 by the ligamentum flavum. Wallerian degeneration developed, so spinal cord atrophy (posterior column) was found mainly over T2-T10. Surgery is mainly applied only in the acute stage, but this is a chronic case of posterior column ataxia including position sense, tactile and kinaesthesia defect. The protocol for rehabilitation in this type of case involvse training the patient to ambulate with greater reliance on his sense of sight and to be aware of the position of his feet. Training also aims at improving the patient's sense of space. In addition, balance training and ambulation assistance devices should be emphasized.

Language

Traditional Chinese

First Page

199

Last Page

203

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