Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
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Isolated Bilateral Midbrain Infarction in A Healthy Female Adolescent: A Case Report

  • Dong Ho Yoo (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Byunghoon Lee (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital) ;
  • Yong Beom Shin (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine) ;
  • Myung-Jun Shin (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine) ;
  • Jin A Yoon (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital and Pusan National University School of Medicine) ;
  • Sang Hun Kim (Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital)
  • Received : 2023.06.15
  • Accepted : 2023.08.28
  • Published : 2023.09.30
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Abstract

Objective: The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient's symptoms and plan effective treatment including pharmacological and rehabilitation interventions. Design: A single case study Methods: A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done. Results: As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being. Conclusions: The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.

Keywords

Acknowledgement

This work was supported by clinical research grant from Pusan National University Hospital in 2022.

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