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PT 7326 Neuroanatomy Case Study V. Will Herritage Brittany Montgomery Ryan Griggs. Examination. Mrs. Margarita 45 y/o Professor at University of Texas Recovering Alcoholic Stopped by Austin Police Dept for staggering gait after football game Saturday night. Examination Cont.
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PT 7326 NeuroanatomyCase Study V Will Herritage Brittany Montgomery Ryan Griggs
Examination Mrs. Margarita 45 y/o Professor at University of Texas Recovering Alcoholic Stopped by Austin Police Dept for staggering gait after football game Saturday night.
Examination Cont. Physical Examination A&O x 3 Muscular, well nourished, well hydrated and appears stated age BP, HR, and respirations slightly elevated Peripheral pulses intact Sober
Examination Cont. Neurologic Examination • Sensations- WNL • Memory & Cognition- WNL • Cranial Nerves Intact • CN III, IV, VI- Normal • Rule Out Wernicke-Korsakoff
Examination Cont. Motor Exam • All LE strength 2/5 • All UE strength 4/5 • LE exhibits hypotonia • Reflexes L3/L4- Diminished S1/S2- Diminished UE- WNL
Examination Cont Neuromuscular Exam (+) Dysdiadochokinesia of LE (+) Dysmetria of LE (+) Ataxia (+) Romberg
Pathology Anterior Lobe Syndrome Impacts vermis & intermediate zones of cerebellum Chronic alcoholics Broad-based, staggering gait General ataxia of leg movements, even when the trunk is supported.
Evaluation: Disablement Model Pathology – Anterior Lobe Syndrome Impairment – Ataxic gait Functional Limitation – pt unable to amb safely to office, classroom, house Disability – pt unable to perform work, home, & social responsibilities
Prognosis The prognosis is fair. The gait disturbance usually develops over several weeks, but may be relatively mild for some time. Continued alcohol consumption will worsen the condition.
GOALS • LTG 1: Pt. will amb ↕ 15 stairs s ataxic gait to access office in 6 wks. • STG: Pt. will amb ↕ 8 stairs s AD in 3 wks. • LTG 2: Pt. will amb 150 ft on level surfaces s AD to get to AA meetings in 6 wks. • STG: Pt. to amb 75 ft on level surface c AD in 3 wks.
APTA Practice Pattern 5E: Impaired Motor Function and Sensory Integrity Associated With Progressive Disorders of the Central Nervous System
PT Intervention • Gait & locomotion training • Balance, coordination, and agility training • Body mechanics & postural stabilization • Flexibility exercises • Aerobic and endurance conditioning • Pt and family education • AA meetings, sponsor, home evaluation • Very Important