On-going Rehabilitation Strategies for Refractory Myoclonus Following Hypoxic Brain Injury: A Case Report

Research Objectives: To describe the occupational, physical, and speech language therapy strategies along with pharmacologic interventions used to rehabilitate Refractory Myoclonus following Hypoxic Brain Injury

Design: Single-patient retrospective case report

Setting: Long-term acute care hospital located in Wallingford, Connecticut, USA

Participants: 25 year old male admitted for inpatient rehabilitation following hypoxic brain injury with presumed Lance Adams syndrome . The patient gave his written approval for the creation of this case report.

Interventions: Interdisciplinary approach that including daily occupational, physical, and speech therapies as well as pharmacologic intervention. The primary therapeutic focus in physical and occupational therapy was placed on improving patient strength, coordination, and postural stability; retraining gait and balance; and developing activity modification strategies. Additionally, he presented with dysphagia, dysarthria, and mild cognitive impairment which was addressed by his speech therapist

Main Outcome Measures: Manual muscle testing, grip strength, Berg Balance Scale, CMS data, Modified Barium Swallow (MBS), 9-Hole Peg Test, cognitive assessments, functional assist level

Results: Visual improvement as shown in recorded sessions. Clinically improved ambulation, swallowing, self-care, cognition, speech intelligibility, and strength. Since admission, his dysphagia has resolved and his cognition has improved for functionally for age and education level. Patient still under-going intensive rehab program at this time.

Conclusions: This unique case highlights the complex and significant rehabilitation needs a patient may require to regain independence after a diagnosis of Refractory Myoclonus Following Hypoxic Brain Injury.

Author(s) Disclosures: no disclosures