アトピー性脊髄炎による運動障害に対するリハビリテーション

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  • The Rehabilitation of a Patient with Several Symptoms Associated with Atopic Myelitis
  • 症例報告 アトピー性脊髄炎による運動障害に対するリハビリテーション
  • ショウレイ ホウコク アトピーセイ セキズイエン ニ ヨル ウンドウ ショウガイ ニ タイスル リハビリテーション

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We report a patient displaying several symptoms of myelitis associated with atopic dermatitis. The patient, a 35-year-old female, initially suffered from gait titubation that gradually developed into motor disturbance. She underwent many tests (blood, cerebrospinal fluid, electromyography, and brain, cervical, and lumbar spinal cord and muscle MRIs) at several hospitals, including a university institution, over the course of two years until she finally came to our hospital. However, her disease was never identified by these tests, and she was referred to our hospital to start rehabilitation for her disability which was believed to be caused by disuse syndrome. On first examination, muscle hypertonia of both legs, hypoesthesia of all extremities, difficulty sitting, and a low performance level of ADL were observed. Judging by the factors (e.g. age, neurological symptoms), we considered that the patient was not suffering disuse syndrome, and recommended that she attend another medical college hospital for a thorough investigation. The disease was finally diagnosed as atopic myelitis, as indicated by the test results (e.g. hyperIgEemia). She could sit without a back rest and undertake gait training between parallel bars after steroid pulse therapy at the hospital. While she undertook rehabilitation at our hospital, we applied some approaches to adapt to her fluctuating symptoms (e.g. making short leg braces for both legs, injection of botulinum toxin A (BOTOX®) in the leg). We recognized we should gather as much information as possible given the rarity of the disease.

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