To investigate Botulinum toxin type B (BNT-B) injection's effect and duration depending on dose for patients with brain lesion.
Twenty one patients with brain lesion and severe drooling were included and divided into three groups. All patients received conventional dysphagia therapy. Group A patients (n=7) received an injection of 1,500 units and group B patients (n=7) received an injection of 2,500 units of BNT-B in submandibular gland under ultrasound guidance. Group C patients (n=7) received conventional dysphagia therapy. Saliva secretion was assessed quantitatively at baseline and at weeks 1, 2, 4, 8, and 12. The severity and frequency of drooling was assessed using the Drooling Quotient (DQ) by patients and/or caregivers.
Group A and B reported a distinct improvement of the symptoms within 2 weeks after BNT-B injection. Compared to the baseline, the mean amount of saliva decreased significantly throughout the study. However, there was no meaningful difference between the two groups. The greatest reductions were achieved at 2 weeks and lasted up to 8 weeks after BNT-B injection. Group C did not show any differences.
Local injection of 1,500 units of BNT-B into salivary glands under ultrasonic guidance proved to be a safe and effective dose for drooling in patient with brain lesion, as did 2,500 units.
Citations
Method: Sixteen stroke and traumatic brain injured subjects participated in this study. Electrical stimulation on the dermatome of spastic muscles was applied for 30 minutes a day for 4 weeks. Spasticity was quantified through the use of a relaxation index obtained from pendulum test and a amplitude and latency from knee tendon reflex test. The measurements were performed 6 times in treatment period. The data were analyzed by repeated measures one way ANOVA.
Results: Relaxation index was significantly increased in treatment period (p＜0.05). In each therapeutic stimulation session, relaxation index of post-stimulation was increased in comparison with that of pre-stimulation (p＜0.01). The amplitude of post-stimulation was significantly decreased in comparison with pre-stimulation status in each measurement session (p＜0.01). The latency of tendon reflex was not changed after stimulation.
Conclusion: These results showed that the electrical stimulation was useful method to decrease spasticity in patients with brain lesions. Further studies are needed to explore the effects of functional improvement and the long-lasting carryover effects on spasticity in electrical stimulation. (J Korean Acad Rehab Med 2003; 27: 27-32)
Objective: To verify the correlation between auditory event-related potential and Cognitive Capacity Screening Examination (CCSE) in patients with brain lesion.
Method: P300 study using an auditory paradigm was performed in thirty patients with brain lesion, age ranged from thirteen to seventy-three years-old, and then was compared with the score of CCSE.
Results: The mean latency of P300 was 383.07⁑50.63 msec. The mean score of CCSE was 17.10⁑8.62. There was no significant difference in P300 latency and score of CCSE between male and female, and among the types of brain lesion. There was significant negative correlation between P300 latency and score of CCSE (p＜0.05, r=0.686), between score of CCSE and age (p＜0.05, r=0.364). There was significantly high intra-rater reliability in P300 latency study (alpha=0.9771).
Conclusion: We conclude that P300 electrodiagnostic study is useful for reflection of cognitive function in patients with brain lesion.
The purpose of this study is to clarify the clinical usefulness of Computerized Balance Evaluation and Training System(COBETS) in treating the patients with balance disturbance. Twenty- three patients who received rehabilitative management due to their balance disturbance after brain damage were treated either by conventional physical therapy(PT) or by visual biofeedback balance training(VBBT) using COBETS for 4 weeks. The static and dynamic postural balance were evaluated at pre- and post-treatment conditions using COBETS balance assessment software. The neurologic and functional assessment and somatosensory evoked potential study were performed as well.
Comparing with the control group, the patients treated by VBBT showed significantly improved static and dynamic postural control.
Visual perceptual dysfunction in stroke patients causes a failure in activties of daily living and learning. Therefore, the correct diagnosis and remediation of visual perceptual dysfunction are important.
Since the mechanism of visual perception is not well studied, it is difficult to treat visual perceptual dysfunction effectively. In this study, we tried to correlate visual perceptual dysfunction with anatomical lesion of brain for the use of visual perceptual training.
We assesed the visual perception and the brain lesions of fiftroke patients, with Motor-Free Visual Perception Test(MVPT), and brain computerized tommography respectively. The visual responses of contralateral side of the lesions were diminished. The raw score of MVPT was low in patients with lesions in both parietal and, right temporal lobes. The right parietal lobe lesions correlated with tests for figure-ground and visual closure, and the left parietal lobe lesions with visual processing time.
The result suggests that the right parietal lobe has an important role in visual perceptions. The right temporal, and the left parietal lobes as well as the subcortex of both hemisphere also has significant roles in visual perceptions.
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