Laura Lee

Poster 400: Central Conus Medullaris Infarction After Thoracic Aortic Tear Repair: A Case Report

C4 ASIA D spinal cord injury (SCI) initially managed with C3-C7 laminectomy. Program Description: The patient presented to outpatient clinic reporting increased weakness in elbow flexors and deltoids, as well as neck and bilateral upper extremity pain. He reported symptom onset 1 week before presentation after “sleeping wrong” one night. Full baseline motor examination was not available to substantiate his complaints. MRI revealed persistent, severe central stenosis at C4/C5, facet arthropathy, and multilevel degenerative changes. EMG/NCS showed evidence of bilateral severe, acute C5/C6 radiculopathies. Setting: Tertiary care hospital. Results: The patient was referred to neurosurgery clinic, but surgical intervention was not recommended. He received physical therapy for upper extremity strengthening and gabapentin for neuropathic pain. His pain has improved, and weakness has remained stable. Discussion: A radiculopathy is a condition resulting from pathologic processes affecting the spinal nerve root and is most commonly caused by a herniated nucleus pulposus or spondylosis. Cervical radiculopathy should be considered in patients who present with extremity pain and weakness. Patients with SCI should be monitored for changes in motor and sensory function. The incidence of cervical radiculopathy in individuals with traumatic SCI after surgical intervention is unknown. However, a study by Greiner-Perth in 2005 examined 121 patients who underwent cervical corpectomies for spondylotic myelopathy. 8.2% developed symptoms of C5 and/or C6 radiculopathies with only 3 subjects developing bilateral symptoms. This case is the first report in the literature of bilateral, acute C5/C6 radiculopathies in the postacute phase in a patient with incomplete tetraplegia. Conclusions: Although it is important to initially consider diagnoses that more commonly cause pain and weakness, such as syringomyelia and rotator cuff pathology, the differential for upper extremity weakness and pain in this patient population should include nerve root compression, resulting in cervical radiculopathy.

Poster 192: Assessing Resident and Attending Physicians' Perceptions of Educational Value of Inpatient Rehabilitation Activities

nication skills to be within functional limits as per the Cognitive-Linguistic QUICK Test. The patient’s speech was characterized by dysrhythmic phonations, interjections, and part-word/whole-word repetitions ranging from 3 to 16 repetitions per syllable/word within all syllable positions and within all word classes. Fluency characteristics remained consistent throughout a variety of speech tasks ranging from automatic speech, repetition, reading, singing, and pacing/ masking techniques. These dysfluencies were accompanied by secondary physical concomitants such as eye blinks, head movements, and excessive tension of the facial/laryngeal region musculature. In addition, the patient presented with severe apraxia exhibiting reduced lingual coordination and agility. She exhibited no anxiety regarding dysfluencies. Setting: Free-standing rehabilitation hospital. Results: The patient received outpatient speech therapy services for 5 months. Therapy techniques focused upon facial/body relaxation, respiratory exercises, oral motor exercises, and use of “slow smooth easy speech” fluency strategies. She is currently 100% intelligible in conversation with 0-1 dysfluencies in a 60-minute timeframe. Conclusions: This is a rare case of neurogenic stuttering following onset of migraine.

Poster 315: Coding Tendencies by Physiatrists in One Academic Department: Safety in the Middle

HOMA and endothelial adhesion molecule levels in overweight young adults in 8 weeks. A potential mechanism to explain this finding is the reduction in oxidative stress by AOX. Long-term studies are needed to determine whether or not AOX are effective in actually suppressing diabetes or vascular activation over time. This intervention may be useful in the short term to help suppress propagation of diabetic and cardiovascular disease processes and subsequent disability in the overweight individual.