B. A. Dahlben, MS and D. Fleischmann, MD
- A 36-year-old man presented with a large epidural collection, shown on MRI to extend from C1-S5 and resulting in spinal canal narrowing (Figures 1-3). The patient was admitted for acute inpatient rehabilitation after neurosurgical treatment and stabilization s/p C7-T1, T7-8, L4-5 laminectomies.
- He presented with impaired mobility and activities of daily living, and reported moderate pain in the back and lower extremities, but without specific distribution, during PT/OT therapies.
- Throughout his 7-day length of stay, the patient was closely monitored for methicillin-susceptible S. aureus bacteremia, and he received IV oxacillin and oral rifampin. Active medical problems included bright red blood per rectum with a likely diagnosis of hemorrhoids, DVT prophylaxis, newly diagnosed Type 2 DM, and urinary retention.
- The patient was switched from straight to intermittent catheter, but inability to void was complicated by urinary tract infection (UTI). Voiding improved after UTI treatment with macrobid antibiotic.
Kara Maharay, M.S., CCC-SLP, BCS-S; Kelly Salmon, M.A., CCC-SLP, BCS-S, CLT-LANA; and Ronald S. Kaiser, Ph.D
Objective: Spinal Muscular Atrophy (SMA) is a genetic and degenerative motor neuron disease that affects muscle control including the muscles responsible for head and neck control and swallowing (Kesting, n. d.). There is limited research on the benefits of exercise as a therapeutic modality for people with Spinal Muscular Atrophy (SMA) (Swoboda et al., 2007) and no existing research specifically targeting pharyngeal or laryngeal strengthening to improve swallow function. As demonstrated by the positive outcome in this case study, speech-language pathologists should be aware that various modalities for dysphagia treatment such as biofeedback, neuromuscular electrical stimulation (NMES), and an exercise based approach in conjunction with compensatory strategies may be effective in the swallowing rehabilitation of patients with patients with SMA.