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KMID : 1012020230120030207
Physical Therapy Rehabilitation Science
2023 Volume.12 No. 3 p.207 ~ p.213
Isolated Bilateral Midbrain Infarction in A Healthy Female Adolescent: A Case Report
Yoo Dong-Ho

Lee Byung-Hoon
Shin Yong-Beom
Sheena Shamoon
Yoon Jin-A
Kim Sang-Hun
Abstract
Objective : The purpose of this study was to understand the complex anatomical structure and function of the midbrain to better understand the patient¡¯s symptoms and plan effective treatment including pharmacological and rehabilitation interventions.

Design : A single case study

Methods : A 17-year-old girl presented with acute onset of drowsiness, gait disturbance, mutism, and ptosis. Physical examination revealed postural instability, rigidity of all limbs, and limitations in extraocular movement. The brain MRI revealed an isolated acute infarction in the bilateral midbrain. Considering the location of the infarction, the presenting symptoms were the result of an impairment of the dopaminergic pathway in addition to lesions in the nuclei of the oculomotor nerve. Levodopa/carbidopa was prescribed. And the intensive and comprehensive rehabilitation program was done.

Results : As a result of the study, through comprehensive intervention, which encompassed assessments such as the manual muscle test, Korean Modified Barthel Index score, and Trail-making test, significant enhancements in the patient's condition were observed. These findings provide evidence supporting the effectiveness of the intervention in promoting the patient's physical functioning and overall well-being.

Conclusions : The results of this case highlight the significance of comprehending the intricate anatomical structure and functional aspects of the midbrain, which led us to approach appropriate pharmacological and rehabilitation interventions. Through active communication among the medical team, we were able to establish a therapeutic plan, which demonstrated that effective treatment can be achieved.
KEYWORD
Ischemic Stroke, Midbrain, Rehabilitation, Dopamine
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