scholarly journals Repeated Clinical Assessment Using Sensory Modality Assessment and Rehabilitation Technique for Diagnosis in Prolonged Disorders of Consciousness

2021 ◽  
Vol 15 ◽  
Author(s):  
Liliana da Conceição Teixeira ◽  
Danielle Blacker ◽  
Carlos Campos ◽  
Carolina Garrett ◽  
Sophie Duport ◽  
...  

Purpose: The recommended way to assess consciousness in prolonged disorders of consciousness is to observe the patient’s responses to sensory stimulation. Multiple assessment sessions have to be completed in order to reach a correct diagnosis. There is, however, a lack of data on how many sessions are sufficient for validity and reliability. The aim of this study was to identify the number of Sensory Modality Assessment and Rehabilitation Technique (SMART) assessment sessions needed to reach a reliable diagnosis. A secondary objective was to identify which sensory stimulation modalities are more useful to reach a diagnosis.Materials and Methods: A retrospective analysis of all the adult patients (who received a SMART assessment) admitted to a specialist brain injury unit over the course of 4 years was conducted (n = 35). An independent rater analyzed the SMART levels for each modality and session and provided a suggestive diagnosis based on the highest SMART level per session.Results: For the vast majority of patients between 5 and 6 sessions was sufficient to reach the final clinical diagnosis. The visual, auditory, tactile, and motor function modalities were found to be more associated with the final diagnosis than the olfactory and gustatory modalities.Conclusion: These findings provide for the first time a rationale for optimizing the time spent on assessing patients using SMART.

2012 ◽  
Vol 13 (3) ◽  
pp. 285-315 ◽  
Author(s):  
Emmah J. Doig ◽  
Amanda T. Lane-Brown

Objectives: To summarise available evidence for responsiveness of six key assessments used with patients with disorders of consciousness: Coma Recovery Scale – Revised (CRS-R), Disorders Of Consciousness Scale (DOCS), Sensory Modality Assessment and Rehabilitation Technique (SMART), Sensory Stimulation Assessment Measure (SSAM), Wessex Head Injury Matrix (WHIM), and the Western Neuro Sensory Stimulation Profile (WNSSP).Method: A literature search of five electronic databases was conducted using a systematic search strategy. Relevant literature was evaluated and pertinent information extracted.Results: Database searches using key terms initially yielded 132 articles. Following review for inclusion identified 24 articles. No studies were specifically designed to investigate responsiveness of any of the measures and therefore responsiveness data were either based on statistical significance of change post-treatment or descriptive analysis of change scores. The majority of studies identified used the CRS-R (n= 11), WHIM (n= 5) and WNSSP (n= 6) and have established responsiveness to change. There is some preliminary evidence for the responsiveness of the other measures, based on very few available studies: DOCS (n= 2), SMART (n= 1) or SSAM (n= 1).Conclusion: Future studies should seek to include responsiveness analysis, particularly in relation to the DOCS, SMART and SSAM.


2021 ◽  
pp. 251660852098429
Author(s):  
Dorcas B. C. Gandhi ◽  
Ivy Anne Sebastian ◽  
Komal Bhanot

Sensory dysfunction is one of the common impairments that occurs post stroke. With sensory changes in all modalities, it also affects the quality of life and incites suicidal thoughts. The article attempts to review and describe the current evidence of various approaches of assessment and rehabilitation for post-stroke sensory dysfunction. After extensive electronic database search across Medline, Embase, EBSCO, and Cochrane library, it generated 2433 results. After screening according to inclusion and exclusion criteria, we included 11 studies. We categorized data based on type of sensory deficits and prevalence, role of sensory system on motor behavior, type of intervention, sensory modality targeted, and dosage of intervention and outcome measures used for rehabilitation. Results found the strong evidence of involvement of primary and secondary motor areas involved in processing and responding to somatosensation, respectively. We divided rehabilitation approaches into sensory stimulation approach and sensory retraining approach focused on using external stimuli and relearning, respectively. However, with varied aims and targeted sensory involvement, the study applicability is affected. Thus, this emerges the need of extensive research in future for evidence-based practice of assessments and rehabilitation on post-stroke sensory rehabilitation.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mona Abdel-Fattah Hegazi ◽  
Aya Mohammed Saad ◽  
Mona Sameeh Khodeir

Abstract Background Lipreading is considered an important skill that varies considerably among normal-hearing (NH) and hearing-impaired (HI) children. It is well known that normal-hearing children use audition as the primary sensory modality for speech perception, whereas HI children use lipreading cues as the primary sensory modality for speech perception. Moreover, speech perception is a multisensory process that involves attention to auditory signals as well as visual articulatory movements, and the integration of auditory and visual signals occurs naturally and automatically in normal individuals of all ages. Most researches proved that lipreading is a natural and important skill needed for language acquisition in HI children. Lipreading also helps HI children to perceive speech, acquire spoken language, and acquire phonology. In the Arabic language, tools are deficient for assessing the lipreading ability for HI children, so this study was conducted to develop a test suitable for assessing the lipreading ability of hearing-impaired children among Arabic-speaking countries. The constructed lipreading test was administered to 160 Arabic-speaking Egyptian children including 100 typically developing NH children and 60 HI children. Participants’ responses were statistically analyzed to assess the validity and reliability and to compare the lipreading ability between the NH and HI children. Ranks of percentiles were established to provide an estimate of the lipreading ability in children. Results Statistically significant differences were found between the normal-hearing and HI children as regards all subtotal and total scores of the Arabic lipreading test, with good validity and reliability of the test. Conclusions The Arabic lipreading test is a valid and reliable test that can be applied to assess the lipreading ability among Arabic-speaking children with HI.


2021 ◽  
Vol 14 (9) ◽  
pp. e243574
Author(s):  
Salini Sumangala ◽  
Thidar Htwe ◽  
Yousuf Ansari ◽  
Lidia Martinez- Alvarez

Primary central nervous system lymphoma (PCNSL) is infrequent and often poses diagnostic conundrums due to its protean manifestations. We present the case of a South Asian young man presenting with raised intracranial pressure and a lymphocytic cerebrospinal fluid (CSF) with pronounced hypoglycorrhachia. Progression of the neuro-ophthalmic signs while on early stages of antitubercular treatment led to additional investigations that produced a final diagnosis of primary leptomeningeal lymphoma. Treatment with chemoimmunotherapy (methotrexate, cytarabine, thiotepa and rituximab (MATRix)) achieved full radiological remission followed by successful autologous transplant. This case highlights the difficulties and diagnostic dilemmas when PCNSL presents as a chronic meningeal infiltrative process. While contextually this CSF is most often indicative of central nervous system tuberculosis and justifies empirical treatment initiation alone, it is essential to include differential diagnoses in the investigation work-up, which also carry poor prognosis without timely treatment. High suspicion, multidisciplinary collaboration and appropriate CSF analysis were the key for a correct diagnosis.


2016 ◽  
Vol 12 (3) ◽  
pp. 840 ◽  
Author(s):  
Adrián Pastor-Barceló ◽  
Vicente Prado-Gascó ◽  
Pilar Bustillo-Casero

Purpose: This research focuses on the construction and validation of a scale designed to assess the quality of the supervised classes: Interaction on Supervised Classes Scale (ISCS).Design/methodology/approach: This is a descriptive correlational study. For the construction of the scale three phases were performed in which different experts assessed the adequacy of the items. Finally, the psychometric properties of the final version were studied in a sample of 314 consumers (69.1% women) aged between 18 and 77 with an average of 39.33 years (SD=12.25).Findings: The scale presents adequate validity and reliability, being a useful tool for measuring the interaction in Supervised Classes.Research limitations/implications: The sampling, non-probabilistic or convenience, have taken the sample of a unique sports facility and the small sample size.Practical implications: The ISCS allows managers to receive better feedback, allowing them to obtain deeper insight into the quality and satisfaction of the service. According to its results, the managers may implement different strategies to improve quality in a key service within sports centers.Originality/value: For the first time the interaction between customers and between customers and employees is evaluated both inside and outside the center, a topic that had not yet been studied in the scientific literature. The scale can be applied to any type of directed activity, and will allow a greater understanding of the quality of service.


1998 ◽  
Vol 56 (2) ◽  
pp. 176-183
Author(s):  
AFONSO CARLOS NEVES ◽  
RICARDO DE CASTRO CINTRA SESSO ◽  
HENRIQUE BALLALAI FERRAZ ◽  
SÍLVIO FRANCISCO ◽  
JOÃO BAPTISTA DOS REIS-FILHO

We evaluated the initial and final diagnosis of 80 patients with delirium arriving at the emergence unit of a university hospital in a large Brazilian city over a period of 30 months up to December 1991. The diagnosis was based on the DSM-IIIR criteria. Patients with a known history of head trauma or epileptic seizure and patients younger than 13 years were excluded. Only patients with a disease of up to 7 days were included.The patients were subdivided into four etiologic groups: vascular; associated with the use of alcohol; infectious-parasitic; miscellaneous.The results showed a rate of correct diagnosis ranging from 65 to 80% with the use of kappa test (standard good to excelent). Sensitivity, specificity, positive predictive and negative predictive values had results showing different conditions for initial diagnosis in each group. This study can help the initial diagnosis of delirium and the choice for diagnostic testing.


2019 ◽  
Vol 3 (01) ◽  
pp. 20-23
Author(s):  
Tasneem Ara ◽  
Qazi Smita Haque ◽  
Salma Afrose

Congenital heart diseases are common cause of congenital cyanosis with polycythaemia. Congenital methemoglobinemia is a rare cause of lifelong cyanosis with polycythemia. Congenital methemoglobinemia is caused either by enzyme deficiency or by an abnormal Hb (Hb M). Asymptomatic despite presence of severe cyanosis indicates this rare disorder. We are reporting a rare case of polycythemia with cyanosis due to congenital methemoglobinemia. The patient was referred to our centre and attended Hematology OPD (out-patient department) when his routine CBC revealed erythrocytosis. At that time, we found him severely cyanosed especially apparent on lips, tongue, hands and feet. He was diagnosed as a case of congenital methemoglobinemia with 38% blood methemoglobin level (normal value-0.00-2.00%). On view of life long persistent cyanosis, without any cardiopulmonary and neurological abnormality, consanguinity of parent’s marriage, dark colored blood with high methemoglobin level, a final diagnosis of Type I enzyme deficiency congenital methemoglobinemia was made. He was treated with oral ascorbic acid 250 mg twice daily. At follow up after 6 months his skin color improved and RBC count returned to normal. We are reporting this case of congenital methemoglobinemia for the first time in Bangladesh to emphasize the importance of this rare entity in the differential diagnosis of asymptomatic cyanosis with polycythemia.


2018 ◽  
Vol 143 (06) ◽  
pp. 427-430
Author(s):  
Christoph Niemietz ◽  
Christoph Röcken ◽  
Matthias Schilling ◽  
Jörg Stypman ◽  
Constantin Uhlig ◽  
...  

AbstractTransthyretin-related Familial Amyloid Polyneuropathy (ATTR Amyloidosis, former FAP, here called TTR-FAP) is a rare, progressive autosomal dominant inherited amyloid disease ending fatal within 5 – 15 years after final diagnosis. TTR-FAP is caused by mutations of transthyretin (TTR), which forms amyloid fibrils affecting peripheral and autonomic nerves, the heart and other organs. Due to the phenotypic heterogeneity and partly not specific enough clinical symptoms, diagnosis of TTR-FAP can be complicated. False diagnoses can include idiopathic polyneuropathy, chronic inflammatory demyelinating polyneuropathy, diabetic neuropathy as well as paraneoplastic syndrome. Hence, it is assumed that many cases remain unreported. Early and correct diagnosis of TTR-FAP is crucial, since appropriate therapeutic options exist. TTR-FAP should always be differentially diagnosed, when apart from a progressive peripheral polyneuropathy, additional symptoms as autonomic dysfunction, cardiomyopathy, gastrointestinal disorders, unexpected loss of weight, carpal tunnel syndrome, restrictions of renal function, epileptic fits, and corneal and vitreous body clouding occur. Histological evidence of amyloid and successive immunohistochemical evidence of transthyretin as well as genetic testing for transthyretin mutations, lead to an accurate diagnosis.


2018 ◽  
pp. 116-118
Author(s):  
M.V. Makarenko ◽  
◽  
D.O. Govseyev ◽  
S.V. Gridchin ◽  
N.H. Isaeva ◽  
...  

Desmoid tumors (also called desmoids fibromatosis) are rare slow growing benign and musculoaponeurotic tumors. Although these tumors have a propensity to invade surrounding tissues, they are not malignant. These tumors are associated with women of fertile age, especially during and after pregnancy and postoperative surgeries. Our clinical case is interesting because of the rarity of the pathology and the difficulties in setting the correct diagnosis. The patient, with a history of laparoscopic myomectomy (2012), was preparing for a routine surgery for the endometrioma of the anterior abdominal wall, according to the results of the ultrasound and computed tomography. After surgical treatment, the final diagnosis was changed, based on the histological findings. Key words: desmoid tumor, abdominal wall tumor, fibroid.


2020 ◽  
Vol 30 (8) ◽  
pp. 4410-4423
Author(s):  
You Li ◽  
Carol Seger ◽  
Qi Chen ◽  
Lei Mo

Abstract Humans are able to categorize things they encounter in the world (e.g., a cat) by integrating multisensory information from the auditory and visual modalities with ease and speed. However, how the brain learns multisensory categories remains elusive. The present study used functional magnetic resonance imaging to investigate, for the first time, the neural mechanisms underpinning multisensory information-integration (II) category learning. A sensory-modality-general network, including the left insula, right inferior frontal gyrus (IFG), supplementary motor area, left precentral gyrus, bilateral parietal cortex, and right caudate and globus pallidus, was recruited for II categorization, regardless of whether the information came from a single modality or from multiple modalities. Putamen activity was higher in correct categorization than incorrect categorization. Critically, the left IFG and left body and tail of the caudate were activated in multisensory II categorization but not in unisensory II categorization, which suggests this network plays a specific role in integrating multisensory information during category learning. The present results extend our understanding of the role of the left IFG in multisensory processing from the linguistic domain to a broader role in audiovisual learning.


Sign in / Sign up

Export Citation Format

Share Document