Holistic Approach for Intervention in Geriatric Male Patient with Parkinson’s Disease: A Case Study

 

Abstract

Parkinson’s disease (PD) occurs most often in the people in their 50’s and 60’s. Hypokinetic dysarthria has been reported to occur in 73% of the patients suffering from PD [1]. The disease is closely related to cognitive difficulties such as impaired attention, disorganized thinking, inefficient processing of abstract new/old information. Speech Language Pathologist’s (SLP) role in the intervention of individuals with PD is not limited to working upon speech impairment but also improving various cognitive functions. This case study reflects the importance of inter-professional collaboration between neurologist, SLP along with other professionals and training of caretaker which plays a crucial role in intervention of individual with Parkinson’s disease. Also, SLP’s focus upon cognitive linguistic deficits, augmentative communication method and communication enhancement strategies could result in achieving communication goals.

 

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A Single Dose of Metoclopramide Associated with Extrapyramidal Symptoms in a Child: A Case Report

 

Abstract

A case of postoperative extrapyramidal symptoms is reported. A healthy 10-year-old boy was admitted to our hospital due to tonsillitis and adenoid hypertrophy pending tonsillectomy and adenoidectomy. A single dose of metoclopramide was given following an episode of vomit that occurred approximately 20 hours postoperatively. One hour subsequent to the administration of metoclopramide the patient developed fever, facial flushing, diaphoresis, headache, increased muscle rigidity, autonomic instability and altered level of consciousness. The clinical manifestations were present for approximately 22 hours. The patient received naloxone and symptomatic therapy and after 24 hours was fully recovered without complication. The ability of dopamine antagonist agents, including metoclopramide to precipitate extrapyramidal symptoms and drugs induced movement disorder is discussed [1]. These extrapyramidal and autonomic symptoms will be discussed as the early recognition of dystonia and/or akathisia by anesthetic personnel following the administration of metoclopramide is of great value for the punctual treatment of these conditions.

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