SP-3-02-F-03
INVESTIGATION OF REMEDIATING STRATEGIES IN A PATIENT WITH A NON-PROGRESSIVE SEMANTIC MEMORY IMPAIRMENT
Hiroyoshi Hara (Aizawa Hospital, Matsumoto, Japan) Toshiko S. Watamori (Hiroshima Prefectual College of Health and Welfare, Mihara, Japan)
Subject: The subject was a 22 year-old male, who showed severe impairment in semantic memory in spite of a relatively intact episodic memory, which was caused by a left temporal lobe contusion.
Method: A comprehensive examination of semantic memory, consisting of the naming of pictured objects, giving definitions of words, reading kanji (logographic / morphographic symbols of Chinese origin), category sorting of words, category fluency, and drawing living and man-made objects, was administered. In an effort to remediate his semantic memory impairment, two types of therapy trials were given: 1) utilization of visual imagery, and 2) utilization of external memory aids.
Result: The subject showed profound difficulties in all the semantic tasks, except for category sorting. After a year of therapy, he failed to acquire general knowledge through repeated learning trials using the visual imagery method. However, he was able to acquire new information which was relevant to his personal life. He was also able to learn the use of an electronic external aid, which helps to retrieve phonological representation of kanji words.
Conclusion: Although there has been considerable interest in memory rehabilitation, the remediation strategies and natutral history of non-progressive semantic memory impairments have not been reported on thus far. The subject reported in this study had a relatively pure case of non-progressive semantic memory impairment. Further investigation is necessary in order to delineate effective strategies for such an impairment, but personalization of information and the use of external aids appear to be promising.
S-3-07-01
PAIN REHABILITATION: A MULTIDISCIPLINARY APPROACH.
Satiko Tomikawa Imamura. Division of Physical Medicine, Institute of Orthopedics and Traumatology, Sao Paulo School of Medicine, Sao Paulo, BRAZIL.
Management of chronic incapacitating pain requires a multidisciplinary approach, integrated into a comprehensive treatment program. Adequate detailed clinical evaluation includes physiatric, neurologic, orthopedic, rheumatologic and psychosocial examination. Pain rehabilitation program should begin with the search for the underlying etiologic factor, in order to remove it. Clinical experience has demonstrated that most patients with chronic pain present primary or secondary muscle involvement which must be correctly diagnosed and treated. Conservative treatment with physical medicine and rehabilitation procedures including inactivation of myofascial trigger points and tender spots by needling and infiltration, electrical stimulation, ice packs, heat, Ryodoraku electroacupuncture associated with tricyclic antidepressants, phenothiazines and non steroid anti-infiamatory drugs are employed. Relaxation exercises should be performed before and after stretching and strengthening of key muscles in a regular and active rather than passive basis. In those patients without symptomatic relief of pain with conservative treatment, spinal cord stimulation with epidural electrodes, lumbar epidural infusion of morphine among other neurosurgical interventions are indicated for the relief of pain and should be followed by an adequate rehabilitation program aiming functional recovery. The therapeutic approach provided satisfactory results in patients with failed back surgery, cumulative trauma disorder, complex regional pain syndrome among other chronic painful conditions.
