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梗塞性腦中風病人接受重複經顱磁刺激術個案報告

The improvement of fingers fine movement in an ischemic stroke patient received repetitive transcranial magnetic stimulation: a case report

摘要


梗塞性腦中風主要是因腦血管的血流阻礙導致腦細胞缺氧壞死,其後遺症造成不同程度的殘障。許多的患者最後無法重返職場,其中一部分患者,雖然失能程度並不嚴重,但是關乎重返職場的重要手部功能,卻經常需要更為冗長的復健訓練,甚至最終的回復並不理想。本文報告一個34歲女性案例,從事專業嬰兒保母工作,過去病史有高血壓與糖尿病。本次梗塞性腦中風發作後,右側肢體大關節無力雖然於初期就有不錯的進步,也能早期離床復健,但是手掌與手指的細部動作仍舊遲緩,評估回到原職場困難。住院期間接受重複經顱磁刺激術(rTMS),治療過程中,其手部的精細動作控制改善,出院後第二次回診已重返保母職場。重複經顱磁刺激術(rTMS)是腦中風病人治療的輔助性選擇。

並列摘要


Cerebral ischemic infarction is caused by obstruction of cerebral vessels, leading to ischemic injury and neurological dysfunction. Stroke causes varying degrees of disability. Many patients are ultimately unable to return to the workplace. For a subgroup, although the disability score is relatively low, important hand functions are not restored and prevent them from returning to the workplace. Often lengthy rehabilitation training is required, and outcomes are not satisfying. This article reports the case of a 34-year-old female who works as a professional nanny and has a past medical history of hypertension and diabetes mellitus. After the ischemic stroke, although the mobility of the large joints of the right limb had improved in the early stage, the right hand and finger movements were still limited and slow. During hospitalization, she received repetitive transcranial magnetic stimulation (rTMS). During the treatment, right hand fine motor control improved, and she returned to her work as a nanny soon after discharge. Repetitive transcranial magnetic stimulation (rTMS) is an important option for early stroke treatment.

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