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Brain Injury
Oral Presentation
Sheryl Katta-Charles, MD
Assistant Clinical Professor
Indiana University School of Medicine
Indianpolis, Indiana
Kyle Littell, MD
Assistant Professor
Indiana University School of Medicine
Indianapolis, Indiana
The symposium will consist of three presentations regarding 1. the prevalence of opioid overdose, 2. unique clinical presentation in inpatient rehabilitation and 3. physical therapy parameters in the presence of compromised cardiac function.
The symposium will consist of three presentations regarding 1. the prevalence of opioid overdose, 2. unique clinical presentation in inpatient rehabilitation and 3. physical therapy parameters in the presence of compromised cardiac function.
First, we will review the epidemiology of opioid overdoses, fatal as well as nonfatal. With the availability of naloxone, an antidote to opioids, as an over-the-counter medication in 46 states of the United States, there is a rise in non-fatal overdoses. This means that a subset of individuals who survive opioid overdose will be left with significant neurological and functional deficits and may be admitted to inpatient rehabilitation facilities. Most clinical management strategies that are applicable in treating traumatic brain injury may be used in non-traumatic hypoxic-ischemic brain injuries. There are also unique clinical scenarios which will be highlighted. The pathophysiology and management of the following issues will be discussed: a) Post-hypoxic myoclonus, Lance Adams Syndrome; b) Delayed Post-Hypoxic Leukoencephalopathy; c) Dystonia; d) Cognitive dysfunction. Finally, we will review the use of high-intensity, body-weight supported treadmill training in this population. High-intensity PT is purported to be helpful in cognitive recovery after ischemic and traumatic brain injury, mediated by BDNF. However, when the myocardium is damaged from anoxia, what safety measures need to be taken to push patients? What parameters can be implemented in inpatient rehabilitation? Is EKG monitoring necessary if the patient cannot reliably communicate cardiac symptoms? These and other questions will be discussed.