PDA

View Full Version : An old strange case of interest?


bernard
10-03-2004, 08:12 AM
Physiol. 1992 Apr;449:503-15
The perceptions of force and of movement in a man without large myelinated sensory afferents below the neck.

Cole JD, Sedgwick EM.

Wessex Neurological Centre, Southampton General Hospital.

1. Motor memory and the sense of effort have been investigated in a man with a complete large fibre sensory neuropathy for over 16 years. The perceptions of pain, heat, cold and muscular fatigue remained but he was without perceptions of light touch and proprioception below the neck. 2. The subject was able to discriminate weights held in the hand with an accuracy only slightly worse than control subjects (20 g in 200 g) when forearm movement and visual inspection were allowed. With eyes shut however he could only distinguish a weight of 200 g from 400 g. It is concluded that a crude sense of effort remains which may have a peripheral origin. 3. A limited motor memory was also present, which allowed him to maintain a posture or continue a simple repetitive movement. No novel movement was possible without visual feedback. 4. Differences in movement ability between this subject and others with similar if less pure sensory neuropathies are ascribed to rehabilitation.

Publication Types:
Case Reports

PMID: 1522522 [PubMed - indexed for MEDLINE]

I think that is a typical case showing fine conclusions?

Green Hornet
11-03-2004, 03:28 AM
This study tells me an important role of proprioception in sensory perception and motor output. All the sensory systems work as a whole to complete our perception and understanding of the world.
The amount of neuropathies seem to differentiate the degree of deficits in sensory-motor function.

Where is learning coming into play, when we face this kind of dysfunction in the clinic?
How much motor learning would be possible?
How do you want to facilitate that?
I think that the use of vision is critical in rehab. Is there other possibility in what we can do?

Green Hornet
12-03-2004, 01:31 AM
Bernard,
I have enjoyed your honesty. It is a very challenging type of patient.