The role of the interdisciplinary team in subacute rehabilitation for central pontine myelinolysis

Abstract

Background: Central pontine myelinolysis is a rare condition that can result in debilitating symptoms. Recent evidence suggests a shift in hypothesized prognosis for individuals with this diagnosis and implies a valuable role for rehabilitation to address prevention of secondary complications and functional recovery. This paper describes a 30 year-old female with central pontine myelinolysis presenting with incomplete locked-in syndrome and chronicles her rehabilitative journey at a comprehensive post-acute rehabilitation center. We present discipline specific interventions and discuss the interactions of the rehabilitation team as it relates to this patient’s care and progression of training.

Methods: Retrospective review of medical records and face-to-face interview were use to compile data for this case report.

Results: The patient demonstrated improvements in function in all areas of mobility, swallowing, communication, and self-care over the course of 6 weeks of interdisciplinary training.

Conclusion: This report illustrates the critical role of a patient-centered and goal-driven interdisciplinary team approach in the rehabilitation of persons with central pontine myelinolysis.

Implications for rehabilitation

• Central Pontine Myelinolysis can result in profound acute disability, including incomplete locked-in syndrome.

• Interdisciplinary post-acute rehabilitation is beneficial in maximizing functional recovery and minimizing secondary complications for individuals with Central Pontine Myelinolysis.

• Ongoing clinical assessment and team collaboration contribute to progressive and comprehensive plan of care development in post-acute rehabilitation.

• A patient-centered and goal-driven interdisciplinary team approach facilitates improvement in outcomes across clinical domains.

• Recovery potential and therapeutic interventions for individuals with Central Pontine Myelinolysis need to be further explored.

Keywords:

• Locked in syndrome
• inpatient rehabilitation
• multidisciplinary rehabilitation
• patient-centered care
• osmotic demyelination syndrome
• neurologic rehabilitation

Acknowledgements

The authors would like to acknowledge the patient in this case for her participation as well as the entire rehabilitation team involved in her care.

Disclosure statement

No potential conflict of interest was reported by the authors.