2005 Volume 42 Issue 8 Pages 553-557
We report a 40-year-old female patient with Spinal Muscular Atrophy (SMA) type III, a slow progressive motor neuron disease, who also had an ADL disorder caused by a bilateral severe pes equinus deformity since she was an infant and newly occurring brachial plexus palsy. Her pes equinus deformity occurred in childhood and was gradually aggravated afterwards, but appropriate guidance was not taken due to her mother's distrust of medical intervention. By the time she was 25, it was impossible for her to walk, and she retired from her job and lived afterward at several homes. Her left upper extremity was inconvenient, but she utilized her right upper extremity, and her independent life indoors was managed by crawling. At 39 years of age, she became unconsciousness in a diabetic coma for four days. When her consciousness returned, right brachial plexus paralysis occurred. All of her ADL needs except meal movement required assistance, so she was transferred to our hospital for the purpose of rehabilitation 11 months after the onset of her paralysis. Finally, she was able to dress herself, roll over and gain locomotion with an electric wheelchair and she became independent, but she still needed assistance for transfer activities. With her improved ADL, her mother's distrust of medical assistance was overcome and a good doctor patient relationship was formed.
