Evaluación y propuesta de tratamiento en un caso de parkinsonismo atípico (DCB)

Acosta Rodríguez, Jose Manuel

Evaluación y propuesta de tratamiento en un caso de parkinsonismo atípico (DCB)

Abstract

Parkinsonism is defined as the presence of bradykinesia and at least one of the following present manifestations: tremor at rest, rigidity or postural instability. A group of several clinical syndromes with features "atypical" to the observed in the classic presentation of Parkinson's Disease (PD) is made up of atypical parkinsonisms or parkinsonisms plus. Approximately 15% to 25% of patients with parkinsonism attending movement disorders centers suffer from a variety of the group of pathologies classified as atypical Parkinson's diseases (Sjostrom et al., 2002). Progressive supranuclear palsy (PSP), multisystemic atrophy (AMS), dementia with Lewy bodies (DCL / DBL) and corticobasal ganglion degeneration (DGCB) are the main neurodegenerative diseases to be considered within the differential diagnoses of the PD. In proportion of cases are much less frequent are the DGCB, frontotemporal dementia linked to chromosome 17 (FTDP-17), Pick's disease, palidonigral degeneration, Wilson's disease and a rigid variant of Huntington's disease, among other existing. In some cases, it is also possible to co-present a progressive cognitive deterioration of magnitude serious enough to produce serious interferences in social and/or work functions, together with variations in cognitive function especially indicated in the field of attention and alert, all this without undermining the behavioral and emotional problems very commonly associated. This fictitious case consists in the evaluation and proposal of neuropsychological treatment of a possible diagnosis of corticobasal degeneration (corticobasal syndrome type) in its initial stage. The neuropsychological evaluation at the beginning will serve to observe the strong and critical points that allow to determine the cognitive performance, together with the behavioral and its performance in daily life, applying an intervention consisting mainly of a stimulation of the executive functions, with palliative and slowing intention about the possible advance of neurodegenerative pathology. The proposal of a first initial phase of neuropsychological intervention will consist of a group of sessions of 45 minutes, three times a week for approximately 3 months, which according to the evolution observed, may define specific minimum objectives to be achieved. The expected results in the post-intervention neuropsychological assessment will seek to achieve a significant improvement, if not a remarkable maintenance in cognitive functioning in terms of efficiency in the use of working memory, impulse control and inhibition management, the improvement of performance in Cognitive flexibility, and also in its multitasking planning and execution capabilities; In the majority of exercises, emphasis is placed on attentional and mnesic processes, together with language. Both with regard to the primary physical therapy care, too speech therapy and occupational therapy, we will transmit to our professional colleagues the impressions arising from the initial assessments and in the performance of the different exercises, all with a transdisciplinary perspective of constant feedback.

Citation

Acosta Rodríguez, J. (2019). Evaluación y propuesta de tratamiento en un caso de parkinsonismo atípico (DCB). Universitat Oberta de Catalunya (UOC). https://hdl.handle.net/10609/93266

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