Faculty Bibliography

Introduction/Rational A 72 year old male with history of amyloid angiopathy and cerebral hemorrhages sustained an acute left temporal parietal intraparenchymal hemorrhage. He was noted to have impairments in visual perception, memory, language and balance. The patient was diagnosed with Balint's Syndrome which includes a trio of symptoms - inability to perceive the visual field as a whole (simultanagnosia), difficulty in fixating the eyes (oculomotor apraxia), and inability to move the hand to a specific object by using vision (optic ataxia). The patient required acute inpatient rehabilitation to address this unique set of impairments. Method/Approach An interdisciplinary approach was utilized focusing on taskbased training to improve his cognitive, functional and physical functioning. The patient benefited from errorless learning techniques, a low stimulation environment, and proprioceptive input to improve balance and coordination. Objective testing with the O-LOG, FIM, Berg Balance Test, and a specialized protocol for spaced retrieval of orientation information were utilized in order to track the patient's rehabilitation progress. Results/Effects The patient demonstrated improvement in orientation (8/30 to 20/30 on O-LOG), balance (0/56 to 17/56 on Berg Balance Test), basic communication skills, and self-care activities over four weeks. This case report demonstrates a unique rehabilitation approach to Balint's Syndrome, whereby established objective scales were incorporated to measure the patient's functional improvements over time. Limited research suggests rehabilitation training should be focused on the improvement of visual scanning, the development of visually guidedmanualmovements, and integration of visual elements. This case report agrees with these findings and supports an interdisciplinary approach to address patients with complex functional impairments. Conclusions/Limitations This case report supports published reports of treating Balint's syndrome with an interdisciplinary approach. However, more research is needed to validate an effective clinical approach for this distinctive syndrome

This paper presents the algorithm and technical aspects of an intelligent diagnostic system for the detection of heart murmurs. The purpose of this research is to address the lack of effectively accurate cardiac auscultation present at the primary care physician office by development of an algorithm capable of operating within the hectic environment of the primary care office. The proposed algorithm consists of three main stages. First; denoising of input data (digital recordings of heart sounds), via Wavelet Packet Analysis. Second; input vector preparation through the use of Principal Component Analysis and block processing. Third; classification of the heart sound using an Artificial Neural Network. Initial testing revealed the intelligent diagnostic system can differentiate between normal healthy heart sounds and abnormal heart sounds (e.g., murmurs), with a specificity of 70.5% and a sensitivity of 64.7%

A 9-year-old female presented with daily episodes of medically refractory paroxysmal bilateral arm posturing, which had long been thought to be epileptic seizures. She also had other types of episodes, including daily staring spells and infrequent generalized tonic-clonic convulsions. Neurologic examination was normal except for delayed cognitive development. The results of previous electroencephalograms (EEG) were normal, and magnetic resonance imaging of the head revealed a Chiari I malformation. Video EEG monitoring revealed no EEG changes during the attacks, and magnetic resonance imaging of the spine revealed a large cervical syrinx associated with the Chiari malformation. The episodes of paroxysmal bilateral dystonic arm posturing resolved after surgical intervention for the syrinx. This report illustrates that cervical cord disease is an unusual although potentially treatable condition to be considered in the differential diagnosis of paroxysmal episodes with dystonic movements of the arms, even in the absence of other physical findings of myelopathy