Treatment of CVA Stroke Paralysis:
A Case Study of Gourhari Ray-
Treated with Inductive Neuroplasty
Gourhari Ray 76 year Male
62/1 Kachari Road,
Burdwan (W.B.)- 713101
INDIA
Personal Profile:
Gourhari Ray basically belongs to a rural simple Bangali family. He started his carrier from school services W.B., he worked as a Teacher, Head Maser, School Inspector then after he joined University services of W.B. He retired from the post of Head of the Department of Commerce. By nature he was a hardworking, ambitious, systematic and simple. He well arranged to give good education to his daughters and wife.
Family Back Ground:
Gourhari Ray have three daughters. Elder daughter is in West Bengal State Services. younger daughter and her husband both are medical professional doctors, they are settled in England. Youngest daughter and her husband are also medical professional doctors, they are working in Medical Collage, Burdwan, India. Wife of Mr. Ray is now has been retired form the post of Sr. Lecturer subject of Philosophy, college services W.B.
Details of Clinical History:
22.04.2008
Early in the morning sudden drowsiness, headache, right side completely paralysis with facial palsy, BP 200/100. patient was admitted in ICU. He got affected by CVA Stroke on date 22.04.2008 consequently completely paralyzed over right side with facial palsy.
Started regular medicines, physiotherapy and medical care under supervision. Food was used to give by Ryle's Tube for 4 months and Catharater was used for 9 months. Patient has diagnosed through CT Scan that intra-cerebral hemorrhage (volume 22ml) with minimal perifocal oedema is seen in left insular cortex extending to left-para ventricular region. The lesion has effected the adjacent sulsi, compressed the left lateral ventricle and a mid line shiftof 3 mm. the right is noted. 19.05.2008 Re-admitted on ICU for Supra-ventricular trachi-cardia. 21.05.2008. CT Scan Report- Hyper dense area having CT value of blood with surrounding edema is seen in left basal ganglia and para-ventricular region with mass effect over left lateral ventricle with middle shift of 2 mm towards right. Sulci are effected adjacent to the lesion. August, 2008. Stared speech therapy along with physiotherapy regularly, but seen no any significant improvement. 6th November- 2008
MRI of Brain was done to rule-out any underlying brain tumor or other cause secondary to which hemorrhage may occur. But basal ganglion, inter capsule, pituitary and hippocampal region reveal no any other obvious abnormality.13th March, 2009 Patient was admitted in a Nursing Home, Kolkata for rehabilitation under Mentamove, a new technique for brain stimulation for paralysed patients. But patient was not willing to stay in hospital. The Mentamove technique was not fond to be effective. 08.12.2008 Treatment started by Dr.J.P.Singh under Psychoplasty Technique, Santiniketan with support of Medicine Specialist Dr.Arindam Chatterjee. 15.12.2008. After seven days treatment of Psychoplasty, the patient is able to stand-up without support and walk with stick with minimum support of others. Overall a significant improvement has observed. It is here to be noticed that the patient's condition was stagnant but Psychoplasty treatment has worked well.
Clinical Features
Date 08.12.2009
Right Upper Limb-
• Power: 0/5 (on sitting position)
• Reduced stability of shoulder joint, contracture of muscles
• Subluxated humerus head from glenoid cavity (shoulder joint)
• Almost one inch groove a separation permitted as very clearly
• Hyper tonic contracture toward palm
• Shoulder, elbow, wrist joints almost rigid, immovable and reduced ROM
Right Lower Limb-
• Power: 1/5 (on standing position)
• Planter reflex- positive
• Hips, knee, ankle joint's mobility restricted, reduced ROM
• No active power in the right lower limb at standing position
• Unable to use unaffected leg properly
• Unable to take support the paralysed limbs in any manner
• Fully dependent to others when standup and walk
• Unable to standup and sitdown unsupported
• Unable to stand unsupported
• Coordination in neuro-muscular activities- Poor
* Self Confidence-Very Poor
* Hope- Broken (thinks there is no any chance of recover)
* Cooperation with therapist and others- Reluctant
* Attitude- Negative
* Behavior- Dominative, adamant, preoccupied minded
* Suggestibility Level- Very poor
* A deep fear to produce any work or activity
* Observed black-out brain activities for certain period
* Confused minded about muscular function and activities
* Unclear speech and voice
* Saliva drops-down from mouth due to facial palsy
* Hard hearing and poor to understand to others
Clinical Review
Date 15.12.2009
Right Upper Limb-
• Power: 1+/5 (on sitting)
• Improved stability of shoulder joint
• Subluxation of humerus head from glenoid cavity has been recovered
• Groove not seen
• Hyper tonic contracture toward palm-No change
• Shoulder, elbow, wrist joints almost rigid, reduced ROM- No any remarkable
improvement observed
Right Lower Limb-
• Power: 3+ / 5 (on standing)
• Planter reflex- positive more clear
• Hips, knee, ankle joint's mobility and ROM- Improved
• Gained active power in the right lower limb
• Able to use unaffected leg properly
• Able to take support the paralysed limbs in walking and standing
• Walk unsupported with elbow clutch
• Able to stand-up and sit-down unsupported
• Coordination over neuro-muscular activities- Improved
* Hope- hopeful (thinks he may be cured)
* Cooperation with therapist and others- Improved, as well as good
* Attitude- Random positive
* Behavior- Dominative, adamant, preoccupied minded
* Suggestibility Level- Not good
* Improve moderate self confidence to produce fearlessly some work or activities
* Black-out brain activities for certain period was seen-Now not observed frequently
* Moderate enlightened about muscular functions and activities
* Improved clarity of speech and voice
* Controlled saliva drops-down from mouth
* Hearing and understanding to others-Slightly improved
* Sleep, quantity of food intake, mood improved and better than before
The Barthel Index
Upgraded from point 29 to 54
within 7 days duration of treatment
REPORT OF CLINICAL REVIEW-
MRI of the brain-
Click the links to observe
movie of the moments-
Seven days administered Inductive Neuroplasty treatment
Gourhari Ray on the bed before treatment-
After treatment sitting and standing
After treatment walking with walker
Condition after one year of the treatment-
© Dr.J.P.Singh www.brainsetup.com