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A 63-year-old woman was referred because of decreased strength of her right leg manifesting with buckling of the knee for the past five years. Sometimes this led to falls, which made her feel insecure while walking. She experienced some aching in her right heel and in her right knee after long walks. She was able to walk for two hours. She and her husband loved to walk in the mountains, and during those hikes she used a cane. The previous history is relevant because at age 5 years she had suffered from poliomyelitis anterior acuta, which had affected both legs. She had a partial recovery in the sense that she regained normal strength of her left leg and was left with residual weakness of her right leg. She underwent surgery at age 10 years (ankle arthrodesis on the right and epiphysiodesis of the left leg).
Significant advances in the development of antiviral medications has come from efforts towardsthe control of human immunodeficiencyvirus (HIV), with nucleoside analogs and protease inhibitors leading the way. Similar are advances in vaccine development and understanding the immune system, including immune senescence with age. Antibodies will be used to directly treat illnesses and also to deliver medications including oligonucleotides to abnormal cells. Similarly, viruses have been used to deliver genes to human cells, including abnormal neurons to treat hitherto untreatable illnesses.
Development of methods to measure T lymphocyte functions will enhance understanding of human viral infections and autoimmune illnesses – both of which vary with age. Included in this will be the role of epigenetics on immune functions.
Understanding of latent virus infections of the nervous system will develop including the role of viral genes and also neuronal genes. Related will be understanding if neuronal damage and the development of the post-polio syndrome.
Milton Erickson is the most famous contemporary hypnotherapist, as well as a legendary psychotherapist. At the age of seventeen, he narrowly escaped death from poliomyelitis, but continued to suffer from residual paralyses that worsened later in his life. This chapter relates how such experiences taught him the power of the unconscious mind and the trance state, and led him to pursue a career in hypnotherapy and psychotherapy. It also discusses Erickson’s view on trance, his relationship with Margaret Mead and Gregory Bateson, and his influences on a new generation of innovative psychotherapists. Also covered are discussions on the nature, origin, and importance of the “altered state of consciousness,” the importance of such phenomena vis-à-vis the evolution of our species, as well as the role “altered state of consciousness” has played in the history of psychiatry.
Edited by
Michael Selzer, University of Pennsylvania,Stephanie Clarke, Université de Lausanne, Switzerland,Leonardo Cohen, National Institute of Mental Health, Bethesda, Maryland,Pamela Duncan, University of Florida,Fred Gage, Salk Institute for Biological Studies, San Diego
This chapter describes the current knowledge on the pathogenesis, the clinical symptoms, and deficits and current therapy concepts during the acute disease state and for rehabilitation including long-term impairment of activities of daily living. It focuses on rehabilitation of patients with diseases of the motor neuron like amyotrophic lateral sclerosis (ALS), spinal muscular atrophy (SMA) and polio. Rehabilitation in polio and post-polio patients is aimed at improving muscle strength, lowering muscle and joint pain, increasing physical independence and quality of life not only of the patient but also of the caregiver. The chapter also explains the rehabilitation of patients with diseases of the peripheral nervous system, especially acute and chronic inflammatory polyneuropathies Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) and other neuropathies. Finally, it also discusses diseases of the neuromuscular junction (myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS)).
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