Rehabilitation in a patient with recent diagnosis of dementia: the physiatrist and the geriatrician compared in taking charge of a case report

Abstract

The rehabilitation of a patient suffering from multiple comorbidities and locomotor disabilities was a difficult task from which the physiatrist does not shy away. The rehabilitation work was even more complex when a new diagnosis of dementia is added to these problems. An elderly patient with numerous comorbidities was hospitalized for spinal surgery and subsequently suffered from infectious complications. In fact, he underwent T12-L1 decompressive laminectomy surgery due to a stenosis of the spinal canal at the T12-L1 levels with myelopathy which was already manifested itself in the past with weakness in the right lower limb and presence of worsening lumbocruralgia with impaired walking. The patient was referred to have rehabilitation programs to regain his independence. However, during his hospitalization, he showed clinical signs that led to a suspected diagnosis of parkinsonism. Subsequently, he was diagnosed with cognitive impairments with frontotemporal dementia. A Parkinson-plus syndrome, also called atypical parkinsonism, is referred to a group of neurodegenerative movement disorders that resemble idiopathic Parkinson’s disease with certain distinguished clinical and pathophysiological features. In this regard, we described a clinical case report in which the skills of the geriatrician and those of the physiatrist were called upon to collaborate closely to take charge of this complex patient.