Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

vascular

 

Síndrome de Millard-Gubler en un paciente joven: diagnóstico y neurorrehabilitación temprana. Millard-Gubler syndrome in a young patient: diagnosis and early neurorehabilitation.

Introduction: Millard-Gubler syndrome (MGS) is a rare neurological entity that affects the brainstem by multiple etiologies. The diagnosis is clinical and requires confirmation by imaging studies such as CT or MRI. Treatment is generally non-surgical with a rehabilitative approach with functional goals.

Clinical findings: In this case we present a 44-year-old male patient from southwestern Colombia, with a history of arterial hypertension who was admitted to the emergency department of a national reference university hospital with a hypertensive emergency and white organ lesion, presenting a sudden loss of mobility of his left hemibody accompanied by involvement of the VI and VII cranial nerves.

Treatment and outcome: Interventions were initiated by a multidisciplinary team, including the rehabilitation service, making the diagnosis of crossed brainstem syndrome (Millard-Gubler) of hemorrhagic vascular etiology. He required monitoring in the NICU until stabilization of his clinical condition, after which early neurological rehabilitation interventions were performed (physical therapy, occupational therapy, speech therapy, orthotics, psychology and pain), achieving an improvement in symptoms and functionality of the motor and cognitive component before h ospital discharge.

Conclusions: This case reflects the importance of a multidisciplinary team with a physician specializing in physical medicine and rehabilitation to ensure the best possible functional outcome, in addition to reporting the interventions performed in a young patient with a rare neurovascular entity.

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