REHABILITATION OF BALANCE IN 2 PATIENTS WITH CEREBELLAR DYSFUNCTION

The treatment of two patients with cerebellar disfunction is described . One patient was a 36-year-old woman with a 7-month history of dizzin ess and unsteadiness following surgical resection of a recurrent piloc ystic astrocytoma located in the cerebellar vermis. The other patient was a 48-year-old man with cerebrotendinous xanthamatosis (CTX) and di ffuse cerebellar atrophy, and a 10-year history of progressive gait an d balance difficulties. Each patient was treated with a 6-week course of physical therapy that emphasized tile practice of activities that c hallenged stability. The patient with the cerebellar tumor resection a lso performed eve-head coordination exercises. Each patient had weekly therapy and performed selected balance retraining exercises oil a dai ly basis at home. Measurements taken before and after treatment for ea ch patient included self-perception of symptoms, clinical balance test s, and stability during selected standing and gait activities; for the patient with the cerebellar tumor resection, vestibular function test s and posturography were also performed. Both patients reported improv ements in symptoms and demonstrated similar improvements on several ki nematic indicators of stability during gait. The patient with the cere bellar tumor resection improved on posturography following treatment, whereas the patient with CTS improved on clinical balance tests. This case report describes two individualized treatment programs and docume nts functional improvements in two patients with different etiologies, durations, and clinical presentations of cerebellar dysfunction. The outcomes suggest that patients with cerebellar lesions, acute or chron ic, may be able to learn to improve their postural stability.