Difficulties in Management of Functional Movement Disorders: Three Illustrative Cases.

Background: Some patients with FND and FEVD cannot re-establish walking ability with standard treatment alone.

Cases: Novel invasive treatment of FEVD trialed in three females, aged 19, 30 and 33 years with >18 month history of FND. None could walk and all were wheelchair-dependent needing home carers.

The positive and the negative impacts of spasticity in patients with long-term neurological conditions: an observational study.

Purpose: To describe the positive and negative impacts of spasticity across different neurological disorders using the Patient Reported Impact of Spasticity Measure (PRISM), deduce any associations between severity of spasticity and its impact, and assess for differences across diagnostic subgroups.

Materials And Methods: PRISM, a spasticity-specific quality of life questionnaire validated in patients with spinal cord injuries, was given to 97 follow-up patients attending a spasticity clinic prior to symptom assessment using the REsistance to PAssive movement Scale (REPAS).

Results: Patients described a minor level of positive impact and a marked negative impact in the domains of "Psychological Agitation," "Daily Activities," "Need for Assistance/Positioning" and "Social Avoidance/Anxiety.

Physiotherapy in Malawi - a step in the right direction.

Physiotherapists in Malawi are in short supply and the demand for this service is increasing. This profession is instrumental in the rehabilitation of patients following accident and disease. Early input from a physiotherapist can be life changing; for example, timely physiotherapy could prevent a patient from becoming wheelchair-bound for life.