Typical cases of neuralgic amyotrophy present with sudden onset of excruciating pain in the shoulders and upper extremities, followed by marked muscle weakness and atrophy over a period of hours to days. Neuralgic amyotrophy is not confined to the brachial plexus, and difficulties in its diagnosis may delay the start of rehabilitation therapy. Here, we report a case of rehabilitation of a patient with neuralgic amyotrophy presenting with Collet-Sicard syndrome (9th, 10th, 11th, and 12th cranial nerve disorder)．A 44-year-old man developed severe pain from the left posterior neck to the occipital region, followed by sporadic onset of dysarthria, dysphagia, and difficulty in raising the left upper limb over several weeks. Nerve conduction studies showed marked bilateral differences in the amplitude of the compound muscle action potential recorded from the trapezius during accessory nerve stimulation. Needle electromyography showed abnormal resting potentials in the left trapezius and left side of the tongue and a decrease in the interference pattern during voluntary contraction. Based on the clinical course, neurological and laboratory findings, a diagnosis of neuralgic amyotrophy was made. Speech language hearing therapy was performed for dysarthria and dysphagia, and physical therapy was performed for difficulty in raising the left upper limb due to accessory nerve palsy. Rehabilitation along with recovery from inflammation-induced neuropathy allowed the patient to become independent in activities of daily living.

Typical cases of neuralgic amyotrophy present with sudden onset of excruciating pain in the shoulders and upper extremities, followed by marked muscle weakness and atrophy over a period of hours to days. Neuralgic amyotrophy is not confined to the brachial plexus, and difficulties in its diagnosis may delay the start of rehabilitation therapy. Here, we report a case of rehabilitation of a patient with neuralgic amyotrophy presenting with Collet-Sicard syndrome (9th, 10th, 11th, and 12th cranial nerve disorder)．A 44-year-old man developed severe pain from the left posterior neck to the occipital region, followed by sporadic onset of dysarthria, dysphagia, and difficulty in raising the left upper limb over several weeks. Nerve conduction studies showed marked bilateral differences in the amplitude of the compound muscle action potential recorded from the trapezius during accessory nerve stimulation. Needle electromyography showed abnormal resting potentials in the left trapezius and left side of the tongue and a decrease in the interference pattern during voluntary contraction. Based on the clinical course, neurological and laboratory findings, a diagnosis of neuralgic amyotrophy was made. Speech language hearing therapy was performed for dysarthria and dysphagia, and physical therapy was performed for difficulty in raising the left upper limb due to accessory nerve palsy. Rehabilitation along with recovery from inflammation-induced neuropathy allowed the patient to become independent in activities of daily living.

Objective：The English version of the Characterizing Freezing of Gait questionnaire (C-FOGQ) that is used to assess detailed information of freezing of gait was developed by Ehgoetz Martens et al. This study aims to develop the Japanese version of the C-FOGQ using guidelines for cross-cultural adaptation and to conduct the pretesting study.Methods：The C-FOGQ was translated with permission into Japanese according to the following guidelines for cross-cultural adaptation： (1) translation (English to Japanese), (2) back-translation (Japanese to English), and (3) pretesting. Thirty-nine patients with parkinsonism-related disorders participated in the pretesting study.Results：There was no significant linguistic problem in the process of translation and back-translation. In pretesting, the average response time of the Japanese version of the C-FOGQ was 526.8 seconds. The error/no-response rate was less than 1%. The average score for section II of the Japanese version of the C-FOGQ was 20.0 points.Conclusion：A linguistically-validated Japanese version of the FOGQ was developed according to the guidelines of cross-cultural adaptation. It seems to be possible to use this questionnaire for detailed evaluation of gait freezing in Japan as well as in the West.

Objective：The purpose of this study was to evaluate the effectiveness of a four-week short-term intensive rehabilitation on ataxia in patients with ambulatory spinocerebellar degeneration (SCD), using the Scale for the Assessment and Rating of Ataxia (SARA) total score and sub-score.Methods：This study included 23 SCD patients；we considered those with a SARA gait score of＜3 points. Our program included a one-hour training session with individualized instructions and a one-hour self-balance training session. Additionally, occupational or speech-language-hearing therapy was performed for one hour daily. Our program was conducted five days weekly for four weeks. We assessed the SARA total score and sub-score findings immediately, before the first and after the last interventions.Results：The SARA total, gait, stance, and heel-shin scores showed more significant improvement after intervention than before intervention (p＜0.05). The other SARA sub-scores were not significantly different between “before and after” interventions.Conclusion：The four-week short-term intensive rehabilitation on ataxia in patients with ambulatory spinocerebellar degeneration improved the SARA total score and ataxia of the trunk and lower limbs.

Objective：The English version of the Characterizing Freezing of Gait questionnaire (C-FOGQ) that is used to assess detailed information of freezing of gait was developed by Ehgoetz Martens et al. This study aims to develop the Japanese version of the C-FOGQ using guidelines for cross-cultural adaptation and to conduct the pretesting study.Methods：The C-FOGQ was translated with permission into Japanese according to the following guidelines for cross-cultural adaptation：(1) translation (English to Japanese), (2) back-translation (Japanese to English), and (3) pretesting. Thirty-nine patients with parkinsonism-related disorders participated in the pretesting study.Results：There was no significant linguistic problem in the process of translation and back-translation. In pretesting, the average response time of the Japanese version of the C-FOGQ was 526.8 seconds. The error/no-response rate was less than 1%. The average score for section II of the Japanese version of the C-FOGQ was 20.0 points.Conclusion：A linguistically-validated Japanese version of the FOGQ was developed according to the guidelines of cross-cultural adaptation. It seems to be possible to use this questionnaire for detailed evaluation of gait freezing in Japan as well as in the West.

Objective：The purpose of this study was to evaluate the effectiveness of a four-week short-term intensive rehabilitation on ataxia in patients with ambulatory spinocerebellar degeneration (SCD), using the Scale for the Assessment and Rating of Ataxia (SARA) total score and sub-score.Methods：This study included 23 SCD patients；we considered those with a SARA gait score of＜3 points. Our program included a one-hour training session with individualized instructions and a one-hour self-balance training session. Additionally, occupational or speech-language-hearing therapy was performed for one hour daily. Our program was conducted five days weekly for four weeks. We assessed the SARA total score and sub-score findings immediately, before the first and after the last interventions.Results：The SARA total, gait, stance, and heel-shin scores showed more significant improvement after intervention than before intervention (p＜0.05). The other SARA sub-scores were not significantly different between “before and after” interventions.Conclusion：The four-week short-term intensive rehabilitation on ataxia in patients with ambulatory spinocerebellar degeneration improved the SARA total score and ataxia of the trunk and lower limbs.