Oculomotor disorder and diplopia cause a decline in quality of life and activities of daily living. The usefulness of orthoptic exercise for oculomotor disorder has been proven. However, there are few reports about orthoptic therapy with diplopia after a cerebrovascular accident in a convalescent rehabilitation ward which usually has no certified orthoptist. A previous study reported that diplopia caused by traumatic subarachnoid hemorrhage was improved after binocular gaze training. On the other hand, it was also reported that binocular training alone did not lead to complete recovery of diplopia, as no improvement was seen after the sixth day. We experienced a case of abducens nerve palsy and diplopia due to subarachnoid hemorrhage. Orthoptic treatment without special equipment restores disordered eye movement and improves double vision. Notably, binocular gazing training, devised to move the gazing target farther away or to the side, improved over a long period, unlike in a previous report. We report this case because it showed the availability of our attempted treatment for oculomotor disorder in a convalescent rehabilitation ward.

Oculomotor disorder and diplopia cause a decline in quality of life and activities of daily living. The usefulness of orthoptic exercise for oculomotor disorder has been proven. However, there are few reports about orthoptic therapy with diplopia after a cerebrovascular accident in a convalescent rehabilitation ward which usually has no certified orthoptist. A previous study reported that diplopia caused by traumatic subarachnoid hemorrhage was improved after binocular gaze training. On the other hand, it was also reported that binocular training alone did not lead to complete recovery of diplopia, as no improvement was seen after the sixth day. We experienced a case of abducens nerve palsy and diplopia due to subarachnoid hemorrhage. Orthoptic treatment without special equipment restores disordered eye movement and improves double vision. Notably, binocular gazing training, devised to move the gazing target farther away or to the side, improved over a long period, unlike in a previous report. We report this case because it showed the availability of our attempted treatment for oculomotor disorder in a convalescent rehabilitation ward.

Acute oropharyngeal palsy is a rare subtype of Guillain-Barré syndrome. It is characterized by dysphagia and diminished deep tendon reflexes, while notably sparing limb muscle weakness and orbicularis oculi paralysis. Due to its rarity, dysphagia caused by acute oropharyngeal palsy may remain undiagnosed. We report a case of dysphagia that developed following diabetic ketoacidosis. The patient was a man in his 70s who was transported to our hospital by emergency services due to diabetic ketoacidosis. Severe dysphagia persisted despite the successful management of his diabetic ketoacidosis. Although the diagnosis was challenging, we established a diagnosis of acute oropharyngeal palsy based on physical examination findings and cerebrospinal fluid analysis results. We observed improvement in dysphagia caused by acute oropharyngeal palsy following balloon dilation therapy. We present this case to emphasize the importance of including acute oropharyngeal palsy in the differential diagnosis when evaluating patients with bulbar palsy.

Acute oropharyngeal palsy is a rare subtype of Guillain-Barré syndrome. It is characterized by dysphagia and diminished deep tendon reflexes, while notably sparing limb muscle weakness and orbicularis oculi paralysis. Due to its rarity, dysphagia caused by acute oropharyngeal palsy may remain undiagnosed. We report a case of dysphagia that developed following diabetic ketoacidosis. The patient was a man in his 70s who was transported to our hospital by emergency services due to diabetic ketoacidosis. Severe dysphagia persisted despite the successful management of his diabetic ketoacidosis. Although the diagnosis was challenging, we established a diagnosis of acute oropharyngeal palsy based on physical examination findings and cerebrospinal fluid analysis results. We observed improvement in dysphagia caused by acute oropharyngeal palsy following balloon dilation therapy. We present this case to emphasize the importance of including acute oropharyngeal palsy in the differential diagnosis when evaluating patients with bulbar palsy.

This report describes a case of an amputee with a lumber spinal cord injury who successfully recovered ambulation with the use of prosthesis.A 30-year-old man with schizophrenia underwent amputation of the lower legs and concurrently developed lumbar spinal cord injury from of a suicide attempt. After the treatment of stump plasty and posterior fusion, the patient was transferred to our facility. Lower-extremity prostheses for both legs were fitted, and orthostatic training was commenced following admission. During the initial evaluation, the patient could not maintain a stable standing position because of weakness in the hip extensor muscle. An inflexion angle of the prosthesis was set to 0° to extend the knee joint and achieve standing stability. Appropriate adjustments of the prosthesis were made as required, specifically addressing the paraplegia caused by his lumbar spinal cord injury. Thus, the patient successfully regained ambulation with the treatment.Recovering walking independence after bilateral lower leg amputations or paraplegia caused by lumber spinal cord injury is not uncommon. However, this case is unique in that the muscle weakness caused by lumbar spinal cord injury presented unforeseen difficulties for the patient to achieve ambulation, which is not ordinarily observed in amputation rehabilitation cases. No similar cases have been reported in which patients concurrently suffered from both these conditions in Japan；therefore, this case is extremely rare.

This report describes a case of an amputee with a lumber spinal cord injury who successfully recovered ambulation with the use of prosthesis.A 30-year-old man with schizophrenia underwent amputation of the lower legs and concurrently developed lumbar spinal cord injury from of a suicide attempt. After the treatment of stump plasty and posterior fusion, the patient was transferred to our facility. Lower-extremity prostheses for both legs were fitted, and orthostatic training was commenced following admission. During the initial evaluation, the patient could not maintain a stable standing position because of weakness in the hip extensor muscle. An inflexion angle of the prosthesis was set to 0° to extend the knee joint and achieve standing stability. Appropriate adjustments of the prosthesis were made as required, specifically addressing the paraplegia caused by his lumbar spinal cord injury. Thus, the patient successfully regained ambulation with the treatment.Recovering walking independence after bilateral lower leg amputations or paraplegia caused by lumber spinal cord injury is not uncommon. However, this case is unique in that the muscle weakness caused by lumbar spinal cord injury presented unforeseen difficulties for the patient to achieve ambulation, which is not ordinarily observed in amputation rehabilitation cases. No similar cases have been reported in which patients concurrently suffered from both these conditions in Japan；therefore, this case is extremely rare.