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Rehabilitation After Tick Born Encephalitis

Konferensbidrag (offentliggjort, men ej förlagsutgivet)
Författare Katharina S Sunnerhagen
Marianne Lannsjö
Ann Hammer
Anna Tölli
Jan Burensjö
Björn Hedman
Gunilla Lindstedt
Åsa Lundgren Nilsson
Publicerad i World Congress of Neuro Rehabilitation Istanbul, Turkiet 8-12 april 2014,
Publiceringsår 2014
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering
Språk en
Ämneskategorier Neurologi, Infektionsmedicin, Epidemiologi

Sammanfattning

Tick born encephalitis (TBE) is a zoonosis, transmitted through ticks. Every year around 150–200 cases of TBE are reported in Sweden. TBE is also seen in Finland, the Baltic States and in middle Europe and increasing in frequuency. The disease is most often manifest as meningitis or encephalitis. Long-lasting or permanent neuropsychiatric sequel has been reported in 10-20% of infected patients. A structured analysis of the trajectory is missing and the rehabilitation course of TBE patients has not been reported. Aims To explore the consequences of TBE for rehab Material and methods 32 patients were admitted to the different rehabilitation clinics in Sweden and 16 men and 16 women and reported to the Swedish quality register Web Rehab during a 5 year period. The average age was 47 years (SD 12.6). Time from diagnosis until admittance for rehab was 29 days (SD 21.8). Dependency was assessed by FIM, and defined as motor FIM (13x6-1) and social-cognitive FIM (5x6-1); i.e. dependence in at least 1 item. Wilcoxon signed test was used to assess significant changes in dependence. Results At admittance, half were dependent in motor FIM and 47 % in social-cognitive FIM. Length of stay was 41 days (SD 26.8). During the rehabilitation period there was a significant improvement in motor FIM (p=0.003) and social-cognitive FIM (p=0.025). The majority was discharged to home without any need for support (22), 7 to their own home but with support from the community and 3 to nursing homes. Conclusion The number of patients (32) admitted for in-patient rehab is lower than one would expect if the report of 10-20 % with sequels is correct. Either the level of sequels is lower than thought or the patients not referred. The frequency of dependency in those admitted is only around 50 %. The majority are discharged to an independent life. These positive results need to be deeper explored since subtle cognitive problems might be missed in ADL activities.

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