Session Information
Session Title: AA 2022 Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Yi Zhou, MD: No financial relationships or conflicts of interest
Case Diagnosis: 65-year-old male with left hemineglect due to right middle cerebral artery (MCA) infarct
Case Description or Program Description: The patient had a right MCA infarct due to right internal cerebral artery and MCA occlusion treated with tPA, mechanical thrombectomy, and ultimately right hemicraniectomy for decompression. He was admitted to acute inpatient rehabilitation (AIR) 18 days after his stroke at which time his exam was notable for left hemiplegia, left sensory impairment, and left hemineglect with left gaze preference.
Setting: Acute Inpatient Rehabilitation Hospital
Assessment/Results: On day 6 of AIR, the patient was trialed on bromocriptine 2.5mg twice daily at 8 am and noon. On day 11 of AIR, for the first time, the patient demonstrated improvement in left hemineglect by correctly identifying light touch to his left leg. On day 12, the patient correctly identified light touch to both his left leg and left arm and also started following commands for the left side. On day 13 bromocriptine was increased to 5mg twice daily. By discharge, his hemineglect had improved with the patient consistently being able to identify light touch on the left side and he was able to look past midline. Extinction of the left side remained present with simultaneous palpation of bilateral upper and lower extremities. The patient was discharged to subacute rehabilitation.
Discussion (relevance): Bromocriptine is a dopamine receptor agonist used for neurostimulation after brain injury. Historically there is low-quality evidence supporting bromocriptine use for spatial neglect. To our knowledge, there has been no published research, including case studies, in the last 20 years pertaining to this treatment. We are presenting a rare case of improved hemineglect with the addition of bromocriptine.
Conclusions: This case demonstrates improvement in hemineglect due to stroke after initiation of bromocriptine. For patients admitted to AIR with hemineglect, one should consider initiation of bromocriptine.
Level of Evidence: Level V
To cite this abstract in AMA style:
Zhou Y, Chung MW, Altonji K, Greenwald BD. Improvement of Hemineglect with Bromocriptine Initiation: A Case Report [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/improvement-of-hemineglect-with-bromocriptine-initiation-a-case-report/. Accessed October 17, 2024.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/improvement-of-hemineglect-with-bromocriptine-initiation-a-case-report/