Recovery of functional ambulation through stepwise rehabilitation treatment in a patient with...

Encephalomyeloradiculoneuropathy is a rare inflammatory disorder for which rehabilitation strategies and functional prognosis are not well established. This report describes the clinical course of a patient with severe lower-limb paralysis caused by encephalomyeloradiculoneuropathy. A man in his 50s developed a fever, impaired consciousness, and respiratory failure requiring mechanical ventilation. Based on the combined involvement of the central and peripheral nervous systems, a clinical diagnosis of encephalomyeloradiculoneuropathy was made. Rehabilitation treatment was initiated early during mechanical ventilation in the acute-care hospital, at a time when he required total assistance for ambulation. Despite immunotherapy, near-complete paralysis of the trunk and bilateral lower limbs persisted with orthostatic hypotension. Rehabilitation treatment was continued in acute-care and rehabilitation hospitals with monthly goal setting. At 8 months, he achieved independent outdoor ambulation.