All three patients experienced gait instability and cranial nervedeficits before surgery, and two of the patients had mild cognitivedeficits. Patients suffered cranial neuropathies ranging from cranialnerves IV through X and XII.Program Description: The customized interdisplinary rehabil-itation plan required the services of speech therapists, audiologists,physical therapists, occupational therapists, neuropsychologists,physiatrists, otolaryngologists, ophthalmologists and optometrists.Setting: Referral based tertiary cancer center.Results or Clinical Course: Each patient showed demonstrablegains in function with inpatient rehabilitation and good outcomes atdischarge.Discussion: Intracranial epidermoid cysts are uncommon, slow-growing brain tumors often found in the cerebellopontine angle.Due to their location, symptoms may present with a complexcombination of headache, cerebellar dysfunction, and cranial nervedeficits affecting functional status. This is the first report of therehabilitation of cerebellopontine angle epidermoid cyst patients.Conclusions: The findings suggest that a customized inpatientrehabilitation plan can result in functional gains. More research onthe rehabilitation of these rare tumors is needed.

Poster 65Barriers to the Acute Rehabilitation of Patients withAnterior Pelvic Exenteration: A Case Series.Jason M. Donnelly, MD (NYP Columbia-Cornell, NewYork, NY, United States); C. David Lin, MD.

Disclosures: J. M. Donnelly, No Disclosures.Case Description: Two patients with recurrence of squamouscell cancer of the vulva underwent anterior pelvic exenteration withrectus flap and were admitted to acute rehabilitation postsurgically.In both cases postoperative precautions included restricting lying atgreater than 45 degree angle with no sitting to prevent wounddehiscence.Setting: Acute inpatient rehabilitation service at New York Pres-byterian Hospital Cornell.Results or Clinical Course: Initial rehabilitation evaluationdemonstrated an ambulation subscale of the Functional Indepen-dence Measure (aFIM) score of 1; requiring maximum assistance forambulation in each case. Rehabilitation was performed lying or side-lying. After 13 and 11 days of admission the patients were unable toachieve their previously stated goals of modified independence forsitting, transfers or ambulation during their admission in acute rehabil-itation and both patients were discharged to subacute rehabilitation.Discussion: Anterior pelvic exenteration is an extensive proce-dure with high chance of dehiscence. The primary challenge foracute rehabilitation is the deconditioning of the abdominal musclesand extensive precautions against sitting or lying at an angle greaterthan 45 degrees. Presurgical habilitation to strengthen the abdomi-nal muscles prior to surgery may be a viable tool to minimize theimpact of deconditioning. Sitting precautions necessitate perform-ing therapy while lying or standing. In today’s setting of managedcare with strict limitations on the amount of acute inpatient reha-bilitation patients receive annually, a course of subacute rehabilita-tion prior to acute rehabilitation admission may be more appropri-ate to allow wound care and proper healing.Conclusions: Anterior pelvic exenteration is a major surgicalprocedure with significant recovery time for wound healing. Post-surgical precautions against sitting necessitate performance of acute

rehabilitation in the lying or side-lying position to prevent wounddehiscence. Presurgical habilitation of the abdominal muscles mayhelp offset the deconditioning that occurs during restrictions onmovement but acute rehabilitation in the immediate postoperativeperiod will likely be limited. As such, these patients are goodcandidates for subacute rehabilitation admission prior to ccuterehabilitation to allow for wound healing.

Poster 66Levodopa/Carbidopa to Improve Motor RecoveryAfter Brain Tumor Excision: An N-of-1 Case Report.Jesse D. Ennis, MD (McMaster University, Hamilton, ON,Canada); Vinjamuri R. Chari, MD; Andrew Graham,PhD; David T. Harvey, MD FRCP; Enoch Ho, MPh, RPT;Shanker Nesathurai, MD.

Disclosures: J. D. Ennis, No Disclosures.Case Description: A 34-year-old woman with residual left-sided hemiparesis after excision of a right frontoparietal oligoastro-cytoma. After 1 month of inpatient rehabilitation followed by 9months of outpatient physiotherapy, she had reached a clinicalplateau with no further gains made.Program Description: Utilizing an N-of-1 randomized, place-bo-controlled format, we scheduled a 6-week course of structuredphysiotherapy accompanied by once daily levodopa/carbidopa(LD/CD) or placebo. The LD/CD or placebo was given in 1-week blocks,for a total of 3 weeks of LD/CD and 3 weeks of placebo treatment.The order of placebo or active drug treatment was randomized, andthe patient and outcome assessor were blinded to the treatmentallocation. The motor sub-scale of the Fugl-Meyer Assessment(FMA) was performed at baseline, and then weekly to track thepatient’s functional performance.Setting: An outpatient physical medicine & rehabilitation practiceat an academic center.Results or Clinical Course: The mean FMA for the LD/CDweeks was 6.90 points above the mean score for placebo (P�.028).The mean placebo score did not differ significantly from baselinemeasures (P�.581). At the end of the study, the patient elected tocontinue with the LD/CD treatment.Discussion: In this N-of-1 case report of a patient post braintumor excision, LD/CD combined with physiotherapy appeared tohave a significant benefit for motor function, compared to physio-therapy with placebo. Motor function was improved despite thepatient being at over 1 year post tumor excision, and in the chronicphase of central nervous system injury. Side-effects were minor andincluded vivid dreams and headache that subsided within 1 week.Conclusions: LD/CD may have a beneficial effect on improvingfunctional recovery after brain tumour excision. Further studiesshould be performed to assess this off-label use of LD/CD in patientswith neurologic impairment secondary to brain tumors.

Poster 67Guidelines: Breast Cancer Rehabilitation.Maira Saul, PhD (Instituto do Cancer do Estado de SãoPaulo da Faculdade de Medicina da Universidade deSão Paulo, São Paulo, Brazil); Linamara R. Battistella,PhD; Mellik Bazan, MD; Christina May M. Brito, PhD;Rebeca B. Cecatto, PhD; Marta Imamura, MD, PhD;Maria Inês P. Lourenção, Occupational Therapist; Pris-cilla S. Otsubo, Physical Therapist.

S211PM&R Vol. 4, Iss. 10S, 2012