(Disclaimer: This article is for scientific purposes only, and the following information has been processed to protect the privacy of the child)
Abstract: This case is a 12-year-old boy whose mother did not perform regular maternal checkups during pregnancy, resulting in the child’s inability to sit and delayed gross motor development at the age of 6 months, and has been diagnosed with spastic cerebral palsy since childhood. She was diagnosed with spastic cerebral palsy and dystonia, and was recommended to undergo rehabilitation exercises. After rehabilitation, his condition has stabilized and his spastic cerebral palsy symptoms have significantly improved and his quality of life has improved.
Basic information】Male, 12 years old
Disease Type】Spastic cerebral palsy, dystonia
Hospital】Shandong Provincial Third Hospital
Consultation time】September 2018
Treatment plan】Rehabilitation functional training (Ueda Masa method + balance functional training)
Treatment period】1 month of outpatient rehabilitation training, 1 year of regular follow-up
【Treatment effect】Stable condition, symptoms improved significantly compared with before, quality of life improved
I. Initial consultation
In September 2018, a 12-year-old boy was seen in the outpatient clinic with hemiplegic joint flexion deformity, elongated trunk limbs, pale skin, and muscle atrophy with weakness. The child’s family communicated with the doctor that the child had been diagnosed with spastic cerebral palsy since he was a child, and after a period of treatment in the hospital when he was small, there was no great improvement, so he had been taken care of at home, and a few days ago, he overheard a patient say that in this case, some of the symptoms could be improved by rehabilitation means, and then he rushed over for consultation. The diagnosis of spastic cerebral palsy with dystonia was made through the child’s past medical history, medical history, physical signs and brain CT examination.
Treatment history
The child’s lower limbs were mostly weight-bearing on the healthy side in the standing position, and the body’s center of gravity was shifted to the healthy side, and the muscles of the healthy limb were compensated to increase; the affected limb had obvious muscle atrophy, and the paralyzed side had abduction and external rotation deformity of the hip joint, abduction and external rotation deformity of the ankle joint, and high muscle tone of the hip and ankle joints. The child was recommended to undergo long-term rehabilitation training in the outpatient clinic to gradually improve the symptoms of limb flexion deformity in order to improve the muscle strength and balance function of the limbs. After the diagnosis, the child was firstly arranged with the Ueda Orthopedic Method to reduce the muscle tone of the paralyzed side; through upper and lower limb exercises, weight-bearing training, and balance function training, the muscle strength of the affected limb as well as the balance function were enhanced.
Treatment effect
In this case, after long-term rehabilitation training, the child could walk alone with a cane, and the upper limb of the paralyzed side could pick up some large objects, and the strength of the limb was improved. In addition, the symptoms of hypertonia were significantly improved. When we talked with the child, the child also clearly felt the improvement of his symptoms, and the smile on his face gradually increased. After one month of systematic rehabilitation treatment, the child’s family was instructed to bring the child to the hospital every month for follow-up to evaluate the rehabilitation effect and correct the poor rehabilitation knowledge.
IV. Precautions
Spastic cerebral palsy is a severe disability, which will bring great burden to the child and his family. Rehabilitation training can effectively prevent limb deformity, avoid muscle atrophy and improve limb strength. As in the case of this child, through active treatment, the child’s condition has improved significantly and his smile has increased, and I am happy for him. However, the rehabilitation training for children with spastic cerebral palsy is long-term and requires the joint persistence of the family and the child. I advised the child and his family to pay attention to avoid non-standard movements in life and learning to prevent joint pain and dislocation.
In addition, rehabilitation training is a gradual, step-by-step process, and it is important to come to the hospital regularly for follow-up and to arrange the next step of rehabilitation work after passing the rehabilitation assessment. In addition, the psychological treatment of the child should be strengthened, so that the child can maintain a good attitude and build up self-confidence to speed up the recovery of the disease.
V. Personal insight
Spastic cerebral palsy is caused by brain dysplasia. At present, the main treatment is surgery and rehabilitation training. Surgery can improve the symptoms of joint deformity and high muscle tone, and rehabilitation training can improve the strength of the limbs and the spasticity of the limbs, and the effect is seen in the child of this case. Since the symptoms of the disease will gradually worsen with age and the deformity of the limbs will also gradually worsen, early intervention is relatively more effective. And both the child’s family and the child should maintain a good attitude and face it positively.