Neurologopedic Therapy in a Child with Moyamoya Disease

Abstract

Introduction. Moyamoya is a rare disease of unknown etiology which leads to strokes resultant from occlusions of intracranial arteries. As a result of the blockage of the arteries in the brain a lateral network of blood vessels develops, forming a characteristic angiographic image.
Case Report. In the paper a case is presented of a child who in the course of a month has suffered two strokes in two cerebral hemispheres. The damage in the central nervous system led to paresis in four limbs, speech impairment (later: lack of speech), problems with swallowing, and limited visual and audial contact.
Discussion. The main aim of the therapy was to improve feeding, drinking, and chewing and an attempt to introduce alternative communication. Elements of sensory integration were employed, and regulatory therapy of Castillo Morales was used to allow swallowing, shutting the mouth fully, and controlling the mandible while eating and drinking. Furthermore, the child’s agility was being simultaneously enhanced the motor skills rehabilitation, the child would also benefit from a Room of World Experiences. Contrary to the initial assumptions, it has not been possible to reach all the aims of the therapy. Epileptic seizures have led to the loss of the acquired skills.
Conclusions. Successfulness of therapy is dependent on a number of factors, which are often independent of the therapist. What is crucial is to adjust the level of the difficulty of the sessions and their duration to the child’s state of feeling on a particular day. After the conclusion of the programme improved eyesight was noticed. However, in the case of a child with such vast damage to the central nervous system the aim of the therapy is to retain the acquired skills and to carry out further attempts to develop new skills through their frequent repetition. (JNNN 2018;7(2):75–79)