Rehabilitation of a young girl with acute transverse myelitis and prolonged lower motor neuron features: a longitudinal case report over 12 months. (2nd January 2022)

• Record Type: Journal Article
• Authors: Hossain, K M Amran; Sakel, Mohamed; Saunders, Karen; Kabir, M Feroz; Hasnat, M Abu Khayer
• Is Part Of: International journal of therapy and rehabilitation. Volume 29:Number 1(2022)
• Page Start: 1
• Page End: 10
• Publication Date: 2022-01-02
• Subjects: Acute Transverse Myelitis -- Clinical reasoning -- Out-patient -- Rehabilitation -- Spinal cord injury; Therapeutics -- Periodicals; Medical rehabilitation -- Periodicals; 615.505
• DOI: 10.12968/ijtr.2020.0049
• Languages: English
• ISSNs: 1741-1645

Abstract

Abstract : Background: This report describes an effective rehabilitation programme for a 13-year-old girl, diagnosed with acute transverse myelitis, as an example of best clinical practice. Case description: Miss A was admitted to the National Institute of Neurosciences and Hospital in Dhaka, where she was diagnosed with acute transverse myelitis, in September 2018. She was discharged and referred for intensive rehabilitation over 3 months as an outpatient at the Centre for the Rehabilitation of the Paralysed in Bangladesh. The therapy team conducted a baseline assessment before starting treatment, which included the following outcome measures: the International Standards for Neurological Classification of Spinal Cord Injury Scale; Spinal Cord Independence Measure; and the Spinal Cord Injury Functional Ambulation Inventory. After 3 months, Miss A was discharged home to continue with a home exercise programme supported by her parents. Outcome measurements were repeated at 3-, 6- and 12-month time points. Results: Miss A regained muscle power in her legs and normal sensation in S4/5 dermatomes, in addition to regaining voluntary anal muscle contraction. Her mobility and transfers improved so that she was able to transfer in and out of her wheelchair independently and use two elbow crutches to walk short distances outdoors. Conclusions: This report shows that it is possible for a child who had been severely disabled by acute transverse myelitis to make substantial physical improvements up to 12 months after diagnosis when provided with effective rehabilitation. It also identifies that rehabilitation can provide multiple benefits and value for the individual patient, family, community and society.