ICNC Abstracts, ICNC 2018

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Speech & Swallowing rehabilitation in Child with GBS: The journey from ICU to School
abhijeet vilas botre

Last modified: 2018-09-09

Abstract


Introduction: We highlight and emphasize the post acute phase recovery with intensive programmed speech and dysphagia rehabilitation in 8 yrs with classical GBS symptoms and multiple bilateral cranial neuropathies with rare incidence in pediatric population.

Case report: 8 years boy, with acute onset gradual progressive lower limb weakness and simultaneously with bilateral V, VII, VII, IX, X & XII   cranial neuropathy over 5 days. His investigations revealed GBS with conclusive NCV and MRI findings. He was managed with supportive care like invasive ventilation and IVIG. At discharge he was ambulatory with NG tube feeds and he had major deficit in speech and oro-pharyngeal phase deglutition (OPxD). Post motor plasticity based Intervention VFSS showed marked (80% with soft solids and 50 % in crunchy solids) improvement in deglutition. Speech came to baseline in 30 days and OPxD around 1.5 months.

Discussion: Tongue protrusion & lateralization   & pharyngeal weakness affected was improved with oromotor & articulatory drills & Chin tuck against resistance, hard bite block over 21 sessions across different consistencies. Dysarthria improved faster than OPxD seen in patient presented with GBS who do not show quick improvement. Intensive rehab, counseling to parent & child, could help restore normal speech, adequate deglutition & gain lingual musculature though mild residual right lingual and right peri-oral musculature atrophy.

Conclusion: There is scarcity of literature in Indian context of reports of children and their speech & swallowing rehabilitation journey. Post medical management rehabilitation in facilitating functional recovery of the patient is worth advocating.

 


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