À propos d’un cas pédiatrique de diplégie spastique : évaluations et élaboration d’un projet thérapeutique à court et moyen terme

Abstract

We report a case of cerebral palsy, following premature birth, in a young girl presenting with spastic diplegia. At age 8years, she benefited from a complete and in depth clinical evaluation, including two major aspects: motor functions and neuropsychology, without forgetting pediatric data. This assessment was based on the “factorial evaluation”, as proposed by G. Tardieu and further developed by Mr Le Métayer. Such an evaluation was performed by a multidisciplinary team including a physiotherapist, a psychomotor therapist, a speech therapist and a psychologist, under supervision of the pediatrician in charge of the reeducational day center. Systematic evaluation led to organize a consistent therapeutic plan of care given previous major surgery, the orthopedic issues was the first concern and we described specificity of motor cares of the child at several levels: orthopedic devices, kinesitherapy, oral and topic treatment of spasticiy and previous surgical interventions. On the other hand, we emphasized on the need to consider visuospatial and orthoptic problems, as well as psychosocial considerations and their impact on the efficiency of reeduction and functional outcome. The ultimate goal of the reeduction is to provide to this child all necessary tools in order to maximize her autonomy level throughout her life.