Effect of Modified Constraint Induced Movement Therapy in Chronic Seizure Disorder and Infantile Hemiparesis: A Case Report

Epileptic seizures in children have the highest rate in infants. The incidence rate reported from India ranges from 0.42 per year in West Bengal to 0.49 per year in rural areas and 0.27 per 1000 per year in urban areas. Intraventricular haemorrhage of a newborn, Transient Ischaemic Attack (TIA), congenital or perinatal injuries to the brain may lead to infantile hemiparesis. A sevenyear-and-four-month-old female presented with difficulty eating with her right hand, an inability to maintain her grip on a pen for prolonged periods, and impaired gait. She was classified as Gross Motor Function Classification System (GMFCS) level II, Manual Ability Classification System (MACS) level III, and had a Quality of Upper Extremity Skills Test (QUEST) score of 29.30%. She was diagnosed with a chronic seizure disorder and right-sided hemiparesis. She was administered modified Constraint Induced Movement Therapy (mCIMT) for hand function three days a week for eight weeks. The constraint time of the left hand was two hours and 30 minutes per session. During the session, she went through intensive exercises for the right hand, like handling spherical and cylindrical objects, manipulating different shapes, and using a pegboard, etc. Within eight weeks, a significant change was seen in handling and manipulating objects. The MACS score improved to II, and the QUEST score increased to 47.95 ∼ 48. While dissociated movement and grasp showed significant improvement, the tripod grasp remained unexecuted. The study concludes that mCIMT for upper limb function can significantly improve the quality of life for children with hemiparesis.