Functional Recovery in a Patient of Abnormal Left Parieto-Occipital Encephalomalacia With Gliosis-Associated Genu Varum Deformity: A Case Report

TL;DR

A 77-year-old man with brain damage and knee deformity showed improved function and quality of life after six weeks of physiotherapy and tele-rehabilitation.

Contribution

This case report highlights functional recovery in a rare combination of brain encephalomalacia and genu varum deformity using targeted rehabilitation.

Findings

The patient showed significant improvement in daily living activities after six weeks of rehabilitation.

Tele-rehabilitation was effective in maintaining patient engagement and progress monitoring.

Proprioceptive neuromuscular facilitation helped in regaining motor function in the patient.

Abstract

Parieto-occipital encephalomalacia is a macroscopic appearance of the brain with loss of cerebral parenchyma associated with gliosis in the brain's anatomical structures. It occurs because of the liquefaction of brain parenchymal necrosis after cerebral ischemia, infection, and haemorrhages. It is often surrounded by glial cell proliferation in response to damage. Rehabilitation after the manifestation of neurological function must be tailored, and well-coordinated intervention must be formulated. We present a case study of a 77-year-old male with parieto-occipital encephalomalacia associated with genu varum deformity with a complaint of generalized weakness, vertigo, giddiness, and fall with one episode of a seizure attack. Further, bilateral genu varum deformity was noted on the knees. Encephalomalcia is associated with vitamin D deficiency. The physiotherapy rehabilitation consisted of resolving the symptoms of the patient, along with working on strengthening weak muscles of the genu varum deformity of the patient. The proprioceptive neuromuscular facilitation (PNF) method is a popular rehabilitation strategy for regaining motor function. Numerous outcome measures were used to monitor the patient's progress. Outcome measures such as the tone grading scale (TGS), motor assessment scale (MAS), dynamic gait index (DGI), Barthel index (BI), and world health-related quality-of-life (WHORQOL) scales were used. The rehabilitation lasted for six weeks. Tele-rehabilitation also plays a crucial impact in the recovery of patients. By the end of our rehabilitation, the patient significantly improved in performing activities of daily living and improved his quality of life. Tele-rehabilitation helped us stay connected with the patient.

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