Increase in Quantity of Purposeful Fast Eye Movements in Children with Anoxic Brain Injury/Hypoxic Ischemic Encephalopathy Following Neurological Rehabilitation

Presentation: Five patients, between the ages of 4 and 6 years old, presented to Plasticity Brain Centers of Orlando for evaluation and treatment of Anoxic Brain Injury (ABI)/Hypoxic Ischemic Encephalopathy (HIE). Two children had HIE from birth trauma; One child had ABI from a near-drowning event; Two children had ABI/HIE from other events. Parents on the patients’ behalves reported visual impairments.

Findings: Saccadometer testing was performed on intake with 100 horizontal saccades with red laser targets at 20 degrees apart while in a dark room. It was calculated on average, patients were able to perform 8 eye movements.

Methods: A 5-day, multi-modal program of neurological exercises was administered in 10 one-hour treatment sessions. Each session consisted of repetitive peripheral somatosensory stimuli, neuromuscular reeducation exercises, vestibular rehabilitation exercises, orthoptic exercises, and off-vertical axis rotation (Gdowski 1999) utilizing a multi-axis rotational chair (MARC).

Outcome: Upon exit, saccadometer testing was performed again. It was calculated on average, patients were able to perform 21.2 (+265%) eye movements.

Conclusion: The authors suggest that multi-modal program of neurological exercise may be a viable intervention to increase the quantity of purposeful eye movements in patients with ABI/HIE. The authors also suggest further investigation into multi-modal, intensive neurological approaches for patients with ABI/HIE.

References:

1. Gdowski GT, McCrea RA. Integration of vestibular and head movement signals in the vestibular nuclei during whole-body rotation. J Neurophysiol (1999) 82:436–49