COMPLEX MANAGEMENT OF WORSTER-DROUGHT SYNDROME: A CASE REPORT OF DOUBLE HEMIPLEGIA AND PSEUDOBULBAR PALSY IN A 13-YEAR-OLD

Abstract

Introduction: Worster-Drought syndrome (WDS) is a rare congenital pseudobulbar palsy causing speech and feeding difficulties due to impaired corticobulbar pathways. Symptoms include drooling, chewing difficulties, dysarthria, and motor impairments, often categorized under cerebral palsy.

Case Report: We report a 13-year-old female with cerebral palsy (double hemiplegia), pseudobulbar palsy, global developmental delay, and speech delay. Key features included drooling since birth, chewing difficulty, and inability to speak. Birth history revealed severe asphyxia and meconium aspiration, requiring a 20-day NICU stay. Developmental delays were evident, with head control at one year and ambulation at two years. Examination showed left-predominant spasticity, hyperreflexia, muscle wasting, dynamic Achilles tendon contracture, and right-sided facial asymmetry. MRI revealed peri-insular temporal gliosis. Multidisciplinary management with speech, oral motor, and swallowing therapy was initiated, emphasizing continued follow-up and home-based exercises.

Results: The case underscores the complexity of managing CP with pseudobulbar palsy, necessitating targeted therapy for motor, speech, and feeding impairments.

Conclusion: Early multidisciplinary intervention in WDS can significantly improve communication, feeding, and daily functioning, enhancing the quality of life.