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Samenvatting Neurodegeneratieve stoornissen en CP
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Logopedie 2 - semester 1 - Complexe logopedische stoornissen: Neurodegeneratieve stoornissen en CP
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SAMENVATTING NEURODEGENERATIEVESTOORNISSEN & CEREBRALE PARESE
INHOUD
1. 4 soorten neuromusculaire aandoeningen ..................................................................................................... 4
1. 2 soorten centraal neurologische aandoeningen ........................................................................................... 5
2. Definitie CP ...................................................................................................................................................... 5
3. Vormen van hersenschade .............................................................................................................................. 5
4. Indeling volgens topografie/distributie........................................................................................................... 5
5. Indeling volgens klinisch beeld: classificaties .................................................................................................. 5
6. Tonus ............................................................................................................................................................... 6
7. Ernst ................................................................................................................................................................ 7
8. Schalen: functionaliteit ................................................................................................................................... 7
A. GMFCS ........................................................................................................................................................ 8
B. MACS .......................................................................................................................................................... 8
C. CFCS ........................................................................................................................................................... 8
D. VSS ............................................................................................................................................................. 8
E. EDACS ......................................................................................................................................................... 8
1. Motorische problemen ................................................................................................................................... 9
A. Orthopedische problemen ......................................................................................................................... 9
B. Hulpmiddelen ........................................................................................................................................... 10
2. Mentale retardatie ........................................................................................................................................ 10
3. Stoornis in aandacht en geheugen ................................................................................................................ 11
4. Gedragsstoornissen....................................................................................................................................... 11
5. Stoornissen in auditieve + visuele functie ..................................................................................................... 11
A. Auditieve functies .................................................................................................................................... 11
A. Visuele functie.......................................................................................................................................... 11
6. Epilepsie ........................................................................................................................................................ 11
A. Behandeling ............................................................................................................................................. 12
7. Stoornis in sensorische integratie ................................................................................................................. 12
A. Sensorische modulatieproblemen ........................................................................................................... 12
8. Communicatie ............................................................................................................................................... 12
9. Voeding ......................................................................................................................................................... 12
A. Behandeling voedingsproblemen ............................................................................................................ 13
B. Als het fout gaat ....................................................................................................................................... 13
Margot Vermeersch
1
, C. Groei + verandering orofaryngeale gebied + gevolgen bij CP .................................................................. 13
10. Gastro-oesofageale reflux ........................................................................................................................ 14
11. Mondhygiëne ........................................................................................................................................... 14
12. Drooling.................................................................................................................................................... 14
1. Spasticiteit ..................................................................................................................................................... 15
A. Lichte spasticiteit ..................................................................................................................................... 15
B. Matige spasticiteit .................................................................................................................................... 16
C. Ernstige spasticiteit .................................................................................................................................. 16
D. Logopedische problemen bij hypertonie ................................................................................................. 16
E. Logopedische therapie bij hypertonie ..................................................................................................... 17
2. Dyskinesie ..................................................................................................................................................... 17
A. Logopedische problemen bij dyskinesie .................................................................................................. 18
I. Comorbiditeit....................................................................................................................................... 19
3. Ataxie ............................................................................................................................................................ 20
A. Logopedische problemen bij ataxie ......................................................................................................... 21
4. Hypotonie (+ prematuriteit) .......................................................................................................................... 21
A. Logopedische problemen bij hypotonie .................................................................................................. 22
5. Hoe klinken stemmen? ................................................................................................................................. 23
1. Prevalentie .................................................................................................................................................... 24
2. Belang van vroegdiagnose ............................................................................................................................ 24
3. Stellen van vroegtijdige diagnose ................................................................................................................. 24
4. Teamwork in COS (= Centrum voor OntwikkelingsStoornissen) ................................................................... 25
5. Referentiecentrum voor CP en Neuromusculair referentiecentrum ............................................................ 25
6. Belang van vroegtijdige interventie .............................................................................................................. 26
1. Logopedisch onderzoek bij CP....................................................................................................................... 27
A. Samengevat.............................................................................................................................................. 27
A. Anamnestische informatie ....................................................................................................................... 28
B. Preklinisch onderzoek .............................................................................................................................. 28
C. Orofaciaal onderzoek ............................................................................................................................... 29
D. Onderzoek slikact + speekselcontrole ...................................................................................................... 29
E. Dysartrie onderzoek ................................................................................................................................. 29
I. Dysartrievorm ...................................................................................................................................... 30
II. Ernstschaal dysartrie ........................................................................................................................... 30
F. Activiteitenniveau: CFCS .......................................................................................................................... 31
G. Onderzoek: eten + drinken (EDACS) ........................................................................................................ 31
H. Mogelijke onderzoeksinstrumenten ........................................................................................................ 31
I. Conclusie logopedisch onderzoek ............................................................................................................ 32
Margot Vermeersch
2
,1. Algemeen ...................................................................................................................................................... 33
A. Ergotherapeuten ...................................................................................................................................... 33
B. Mogelijke therapieconcepten .................................................................................................................. 33
I. NDT-Bobath ......................................................................................................................................... 33
II. Bobath – Müller ................................................................................................................................... 34
III. KNR ...................................................................................................................................................... 34
2. Logopedisch handelingsplan ......................................................................................................................... 34
3. Logopedische therapie bij CP ........................................................................................................................ 34
A. Houding/motoriek ................................................................................................................................... 35
B. Eet- en drinktherapie ............................................................................................................................... 36
I. Totale controle .................................................................................................................................... 36
II. Lokale controle of mondcontrole ........................................................................................................ 36
III. Lepelvoeding........................................................................................................................................ 37
IV. Kauwen ................................................................................................................................................ 37
V. Drinken (uit een beker) ........................................................................................................................ 37
VI. Drinken (met een rietje) ...................................................................................................................... 37
VII. Bij welke mensen vraagt voeding extra aandacht ........................................................................... 37
VIII. Richtlijnen eet- en drinktherapie samengevat ................................................................................ 38
C. Tandverzorging + mondhygiëne............................................................................................................... 39
D. Drooling.................................................................................................................................................... 39
E. Ademhaling .............................................................................................................................................. 39
F. Fonatie ..................................................................................................................................................... 40
G. Resonantie ............................................................................................................................................... 40
H. Spraak, taal, communicatie ...................................................................................................................... 41
I. Non-verbale + ondersteunde communicatie ........................................................................................... 41
4. Logopedische therapie bij NMA .................................................................................................................... 41
A. Ademhaling en stemgeving ...................................................................................................................... 42
I. Kinesitherapeutische AH-therapie....................................................................................................... 42
II. Logopedische AH-therapie .................................................................................................................. 43
B. Mondmotoriek ......................................................................................................................................... 43
C. Eet- en drinktherapie ............................................................................................................................... 44
I. Casus S. ................................................................................................................................................ 45
D. Taalontwikkeling ...................................................................................................................................... 46
Margot Vermeersch
3
, NEURODEGENERATIEVE STOORNISSEN &
CEREBRALE PARESE
(Korte herhaling)
Neuromusculaire aandoeningen Centraal neurologische stoornis
- Stoornissen i/h bewegingsapparaat - Stoornissen i/h bewegingsapparaat
- Gevolg van stoornis i/h centrale zenuwstelsel
- Gevolg van stoornis i/h perifere sensorische +
motorische systeem
HOOFDSTUK 1 – NEUROMUSCULAIRE
AANDOENINGEN
1. 4 SOORTEN NEUROMUSCULAIRE AANDOENINGEN
1. Voorhoorncelaandoeningen (SMA, ALS)
2. Mono en polyneuropathieën (GBS)
3. Ziekte v/d neuromusculaire junctie = myasthenieën (MG)
4. Myopathieën/spierziekten (Duchenne)
- Oorzaken liggen in perifeer zenuwstelsel
- Nooit hersenletsel
- Genetische aandoening
- Vaak degeneratief
Bij kinderen 2 grote groepen
- Duchenne en SMA (= Spinal Muscular Athrophy)
→ Behandeling is eenvoudiger dan bij CP, kinderen vertonen dezelfde symptomen
Margot Vermeersch
4
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