Long-term Outcome of Motor Function in a Child with Moyamoya Disease: A Case Report

[Purpose] This observational study provides a retrospective description of changes in motor function of a 10 year old child who suffered from motor weakness caused by Moyamoya disease (MMD) over an approximately 3 year follow-up observation period. [Methods] The child was diagnosed as MMD due to multifocal encephalomalacia in both frontal and parietal cortices. After the ischemic attack, the child received physical therapy the based on stroke rehabilitation, including muscle strengthening exercises, training of functional activity/ADL, and neurodevelopmental treatment. [Results] The child's MRI showed areas of ischemic infarction in both the frontal and parietal lobes. Steno-occlusive findings for both the anterior cerebral artery and middle cerebral artery were observed on cerebral angiography. Regarding changes of motor function during the three-year follow-up, significant improvements, in the Motricity index, Modified Brunnstrom Classification, manual function test, and functional ambulatory category were observed. [Conclusion] The basic motor function and functional abilities of the child showed improvement with conservative treatment over approximately three years. The functional motor ability of children with MMD may be similar to the recovery progression of pediatric stroke patients, if there is no re-occurrence of ischemia.