%0 Journal Article
%T Adaptations in the Treatment of Congenital Lymphedema Centered on the Quality of Life
%A Jose Maria Pereira de Godoy
%A Ana Paula Sanchez
%A Daniel Zucchi Libanore
%A Maria de Fatima Guerreiro Godoy
%J Case Reports in Medicine
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/456060
%X Case Description. This report describes the evolution, necessary adaptations, and complications in the treatment of a 9-year-old child with primary congenital lymphedema. Description of Intervention. The clinical treatment of lymphedema was started in the first year of the patient¡¯s life and for five years she was only treated using the Godoy & Godoy technique of cervical stimulation. Three years ago the patient was prescribed a compression stocking made from a cotton-polyester fabric (grosgrain) because of a sudden increase in the lymphedema after she started to take growth hormones. Outcome and Conclusion. The combination of cervical stimulation and a compression stocking was effective to keep the child¡¯s life relatively normal, performing all day-to-day and recreational activities. 1. Introduction Lymphedema is defined as the abnormal buildup of protein-rich fluid in soft tissues resulting from dysfunction of the lymphatic system, that is, an imbalance between the formation of lymph and its absorption into the initial lymphatic system [1]. Primary lymphedema is classified as idiopathic or family (hereditary). Hereditary lymphedema may or may not be associated with congenital anomalies or physical changes [2]. It has great clinical heterogeneity, both within and between families and the age at onset varies. There are more than four distinct genetically known conditions related to lymphedema with mutations of three genes having been discovered in families with lymphedema [3]. The recommended treatment for lymphedema is a combination of therapies including manual and mechanical lymph drainage, compression (garments and bandages), myolymphokinetic exercises and activities, and hygienic care [4¨C9]. 2. Case Report The case of a nine-year-old female child, who was born with congenital lymphedema of the left leg, is reported. She was referred for treatment when she was one year old. Diagnosis of lymphedema was clinical with perimetric measurements (every 3£¿cm) along the foot and leg (Figure 1). Cervical stimulation using the Godoy & Godoy technique was performed until the age of six. It was initially carried out by the medical team but, after teaching the mother, she performed the cervical stimulation with clinical control being carried out by the medical team initially every week, then every fortnight, and eventually once per month. Cervical stimulation is the only lymph drainage technique that has been evaluated in isolation and proven to be efficacious in the reduction of edema. The hypothesis of the mechanism of action is that cervical stimulation causes
%U http://www.hindawi.com/journals/crim/2014/456060/