Ehlers-Danlos Syndrome EDS Hôtel-Dieu de Paris Bird meeting ASED 06 09 2012 Claude Hamonet*, Monique Vienne ** *Department of Physical Medicine and Rehabilitation (Pr. S. Poiraudeau, Dr. JY Maigne), Hôtel-Dieu Hospital, Paris **IMAP, Nice. With support of Department of Public health and Epidemiology (Pr. Ravaud), Hôtel-Dieu Hospital Paris. Grant : Fondation de France. Welcome Dr. Bird, you safe the life of our patients or you enhance their quality of life André Grossiord The pionner of French Rehabilitation. Garches. First description : a law student. By Edward EHLERS, a Dermatologist, Danish Society of Dermatology Copenhaguen 12 15 1900. Published in german language What is EDS today? A genetic disorder of connective tissue (collagen especially) autosomal dominant. Without genetic test, the diagnosis is clinical Which is not a "rare disease" but a frequent and an syndrome currently confused with another diagnosis… Most important signs for diagnosis (personnal serie of 586 patients Beighton scored 4/9 or more) PAINS (98%): (joints, muscles, belly, chest, skin, head,..) 71% very intensives ASTHENIA (97%) 69% very intensive PROPRIOCEPTIVES disorders (85%) HYPERMOBILITY (100%) HEMORRHAGES (92%) FRAGILITY OF THE SKIN (86,6%) Other family case(s) (95%). Respiratory symptoms in EDS (586 patients) Pseudo Asthma : 65% Dyspnea : 66% Dysphonia : 53% Bronchitis : 56% Strentchening of skin Popular but inconstant Beighton test : the thumb sign KNEES Recurvatum Ecchymosis « EDS FOOT » (Flat forward, Hollow in the middle, normal behind). Pathophysiological hypothesis (proprioception) No (or bad) emission of signals from sensors rom too soft tissues. Proprioceptive garments Cereplas. Rigid trunk orthesis Special seat adapted for a young boy with EDS Light rest hand orthesis (Néokraft) Functionnal hand splint Murphy finger orthesis Lower limb orthesis with hip device to stop hip luxation Lower limbs orthesis with elastic artificial muscles (Made by JC Chignon, Orthesist) She is walking, She was in a Wheelchair ! The discovery of Dr. Bird 1980, F.M. BIRD invented « Percussive intrapulmonary Ventilation », with internal percussion of pulmonary structures by IMPULSATOR Effects of Impulsator Improve breathing status and the new discover that (+ 02) is also in EDS a treatment against fatigue and migraines ! A chidren using percussionnaire + oxygen at home Carnitine is also used with success against the fatigue. Conclusion « To believe in rehabilitation is to believe in humanity » Howard Rusk (New-York)