Cerebral palsy refers to brain injury or disorders that affect a person's ability to move thus making the brain non-progressive. Cerebral palsy is a condition that results from injuries or abnormalities of the brain, mostly in the mother’s womb or occurs any time during 2 years after birth. It affects brain and nervous system functions such as thinking, seeing, hearing, learning and movement.
The term Cerebral Palsy refers to Cerebral - of the brain, Palsy - lack of muscle control and cluster of neurological disorders that appear in infants or early childhood and affect body movement, muscle coordination, and body balance permanently. CP affects the part of the brain that controls muscle movements. Most children with cerebral palsy are born with it, although it may not be detected until months or years later. The early signs of cerebral palsy mostly appear before a child reaches 3 years of age. The most common sign is a lack of muscle coordination in voluntary movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes. Other common neurological symptoms include seizures, hearing loss and impaired vision, bladder and bowel control issues, and pain and abnormal sensations. These disorders are not progressive which means that the damage of the brain damage doesn't get worse over time.
Cerebral palsy refers to the disorders of the development of movement and posture, causing activity limitation. Along with problems of muscle contractions , difficulties with thinking, learning, feeling, communication and behaviour, CP occurs with epilepsy and problems with the vision. In cerebral palsy bone and joint deformities is caused due to uneven growth between muscle-tendon units and bone. High muscle tone is due to spasticity or dystonia. Babies born with severe cerebral palsy often have an irregular posture; their bodies may be either very floppy or very stiff. Birth defects such as spinal curvature, a small jawbone, or a small head sometimes occur along with CP. Symptoms may appear or change as a child gets older. CP becomes noticeable when the baby reaches the developmental stage at age of 6 to 9 months and is starting to mobilise, where preferential se of limbs, gross motor developmental delay is seen.
Drooling, lower urinary tract symptoms, sensory processing issues are the most common symptom among children with cerebral palsy.
Cerebral palsy occurs because of problem in brain development while baby is growing inside the mother's womb, or because of brain damage during birth or soon after birth.
Problems before birth include :
Problems during or after birth include :
Some pregnancies or births are at high risk of such brain damage. These include
The current available treatment options help the patients in managing the symptoms to some extent, but they do not repair the brain damage directly or effectively. Therefore, scientists and researchers are now considering stem cell therapy as an effective treatment option for patients suffering from cerebral palsy worldwide. It was believed that brain damage during birth is irreversible. However, now with advance research; we understand that it is possible to repair the damaged brain tissue using Stemcell Therapy. The autologous bone marrow derived mononuclear cells (BMMNCs) are used for transplantation. The transplanted stem cells work around the damaged tissue and affected areas helping in the repair of the damage in the brain. They help in decreasing the damage in those areas and differentiate into various cell types of the nervous system such as oligodendrocytes, glial cells and other cells of the nervous system. The process that help the tissue to repair and regenerates includes:
These mechanisms repair and regenerate the damaged tissue, restoring activities in the affected area, which turns into clinical improvements. This plays a great role in improving the overall quality of life. Most importantly autologous BMMNCs do not show any adverse side effects and they do not face any immune rejection. As they are obtained from the same patient therefore are free of the ethical issues.
Stemcell Therapy minimizes the symptoms, prevents future complications, and maximizes functional independence.
A multidisciplinary approach is being followed to achieve the above goals includes:
1. Physiotherapy :
Physiotherapy is one of the most important therapy for cerebral palsy. Physiotherapy helps in increasing the strength of weak muscles, encourage movement, lessen the tight muscles, prevent contractures of muscles, alleviate pain, enhancing mobility and maximizing independence. Physiotherapists use techniques such as NDT, Bo bath, Rood's approach, Stretching, Gait training, Selection of appropriate aids and Orthosis to achieve the above goals.
2. Occupational Therapy :
Occupational therapy helps in identification of the day to day problems that a child faces and enable the child to carry out complex movements involved in daily tasks such as bathing, dressing, transferring to the toilet, etc. Also, parents are educated to assist the child in a functional activity. Occupational therapy helps boosting children's and parent's self-esteem and confidence, helping the children to become independent with their daily activities.
3. Speech Therapy :
Children with cerebral palsy may have difficulty in speech and language development, facial expressions and hand gestures. Speech therapy improves the oral motor skills, speech and language skills. Children who cannot speak, are taught sign language, and the use of special equipment like computer/tablet for communicating through pictures, etc. A speech therapist provides guidance regarding hearing aids if hearing problem is the cause of delayed speech. Children with cerebral palsy may also suffer from chewing and swallowing difficulties due to weakness of masticatory (chewing) muscles and pharyngeal (swallowing) muscles. Difficulty in swallowing can cause severe choking or food entering the wind pipe causing difficulty in breathing which can be life threatening, or it can cause aspirational pneumonia of the lungs causing long term ailments and malnutrition. Therefore, a speech therapist teaches children and parents the swallowing techniques, accurate position and exercises, makes proper changes in the diets.
4. Medication :
Medications are given to children with cerebral palsy to manage symptoms such as seizures, spasticity, dystonia, pain, drooling, etc. Parents must consult a paediatric neurologist or paediatrician for medical assistance.
The use of hyperbaric oxygenation in the paediatric patient is most common advance technique used for the treatment. HBOT has been used in for resuscitation in respiratory failure, for cranial birth injuries, and for haemolytic disease of the new born. HBOT was reported to reduce high serum bilirubin levels and prevent development of neurological disorders. The results showed significant reduction of spasticity: 50% reduction in spasticity was reported in 94.78% of the patients. The parents claimed the positive changes in balance and has found reduce frequency of seizure activity. It is advised that HBOT therapy must be applicable with Stemcell Therapy for better and effective result for the Cerebral Palsy.
The patient must stay for 30 days, however in some cases 45 days of stay is recommended. The approximate cost of Stemcell Treatment would range between USD 6500 to USD 10000 per cycle depending on current condition of the patient.
Hyperbaric treatments average cost between 50-90 USD per session each of 60-90 minutes for 25-30 days daily.
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