Cerebral (brain) palsy (weakness) is an unchanging motor/movement disorder of early childhood.
Cerebral palsy is actually a group of disorders that are characterized by problems with movement, balance, and posture. Since this is a neurological disorder, the symptoms of cerebral palsy result from injury to the areas of the brain that affect motor function. These injuries can occur at any point during pregnancy, birth, or in early childhood. In most cases, the injury occurs during birth or shortly after birth in premature babies who experience spontaneous bleeding in the white matter of the brain. The white matter is the tissue in the brain that conducts electrical signals and connects all of the brain cells (gray matter) to each other. It is similar to telephone lines that connect all of our homes to each other. The white matter in which this bleeding typically occurs are the connecting tracts that carry the electric signals sent by large brain cells to our muscles.
Effects of Cerebral Palsy
The injury that causes cerebral palsy presents itself as problems with tone, uncontrollable movement, and poor balance and coordination. The symptoms and severity of symptoms will vary from person to person, by the type of CP, and by the number of arms and legs affected. Someone with severe CP might not be able to walk at all. Someone with mild CP might simply walk a little awkwardly. Some can have all four limbs affected, others just the legs, one side of the body, or just an arm or leg. While the condition doesn’t get worse over time, the specific symptoms a person experiences may change over their lifetime.
There are four main types of cerebral palsy: spastic, dyskinetic, ataxic, and mixed. They differ primarily by the regions or combination of regions of the brain that are injured or have experienced bleeding.
Spastic Cerebral Palsy
This type of CP is the most common, affecting about 80% of people with CP. People with spastic CP have increased muscle tone, meaning their muscles are tight and their limbs are stiff. As a result of this, their movements can be awkward or “spastic.”
Dyskinetic Cerebral Palsy
People with this type of CP have trouble controlling the movement of their hands, arms, feet, and legs. This makes it difficult for them to sit and walk. Their movements are uncontrollable and may either be slow or rapid. A patient with dyskinetic CP can have muscle tone that changes not only day to day, but during a single day.
Ataxic Cerebral Palsy
Patients with ataxic CP have problems with balance and coordination. They might be unsteady while they walk or could have a hard time with quick movements. They may also have difficulty with movements that need a lot of control like writing.
Mixed Cerebral Palsy
Some CP patients have more than one type of cerebral palsy. Most commonly, the mixture is spastic-dyskinetic.
Cerebral Palsy
Children with Cerebral Palsy experience a generalized improvement in their neurological deficits. In Dr. Harch’s experience, the seven most common dysfunctions which improve in CP children under his care are: 1) Alertness and awareness, 2) Gross motor function (movement of arms and legs), 3) Fine motor function (use of hands and fingers), 4) Tone (high tone comes down and low tone increases), 5) Cognition and speech, 6) Oral motor function (chewing, swallowing, drooling, secretion handling), 7) Balance (sitting or standing, depending on stage of development at time of HBOT). Our average CP patient sees improvement in 4 of these 7 dysfunctions. In addition, patients with cortical impairment of vision or hearing, and those with autonomic dysfunction will often see improvement. These improvements have been documented in published studies.
Why Come to Dr. Harch for Hyperbaric Oxygen Treatment of Cerebral Palsy
When standard medical approaches are not working, HBOT can be a great way to improve a cerebral palsy patient’s quality of life. Dr. Harch is the leader in hyperbaric oxygen treatment of cerebral palsy around the world. In fact, his research and proprietary protocols, Harch ProtocolsTM have revolutionized and expanded the understanding and use of HBOT around the world. HBOT works best when it is dosed properly, which is Dr. Harch’s specialty. With the correct dosage prescribed by Dr. Harch, you or your loved one are very likely to see a noticeable improvement in symptoms.
Case Study
Michael was an eight year old boy who was born premature and developed spontaneous bleeding in the white matter of both sides of his brain, more severe on the left side. This was manifest during his infancy with irritability, stiffness on the right side of his body, and delayed milestones. By eight years old he had cognitive deficits with attention/concentration and learning difficulties, constipation, uncontrollable behavior, and incontinence (no toilet training).
Michael’s SPECT brain blood flow scans before and after his first HBOT in 1999 are shown below. He was given two blocks of 40 HBOTs separated by a one month break. During the first block of HBOT Michael showed improvement in many of his problems for the first time in his life. At the end of 80 HBOTs he had improved use of his right leg, less stiffness in the right side of his body, a marked decrease in his constipation, cessation of incontinence (toilet training), improvement in his cognitive deficits/attention/concentration and learning difficulties, and improvement in his behavior. His repeat SPECT brain scan is shown after these 80 HBOTs.
Michael’s SPECT scan before HBOT: these are sagittal pictures (taken from the side view) through the middle two-thirds of the brain. The areas of purple are significantly reduced brain blood flow. The highest brain blood flow is white, and proceeds to lower levels of yellow, orange, purple, blue, and black (black means no blood flow, dead brain tissue).
3D surface reconstruction of Michael’s SPECT scan before HBOT. While the sagittal slices above show a diffuse injury to the brain, the 3-D surface image mainly shows injury to the temporal lobes and the lower part of the frontal lobes.
Michael’s SPECT scan after one HBOT: note the generalized relative increase in blood flow with a filling in of the purple areas with more blood flow (yellow, orange).
Note: A SPECT scan is often performed before HBOT and again after one HBOT to display recoverable brain tissue. In order for the increased blood flow to be more permanent, at least approximately 40 treatments are then completed.
3D surface reconstruction of Michael’s SPECT scan after 1 HBOT: while there has been a generalized improvement in blood flow on the sagittal slices, the 3-D image mainly captures improvement in the frontal and temporal lobes.
Note: A SPECT scan is often performed before HBOT and again after one HBOT to display recoverable brain tissue. In order for the increased blood flow to be more permanent, at least approximately 40 treatments are then completed.
Michael’s SPECT scan after 80 HBOTs: A generalized relative increase in brain blood flow (much more white, yellow, and orange) that is accompanied by an improvement in nearly all of Michael’s motor, intellectual, and developmental problems.
3D surface reconstruction of Michael’s SPECT scan after 80 HBOTs: Note the improvement in the frontal and temporal lobes, as well as the back of the brain, which is consistent with Michael’s overall clinical improvement.
Supportive Research and Information
Comprehensive Lecture on CP and the Evidence for HBOT Effectiveness in CP:
HBOT in Cerebral Palsy: What do we know? By: Dr Pierre Marois Md FRCP(c) Physiatrist Ste-Justine University Hospital Montreal
Note: Dr. Pierre Marois is one of the seminal researchers and master clinicians in pediatric physiatry, particularly hyperbaric oxygen therapy for CP. Starting with an observation of the dramatic improvement in spasticity and other neurological functions that twin CP boys in Montreal experienced after a short course of HBOT in England in the mid-1990s Dr. Marois acted on these findings and initiated a series of clinical trials on HBOT in CP. This lecture summarizes his research and others’ research upto 2017 and the proof for HBOT in CP. This proofing involved the use of a newly developed tool, the Gross Motor Functional Measures Evolution Ratio (GMFM ER), which evaluated changes in motor function of CP children using the gold standard motor evaluation tool for CP, the Gross Motor Functional Measures (GMFM). The GMFM ER is a comparison of any CP child’s change in GMFM compared to the natural history of improvement in GMFM of CP children.
Given at HBOT 2017:
The 11th International Symposium
The Oxygen Revolution: “Healing Across the Spectrum of Disease and Beings”
International Hyperbaric Medical Foundation
The Intercontinental Hotel
August 18-20, 2017
New Orleans, Louisiana
https://www.ncbi.nlm.nih.gov/pubmed/11558483. (Famous Collet study where children were given two different doses of hyperbaric therapy, one of which was compressed air. Both groups achieved substantial clinical improvement in nearly all measured dysfunction that was greater, faster, and a greater number of domains than standard therapies for CP.
http://www.jpands.org/jpands1204.htm (Review article page 109-in pdf format for free download. Compares HBOT to all other published therapies for CP that used the Gross Motor Functional Measures test as an outcome. The GMFM is the gold standard for motor testing in CP).
Review chapter in the Textbook of Hyperbaric Medicine, Chapter 23 by Dr. Harch
