WHAT IS CEREBRAL PALSY ?

Cerebral Palsy (CP) is a non progressive disorder of the brain that leads to inability in performing movements due to lack of muscle co-ordination or excessive tightness of the muscles. The worldwide prevalence of CP is 1.5 to 4 per 1000 live births.It is a condition in which the patient will experience abnormal brain development or injury to the brain as it grows. It may occur before or after birth, or during birth or early childhood. It is often described as an ‘umbrella term’ as it applies to a compilation of conditions where there is largely a disorder of voluntary movement or co-ordination.

About Cerebral Palsy

A child with cerebral palsy finds difficulty in controlling movements as they grow up and mature. The nature of his condition may change as the child continues to grow. But again cerebral palsy is not progressive; the damage to the brain does not change. It is important to note that all the children with cerebral palsy do not have similar symptoms. So in accordance to that, all their treatments and therapies are adapted to individual needs. Generally we talk about three main types of cerebral palsy like spastic, dyskinetic and ataxic cerebral palsy. These types of cerebral palsy affect the body and the muscle tone of the brain area. People with cerebral palsy may show a combination of these types.

Symptoms of cerebral palsy

The injury that occurs in CP is not fixable in most cases and the occurrence of the disabilities is permanent. The signs and symptoms of children with Cerebral palsy are:

  • Lack of muscle coordination when performing voluntary movements (ataxia)
  • Stiff or tight muscles and exaggerated reflexes (spasticity)
  • Weakness in one or more arm or leg
  • Walking on the toes, a crouched gait, or a “scissor” gait
  • Variations in muscle tone, either too stiff or too floppy
  • Excessive drooling or difficulties swallowing or speaking
  • Shaking (tremor) or random involuntary movements
  • Delays in reaching motor skill milestones
  • Difficulty with precise movements such as writing or buttoning a shirt

In addition some cases of cerebral palsy may display intellectual disability, seizure, delayed growth and development, impaired vision and hearing loss. The symptoms of CP vary in category and seriousness of one person to another person and may change in an individual over time.

Causes of Cerebral Palsy

An injury to the brain or a malfunction in the brain during the developmental stages can cause cerebral palsy. This occurs during or after birth based upon the type and timing of the injury. The rate of CP in infants can constituted to the following causes:
  • Reduced oxygen supply to the brain due to the umbilical cord wrapping around the neck of the child during child birth
  • Physical injury or infections during pregnancy
  • Complications associated with premature birth
  • Decreased oxygen supply to the brain as a result of critical illness at birth ( neonatal encephalopathy)
  • Development of the brain in an unusual shape or structure
  • The effect of genetic mutations on the brain cells

Treatment For Cerebral Palsy

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STEM CELL THERAPY FOR CEREBRAL PALSY AT NEUROGEN

The treatment options that are available at the moment aid the patients in running the symptoms to a certain extent and do not get to the core of the brain damage. As a result, a standard therapeutic approach needs to be developed. The stem cell therapy has become so popular that scientists and researches all over are now considering this treatment option to help cerebral palsy patients.

Objective radiological evidence of improvement in a cerebral palsy patient

Pre stem cell and Post stem cell PET-CT scan of a 14 year old male, diagnosed with quadriplegic cerebral palsy.

Pre stem cell therapy. PET CT scan shows the blue/black area in the neural tissue indicating the damage that occurs to the brain due to cerebral palsy
Post stem cell therapy. there is reduction in the blue and the black areas and more active areas are seen. This indicates reduction in damage and improved brain function. Autologous stem cell therapy. is safe, practicable and useful treatment strategy for cerebral palsy children. This renews the core of the brain damage and can be monitored on PET CT scan of the brain improvement. These stem cell therapies along with standard treatment add to the growth and improvement of the children.

cerebral-palsy

How stem cell therapy works in cerebral palsy

Until recent times, it was assumed that brain damage during birth time can be permanently damaging. But it has been proven with recent study in nervous tissue regeneration that it is now possible to repair the damaged brain tissues. Stem cells attained from different sources can be used for stem cell therapy. Our approach at NeuroGen BSI makes the usage of autologous bone marrow derived mononuclear cells for transplantation. These transplanted stem cells have the capability to migrate to the damage tissue part of the brain and settle in the affected areas to help repair the damage. They release some trophic factors that reduces the damaging processes and make a distinction of several types of cell types of the nervous system like oligodendrocytes, glial cells and other cells of the nervous system.

The main mechanisms that help tissue repair and regeneration include:

  • Prevention of cell death in neuronal population
  • Establishment of new blood vessels
  • Cell multiplication and integration
  • Establishment of new neuronal maps in the brain in order to learn new functions.

These mechanisms restore and renew the damaged tissues and restore activity in the affected area which is a marked clinical improvement. It plays a diversified role in overall development and improvement. Autologous BMMNCs do not present any side effects and do not face an immune rejection. It is derived from the same patient and are thus freed from all ethical issues around the usage of stem cells.

The NeuroGen Outcome

We have successfully treated over 425 cerebral palsy patients with our complete approach to direct and support our patients. The patients who have been have taken care of at our centre have shown huge improvements. The symptoms that are seen in cerebral palsy are oromotor or speech, balance, trunk activity, upper limb activity, lower limb activity, muscle tone and ambulation. Altogether they affect the daily activities of life. Patients tend to show greater improvement after their +stem cell therapy. and subsequent rehabilitation. In a recent study report, 92.6% of our patients found stem cell therapy. to be a safe and effective form of therapy. When we made a follow up on our record of four years out of the 108 patients, we show significant improvements of 15.74% and 48.14% of patients showed fair improvement and 28.7% showed mild improvements. When we record the positive improvement of our patients, we do not just keep an update on the symptomatic improvement but also make changes in their brain metabolism as monitored in their PET-CT scans.

Cerebral Palsy Stem Cell Treatment Center in Mumbai
Cerebral Palsy Stem Cell Treatment Center in Mumbai

Read success stories of our patients treated for Cerebral Palsy

When a Son Holds a Fathers Hands – Cerebral Palsy Treatment with Stem Cell Therapy
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Seven years of hope now finally being realized! – Cerebral palsy Treatment in India
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Case Studies : Cerebral Palsy

Young mother of a child with cerebral palsy proves the age old saying of ‘where there is a will there is a way’ true!!

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Patient with Cerebral Palsy with Autistic Features

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“If there is a difference in my child, then there will be difference in yours. Don’t give up.” Says Mrs Menon, mother a two year old with cerebral palsy.

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From complete dependence, a step towards independence

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Improvement in Functional Independence Measure from 46 to 52

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Stem cell therapy gives a ray of hope to worried parents

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Your most common questions answered

My child has been diagnosed with Cerebral Palsy. Can my child get better?

Yes, there are several medical aids available to help your child live a better life. Although No cure is yet known.

Will my Child’s condition deteriorate further?

Not unless your child suffers from further infections of illness. This can cause the progress to come to a standstill.

Why do the muscles become weak in Cerebral palsy or why do deformities happen?

  • Muscle stiffness is seen due to spasticity, contractures or both
  • Rapid growth of bones as compared to muscle growth is seen in growing children Due to these reasons, Children with CP may show weak muscles and have difficulty in activities like walking, balance etc.

Will my child learn how to walk?

The answer to this question varies with every case. But in general, a child with mild CP can learn to walk independently and a child with moderate CP may need external aid. Child with severe CP however are generally wheelchair bound.

Will my child learn how to talk?

The answer to this also depends on the case. While some children may not face any difficulties, while others may be slow to grasp. A speech therapist can help with learning to speak and other forms of communication.

Can my child be independent?

Guidance and encouragement can make it possible for a child to be independent despite the condition. A child with a mild case of CP can attain independence a lot more easily than a child with a severe case. As a parent, you play the most important role here.

Can my child develop behavior problem?

Most children develop behavior problems as an outlet to their frustration. This development entirely depends upon the case specifically. A clinical psychologist can help with examining and encouraging a feel good factor.

Will my child have a normal life expectancy?

Yes most of the children with cerebral palsy lead a normal healthy life. However children with severe brain damage are diagnosed with conditions like epilepsy and run a risk of reduced life expectancy.

If am planning a second child, will my second baby be affected as well?

Studies have revealed that there is a 6-9 fold increase, in case of an affected sibling during pregnancy complications or complications at birth. “6-9 fold” appears large in terms of percentage; but it translates to an incidence of 0.6-1%. With due precautions for the preventable causes, this incidence can be reduced in individual cases.

What can I do to prevent a recurrence of Cerebral Palsy in my second child?

There are no known cases for the prevention of recurrence of CP. But there are some related factors that if prevented can help reduce the risk of CP in the child.

  • prematurity
  • low birth weight
  • meconium aspiration syndrome
  • birth asphyxia
  • low blood sugar in the baby
  • infections
  • injuries etc

Should I go for cord blood/umbilical cord banking?

The potential of the usage for the same in the future is huge. Having said that, the store scenarios are: a) In a case of blood related disorders occurring in siblings, the cord blood can be a possible source of stem cells, instead of allogenic bone marrow. b) We have increasingly seen cases of Cerebral Palsy and autism on the rise. For such instances too, cord blood cells are a good source of stem cells. But their use in neurological disorders has not yet been approved. In absence of the above, Umbilical Cord Blood Bank storage would be more like an insurance policy; we hope never to use it! If money/ Finances are not an issue, then cord blood storage can be chosen In the absence of cord blood cells, autologous cells (bone marrow derived) are available at any age and in fact are much more easy to use source.

How does stem cell therapy work?

The natural work of stem cells is to repair and renew the damaged cells. Stem cell therapy makes use of this function by directing these cells in high concentrations directly in and around the damaged tissue, where it is progressing towards its self healing and repair.

Are there ethical concerns surrounding adult stem cell research and therapy?

Bone marrow transplantation has effectively been used for genetic disorders of blood, such as sickle cell anemia, thalessemia, as well as cancers such as leukemia. Since our therapy makes use of autologous cells, there are no major ethical concerns. Ethical concerns are mainly concerned on the use of embryonic stem cells (which we do not use).

Does the treatment have any side effects?

Stem cell therapy is all-encompassing and practically safe. None of our patients have shown any neurological worsening as far as its connection with the stem cell therapy. Some side effects, such as headache (spinal headache) lasting 3-4 days which is generally self limiting, neck/back pain, vomiting, some mild rash or pain at the site of bone marrow aspiration/stem cell injection may occur. However, no medical or surgical treatment comes without unexpected complications. These complications may relate to the medicines prescribed, the stem cell procedure, the anesthesia, and the rehabilitation or to any of the preexisting medical or neurological conditions. There is a slight possibility in the case of children with seizures, or previous history of seizures or an abnormal EEG. However, proper antiepileptic cover/drugs could avoid this problem.

How long will it take me to know that I have benefitted from the treatment?

Most improvements are seen within 3-6 months after the treatment. Some patients take several months/years together to get better. While on the other hand, most patients show some immediate improvements even before their discharge.

Is the transplantation of the stem cells done once or more than once?

This decision is taken after seeing the growth and improvements after the first therapy. If the patient show considerable amount of improvement, then the case is evaluated by the whole medical and rehabilitation team. Some special imaging tests, such as PET CT Scan of the brain are repeated and then a second treatment may be suggested. It can be done anytime between 3-6 months of the first therapy.

Can other treatments be taken at the same time?

In most cases we allow the patients to proceed on with their other treatment. First do evaluate what other prescription the patient is on. This decision is not taken deciding on a case by case study. It is better that you notify us before taking any medications.

How much improvement will the patient have?

The question of improvement will depend on many factors like the age of the patient, type of illness, duration of illness and extent of rehabilitation taken after the treatment. It is essential that at NeuroGen gives no surety of any improvements as such. At NeuroGen Brain and Spine Institute, we have treated over 150 CP cases. Stem cell therapy was found to be safe and effective in 92.6% of the patients in a study taken of 108 patients with a maximum follow up of 4 years, Our information is published on a regular basis in various medical and scientific journals. You are strongly advised to study all the guidelines before proceeding on with the treatment.