HBOT and Cerebral Palsy: Can Hyperbaric Oxygen Therapy Help?
The idea behind hyperbaric oxygen, HBOT and cerebral palsy is that there may be damaged or inactive brain cells around the area of injury. The administration of 100 percent oxygen at increased pressure floods the brain with oxygen, stimulating brain cell growth, increased blood flow and stimulation of inactive cells. While not all patients see an improvement in their symptoms, many experience improvements in vision, hearing, cognitive abilities and speech.Research, Cerebral Palsy, and HBOT
Studies in the treatment of cerebral palsy with hyperbaric oxygen and HBOT have shown mixed results. While some patients do improve, others may see no difference. Cerebral palsy is a very individualized disease with no patient being the same, so not seeing a positive response in all cases would be expected.
One study in Sao Palo, Brazil, looked at 230 patients treated in the early stages of the condition. Treatment consisted of 20 sessions of one hour each, once or twice daily. The results showed that the participants showed a significant reduction in muscle spasticity and improved muscle control. Parents of the participants noted a significant increase in balance and cognitive improvements. Other improvements included increased attention, memory, comprehension, and visual perception. The study showed that early hyperbaric oxygen and HBOT treatment provides the best results in patients with cerebral palsy.
The Specialized Hospital for Residential Treatment for Rehabilitation of Children with Cerebral Palsy in Bulgaria has used HBOT as the main form of treatment for children with cerebral palsy since 1997. They report improvement in motor and cognitive function in 86 percent of their patients after 20 HBOT sessions.
A 2000 study conducted by Dr. Maureen Packard of Cornell University looked at 26 children with various degrees and types of cerebral palsy. Patients received 40 one-hour sessions of HBOT. Improvements were seen in muscle spasticity as well as cognitive improvements. In some patients, the muscle improvements diminished after treatment stopped, but the cognitive improvements remained.
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What is Cerebral Palsy?
Cerebral palsy is a condition where there is abnormal brain development or disruption in brain function that causes the brain to improperly control muscle function and movement. It is the most common motor disability in children. Unlike many different conditions, cerebral palsy does not just have one cause. In some cases, the cerebral motor cortex of the drain does not develop properly during fetal growth. This child is born with congenital cerebral palsy, though the symptoms may not appear for months or even years after birth.
Injury to the brain during fetal development, during birth or even after birth can lead to cerebral palsy. This results in acquired cerebral palsy and the damage can occur from things such as bacterial meningitis, viral encephalitis, a disruption in blood flow to the brain, a head injury or child abuse. During a problematic delivery, it is possible for the infant to have a disruption in oxygen to the brain. This disruption of oxygen can lead to hypoxic-ischemic encephalopathy, which destroys the brain tissue in the cerebral motor cortex and other areas of the brain.
Every person with cerebral palsy is different as are their symptoms. Infants and children may show signs of developmental delays in areas of movement, such as rolling over, sitting, crawling or walking. A loss of muscle tone can result in a child feeling “floppy” when held or increased muscle tone can make a child feel stiff and ridged. In many cases, it can take months or years to receive a diagnosis of cerebral palsy. While these symptoms are early warning signs, as a child gets older, symptoms can include:
- Ataxia – A lack of muscle coordination
- Spasticity – Stiff and tight muscles with exaggerated reflexes
- Weakness in the arms and legs
- Altered Gait – This can include walking on the toes, or a scissor gait, where the thighs and knees hit or even cross, like scissors.
- Favoring one side of the body over the other
- Muscle tone variations – Muscles may be stiff or floppy
- Difficulty swallowing and excessive drooling. This can also affect eating
- Difficulty with speech development
- Tremors and involuntary muscle movements
- Problems with small motor skills, such as buttoning up a shirt, holding a pencil, or feeding oneself
Other Conditions Associated with Cerebral Palsy
In addition to the common symptoms, other conditions are also common and associated with cerebral palsy. Some of these conditions can include:
- Intellectual Disability – 30 to 50 percent of cerebral palsy patients experience some form of intellectual disability
- Spinal Deformities – Due to impaired muscle tone, deformities such as scoliosis, kyphosis, and lordosis of the spine can occur. In addition, abnormal pressure and misalignment of the joints can lead to osteoporosis.
- Vision Impairment – Strabismus, or cross eyes, is common and can lead to visual impairment. Other vision complications can include the inability of the brain to process visual stimuli, blurry vision or blindness.
- Hearing Loss – often this occurs when the brain has been deprived of oxygen
- Incontinence – Poor muscle control can result in loss of bladder control
- Abnormal sensations – People with cerebral palsy may experience abnormal pain with something as simple as a touch
- Contractures – These occur when muscles become tightly fixed into abnormal positions and can lead to deformity
Different Types of Cerebral Palsy
There are four different types of cerebral palsy and they are determined by the locations of abnormalities, the type of abnormalities and the extent of disability. The four different types include:
- Spastic Cerebral Palsy – This is the most common type of cerebral palsy and affects about 80 percent of patients. Spastic Cerebral Palsy patients have increased muscle tone with stiff muscles. It is broken down into three categories. The first is spastic diplegia/diparesis affects mainly the muscles in the legs. The second is spastic hemiplegia/hemiparesis affects one side of the body. The third is spastic quadriplegia/quadriparesis is the most severe form and affects all four limbs, the body, and the face.
- Dyskinetic Cerebral Palsy – Characterized by uncontrollable jerking movements of the hands and arms as well as the legs and feet. This hyperactive muscle activity can affect the face and tongue.
- Ataxic Cerebral Palsy – This form of cerebral palsy affects balance and coordination, resulting in an unsteady gait and problems with tasks such as reaching for a book.
- Mixed Cerebral Palsy – Patients diagnosed with mixed cerebral palsy have signs and symptoms of more than one of the other types. A person may have some limbs with still muscles, while others are overly relaxed and floppy.
Traditional Treatment Options
There is no cure or standard form of treatment for cerebral palsy as every condition is different. Treatment focuses on improving the ability of the patient, so treatments such as physical therapy, occupational therapy, speech therapy, and recreational therapy are the main course of treatment. Drugs are often prescribed to relax stiff muscles, as well as botulinum toxin injections or an implantable pump that delivers constant muscle relaxants. When spasticity is severe, surgery is often needed and can lengthen muscles or tendons, fix spinal deformities, or cut overactive nerves. Assistive devices, such as braces, wedges, wheelchairs, walkers and more can help with regular daily activity.
If you or a loved one lives with cerebral palsy and would like to learn more about what HBOT can do, give our office a call today to set up an initial consultation with Dr. Spiegel and his team. You may also visit HERE to fill out an information form and someone from the office will get in contact with you.