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Cerebral - of the brain, Palsy: lack of muscle control
Cerebral palsy is an umbrella term that refers to a group of non-progressive brain injury or malformation disorders that affect a person's ability to move.
It happens due to damage to the developing brain either during pregnancy or soon after birth.
Children with cerebral palsy may also have visual, hearing, speech, learning, epilepsy and intellectual problems.
Types of Cerebral Palsy
Areas involved (fig 4)
Cerebral palsy happens 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:
Common physical symptoms
Currently there is no cure for cerebral palsy. Treatments available help in minimizing the symptoms, preventing future complications, and maximizing functional independence.
A multidisciplinary approach is being followed to achieve the above goals. This includes:
The treatment options that are currently available help the patients in managing the symptoms to some extent, but they do not repair the underlying brain damage. Therefore developing a standard therapeutic approach is a need of the hour. Scientists and researchers worldwide are now considering stem cell therapy as a potential treatment option for patients suffering from cerebral palsy.
How stem cell therapy works in cerebral palsy
Till very recently, it was believed that brain damage during birth is irreversible .However, now with emerging research; we understand that it is possible to repair the damaged brain tissue using cell therapy.
Stem cells obtained from various sources can be used for stem cell therapy. Our approach, at NeuroGen BSI makes use of autologous bone marrow derived mononuclear cells (BMMNCs) for transplantation. The transplanted stem cells have the ability to migrate to the area of the damaged tissue in the brain and home in those affected areas to help repair the damage. They release several trophic factors that decrease the process of damage in those areas and also differentiate into several cell types of the nervous system such as oligodendrocytes, glial cells and other cells of the nervous system. The main mechanisms that help tissue repair and regeneration include:-
These mechanisms repair and regenerate the damaged tissue, restoring activity in the affected area, which translates into clinical improvements .This plays a great role in improving the overall quality of life. Also autologous BMMNCs do not show any adverse side effects and they do not face any immune rejection. Also, they are obtained from the same patient and thus are free of the ethical issues surrounding the use of stem cells.
With our comprehensive approach and our aim to guide and support our patients through thick and thin, we have successfully treated over 276 patients with cerebral palsy. The patients who had reached a plateau stage, after stem cell therapy have shown colossal improvements in their symptoms. Most of the symptoms that are seen in cerebral palsy are oromotor/speech, balance, trunk activity, upper limb activity, lower limb activity, muscle tone and ambulation. Together, they affect activities of day to day life.
Graph demonstrating improvements after stem cell therapy in cerebral palsy.
We analysed the effect of stem cell therapy in 267 patients diagnosed with cerebral palsy. Changes in common symptoms like oromotor/speech, balance, trunk activity, upper limb activity, lower limb activity, muscle tone, ambulation and Activities of Daily Living were recorded on follow up. The improvements were graded as no change, mild improvements, moderate improvements and significant improvements. Analysis revealed that out of 267 patients, Overall 91.01% patients showed symptomatic improvements. 8.98% of patients showed no improvements in any of the symptoms. Mild improvements were observed in 29.96% of patients, moderate in 41.19% of patients, whereas, 19.85% of patients showed significant improvements. We observed that patients who continued regular exercise program at home under supervision of professional therapists showed significant improvements. Patients who did not follow regular rehabilitation showed mild improvements. Therefore, in our experience stem cell therapy should be followed by regular rehabilitation under supervision of a therapist.
The positive changes that we record in our patients are not just restricted to their symptomatic improvements, but also bring about a constructive change in their brain metabolism as observed in their PET-CT scans.
Intrathecal autologous stem cell therapy is safe, feasible and effective treatment strategy for children with cerebral palsy. This repairs the underlying brain damage which can also be objectively seen on PET CT scan of brain along with improvement in functional and achievement of milestones in children. Stem cell therapy along with standard treatment augments the development and improves the quality of life of these children.
1. Ashrut Yadav
Master Ashrut Yadav, a 5 years old male child is a known case of Diplegic Cerebral Palsy. Ashrut's chief complaints were drooling, unclear speech, difficulty in standing and walking without support, poor hand functions of left arm, affected coordination, poor sitting and standing balance, Improper Gait, tightness in arms and legs, poor cognition, etc. Like every parent Mr. and Mrs. Yadav consulted many doctors from different parts of India, from big to small hospitals, and also tried homeopathy. But no one said that there can be any improvement. Everyone said nothing can be done, shattering all their hopes each time. Ashrut used to go for physiotherapy but not on regular basis. "In a local function we met a family having a child like Ashrut, they told us about NeuroGen Brain and Spine Institute in Mumbai, we immediately started our search. I went through their website, spoke to Dr.Nandini Gokulchandran on phone about my child's case and decided to take Ashrut to NeuroGen for Stem Cell Therapy."- says Mr.Yadav.
Ashrut came to NeuroGen in August 2015, where he underwent Stem Cell Therapy along with a customized rehabilitation program which aimed at increasing the strength of affected areas, improving dissociations, posture, balance, walking, grip, cognition, and increasing overall stamina of the patient. Mr. and Mrs. Yadav found new hope with NeuroGen's Stem Cell Therapy and were motivated and positive for their child after going back home and they continued with his rehabilitation.
There were tremendous improvements seen in Ashrut's condition on follow up in December 2015:
Life of this cute child Ashrut yadav has changed after Stem Cell Therapy. The child can play a little better; can understand better, he can enjoy his childhood a little better today. His parents decided to give Stem Cell Therapy to Ashrut for the second time in March 2016 and are hoping for their son to attain near normalcy. "After consulting many doctors and hospitals my search finally ended at NeuroGen BSI where we got great positive results. Today we are more positive, motivated and very well guided in our path to help our child recover. I would suggest all parents like us should at least go to NeuroGen BSI (Mumbai) once." - concludes Ashrut's Father.
2 Diyan Jain
Master Diyan Jain, 5 year old boy from Vijayawada is a known case of Cerebral Palsy (Diplegic). " Our major concern for Diyan were his delayed milestones, thanks to our family and their support, we did not let the reality affect us and started looking for various treatment options. In April 2016 Diyan's Physiotherapist asked Mr. & Mrs. Jain to check Stem Cell Therapy at NeuroGen Brain & Spine Institute, Mumbai. Diyan's parents found new hope for development of their son. In the urge of not delaying the treatment further they decided to undergo stem cell therapy for Diyan in May 2016.
Diyan's complaints according to his parents were inability to transfer from one place to another, stooped sitting, tightness in legs, thighs, calves, difficulty in crawling, inability to stand and walk independently, difficulty in gripping objects, cognition and problem solving not age appropriate, inappropriate eye hand coordination.
At NeuroGen, Diyan underwent Stem Cell Treatment followed by intensive neurorehabilitation which included physiotherapy, occupational therapy, cognitive and behavioral therapy, special education which aimed at reducing spasticity and tightness, improving movement control, gross and fine activities, problem solving, etc.
Following were the improvements seen in Diyan's condition six months post Stem Cell Therapy
Diyan had now started going to school. "Our experience at NeuroGen BSI was good, we are satisfied with the guidance we got, the doctors and the entire support staff are very helpful. Stem cell therapy has given that push in Diyan's progress and a hope in our minds that he will soon start living an independent life. Looking at Diyan getting so much love from everyone who meets him is very motivational for us" - concludes Mr.Gautam Jain, Diyan's father.