Cerebral palsy (CP) is characterized by motor impairment and can also present with global, physical and mental dysfunction. It is the commonest physical disability in childhood, occurring in 2.0 to 2.5 per 1000 live births. About one half of paediatric patients have seizures. Growth problems are common, as well as neurologic abnormalities such as impaired vision or hearing and abnormal touch and pain perceptions.
CP by definition is non-progressive, therefore, children who show deterioration with respect to previously acquired skills and development should be evaluated for genetic, metabolic, muscular, or neuronal tumour disorders that precipitate neurodegenerative conditions. It is not possible to early diagnose CP in infants less than 6 months cases. Observation of slow motor development, abnormal muscle tone, and unusual posture are common initial clues to the diagnosis of cerebral palsy.
“CP is a chronic condition with considerable impact on affected individuals. Overall prevention of CP has not been successful. Mesenchymal stem cells are able to travel to and change the injured environment, increasing survival of neurons and making up for losses, thus proving to be a promising approach for treatment of CP,” said Dr Pradeep Mahajan, Regenerative medicine researcher, StemRx.
Spasticity is present in 70-80% of patients with CP. Affected limbs may demonstrate increased deep tendon reflexes, tremors, muscular hypertonicity, weakness, and a characteristic scissors gait with toe-walking. Some are characterised by abnormally slow, writhing movements of the hands, feet, arms, or legs that are exacerbated during periods of stress and absent during sleep. In few other instances, CP predominately impairs balance and coordination. These patients walk with a wide-based gait and have intention tremors that complicate performance of daily activities requiring fine-motor function. Intellectual impairment occurs in about two thirds of patients with CP.
About one half of paediatric patients have seizures. Growth problems are common, as well as neurologic abnormalities such as impaired vision or hearing and abnormal touch and pain perceptions. CP by definition is non-progressive, therefore, children who show deterioration with respect to previously acquired skills and development should be evaluated for genetic, metabolic, muscular, or neuronal tumour disorders that precipitate neurodegenerative conditions.
Bone marrow and umbilical cords are rich sources of mesenchymal stem cells (MSC), which normally produce the tissues of the skeletal, muscle, and circulatory systems. Evidence suggests that MSCs can migrate to the brain and improve function following injury with the help of its strong self-renewal, proliferation, and differentiation potentials. These cells can be induced to differentiate into neuron-like cells and glial cells. The mechanism underlying the function of stem cell transplantation in neurological conditions may involve cell replacement function and neurotrophic effect.
Additional modalities of physiotherapy, neuromuscular stimulation, oxygen therapy, yoga, diet modification, nutraceuticals also play an important supportive role in management of cases with CP. Studies have reported an improvement in spasticity, gait as well as cognitive and behavioural parameters following cellular therapy and rehabilitation programme.
A rare case of Prathamesh Tanavade, 20 years old was experiencing recurrent seizures; he is a known case of hypoxic brain injury. He has been under anti-epileptic medications since his first seizure episode in 2008. Incidents of falls during seizures have also been reported. Prathamesh also had delayed developmental milestones and still speaks slowly and stammers while speaking. He had no medical history except for being kept in incubator for 15 minutes after birth, but no other pre or post-natal complications were reported.
“After meeting Dr Mahajan, Prathamesh underwent 3 sessions of cell based therapy. He also underwent sessions of Hyperbaric Oxygen therapy as adjuvant to cell based therapy. He was also advised regular Yoga, Physiotherapy and Nutraceuticals. Improvement was noticed as the intensity of convulsions that Prathamesh suffered had reduced. No new incidents of falls were reported. Speech is also gradually improving,’’ said Pradeep Tanavade, Father of the patient.
Milder convulsion, no stammering, Matured look and reduced weight are signs of improvement in Prathamesh.