Philadelphia Birth Injury Lawyer Blog

Children suffering from spastic cerebral palsy have severe muscle tightness and daily activities such as walking and brushing their teeth are nearly impossible. A surgery called Selective Dorsal Rhizotomy (SDR) may be an option to some cerebral palsy children to loosen muscle tightness in hopes to improve muscle control and movement.

During an SDR procedure, misfiring nerves are severed and in some cases vertebrates are removed. The selective operation alleviates muscle tightness and can correct the gait of cerebral palsy suffers. A successful operation will have all spasticity eliminated but leaves the patient with very weak muscles. After intensive physical therapy, cerebral palsy patients can regain strength in their muscles and perform daily tasks without assistance.

The earlier the operation is performed the greater the results. SDRs are not routinely performed in children over the age of 6 because the older the patient gets the harder it is to alleviate spasticity and the harder the rehab process becomes.

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Philadelphia women looking to get pregnant with in vitro fertilization (IVF) should know that there is a heightened risk of their child developing cerebral palsy. Cerebral palsy is more common in children born to mothers that have had assistance in conception such as IVF when compared to women who became pregnant naturally.

The increased risk comes not because of the procedure but because of the nature of IVF pregnancies. IVF pregnancies are more common to have multiple children in one pregnancy and children born prematurely. These two factors elevate the chance of a child developing a serious birth injury such as cerebral palsy.

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Multiplicity and early gestational age contribute to an increased risk of cerebral palsy from assisted conception

Mannitol, a sugar-alcohol compound, has been found to increase the effectiveness of cord blood used to treat cerebral palsy.

There is no cure for cerebral palsy but multiple studies have shown that symptoms can be eased when treated with the child's own cord blood. The effectiveness of the treatment varies from case to case but a new study has shown that mannitol can help the stem cells of the cord blood reach the site of the injury. A blood-brain barrier exists at the site of cerebral palsy injuries and it can be difficult for the stem cells to reach the injury and correct the problem if this barrier is not broken.

A study split animals with cerebral palsy into two groups, one group received mannitol and cord blood while the other received cord blood alone. All animals showed improvement but those injected with the combination therapy showed greater and more functional improvement than those injected with cord blood alone. Mannitol has shown to help the cord blood break through the blood-brain barrier and help cord blood rejuvenate damaged cells.

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Mannitol Improves Cerebral Palsy Treatment

Recent studies have proven that cord blood can be used to treat a variety of birth injuries, including cerebral palsy. Now a study suggests that waiting to clamp the umbilical cord of the baby can prevent injuries and improve infant health.

In most delivery rooms across the country, including those in Philadelphia, doctors clamp the umbilical cord of an infant seconds after delivery. Clamping and cutting the cord cuts off the flow of blood between mother and child, potentially robbing the infant of the last few minutes of cord blood. Cord blood has been found to contain stem cells that have regenerative properties allowing them to grow into a multitude of different cells.

Immediately clamping and cutting the cord is not harmful to the infant but waiting until the cord stops pumping blood has been shown to benefit the child. Waiting just thirty seconds to clamp the cord has shown a decrease in anemia, brain bleeds, chronic lung disease, eye problems, infections and the need for a blood transfusion.

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Waiting to Clamp the Umbilical Cord May Be Better for Babies

Wait before cutting the umbilical cord, say researchers

Doctors and researchers have found a new indicator of health problems in newborns. A high level of acidity in cord blood can has been linked to cerebral palsy, brain damage and death in childhood. Through testing doctors hope to predict which children need close monitoring as they mature and develop.

Acid is measured on the pH scale. A score of 7 is neutral, below 7 is acidic and a score above 7 indicates higher levels of alkaline. Umbilical cord blood should be extremely close to 7 but complications during birth, such as loss of oxygen, can cause the infant to produce more lactic acid. The increase of lactic acid increases the acidity of the cord blood and predicts the child may have some problems with normal development.

Currently, cord blood is only tested when it is suspected that the child has experienced a lack of oxygen at birth but the links found in this study may see cord blood tested more routinely as a prediction for birthing complications. A lack of oxygen at birth can lead to brain damage or cerebral palsy in newborns of infants. Currently there are no cures for the crippling diseases but any sign or indicator that can inform doctors of potential problems can lead to a quicker diagnosis and treatments that will improve the child's life.

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A new predictor of newborn health: Umbilical cord blood pH

Doctors and researchers have found that a specific cell in the nose that is used with the olfactory nerve can help heal lesions in the central nervous system.

Olfactory ensheathing cells (OECs) support and surround neurons in the nose to help us smell. OECS are known to have exceptional plasticity and promote olfactory blood vessel growth while offering neuroprotection to cells. Doctors have transplanted OECs to the frontal lobe of patients with debilitating neurological disorders such as amyotrophc lateral sclerosis (ALS), multiple sclerosis (MS), and other spinal cord injuries. The unique abilities of the OECs promoted healing in the brains of patients and most saw improvement in their daily lives.

Cerebral Palsy is a similar neurological condition to ALS and MS. Doctors conducted a separate study on children and adolescents with cerebral palsy to determine if the OECs would heal cerebral palsy lesions on the brain. The study found healing in over 80% of participants while not causing any significant side effects. Neurological and functional improvement was also noted in the children who participated in the study.

Doctors are optimistic that as they continue to study the healing powers of OECs they will one day be a realistic and successful treatment to those suffering from cerebral palsy.

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Cell transplants to cure cerebral palsy

Doctors have found that exposing babies to xenon gas can help reduce brain injuries suffered by babies born with a lack of oxygen at birth.

The doctors and researchers conducting the xenon gas treatment option were the first to treat newborns with the controversial "cooling method" to reduce the effects of lack of oxygen at birth. With a cooling method the infant's temperature is reduced to lower the oxygen requirement for cells to reduce injury and delay the death of cells. The same doctors who pioneered the "cooling method" are now testing the role xenon gas has in preventing permanent injuries in newborns such as cerebral palsy.

For almost a decade the doctors have proved in the lab that xenon gas doubles the protective effort of cooling the brain in babies born with birth injuries. The problem was the scarcity, cost and delivery of the gas to the newborn. To remedy the problems, the doctors created a "closed circuit system" that is fitted to an incubator to deliver the xenon along with appropriate amounts of oxygen to the newborn. The system works by recycling the xenon that is not absorbed by the infant and pumping it back into the incubator.

The system has greatly reduced the cost of the treatment and has shown promise in the few infants who have tested the system. Doctors and researchers are gearing up for a clinical trial that will hopefully yield positive results and make xenon treatments routine and inexpensive for babies born with birth injuries.

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First baby given xenon gas to prevent brain injury

Magnesium sulphate injections given to mothers experiencing a preterm birth may help prevent the infant from developing birth injuries such as cerebral palsy.

Babies before 30 weeks of gestation pose a much higher risk of developing cerebral palsy than babies born at full gestation. After several trials over a 14 year period doctors and researchers recommend that mothers begin receiving doses of magnesium sulphate by injection within 24 hours of delivery if they are experiencing preterm labor.

The health community is unsure of exactly how the magnesium sulphate protects the brain but the compound is critical to normal cell function, can improve blood flow and may protect cells against harmful molecules. The injections pose no serious side effects or complications to mothers or infants. Some minor side effects to delivering mothers include: sweating, flushing, nausea, vomiting, headaches and palpitations.

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Engineers at Rutgers University in New Jersey have developed software and modified a gaming glove for the popular Playstaion 3 that helps teens with cerebral palsy improve function in their hands and fingers.

A clinical trial involving three teens showed that after three months of therapy vast improvements were shown in their ability to move their hand and perform daily tasks such as brushing their teeth, dressing themselves and eating with a spoon. Each teen had specific software designed for their degree of disability. The teens were asked to participate in therapy for thirty minutes a day, five times a week. The software is a series of games that engage the fingers and hands of the patient by flicking an imaginary butterfly or manipulating images on the screen.

As cerebral palsy patients age they are less likely to participate in conventional therapy because they find it tedious and boring but this virtual rehabilitation technology is disguised as a game and holds the teen's interest for the duration of the therapy regiment. The most promising finding to come from the study is the confirmation that even though a decade or more has passed since the injury improvement can occur and it can be life changing.

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Botox is becoming a common treatment option for patients with cerebral palsy and is even used at Children's Hospital in Philadelphia but this use may also be harming patients.

Botox is commonly thought of a medication used to treat wrinkles in senior citizens but doctors and researchers and seeing its extended benefits in treating spastic or constricted muscles. Botox has yet to be approved by the Food and Drug Administration in this capacity but it is has been approved to treat cervical dystonia or repetitive neck muscle contraction, abnormal twitching of the eyelids, crossed eyes and even severe underarm sweating. The drug has been routinely used to decrease muscle tightness and used to treat cerebral palsy patients with the majority of results being beneficial.

Treating cerebral palsy patients with Botox has yet to be approved by the FDA and is considered an "off label" use of the drug. An "off label" use is not illegal or inappropriate as long as patients are warned about the all the potential side effects of the drug. Doctors who use Botox as a treatment for cerebral palsy see little side effects but some patients are claiming it has taken the lives of their children. In rare cases Botox has been shown to cause muscle paralysis and difficulty breathing especially when injected in the neck area. Two lawsuits have been filed against Botox, its manufacturer and treating physicians for the deaths of two children with cerebral palsy. In both cases, parents claim that after Botox injections their child stopped breathing and was unable to be resuscitated.

It is always important to fully discuss all treatment options with your physician especially when a drug is being used "off label." No one in the medical community doubts the benefits of Botox but doctors and patients must be aware of the rare but dangerous side effects.

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Doctors and researchers hope that blood from an infant's umbilical cord will be the newest, safest, and most effective treatment for children born with neurological birth injuries such as cerebral palsy. Now there is an initiative to help supply researchers with samples to fuel this groundbreaking research.

The initiative is part of a program launched by Cord Blood Registry and Save the Cord Foundation and other non-profit organizations in Arizona. The goal of the program is to save cord blood for infants at risk of developing neonatal brain injuries such as cerebral palsy. Cord blood will be saved at no cost to the family and the program is looking to enroll 700 patients in its first year.

By removing the obstacle of cost, the program is hoping to not only help patients enrolled but also further the advancement of research into the healing capabilities of cord blood. Another goal of the program is to encourage similar programs to be set up across the nation to help more patients suffering from neonatal brain injuries such as cerebral palsy.

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Pioneering Initiative Will Enable Children Born at Risk for Brain Injuries to Participate in Medical Research Using Cord Blood Stem Cells

Hyperbaric therapy has recently become an alternative treatment for neurological conditions such as cerebral palsy. While there is no definitive study on its benefits to improve neurological conditions, anecdotal evidence has patients across the United States treating in hyperbaric chambers.

Hyperbaric therapy or HBOT works why delivering 100% oxygen at a higher level than atmospheric pressure. It is routinely used to treat carbon monoxide poisoning and has been shown to promote the healing of wounds. It is now being used in some locations to treat chronic illnesses such as cerebral palsy. The belief is that the high level of oxygen concentration in the chamber stimulates injured or inactive parts of the brain and helps improve blood flow throughout the body.

HBOT is not claiming to heal or correct any of the symptoms associated with cerebral palsy but it has been shown to improve blood flow and lessen some numbness and tightness in cerebral palsy patients. Those who wish to undergo the treatment lay in a hyperbaric chamber for less than two hours and a typical regiment is forty sessions.

Currently the only things stopping patients from trying this low risk therapy is cost and location. Not many places offer these treatments and treatments typically cost $150 and are not usually covered by insurance. Hyperbaric treatments will not become a more readily available treatment alternative until a study is completed on its effectiveness in treating neurological conditions but anecdotal evidence is giving some hope to patients.

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Cerebral Palsy rates have been increasing in premature infants born in Pennsylvania and nationwide. A new study has discovered a link between premature births, an inflamed umbilical cord and cerebral palsy.

Doctors have studied over 200 placentas from preterm births and have found that cerebral palsy is associated with inflammation in the connective tissue of the umbilical cord. The inflammation usually leads to an infection and is most common in preterm births or a premature rupturing of the amniotic sac. Infants born premature due to preeclampsia are less likely to have the inflammation.

Doctors and researchers hope to use this information to reduce the risk of birth injuries by treating the inflamed tissue in the umbilical cord.

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A three year old cerebral palsy child who is participating in a cord blood treatment study at Duke University has rapidly shown improvement in motor functions and speech.

The child is participating in a study in which the child is infused with cord blood cells banked by their parents at birth. The injection took about 15 minutes and her parents are already calling the treatment a miracle. Before the treatment her right hand was always clenched and virtually no use to her and now her right hand has opened up and she is beginning to use both hands. Her speech has also greatly improved and she is now able to walk flatfooted with the support of a leg brace. Her parents believe she is about 85 percent cured of cerebral palsy.

While researchers will not be able to scientifically prove that the treatment will correct problems associated with cerebral palsy until the study is complete, anecdotal evidence is giving parents with cerebral palsy hope that someday their child will be able to lead a more normal life.

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Child's own stem cells help her cerebral palsy

The American Academy of Neurology and the Child Neurology Society have released reports on the beneficial uses of Botox injections and the drug diazepam to help reduce the effects of muscle spasticity in children suffering from the cerebral palsy.

The study states that botulinum toxin injections, Botox, are an effective way to reduce spasticity and muscle tightness that reduces movement in children and young adults. According to the study Botox imposes only a slight risk of generalized weakness after an injection. The Drugs, diazepam and tizanidine were also named in the study but for short term use and with a higher risk of side effects.

Several other treatments and medications were examined in the study but they could not gather enough research to make recommendations. Researchers attest there is an urgent need for more research to establish definitive recommendations for current and future medications and treatment for those suffering from birth injuries such as cerebral palsy.

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New Guidelines Suggest Botox for Cerebral Palsy