Healthy Living
Cerebral Palsy - Hyperbaric Oxygen Therapy
By David Perlmutter, MD, FACN
The term "cerebral palsy" is not a specific diagnosis, but is now generally applied to children who experience some form of brain trauma either at the time of birth or shortly before. Typically, these children manifest some degree of cognitive impairment as well as physical impairment, often with weakness and spasticity of arms and legs. Typically treatment therapies for children with cerebral palsy have been directed at the physical manifestations of the underlying problem. That is, most efforts are geared to increase range of motion, reduce spasticity, and increase strength, along with specific therapies designed to enhance skills of communication and academic performance. Evidence from around the globe is now accumulating providing strong support for the use of hyperbaric oxygen therapy (HBO) as an approach to the actual underlying problem in children with cerebral palsy - a technique which actually targets the abnormalities of brain function. The use of hyperbaric oxygen therapy in cerebral palsy offers an exciting new therapeutic approach for the treatment of cerebral palsy. In actuality however, hyperbaric oxygen therapy itself is not a new technique.
It has been utilized for decades for the treatment of injuries related to underwater diving, and in addition has found great utility in the treatment of poorly healing wounds, burns, various bone disorders, complications of radiation therapy, circulatory problems, carbon monoxide poisoning, multiple sclerosis, head injury, and stroke. Hyperbaric oxygen therapy is approved by the FDA as well as the AMA and acts by enhancing tissue levels of life-giving oxygen. Normally, oxygen is almost exclusively carried by red blood cells. During hyperbaric oxygen therapy, there is a substantial increase in the amount of oxygen carried in all body fluids, including plasma, cerebrospinal fluid, lymph and intracellular fluids. This allows increased oxygen levels in areas of tissue damage or injury. Increasing oxygen levels promotes growth of blood vessels and increases the metabolic activity of previously marginally functioning cells, including brain neurons. Patients receiving hyperbaric oxygen therapy enter a monoplace (one-person) clear acrylic chamber where they breathe 100% oxygen delivered to the chamber under increased atmospheric pressure. Typically, treatments last one to two hours during which time patients relax, watch television, or sleep, while they are carefully monitored by highly trained technicians.
Most chambers are large enough to comfortably treat both an adult and a child. The effectiveness of hyperbaric oxygen therapy in children with cerebral palsy is likely a manifestation of enhanced function of previously damaged neurons. These neurons have been called "idling neurons" in that while they are still alive, they have been damaged to the extent that their function is compromised. The concept of enhancing the function of these idling neurons has been extensively described in stroke patients as we have reported in previous issues of the Perlmutter Letter. Canadian researchers have been vigorously exploring the utility of HBO in cerebral palsy. Dr. Pierre Marois and his team of researchers from McGill University in Montreal have recently studied 25 children with cerebral palsy, aged 4 to 7 years, treated with hyperbaric oxygen therapy on a daily basis for 20 days at McGill University. Another 15 children were treated twice a day for 10 days. Both groups thus received a total of 20 treatment sessions. The results of their post-treatment evaluation were truly remarkable. According to Dr. Marois "…the results are really incredible! 23 of the 25 children have great results.
Twenty-three have amelioration with their spasticity and may have amelioration with speech and cognitive function". Further, their published results reveal "the clinical observations do list numerous functional changes, definite improvements, a large amount in the level of arousal/response to communication." From statistical analysis of the objective estimations we confirm these change, more particularly on the level of motor functioning like walking and the quality of sitting position, similarly on the level of spasticity. These results are suprising considering the small number of treatments given (20), and of extreme importance because its (a question of) the first study documenting objectively the prospects of beneficial effects of HBO in the treatment of children suffering from cerebral palsy. While it is important to recognize that hyperbaric oxygen therapy clearly represents an important tool in the treatment of children with cerebral palsy, it should be viewed as an adjunctive form of therapy to be used in conjunction with other established treatment protocols including physical therapy, occupational therapy, speech therapy, as well as pharmaceutical therapy designed to reduce spasticity. The use of HBO in children with cerebral palsy is now gaining a strong foothold in the United States and there is no doubt that because of its profound effectiveness, its utilization will become much more widespread. Public awareness of the use of hyperbaric oxygen therapy in children with cerebral palsy in North America can be credited in large part to the work done by Mothers United for Moral Support (MUMS).
This worldwide organization, founded by Julie Gordon, a mother of a child with cerebral palsy, seeks to unite parents of children with cerebral palsy and other needs and to share information concerning various therapeutic options. They can by contacted at telephone 920-336-5333. E-Mail can be directed to the MUMS National Parent - to - Parent network by contacting MUMs@netnet.net. We are proud to report that the Perlmutter Hyperbaric Center has become a world leader on the use of hyperbaric oxygen therapy in cerebral palsy and other neurological disorders. To receive more information about hyperbaric oxygen therapy in the treatment of cerebral palsy, contact The Perlmutter Hyperbaric Center at 941-434-9699 and visit our web site.