Disease States

Cerebral Palsy (CP) and Hyperbaric Oxygen Therapy

Cerebral palsy (CP) is a blanket term for a number of neurological disorders that appear in infancy or early childhood. It permanently affects body movement and muscle coordination. Even though CP affects muscle movement, it is not caused by problems in the muscles or nerves.

CP is caused by damage to the motor control centers of the developing brain, and can occur during pregnancy (~75%), during childbirth (~5%), or after birth (~15%). Brain damage does not worsen over time, but secondary orthopedic difficulties , such as early adult onset of arthritis and osteoporosis are common.

CP is second only to mental disabilities as the most expensive developmental disorder to manage over the course of a person’s life. In general, the earlier treatment begins the better chance children have of learning ways to accomplish tasks that challenge them. Treatment may include physical and speech therapy, medications to control seizures and pain, braces and orthotic devices, and wheelchairs and rolling walkers. Hyperbaric oxygen therapy (HBOT) has shown promise in clinical trials, and is being sought by parents as an adjunct therapy.

The Journal of American Physicians and Surgeons Winter 2007 issue reports that CP is often caused by an ischemic/hypoxic injury. Hypoxia may cause cell death, however, there may be a zone called the “ischemic penumbra”, in which brain cells receive just enough oxygen to survive, but not enough to function normally. Cells to which the blood flow is dramatically reduced for approximately 10 minutes (less than 10ml of blood per 100g of brain tissue per minute) undergo necrosis and form the core of a lesion. With less sever hypoxia, some researchers believe that cells can survive for a long time in an “idling” state, and may be reactivated if blood flow is restored. Researchers who observed a decrease in spasticity and functional improvements with HBOT hypothesize that neurons might be viable but inactive much longer than previously believed.

A 1999 study at McGill University in Montreal involved 25 CP patients. They were treated with 20 sessions of HBOT at 1.75ATA for 60 minutes five days per week. Results indicated improved gross motor function in three of the five gross motor function measure (GMFM) tests, improved fine motor function in three of the six hand tests, reduced spasticity in three of four muscle groups, and improvements of four of nine questions posed to parents.

The University of Texas Medical Branch in Galveston treated five children , average age 41.8 months with sixty treatments of HBOT at 1.5 ATA, one hour per day five days per week. One child dropped out of the study before completion. Modest decreases in spasticity and improvements in the modified GMFM scores were noted on the remaining patients. Cortical visual evoked potentials (VEPs), which were absent before therapy in one patient were measurable after HBOT.

Reorganization in the visual cortex is suggested by the appearance of these visual evoked potentials.

Hyperbaric Center of Alabama provides Celebral Palsy (CP) treatment options using hyperbaric oxygen chambers. We serve patients from Alabama, Mississippi, West Georgia and Northwest Florida in our clinic in Birmingham.