Can Acupuncture Cure Stroke

Some research suggests that acupuncture may benefit people who have suffered a stroke, a medical emergency that occurs when the blood supply to your brain is suddenly cut off or when a blood vessel in your brain bursts. A type of needle-based alternative therapy long used in traditional Chinese medicine, acupuncture may help treat several of the disabilities that commonly occur in people who have experienced a stroke.

To date, there is a little scientific support for the effectiveness of acupuncture in the treatment of conditions caused by stroke. For instance, a 2006 review of five trials (with a total of 368 patients) concluded that "there is no clear evidence on the effects" of acupuncture for stroke rehabilitation. However, several small studies indicate that acupuncture may be of some benefit to stroke patients. Here's a look at their findings:
1) Balance Function
Acupuncture may boost balance in people who have suffered a stroke, according to a 2009 study of 30 patients. After undergoing a single acupuncture treatment, study participants showed improvements in balance function (as well as in muscle strength).
2) Upper-Extremity Rehabilitation
In a 2005 study of 33 stroke patients with chronic hemiparesis (weakness on one side of the body), researchers tested the effects of up to 20 acupuncture sessions over an average of 10.5 weeks. While acupuncture failed to improve upper-extremity function or quality of life in the study participants, some subjects did experience gains in motor function over the course of the study.
3) Spastic Dyskinesia
A study published in 2007 shows that acupuncture may help treat spastic dyskinesia (difficulty in performing voluntary movements), a common problem among stroke patients. The study involved 96 stroke patients, all of whom underwent one acupuncture session. Study results suggest that acupuncture may significantly improve spastic dyskinesia, as well as enhance daily functioning.
Using Acupuncture for Stroke Rehabilitation

Due to the lack of research, it's too soon to recommend acupuncture for stroke rehabilitation. If you're interested in using acupuncture to treat conditions caused by stroke, it is essential that you talk to your physician first. Keep in mind that self-treating and avoiding or delaying standard care can have serious consequences. In using acupuncture for stroke rehabilitation, it's important to work with a qualified medical acupuncturist.

Types of Cerebral Palsy

Cerebral Palsy (CP) is a nervous system developmental disease. Usually CP is referred to as a central movement disorder; which is caused by non-progressive cerebral injury or encephalodysplasia during pregnancy during childbirth or after birth up to about one month due to many reasons. The incidence of CP is about 1.2-2.5%, clinical features are abnormal in posture and muscular tension, involuntary movement and ataxia, which are usually associated with sensory disturbance, cognitive dysfunction, behavioral disorder, secondary skeletal muscle abnormalities and epileptic seizures. The non-progressive central movement disorders, which are also called acquired cerebral palsy, are caused by many reasons one month after birth. Approximately 10% of CP cases include: the cause of congenital brain disorder etiology, premature matrix hemorrhage, periventricular leukomalacia, hypoxic ischemic injury, spastic diplegia, infantile hemiplegia, paraplegia and quadriplegia, extrapyramidal syndrome, hands athetosis, bilirubin encephalopathy, neonatal congenital ataxia, bridge cerebella dysplasia, flaccid paralysis, which all belong to the acquired development diseases. The diseases of intrauterine infection caused by intrauterine and neonatal infection, result in cerebral malformations and anomalies, that belong to infectious development diseases. Those patients show more or less symptoms of mental retardation.
Spastic Hemiplegia
The most common type, involving one side of the body, upper limbs are shown to be worse than lower limbs, far-end worse than near-end, face is usually normal. Children often show obvious symptoms after 3 months, such as less limbs move, persistent fist, grasp reflex disappears, forearm pronation posture, circle gait and so on. Part of the patient's first symptoms can be low muscle tone, and then it turns to spasticity. Mental retardation and epilepsy are common in this type. Epileptic seizures show partial or secondarily generalized seizures. Strabismus is very common.
Spastic Quadriplegia
Spastic quadriplegia is usually found in children who suffer from severe asphyxia. Their limbs muscle tension is increased, often showing signs of opisthotonos, and with supranuclear bulbar paralysis, causing swallowing and articulation disorder. About half of the patients show signs of epilepsy and mental retardation.
Dyskinetic CP
Dyskinetic CP is found in about 10% of CP patients, main causes are hypoxic brain injury and neonatal nuclear jaundice. Patients commonly show hypotonia in early infancy, and then have extrapyramidal symptoms, such as athetosis. Salivation, dysphagia and the language barrier can be found as well. Deep tendon reflex in the lower limbs is shown to be normal or increased. Patients may have persistent primitive reflex, intelligence is mostly in the normal or critical state. About 1/4 of the patients have epilepsy. Cases caused by nuclear icterus show athetosis, sensory deafness, enamel hypoplasia, etc.
Ataxia CP

This type of CP is present in about 10% of CP patients; symptoms are usually hypotonia, balance disorder and motor retardation in infancy, Dysmetria, intention tremor in childhood, pyramid sign is not common, and many patients show signs of mental retardation, but nothing serious.

Click Here to know more about cerebral palsy
How to treat Cerebral Palsy
Stem Cells Treatment For Cerebral Palsy

The Effects of Stroke at Birth

Although strokes are commonly associated with adults, they can occur in newborns during the birth process or in utero. Neonatal strokes can be ischemic, meaning a blood clot reduces blood flow to an area of the brain, or hemorrhagic, meaning bleeding occurs within the brain. Around 25 in 10,000 newborns suffer strokes, the Children’s Hospital of Philadelphia (CHOP) states. Causes of neonatal stroke include congenital heart defects, blood disorders, asphyxia, trauma and infection. The effects of neonatal stoke can impact a child for life.
Seizures in the newborn period most often first draw attention to the possibility of stroke, lead author K.B. Nelson of the National Institute of Neurological Disorders and Stroke reports in Lancet Neurology in a March 2004 article entitled “Stroke in newborn infants.” Seizure activity in neonates may not be as easily identified as it is in older children and adults. Symptoms of seizures related to neonatal stroke include stiffening or tightening of muscles, bicycling motions, apnea, periods of no breathing and twitching followed by period of relaxation, neurologist Gabrielle de Veber, M.D., director of the Children’s Stroke Program at the Hospital for Sick Children, states. Emory University reports that labor and delivery are often uneventful and that symptoms don’t appear for the first 12 to 48 hours. Seizure medication reduces the frequency of seizure activity. Epileptic seizures may continue to occur and require treatment in childhood as a long term complication of neonatal stroke, according to the Hospital for Sick Children.
Cerebral Palsy

According to Pediatric Stroke, perinatal arterial ischemia related to stroke in the three days surrounding birth accounts for 50 to 70 percent of congenital hemiplegic cerebral palsy, or cerebral palsy which affects one side of the body only. Cerebral palsy, a permanent motor disorder, may go unrecognized after neonatal stroke for four to six months, when an infant shows signs of weakness on one side or uses only one side of the body, CHOP reports.

Exercises for Spastic Cerebral Palsy

Spastic cerebral palsy is the most common form of the condition, according to the American Academy of Orthopaedic Surgeons. This condition is characterized by stiffness and a contraction of the muscles that can be localized in the arms, legs and back, or can be spread throughout the body. Tight muscles due to spastic cerebral palsy make movement difficult, and any type of exercise may treat this lack of mobility.
Swimming/Water Therapy
An aquatic-based rehabilitation plan, according to the Cerebral Palsy Source website, can benefit spastic cerebral palsy patients because water reduces the force of gravity and provides some support to the body when submerged. The tightness in the musculature of a cerebral palsy patient makes it difficult to straighten out limbs completely. Water exercises like swimming or walking in water can help loosen the tight muscles, making movement easier.
Arm Cycling
If your condition is localized in your arms, your doctor or therapist may suggest a bicycling motion performed with your arms. This exercise often requires an arm cycling machine called an ergometer, or can be performed with a bicycle designed to be pedaled with the arms. This exercise can improve heart and lung function, muscular strength and flexibility.
Yoga/Tai Chi

The United Cerebral Palsy Foundation notes that some exercises performed in yoga and tai chi can benefit cerebral palsy patients by improving bone strength, balance as well as mobility. Focus initially on breathing and stretching exercises, and increase the amount of exercises you perform as your condition improves.

Herbal Therapies for Cerebral Palsy?

Cerebral palsy covers a wide spectrum of brain-related motor problems. Cerebral injuries that occur at or soon after birth may result in muscular or nerve dysfunction, which can present in the form of paralysis in one or more area of the body. Individuals may experience a range of severity with this non-progressive lifelong condition. Conventional treatments and herbal therapies alike show great promise for Cerebral palsy patients, especially if the diagnosis takes place early on. Several herbs have therapeutic uses in cerebral palsy.
Herbs can be used to nourish the brain, improve motor control, and increase mental acuity. Neurotransmitters are chemicals that are similar to hormones. They are a major part of the central nervous system that work not only in the brain, but throughout the entire body. Ginkgo biloba, Panax and Siberian ginseng can increase the activity of these neurotransmitters for improved muscle functions. These herbs also have other helpful uses in cases of cerebral palsy.
Free radicals are often prevalent in cases of cerebral palsy. Antioxidant rich herbs can help counteract and prevent further cell damage caused by their presence. Rosemary, ginger, and ginkgo biloba are among those that have been cited for their high antioxidant content. Antioxidants are also helpful in assisting the body with proper oxygen utilization, which is very important for proper brain, nerve and muscle function.
Ginger may also be used to improve circulation to the extremities. For improved circulation throughout the entire body, prickly ash is another good option. Again we see Ginkgo as useful for improved circulatory function. The better circulation of blood, the more optimal oxygen levels and vital nutrients will be in the brain and nerve cells.
Additional Supplementation
Various nutrients work to provide improved muscle tone. Magnesium, vitamin C and thiamine are not always consumed in adequate amounts in today's modern diets, so supplementation may be helpful. Multivitamins with added minerals are best in organic, whole food forms. Adequate protein intake is also important because of the amino acids provided for proper muscle growth.
Dietary Considerations

Preservatives and food additives found in processed foods should be avoided. Many of them, like MSG, can pose the threat of toxicity to the brain. Foods should be consumed in the most natural form when available. Whole grains, fresh vegetables, and fruits are good options. Check with a doctor to rule out any possible food allergies that may cause an increase in symptoms.

Diseases That Can Be Mistaken for Cerebral Palsy

Cerebral palsy describes a neurologic disorder caused by brain damage usually sustained during fetal development or delivery. The damage to the brain interferes with muscle coordination and body movements causing delayed development in infants. Symptoms of cerebral palsy include a lack of muscle coordination, stiff or tight muscles, a drop foot, an unbalanced gait, crouched walking, walking on the toes, a lack of muscle tone, excessive drooling, tremors and difficulty with tasks requiring precise movements like buttoning a shirt. Doctors often mistake many other diseases with similar symptoms for cerebral palsy; however, one of the most distinguishing characteristics is that cerebral palsy is not degenerative, meaning symptoms do not worsen over time.

Pelizaeus-Merzbacher Disease

Pelizaeus-Merzbacher disease, classified as a rare genetic disorder, belongs to the group of diseases known as leukodystrophies. Leukodystrophies affect the growth of myelin—the fatty substance which surrounds nerves throughout the body and brain. Like cerebral palsy, Pelizaeus-Merzbacher disease causes muscle weakness and a lack of coordination resulting in delayed development as described by the National Institute of Neurologic Disorders and Stroke.

Although the symptoms of Pelizaeus-Merzbacher disease often cause a mistaken initial diagnosis of cerebral palsy, several differences distinguish the two disorders. Cerebral palsy occurs due to brain damage, while Pelizaeus-Merzbacher occurs due to a genetic mutation that affects the production of a myelin protein. Pelizaeus-Merzbacher is a degenerative disease causing symptoms to progressively worsen over time while cerebral palsy symptoms remain the same.

Charcot-Marie-Tooth Disease

Charcot-Marie-Tooth disease, CMT, is the most common neurological disorder, according to the Charcot-Marie Tooth Association, affecting approximately 2.6 million people world-wide. Although symptoms of CMT, including muscle weakness, a drop foot, an unbalanced gait and tremors, resemble cerebral palsy causing a mistaken diagnosis, the two disorders possess different characteristics.

CMT is a progressive neurological disease affecting the nerves that control the muscles, unlike cerebral palsy that affects the brain. CMT causes a loss of nerve function resulting in a tingling or burning sensation, neuropathic pain and a sensory loss.

Can cerebral palsy be treated with stem cells?

Mesenchymal stem cells from umbilical cord are considered to be universal donor cells because they are not immediately recognized as foreign. The cells home to damaged tissue and are known to secrete molecules called trophic factors.
Trophic factors from mesenchymal stem cells are known to stimulate repair of damaged nervous tissue in both the brain and the spinal cord. Some of these are neurotrophic factors that promote neuronal growth, induce new blood vessel growth, neurogenesis and astroglial activation, encourage synaptic connection and axonal remyelination, decrease programed cell death, and regulate microglial activation.
Mesenchymal stem cells stimulate brain repair after stroke1 and traumatic brain injury.
Animal studies show that mesenchymal stem cell can migrate into the brain and survive.
Because we utilize allogeneic cord tissue-derived mesenchymal stem cells, we are able to offer treatment to any qualified patient, not just those who saved their own cord blood at birth. We will discuss several additional advantages of allogeneic cord-derived stem cells below.
There is evidence to support that bone marrow-derived mononuclear cells are safe and improve the quality of life in children with neurological disorders including cerebral palsy.
Which kinds of stem cells are utilized for CP treatment and how are they collected?
The Stem Cell Institute leverages adult stem cells from human umbilical cord tissue to treat cerebral palsy. These stem cells are harvested from donated umbilical cords. In accordance with International Blood Bank standards, all umbilical cord-derived stem cells are rigorously screened for viruses and bacteria at Medistem Labs before they are approved for use in patients.

In some cases, stem cells harvested from the patient’s own bone marrow are used in addition to umbilical cord tissue-derived cells.

Eating and Drinking for Cerebral Palsy

Eating and drinking may be difficult for some people living with cerebral palsy. This may be apparent soon after birth, with babies experiencing problems feeding either from the breast or bottle, or may start later in life.
Cerebral palsy can affect the muscles that open and close the mouth and move the lips and the tongue. Some people living with cerebral palsy may have difficulties in chewing and swallowing food and drink – a condition known as dysphagia.
Cerebral palsy often impacts fine motor skills and this can affect the ability of people to easily use cutlery, hold a cup, or transfer food from a plate to their mouth using their hands.
Others may suffer from gastroesophageal reflux – where acid from the stomach rises into the oesophagus – which makes eating uncomfortable or painful. This can sometimes be controlled by medication.
1 in 15 children with cerebral palsy are unable to take food through their mouth and need to be fed through a feeding tube. Speech pathologists and occupational therapists can help people with cerebral palsy who have eating and drinking difficulties.
If you are a person with cerebral palsy who has concerns about eating or you are a parent or carer concerned about your child or someone you know, then it is important that you seek advice and support.
Services that may assist with this area include:
Occupational Therapy
Speech Pathology

Spastic Cerebral Palsy – Facts, Causes , Symptoms and Treatments

Spastic Cerebral Palsy – Facts, Treatments, and Outcomes

Spastic cerebral palsy is the most common form of cerebral palsy, occurring in 50-75% of all cases. People with spastic cerebral palsy have too much muscle tone or tightness, a condition called hypertonia. Their movements are stiff and jerky, especially in the legs, arms, and back.
Sometimes an infant born with weak muscle tone, called hypotonia, will progress to hypertonia after the first 2 to 3 months of life. Children with cerebral palsy may exhibit unusual posturing or favor one side of the body when they move.
Up to 80% of all people with cerebral palsy suffer from some degree of spasticity. Spastic cerebral palsy is further categorized by what parts of the body are affected. In spastic diplegia, the main effect is found in both legs. Spastic hemiplegia involves one side of the person’s body. Spastic quadriplegia affects a person’s whole body (face, trunk, legs, and arms).
A person can have spastic cerebral palsy so mild that walking can simply look awkward, or be so severe that the use of a wheelchair is required.

Causes of Spastic Cerebral Palsy

According to the National Institutes of Health, four types of brain damage cause the characteristic symptoms of cerebral palsy:
Damage to the white matter of the brain (periventricular leukomalacia [PVL]). The white matter of the brain is responsible for transmitting signals inside the brain and to the rest of the body. Periventricular leukomalacia describes a type of damage that looks like tiny holes in the white matter of an infant’s brain. These gaps in brain tissue interfere with the normal transmission of signals. There are a number of events that can cause PVL, including maternal or fetal infection. Researchers have also identified a period of selective vulnerability in the developing fetal brain between 26 and 34 weeks of gestation. During this time, periventricular white matter is particularly sensitive to injury.
Abnormal development of the brain (cerebral dysgenesis). Any interruption of the normal process of brain growth during fetal development can cause brain malformations that interfere with the transmission of brain signals. The fetal brain is particularly vulnerable during the first 20 weeks of development. Mutations in the genes that control brain development during this early period can keep the brain from developing normally. Infections, fevers, trauma, or other conditions that cause unhealthy conditions in the womb also put an unborn baby’s nervous system at risk.
Bleeding in the brain (intracranial hemorrhage). Intracranial hemorrhage involves bleeding inside the brain caused by blocked or broken blood vessels. A common cause of this kind of damage is fetal stroke. Some babies suffer a stroke while still in the womb because of blood clots in the placenta that block blood flow. Other types of fetal stroke are caused by malformed or weak blood vessels in the brain or by blood-clotting abnormalities. Maternal high blood pressure (hypertension) is a common medical disorder during pregnancy that has been known to cause fetal stroke. Maternal infection, especially pelvic inflammatory disease, has also been shown to increase the risk of fetal stroke.
Brain damage caused by a lack of oxygen in the brain (hypoxic-ischemic encephalopathy or intrapartum asphyxia). Asphyxia, a lack of oxygen in the brain caused by an interruption in breathing or poor oxygen supply, is common in babies due to the stress of labor and delivery. But even though a newborn’s blood is equipped to compensate for short-term low levels of oxygen, if the supply of oxygen is cut off or reduced for lengthy periods, an infant can develop a type of brain damage called hypoxic-ischemic encephalopathy, which destroys tissue in the cerebral motor cortex and other areas of the brain. This kind of damage can also be caused by severely low maternal blood pressure, rupture of the uterus, detachment of the placenta, or problems involving the umbilical cord.

How Movement is Spastic Cerebral Palsy Affected

The type of brain damage that leads to cerebral palsy affects movement. Movement is governed by muscle tone, which is the continuous and passive amount of tension in a muscle that allows us to change or keep certain postures.
Healthy muscles work in groups. For example, when you bend your arm, the group of muscles on the front of your arm contract and the muscles on the back of your arm relax, which is what allows the bend to occur. Except in deep sleep, our muscles are in a constant state of active or passive tension, which allows us to do things like sit up, raise our heads, or stand.
Our brain sends out signals to muscles telling which ones to contract and which to extend to make our movements smooth and controlled. When any movement occurs, there are two sets of muscles working around a joint. Normally, the muscles on one side of the joint must relax so that the muscles on the other side can contract. In people with spastic cerebral palsy, the brain activates muscles at the same time, causing muscle groups to work against each other. The result is stiff, jerky movements.

Symptoms of Spastic Cerebral Palsy

Brain damage can occur before an infant is born, during labor and delivery, or when a child is older as the result of illness, accident, or injury. If the damage occurred before or during birth, an infant might have low APGAR scores, floppy muscle tone, poor color, weak breathing, the inability to suck, and development of seizures. In less severe cases, brain injury may not be obvious until the child fails to meet developmental milestones. In most cases, children with cerebral palsy are diagnosed by age three. Your child’s physician may order a brain scan or MRI for the diagnosis of cerebral palsy. This study may show lesions or other possible suspected causes of spastic cerebral palsy.
Following are some symptoms of spastic cerebral palsy in children:
Contractures-Contractures are “frozen joints,” and occur when a limb cannot be stretched or moved (when another person tries to moves it about its joint). Contractures may develop because the muscles were shortened or wasted away (atrophy), or from the development of scar tissue (fibrosis) formed over the joints.
Clonus –Clonus is a movement characterized by rapid, alternate contractions and relaxations of a muscle. Clonus is frequently observed in conditions such as spasticity and certain seizure disorders. A child with spastic cerebral palsy may experience episodes of clonus when trying to walk or navigating stairs. Clonus may cause the child’s foot to move up and down uncontrollably or shake erratically. In the case of clonus involving the arms, an attempt at controlled movement may trigger rapid, violent tremors or shaking of the arms and hands, sometimes leading to violent scissoring of the arms, possibly banging of the fists together.
Dystonia-Dystonia is a movement disorder characterized by lasting muscle tightening or contractions. The contractions result in repeated twisting or writhing movements and unusual postures or positioning that the person with dystonia cannot control. This disorder may be limited to specific muscle groups and may result from the use of certain medications.
Exaggerated deep tendon reflexes-Knee jerk and other reflexes may be exaggerated.
Exaggerated startle reflexes and hypersensitivity-Infants may seem particularly sensitive to their environment, such as noise and light. They may seem especially sensitive to touch, startling easily and becoming fussy when stroked or held.
Hip dysplasia and dislocation-Hip dysplasia and dislocation is a common feature of cerebral palsy. The hip joint is normal at birth but the spastic muscle imbalance and lack of weight bearing leads to the development of progressive structural changes around the hip joint. These deformities contribute to hip dysplasia and dislocation. The consequences of a hip dislocation include difficulty with toileting and hygiene and result in problems with sitting.
Myoclonus-Myoclonus is a neurological movement disorder characterized by brief, involuntary, twitching or “shock-like” contractions of a muscle or muscle group. Depending on its cause, the muscle jerks can occur repeatedly or infrequently. They also may tend to occur only during specific circumstances. The muscle jerks can affect any body region or regions.
Muscle spasms or scissoring-Involuntary crossing of the legs or arms.
Categories of Spastic Cerebral Palsy
Spastic Diplegia-Spastic Diplegia is spastic cerebral palsy that may involve both legs, causing difficulty with walking due to tight muscles in the hips and legs causing legs to turn inward and cross at the knees (scissoring).
Spastic Hemiplegia-Spastic hemiplegia affects one side of the body. In the brain, one hemisphere (side) controls the opposite side of the body. So, if the left side of the brain experiences damage, the symptoms will appear on the right side of the body and vise versa.
Spastic Quadriplegia-Spastic quadriplegia is spastic cerebral palsy that involves all four limbs and the trunk, often along with the muscles controlling the mouth and tongue and also those controlled by the autonomic system responsible for swallowing, gastric emptying, and intestinal motility. This is the most severe form of spastic cerebral palsy.

Treatments for Spastic Cerebral Palsy

Treatment for spastic cerebral palsy focuses on controlling excess tone and spasticity by means of medication, surgery or spinal cord stimulation, alleviating pain, and providing regular physical therapy. Failure to control excess tone and spasticity to the extent possible can lead to contractures, scoliosis, and hip dysplasia, and it may severely impact quality of life.
Common Medications
Benzodiazepines–A class of medications that act upon the central nervous system to reduce communication between certain neurons, lowering the level of activity in the brain. Benzodiazepines are muscle relaxants such as diazepam, oral baclofen, and dantrolene and are frequently the first line of treatment in managing movement disorders.
Intrathecal baclofen–Approved by the Food and Drug Administration (FDA) in 1996 for treatment of cerebral palsy, this therapy is becoming the common choice of treatment in movement disorders that do not respond well to other forms of treatment. This form of therapy uses an implanted pump device to deliver baclofen (muscle relaxant) into the spinal cord. This form of therapy is most appropriate for children with severe hypertonia and uncontrolled movement disorders throughout the body.

Surgery for Spastic Cerebral Palsy

Orthopedic surgery is often recommended when spasticity and stiffness are severe enough to make walking and moving difficult or painful. Commonly, surgery involves lengthening muscles and tendons that are proportionately too short. Orthopedists generally time surgeries to coincide with a specific stage of the child’s physical development.
Spasticity in the upper leg muscles, which causes a “scissor pattern” walk, is a major obstacle to normal gait. The optimal age to correct this spasticity is 2 to 4 years of age with adduction release surgery. On the other hand, the best time to perform surgery to lengthen the hamstrings or Achilles tendon is 7 to 8 years of age. If adduction release surgery is delayed so that it can be performed at the same time as hamstring lengthening, the child will have learned to compensate for spasticity in the adductors. By the time the hamstring surgery is performed, the child’s abnormal gait pattern could be so ingrained that it might not be easily corrected. With shorter recovery times and new, less invasive surgical techniques, doctors can schedule surgeries at times that take advantage of a child’s age and developmental abilities for the best possible result.

Selective dorsal rhizotomy (SDR) is a surgical procedure recommended only for cases of severe spasticity when all of the more conservative treatments have proven ineffective. In this procedure, surgeons locate and selectively sever over-activated nerves at the base of the spinal cord to reduce spasticity in the legs.

Management for Cerebral Palsy

Over time, the approach to Cerebral Palsy management has shifted away from narrow attempts to fix individual physical problems – such as spasticity in a particular limb – to making such treatments part of a larger goal of maximizing the person's independence and community engagement.:886 However, the evidence base for the effectiveness of intervention programs reflecting this philososphy has not yet caught up: effective interventions for body structures and functions have a strong evidence base, but evidence is lacking for effective interventions targeted toward participation, environment, or personal factors. There is also no good evidence to show that an intervention that is effective at the body-specific level will result in an improvement at the activity level, or vice versa.Although such cross-over benefit might happen, not enough high-quality studies have been done to demonstrate it.
Treatment of cerebral palsy is a lifelong process focused on the management of associated conditions. It tries to allow healthy development on all levels. The brain, up to about the age of 8, is not set and has the ability to reroute many signal paths that may have been affected by the initial trauma; the earlier it has help in doing this the more successful it will be.
The treatments with the best evidence are medications , therapy (bimanual training, casting,constraint-induced movement therapy, context-focused therapy, fitness training, goal-directed training, hip surveillance, home programmes, occupational therapy after botulinum toxin, pressure care) and surgery
Various forms of therapy are available to people living with cerebral palsy as well as caregivers and parents. Treatment may include one or more of the following: physical therapy; occupational therapy; speech therapy; water therapy; drugs to control seizures, alleviate pain, or relax muscle spasms ; surgery to correct anatomical abnormalities or release tight muscles; braces and other orthotic devices; rolling walkers; and communication aids such as computers with attached voice synthesisers.

However, there is only some benefit from therapy. Treatment is usually symptomatic and focuses on helping the person to develop as many motor skills as possible or to learn how to compensate for the lack of them. Non-speaking people with CP are often successful availing themselves of augmentative and alternative communication.

Effects of Cerebral Palsy

1. Energy level and energy usage
There is no point in beating around the bush. This is by far the biggest change I noticed compared to when I was say, 15. I get tired way more easily, and when I get tired, I get really tired. I would describe it almost like influenza symptoms if I push it too far. My body starts to ache; I find it difficult to think straight, and in general to concentrate on anything. Thankfully, changing my job to working even more of a desk job than my previous job, has helped quite a bit. In my previous job as an IT technician I would tire a lot faster due to walking and lifting etc. at work. That resulted in me only being able to work a 50% position. Now I can work a lot more before I feel tiredness, and that is good. I need to do something and be productive to be happy. I’ve found this side of the CP to be difficult to communicate to others though. They see the obvious sings of the CP, they don’t see the fatigue and low energy. I remember that I used to be afraid of others thinking I was lazy, back when I first encountered problems with this during high school.
2. Lower mobility and increased stiffness.
Although I will still consider myself plenty mobile enough, since I can achieve what I want, I do notice a significant change in my mobility compared to when I was in my teens. My feet are usually stiffer; I notice that especially if I try to play soccer now, I’ve lost a lot of the “fine touch” I used to have in being able to control my feet. They don’t rotate as easily to either side, and they are generally tougher to control. I suspect also that my achilles tendons are “regressing” quite a bit, I can feel that they are shortening and fighting up. That is something to be expected though, and it reminds me that I really should get better at stretching a lot more often. Even though I’ve always found that quite boring I must admit.
3. Cramps.
Yep, simple as that. I can’t remember having cramps in my feet when I was younger, if I did it was most surely a rare occurrence. Now, I get instant cramps if I tense up my musculature, especially in my feet. That is not such a great combination when you consider my hypersensitive startle reflex.
I guess this one fits pretty well into overall increased tightness and spasticity though
4. Motion sickness.
Now, I can’t 100% say that this is due to my CP, but I have some reason to believe so. I used to have motion sickness a little when I was younger, but not as bad as it can get now. And its not just general motor sickness after a long car ride, I get physically disoriented and dizzy if I ride a bus for example. I have mentioned this to a few doctors and they say it can very well be related to the CP. They say since it is tied to balance issues, if my balance has worsened (spoiler alert, its the next point) that can increase the likelihood of me experiencing problems with motion sickness
5. Reduced balance.

As mention in number 4, my balance has decreased somewhat. I notice that I fall over more easily than I used to. Mind you I never had a stellar balance really, but it’s noticeably worse now. Living in icy Norway can sometimes be a challenge, but I was smart enough to invest in shoes with metal spikes underneath, so now I can walk on the ice without noticing much, which believe me, is a God send. I remember that I used to fall several times each winter; it’s really a wonder that I have never broken anything. I’m thankful I thought myself falling techniques though (karate is great for this).

Cerebral Palsy Diagnosis and Tests

Unlike with many other conditions, no single test can diagnose cerebral palsy. Instead, a diagnosis involves understanding a child’s medical history and identifying symptoms consistent with the condition. Diagnosing cerebral palsy as soon as possible ensures early intervention and a lifetime of excellent medical care.
Diagnosis Shortly After Birth
In some cases, doctors diagnose cerebral palsy shortly after birth. Babies born prematurely or who have other significant risk factors are most likely to receive an early diagnosis. In such cases, a newborn often will have an MRI that shows damage to the brain. A neurological exam with abnormal results also helps support an early diagnosis.
In cases of early diagnosis, Gillette specialists might provide evaluations or consultations while a baby is still in a neonatal intensive care unit (NICU). Once a baby comes home from the hospital, regular visits with Gillette’s cerebral palsy specialists play an important role in maximizing a child’s health and abilities.
Diagnosis During Toddlerhood
Most often, children receive a cerebral palsy diagnosis between ages 1 and 3. Such children usually have a birth and medical history that increases their risk of cerebral palsy. Symptoms at birth, however, might not be clear enough to warrant an early diagnosis. Instead, parents and care providers watch for developmental concerns.
Parents and care providers might suspect cerebral palsy if a child misses milestones (such as sitting up or crawling) or shows other symptoms consistent with the condition. Sometimes pediatricians and family practitioners diagnose patients with cerebral palsy. In other cases, they send their patients to a specialty center like Gillette for evaluation.
Diagnosis During Childhood
Although the situation is rare, some children receive a cerebral palsy diagnosis after their toddler years. In such cases, providers might have missed very mild symptoms, or a child might have failed to outgrow what was thought to be another condition (such as idiopathic toe walking).
In addition, children older than 1 can develop symptoms similar to those of cerebral palsy if they sustain traumatic brain injuries, experience a lack of oxygen, or contract an infection such as meningitis. Children whose injuries occur when they are older than 1 typically receive a diagnosis of brain injury rather than cerebral palsy.
Tests and Evaluations to Help Diagnose Cerebral Palsy
Although no single test can diagnose cerebral palsy, doctors use various tests and evaluations to help make a diagnosis. Common tests and evaluations include:
Magnetic resonance imaging (MRI)
Computed tomography (CT)
Cranial ultrasound
Developmental screenings (during well-child visits)

Developmental assessment conducted by a neurologist, pediatric rehabilitation medicine specialist or neurodevelopmental pediatrician

What are the Different Types of Cerebral Palsy Therapy?

There are no established, consistent cures for cerebral palsy, but people who live with the condition can learn how to enjoy active, fulfilling lifestyles despite their disabilities. Guided cerebral palsy therapy provided by licensed specialists can help children and adults keep their independence and succeed in work and school. There are many different types of valuable cerebral palsy therapy, from physical therapy to speech programs to special education. With the right tools, people can learn how to overcome obstacles and become productive members of society.
Physical therapy sessions are vital elements of most patients' cerebral palsy treatment. It is common for a patient to start attending physical therapy at a very young age to begin building enough strength and balance to stand upright and learn to control motor movements. Older children are taught how to establish good posture and how to move about with the aid of braces, crutches, or wheelchairs.

As an adult, a patient's physical therapy program is usually focused on maintaining the muscle strength and control necessary to get around independently. Patients might practice dressing and bathing themselves, holding utensils, and working with computers. Of course, the severity of disabilities varies from patient to patient, so particular elements of cerebral palsy therapy are more emphasized in some programs than in others.

What is Cerebral Palsy Law?

Cerebral palsy law is an umbrella term that covers a range of legal rights that apply to a person with cerebral palsy. A person with cerebral palsy has a right to go to school, for example, as well as the right to work. He also has the right to proper medical care and may be entitled to receive services for those with disabilities. If an individual faces discrimination because of his disability or is denied the support he needs, his parents may take legal steps to secure his rights. Sincecerebral palsy is usually diagnosed in infants or very young children, parents or legal guardians are usually responsible for taking legal action when necessary.

In many cases, a person with cerebral palsy may be entitled to financial assistance for paying for things such as wheelchairs, medications, and medical treatment. He may be entitled to financial payments that help with living expenses as well. The rights a patient has to these and other types of assistance also fall under the cerebral palsy law umbrella.
Another part of cerebral palsy law focuses on the claims that may be filed on behalf of a person who has cerebral palsy that was caused by medical malpractice. If a medical professional makes mistakes that cause cerebral palsy, he may face a medical malpractice lawsuit. Some examples of mistakes that may lead to the condition include the failure to perform a C-section when an unborn child is in distress and the failure to treat a pregnant woman for infections that may harm her unborn child. Likewise, medical malpractice claims may be filed because of injuries that happen during childbirth, such as when a doctor uses forceps or vacuum extraction improperly.
When a parent believes his child's cerebral palsy has resulted from a medical mistake ornegligence, he may hope to win a malpractice lawsuit and secure compensation. He may also hope to hold the medical professional who made the mistake responsible for his actions. In such a case, the parent has to prove that the doctor made a mistake, was negligent, or failed to provide a reasonable standard of care. If the child has cerebral palsy because of a birth defect or situation that was beyond the doctor's control, the parent is unlikely to win his case.

An individual who wants more information about cerebral palsy law may contact a lawyer for help. Likewise, organizations that provide services for individuals with disabilities may provide information as well. There are even some advocacy groups that may help patients and their families to get the help they need.

When to See A Doctor For Cerebral Palsy

If your child with cerebral palsy (CP):
Is having problems breathing.
Chokes during feeding and you are not able to dislodge the food.
Call a doctor right away if:
Your child has a seizure for the first time.
If you have a child diagnosed with CP, call your doctor if your child has:
A seizure (if it is the first time, call your doctor or seek care right away).
Constipation that isn't relieved by home treatment.
Skin irritation that isn't getting better, starts to bleed or weep fluid, or causes pain.
Feeding problems that aren't relieved by home treatment, such as:
A pattern of coughing and choking during feeding. If food is inhaled into the lungs, it increases the risk of pneumonia.
Trouble chewing, along withweight loss or complaints of being hungry.
Frequent accidents that threaten your child's safety.
Other signs of complications. These may include bladder control problems, bleeding gums, or an increase in joint stiffness.
If you have cerebral palsy and you are pregnant, talk with a doctor about how CP can affect your pregnancy and delivery.
Who to see
A team of health care providers will be involved in your child's care. Health professionals who can diagnose and treat people who have cerebral palsy include:
Pediatricians (some pediatricians specialize in developmental disabilities).
Family medicine doctors.
Nurse practitioners.
Physician assistants.
Internists.
Neurologists.
Neurological surgeons.

Physiatrists, physical medicine and rehabilitative physicians, and other doctors who specialize in therapeutic and long-term treatment issues.

Drug Therapy for Cerebral Palsy

One of the major characteristics of cerebral palsy is spasticity, meaning that the muscles are stiff or rigid muscles. It also describes stiff, rigid muscles interfering with normal muscle activity, movement, walking or speaking. If muscles or tendons remain tense for too long, joints become bent in a fixed rigid position called a contracture.

Spasticity is caused by damage to the portion of the brain that controls voluntary movements. The motor area of the brain is found in the cerebral cortex. If this portion of the brain is damaged, it can affect how nerve impulses from the brain are carried along the spinal cord and through the nervous system to the muscles and tendons. These interrupted or abnormal messages can cause hyperactive deep tendon reflexes, causing knees to jerk, legs to scissor (open and close like a pair of scissors), and repetitive, or jerky motions.

Interrupted or irregular nerve impulses can also cause individuals with diseases like cerebral palsy, or with brain injuries, to hold their shoulders, arms or fingers in odd ways. Spasticity can be extremely debilitating and painful. It is also common in brain injured individuals. Common treatments for spasticity include physical therapy, medications and surgery.

Drugs are sometimes used to control spasticity, particularly following surgery. The three medications that are used most often are diazepam, which acts as a general relaxant of the brain and body; baclofen, which blocks signals sent from the spinal cord to contract the muscles; and dantrolene, which interferes with the process of muscle contraction. Given by mouth, these drugs can reduce spasticity for short periods, but their value for long-term control of spasticity has not been clearly demonstrated. They may also trigger significant side effects, such as drowsiness, and their long-term effects on the developing nervous system are largely unknown.

Patients with athetoid cerebral palsy may sometimes be given drugs that help reduce abnormal movements. Most often, the prescribed drug belongs to a group of chemicals called anti-cholinergics that work by reducing the activity of acetylcholine. Acetylcholine is a chemical messenger that helps some brain cells communicate and that triggers muscle contraction. Anticholinergic drugs include trihexyphenidyl, benztropine, and procyclidine hydrochloride.


Occasionally alcohol "washes" -- or injections of alcohol into a muscle � are used to reduce spasticity for a short period. This technique is most often used when physicians want to correct a developing contracture. Injecting alcohol into a muscle that is too short weakens the muscle for several weeks and gives time to work on lengthening the muscle through bracing, therapy, or casts. In some cases, if the contracture is detected early enough, this technique may avert the need for surgery.

Medications And Drugs For Cerebral Palsy Treatment

Medicine for CP is meant to help patients control pain and reduce complications associated with the disorder. As with other forms of treatment, the type of medicine your child needs will depend on the severity of CP and the complications involved. The most common types of medication for CP include:

Muscle Relaxants: Muscle relaxants such as Valium and Baclofen promote muscle relaxation by reducing spasms and stiff muscles. Most muscles relaxants are given orally unless special surgery is needed to continuous administration.

Seizure Medication: Seizures are a common problem for many people who have CP. Anti-convulsant medication such as Trileptal and Lamictal helps control seizures.
Anticholinergic Medication: For people who suffer from dystonic CP, antocholinergic medication, such as Robinal, may be prescribed. These types of medications help those who drool often and have uncontrollable body movements.


It’s important to note that many doctors feel that giving muscle relaxant medication to growing children is harmful, specifically because the side effects may be more detrimental than the spasms and muscle stiffness. Some doctors, however, feel that the benefits that muscle relaxants give to children with CP outweigh the side effects. Your physician will be able to provide information to you and your child’s needs.

Risk Factors of Cerebral Palsy

Cerebral palsy risk factors are events, substances or circumstances that increase the chances of a child developing cerebral palsy. Events that create a greater risk for a child to develop cerebral palsy include accidents, traumatic brain injury, medical malpractice, and shaken-baby syndrome. Events could also include infections, complicated birth, maternal seizures, inflammation and improperly managed chronic health conditions. Risks can be avoidable, or unavoidable.
A mother’s intake of or exposure to toxins from cigarette smoke, illegal drugs, pesticides, hair dye, and even the use of some prescription medications during pregnancy can increase the likelihood that a child conceived later will develop cerebral palsy. An expectant mother’s exposure to illnesses such as Rubella or the chicken pox virus also place the fetus at risk for developing cerebral palsy.
Parental health and habits are known contributing risk factors. For example, parents younger than 18 or older than 34 are more likely to have a child with cerebral palsy. Mothers with eating disorders that aren’t managed properly during pregnancy can contribute risk.

A risk factor does not ensure a child will develop cerebral palsy; it means chances are higher than if that risk factor was not present. Likewise, the absence of risk factors does not ensure that a child will not develop cerebral palsy.
Cerebral palsy risk factors are often confused with signs, symptoms or causes of cerebral palsy; they are different. To clarify, risk factors increase the odds of cerebral palsy occurring. They effect the causal pathway that leads to brain injury or brain malformation. Symptoms, on the other hand, are the experiences of the individual, which may indicate a condition exists, and signs are clinical proof of the condition. The cause of cerebral palsy is one of four types of brain damage:
Periventricular Leukomalacia, or PVL – damage to white matter tissue in the brain
Cerebral Dysgenesis – brain malformation or abnormal brain development
Intracranial Hemorrhage, or IVH – brain hemorrhage
Hypoxic-Ischemic Encephalopathy, or HIE, also referred to as Intrapartum Asphyxia – lack of oxygen to the brain or asphyxia

Although risk factors increase chances of a child developing cerebral palsy, the likelihood is still low. Approximately two to four in every 1,000 infants develop cerebral palsy in the United States. Even when risk factors are present, the probability of a child developing cerebral palsy is low.

Different Types Of Cerebral Palsy

Athetoid CP affects a kid's ability to control the muscles of the body. This means that the arms or legs that are affected by athetoid CP may flutter and move suddenly. A kid with ataxic CP has problems with balance and coordination.

A kid with CP can have a mild case or a more severe case — it really depends on how much of the brain is affected and which parts of the body that section of the brain controls. If both arms and both legs are affected, a kid might need to use a wheelchair. If only the legs are affected, a kid might walk in an unsteady way or have to wear braces or use crutches. If the part of the brain that controls speech is affected, a kid with CP might have trouble talking clearly. Another kid with CP might not be able to speak at all.

No one knows for sure what causes most cases of cerebral palsy. For some babies, injuries to the brain during pregnancy or soon after birth may cause CP. Children most at risk of developing CP are small, premature babies (babies who are born many weeks before they were supposed to be born) and babies who need to be on a ventilator (a machine to help with breathing) for several weeks or longer. But for most kids with CP, the problem in the brain occurs before birth and doctors don't know why.

Spastic cerebral palsy In this form of cerebral palsy, which affects 70 to 80 percent of patients, the muscles are stiffly and permanently contracted. Doctors will often describe which type of spastic cerebral palsy a patient has based on which limbs are affected, i.e spastic diplegia (both legs) or left hemi-paresis (the left side of the body). The names given to these types combine a Latin description of affected limbs with the term plegia or paresis, meaning paralyzed or weak. In some cases, spastic cerebral palsy follows a period of poor muscle tone (hypotonia) in the young infant.

Athetoid, or dyskinetic cerebral palsy. This form of cerebral palsy is characterized by uncontrolled, slow, writhing movements. These abnormal movements usually affect the hands, feet, arms, or legs and, in some cases, the muscles of the face and tongue, causing grimacing or drooling. The movements often increase during periods of emotional stress and disappear during sleep. Patients may also have problems coordinating the muscle movements needed for speech, a condition known as dysarthria. Athetoid cerebral palsy affects about 10 to 20 percent of patients.

Ataxic cerebral palsy. This rare form affects the sense of balance and depth perception. Affected persons often have poor coordination; walk unsteadily with a wide-based gait, placing their feet unusually far apart; and experience difficulty when attempting quick or precise movements, such as writing or buttoning a shirt. They may also have intention tremor. In this form of tremor, beginning a voluntary movement, such as reaching for a book, causes a trembling that affects the body part being used and that worsens as the individual gets nearer to the desired object. The ataxic form affects an estimated 5 to 10 percent of cerebral palsy patients.

Mixed forms. It is not unusual for patients to have symptoms of more than one of the previous three forms. The most common mixed form includes spasticity and athetoid movements but other combinations are also possible.

Cerebral Palsy in Adults

Cerebral palsy is a group of problems that affect body movement and posture. It is related to a brain injury or to problems with braindevelopment. It is one of the most common causes of lasting disability in children.

Cerebral palsy causes reflex movements that a person can't control and muscle tightness that may affect parts or all of the body. These problems can range from mild to severe. Intellectual disability, seizures, and visionand hearing problems can occur.

Cerebral palsy is a lifelong condition that cannot be cured. However, treatment, including physical therapy and exercise, the use of antispasmodic medicines to relax muscles, and mechanical aids, can improve an affected person's capabilities, increasing motor function and independence. Many adults with cerebral palsy are able to live and care for themselves independently. Others may need assistance in caring for themselves, help with transportation, and special employment arrangements geared to their abilities. Although the brain injury that causes CP does not get worse over time, some of its effects can appear for the first time, change, or become more severe with age. Follow the links below to find WebMD's comprehensive coverage about cerebral palsy in, treatment for cerebral palsy in adults, assistive technology for adults with cerebral palsy, physical therapy for adults with cerebral palsy, and much more.