HOPE for Cerebral Palsy with Supercharged Oxygen! David A. Steenblock BSc, MSc, DO

An exciting new therapy using supercharged oxygen is offering HOPE for families that have a child with cerebral palsy or other brain injury. On July 23-25,1999 the First International Congress for Hyperbaric Oxygen in Cerebral Palsy and the Brain Injured Child was held in Boca Raton, Florida to discuss this exciting new concept.

Cerebral Palsy is a disorder caused by damage to the brain during pregnancy, delivery or shortly after birth. It is often accompanied by seizures, hearing loss, difficulty speaking, blindness, lack of co-ordination and mental retardation.

About 25 percent of cases come from a prenatal cause such as anemia, improper nutrition, viruses, x-rays, or premature delivery. About 40 percent are caused by a lack of oxygen while the remainder are of unknown cause. Recently a number of reports have been appearing that suggest positive results with the use of supercharged oxygen (also known as hyperbaric oxygen). Pressurized oxygen is given to the patient via oxygen mask while he/she sits in an enclosed chamber. For small children, mom or another caregiver sits in the chamber with the child.

Injured brains are thought to have damaged blood vessels which curtail oxygen from getting to the injured areas. The lack of adequate oxygen prevents those parts of the brain from functioning normally and can cause the loss of functions seen in cerebral palsy, traumatic brain injuries and strokes. It has now been proven that daily treatment with supercharged oxygen contributes to the formation of new blood vessels in any part of the body that is not receiving enough oxygen. As new blood vessels slowly form, the injured tissues are able to begin to repair themselves and to begin to function more normally. This translates into better mental and bodily functions.

Research on Hyperbaric Oxygen and Cerebral Palsy

Barrett, Kevin M.D., et al. "Pediatric cerebral palsy treated by 1.5 ATA hyperbaric oxygen - a pilot study." (Professor of Hyperbaric Medicine, University of Texas Medical Branch, Galveston, Texas). Five children, average age 41.8 months, were treated with 1.5 ATA hyperbaric oxygen therapy (HBOT) for a total of sixty treatments administered for one hour daily, five days per week. The authors conclude that hyperbaric oxygen therapy effected improvements in tests of gross motor and fine motor function and decreased spasticity as measured by the modified Ashworth spasticity score in patients with chronic cerebral palsy. Functional reorganization in the visual cortex is suggested by the reappearance of visual evoked potentials, where none had existed before HBOT.

Cronje, F. "Hyperbaric oxygen therapy for children with cerebral palsy." SOUTH AFRICAN MEDICAL JOURNAL, 1999, 89(4): 359-60. Letter. Subjective and objective clinical improvements have been reported anecdotal in almost all children treated with hyperbaric oxygen throughout the world, including South Africa, with no adverse effects. Possible mechanisms by which hyperbaric oxygen therapy may benefit these children include: 1) Normalization of glucose metabolism by injured brain cells - positive effects continue even after the oxygen exposure has ceased. 2) Hyperbaric oxygen has a dramatic effect on reducing tissue swelling and is used in the treatment of crush and traumatic injuries for that reason. The improvement in motor function and decrease in spasticity in chronic brain injury and CP seems to be related to a "recanvassing" of idling neurons in the affected area of the brain - neurons that survived the original hypoxia or trauma but have not resumed their former electrical activity due to com-promised blood supply and oxygen delivery.

Koren, G. et al. "A multicenter, prospective study of fetal outcome following accidental carbon monoxide poisoning in pregnancy." REPROD TOXICOL, 1991, 5(5): 397-403. The authors report the results of the first prospective, multicenter study of acute carbon monoxide poisoning in pregnancy. All adverse outcome occurred in cases treated with high flow oxygen, whereas the 2 cases of severe toxicity had normal outcomes following hyperbaric oxygen therapy.

Machado, J.J. "Clinically Observed Reduction of Spasticity in Patients with Neurological Diseases and in Children with Cerebral Palsy From Hyperbaric Oxygen Therapy." Neurological Advisor of "Centro Brasilerio de Medicina Hyperbarica" - Rua Bento de Andrade, 70, Sao Paulo, Brazil. The author presents case studies of 230 children with spastic cerebral palsy who received hyperbaric oxygen therapy (20 sessions of 1 hour each). The author observed a significant reduction in spasticity and improved respiratory function in 94%, and continued reductions in spasticity, improved motor control and a reduction in convulsions and episodes of bronchitis in 75% of those followed for 6 months.

Paleg, Virginia, M.S., P.T. "The effect of Hyperbaric Oyxgen Treatment on Functional Outcomes in Children with Cerebral Palsy: A Single Case Description." (The Hospital for Sick Children, 1731 Bunker Hill Road NE, Washington, D.C., 20017). The author describes a case study of a 15 month old diagnosed with Level V (Severe) spastic quadraparetic cerebral palsy, cortical vision impairment, and seizure disorder. The boy was treated with hyperbaric oxygen at 24 mmHg for one hour for 33 treatments. Immediately following HBO, the subject appeared to have gained the skills of lifting his head up in sitting and prone on elbows, and the ability to sit with minimal assistance. Other changes noted by parent and therapist include an increase in endurance (child now holding up head in prone on elbows greater than 10 minutes) and head righting (child no longer gets stuck in cervical extension, but can right his head independently). The subject is, at this time, 3 months post HBO and reportedly continues to make gains. He is vocalizing more, is more alert, has improved passive and active range of motion, is more responsive visually, and opens his hands when reaching.