HYPERBARIC OXYGEN THERAPY FOR CEREBRAL PALSY CHILDREN (excerpted)
James MB ChB, DIH, PhD, FPOM. Wolfson Hyperbaric Medicine Unit. The University of Dundee, Ninewalls
Medical School, Dundee
of the brain has shown that the events which cause the development of cerebral palsy almost certainly occur at the time of
birth, (1) although it may be many months before spasticity develops. (2)
When an event
causes lack of oxygen the blood vessels leak, the tissues become swollen and there may be leakage of blood. The increased
water content, termed oedema, interferes with the transport of oxygen. These changes apply to any tissue, but a sufficient
quantity of oxygen is vital both to the function and development of the brain.
When the controlling
nerve cells in the brain are disconnected from the spinal cord, the signals to the arms and legs cannot pass and the ability
to move is lost. Eventually, they send an excess of signals to the muscles, causing the uncontrolled contractions known as
develop spasticity often appear to develop normally for several months and then lose function gradually. This is almost certainly
is due to the failure of the coverings of the nerve fibres, known as myelin sheaths, to develop and the evidence has come
from MRI. (2) Myelination normally begins about a month before birth and progresses to completion by the age of two. If there
is tissue swelling in the mid-brain the delicate cells that form myelin die and the nerve fibres are left exposed and slowly
deteriorate with the development of spasticity.
Loss of function
in the brain can be due to tissue swelling, which is reversible, or tissue destruction, which is not. By giving hyperbaric
oxygen, areas which are not "dead but sleeping" can be identified through SPECT imaging. Authorities have even stated that
the critical parameter is not blood flow it is oxygen delivery. (4)
A course of oxygen
therapy sessions at increased pressure have been shown to resolve tissue swelling after the lapse of years. It works by constricting
blood vessels and interrupting the vicious cycle where oxygen lack leads to tissue swelling, which then leads to further oxygen
deficiency. Also, in children, the brain is still developing and therefore the prospects for improvement are very much greater.
1. Pape KE, Wiggleworth JS.
Haemorrhage, ischaemia and the perinatal brain. Clinics in developmental medicine. Nos. 69/70 William Heinemann Medical Books,
2. Dubowitz LMS, Bydder GM,
Mushin J. developmental sequence of periventricular leukomalacia. Arch Dis Child 1985: 60:349-55.
4. Astrup J, Siesjo BK, Symon
L Thresholds in cerebral ischemia; the ischemic penumbra. Stroke 1981; 12:723-25.