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Cerebral Palsy Male, 10 months old, October 2018

Summary

DiagnosisSexAgeNationality
Cerebral PalsyMale 10 monthsBritish
InjectionsCell typeAdmission dateDischarge date
6UCBSC2018-10-022018-10-27

Medical history

This is a 10 months old baby who suffered from long and complicated labor. An emergency Cesarean section was performed after failure to proceed with natural delivery and there was no heartbeat at birth. Despite prolonged resuscitation (30+ minutes), given the lack of response, care was withdrawn and the baby was given back to his parents. Shortly after, unexpected signs of life started to appear and he was intubated and taken care of in an intensive care unit. The MRI scan examination performed at 7 days of life confirmed the diagnosis of neonatal ischemic hypoxic encephalopathy.

Condition On Admission

The patient had good neck and trunk control, good hearing and eye tracking, mild muscle tightness in lower extremities and mild hypertonicity in the lower extremities predominantly affecting the right side. In terms of functional ability, he was able to roll over with minimal guidance. He could sit without support for up to 5 minutes. In ring sitting, his trunk was slightly slouched, but he could sit without support. Prior to our treatment program, the patient was having 3 sessions of Bobath physiotherapy per week (45 minutes per session).

Treatment Schedule

The patient received 6 umbilical cord blood-derived stem cell (UCBSC) packets by intravenous (IV) and intrathecal injections, as per the schedule below. In addition to stem cell injections, the patient received a daily rehabilitation therapy program that included physiotherapy, aquatic therapy, transcranial magnetic stimulation, acupuncture and hyperbaric oxygen therapy.

NumberDateCell TypeDelivery MethodSide Effects
12018-10-03UCBSCIntravenous Injectionnone reported
22018-10-08UCBSCIntravenous Injectionnone reported
32018-10-12UCBSCIntrathecal Injectionnone reported
42018-10-16UCBSCIntrathecal Injectionnone reported
52018-10-19UCBSCIntrathecal Injectionnone reported
62018-10-22UCBSCIntravenous Injectionnone reported

Condition at discharge

During our 3 weeks treatment program, the patient has gradually shown some improvement in terms of movements. For instance, his spasticity has decreased to a nearly normal tone. As a consequence, his pattern of gross movement control is better. He can also open his left hand better compared to our initial assessment. He tends to open both hands more to grasp objects and fully push on his hand in crawling position. Recently he started to have full elbow extension while crawling for nearly 2 meters (he initially needed moderate support for his elbows when crawling). The patient is now able to sit with his back fully straight in a ring sitting position while trying to reach an object above his head.

Condition 3 months after treatment

During our 3 weeks treatment program, the patient has gradually shown some improvement in terms of movements. For instance, his spasticity has decreased to a nearly normal tone. As a consequence, his pattern of gross movement control is better. He can also open his left hand better compared to our initial assessment. He tends to open both hands more to grasp objects and fully push on his hand in crawling position. Recently he started to have full elbow extension while crawling for nearly 2 meters (he initially needed moderate support for his elbows when crawling). The patient is now able to sit with his back fully straight in a ring sitting position while trying to reach an object above his head.

Condition 12 months after treatment

Please see an excerpt from the patient’s 12 month assessment below (assessment made by the patient’s parents):

SymptomAssessment of Improvement
AppetiteModerate improvement
BalanceModerate improvement
CrawlingSmall improvements
DroolingNot applicable
Involuntary movementsModerate improvement
Limb muscle strengthModerate improvement
Range of movementModerate improvement
SpasticityModerate improvement
Speech (babbling for infants)Moderate improvement
Standing upModerate improvement
SwallowingModerate improvement
Trunk muscle strengthModerate improvement
WalkingModerate improvement