Summary
| Diagnosis | Sex | Age | Nationality |
|---|---|---|---|
| Cerebral Palsy | Male | 3 years | UK |
| Injections | Cell type | Admission date | Discharge date |
| 6 | UCMSC | January 2023 | January 2023 |
Medical history
The patient, born on February 22, 2020, has a medical history marked by severe hypoxia at birth leading to a primary diagnosis of cerebral palsy. This condition has manifested in symptoms such as hypertonia, dystonia, an unsafe swallow, severely impaired vision with cortical visual impairment (CVI), and a history of seizures. The patient underwent various treatments, including cooling therapy, midazalam, keppra, phenobarbitone, and baclofen for dystonia. Additionally, hyperbaric oxygen therapy (HBOT) was administered, proving beneficial for vision improvement. The patient currently relies on an NG tube for feeding due to reflux issues and takes medications such as phenobarbitone, keppra, omeprazole, and baclofen to manage seizures, reflux, and dystonia. Despite a recent burst ulcer and internal bleeding, the patient’s family is considering stem cell treatment for better head control and vision.
Condition on Admission
The patient exhibits limited verbal communication, reacting to touch and smiling when spoken to. Developmentally, the patient experiences global delay, as indicated by infrequent laughter, cooing, and inability to roll independently. Assistance is needed for sitting unsupported. Although there is a history of seizures, the patient has not experienced an obvious seizure since May. The family reports no notable allergies, but the patient deals with reflux and gas related to the NG tube. The medical team emphasizes the importance of stabilizing the patient’s gastrointestinal tract for at least three months before considering stem cell treatment for potential improvements in cognition, development, muscle tone, neck control, and fine motor skills.
Treatment Schedule
Patient received 7 packs of umbilical cord derived stem cell (UCMSC) by intravenous (IV) injection and intrathecal injection via lumbar puncture (LP), as per the schedule below:
| Number | Date | Cell Type | Delivery Method | Side Effects |
|---|---|---|---|---|
| 1 | 2. March 2023 | UCMSC | Intrathecal Injection & Intravenous Injection |
none reported |
| 2 | 6. March 2023 | UCMSC | Retrobulbar Injection | none reported |
| 3 | 9. March 2023 | UCMSC | Intrathecal Injection | none reported |
| 4 | 13. March 2023 | UCMSC | Intrathecal Injection & Intravenous Injection |
none reported |
Condition at discharge
The patient has experienced several improvements following stem cell treatment, particularly in the general physical condition. Despite small improvements in appetite, head control, range of movement, spasticity, trunk muscle strength, and walking, there is a notable worsening in the mood disorder after the treatment. The patient is somewhat satisfied with the current treatment outcome, and there have been no other treatments or new diagnoses.
| Symptom | Parents’ Assessment of Improvement |
|---|---|
| Appetite | Small improvement |
| Head Control | Small improvement |
| Range of Movement | Small improvement |
| Spasticity | Small improvement |
| Trunk Muscle Strength | Small improvement |
| Walking | Small improvement |
| Mood Disorder | Worse than before treatment |
Condition 1 month after treatment
The patient has continued to exhibit overall improvements in their general physical condition since the previous treatment update. Notably, there are moderate improvements in the ability to sit unaided for a few minutes with minimal support, reflecting enhanced core strength and stability. The patient’s increased vocalization and responsiveness indicate progress in their communicative abilities, aligning with the desire to communicate more. Regarding specific symptoms, there is a moderate improvement in head control, limb muscle strength, and standing up. Additionally, small improvements are observed in balance, range of movement, spasticity, and speech. While the patient has experienced some improvements, walking ability has not shown any significant change. The parents, along with the doctor, have confirmed these positive changes, expressing satisfaction with the treatment outcome. The decision to increase baclofen dosage from 5ml to 7.5ml suggests a proactive approach to address specific symptoms and further enhance the patient’s well-being.
| Symptom | Parents’ Assessment of Improvement |
|---|---|
| Appetite | Moderate improvement |
| Balance | Small improvement |
| Drooling | Worse than before treatment |
| Head Control | Moderate improvement |
| Limb Muscle Strength | Moderate improvement |
| Range of Movement | Small improvement |
| Spasticity | Small improvement |
| Speech | Small improvement |
| Standing up | Moderate improvement |
| Swallowing | Small improvement |
| Trunk Muscle Strength | Moderate improvement |
Condition 3 months after treatment
The patient has shown continued progress in their general physical condition, with small improvements observed. Notably, the patient has achieved a significant milestone by starting to take steps with a walker, marking a remarkable improvement in walking ability. The parents express their satisfaction with the treatment outcome, emphasizing the patient’s increased alertness and awareness. Additionally, the patient has become more friendly towards strangers, indicating positive social adaptability developments. In terms of specific symptoms, there are moderate improvements in appetite, head control, limb muscle strength, range of movement, speech, standing up, and trunk muscle strength. Small improvements are noted in balance, crawling, drooling, involuntary movements, and swallowing. Notably, there is a significant improvement in walking, showcasing the effectiveness of the treatment. The parents report that the patient can now communicate their desires, understand expressions and actions, control head movements, and perform activities such as sitting and standing to a considerable extent. However, challenges remain in certain language functions and self-directed actions, reflecting areas for potential further improvement.
| Symptom | Parents’ Assessment of Improvement |
|---|---|
| Appetite | Moderate improvement |
| Balance | Small improvement |
| Crawling | Small improvement |
| Drooling | Small improvement |
| Head Control | Moderate improvement |
| Involuntary Movements | Small improvement |
| Limb Muscle Strength | Moderate improvement |
| Range of Movement | Moderate improvement |
| Speech | Moderate improvement |
| Standing up | Moderate improvement |
| Swallowing | Small improvement |
| Trunk Muscle Strength | Moderate improvement |
| Walking | Significant improvement |