HBOT for Cerebral Palsy and Static Encephalopathy of Childhood
Paul G. Harch, M.D., Keith Van Meter, M.D., Paul Staab, M.D., Sheldon Gottlieb, Ph.D.,
Baromedical Research Institute, New Orleans, LA and Family Physicians Center, Marrero, .LA
INTRODUCTION: From 1992 to 1999 26 children with CP or static encephalopathy were evaluated under a unique neurorehabilitation program of the Baromedical Research Institute (BRI) of New Orleans to see if the sequence of baseline SPECT brain scan, single HBOT at 1.5 ATA, and repeat scan could identify potentially recoverable brain tissue and predict neurological improvement after repetitive HBOT.
METHODS: 26 Children ages 11 mos. to 11 yrs, avg. 2 to 4 yrs., were evaluated with the Neubauer/Gottlieb technique of scan-dive-scan using Sechrist 2500 monoplace hyperbaric chambers and a Picker Prism 3000 triple head SPECT scanner. HMPAO or ECD was injected prior to conscious sedation with short-acting sedatives. Raw scan data was analyzed by computer assisted method. Children underwent physical exams, videotaping, and the parents were interviewed pre and post treatment. HBOT was administered at 1.5 ATA/90 mins in the first 4 patients and 1.5 ATA/60 mins in the remainder, q.d. or b.i.d, for 80 HBOTs with at least a 3 week break at 40 HBOT's.
RESULTS: 18 children completed the entire treatment and evaluations. 8 are still under treatment. Computer analysis of SPECT is in process. Generally, scans showed a diffuse heterogeneous appearance that smoothed after one and after a series of HBOT's and was consistent with improvement in one or more of 7 functions: awareness, tone, motor (fine and gross), communication, balance/gait, overall cognition, and swallowing. Two of the 18 showed minimal or no neurological change. Complications included mild over-sedation in 4 of 70 conscious sedations for scanning.
CONCLUSIONS: HBOT was well tolerated in children with CP or static encephalopathy. A single HBOT caused qualitative improvement in SPECT brain imaging in most children which predicted clinical and final SPECT improvement with repetitive HBOT. Placebo effects were non-existent due to lack of cognition.