Dr Anirban Deep Banerjee, Director, Neurosurgery, Medanta – The Medicity, Gurgaon
Cerebral Palsy is a group of neurological disorders that affect muscle coordination, movement, and posture. This non-progressive condition is caused by abnormal brain development or damage to the brain that occurs during pregnancy, birth, or after birth. It is the most common motor disability in children, with symptoms appearing throughout infancy and early childhood.
Many children with CP have trouble walking, muscle stiffness, tremors, and involuntary movements, which can significantly impact their quality of life.
Nearly 15-20 per cent of physically disabled children are affected by Cerebral Palsy. In India, the estimated incidence is around 3 per 1000 live births. While traditional treatments like physical therapy and medication can help manage symptoms they often offer limited improvement in severe cases.
Deep Brain Stimulation (DBS) has emerged as a gamechanger for cerebral palsy patients with dystonia, offering over 50 per cent success in improving motor abilities and overall well-being in well selected patients.
What is Deep Brain Stimulation (DBS)?
DBS is a neurosurgical procedure that involves placing electrodes in specific areas of the brain that are connected to a pacemaker-like device through insulated wires. These electrodes deliver electrical impulses that help regular abnormal brain activities associated with motor disorders.
Primarily developed to treat movement disorders such as Parkinson’s disease, DBS has shown promise in improving movement control in CP patients by targeting areas in the brain that affect muscle function. As symptoms change, these signals can be reprogrammed or adjusted to accommodate varying needs. By focusing on the areas of the brain responsible for motor control, DBS aims to reduce symptoms and improve functional outcomes for CP patients.
How DBS enhances quality of life for CP patients
1. Reduction in muscle stiffness and tightness: DBS helps alleviate generalised stiffness and tightness in muscles which is common in cerebral palsy patients. With reduced muscle tension, patients experience smoother movements, enabling them to perform daily tasks with greater ease, contributing to a higher level of independence.
For patients who have significant spasticity of the lower limbs, another surgical procedure known as intrathecal baclofen pump, is helpful in reducing symptoms.
2. Enhanced motor control: By regulating abnormal brain signals, DBS enhances coordination and muscle control, allowing for more voluntary movements. Improved motor control means patients can walk, eat, and perform fine motor tasks more effectively, leading to greater confidence and self-reliance.
3. Improved posture, balance, and mobility: DBS improves balance and posture by targeting the brain’s motor pathways, helping patients walk with more stability and reducing the risk of falls. This improvement not only facilitates mobility but also allows patients to participate more fully in social and community activities, significantly improving their quality of life.
4. Reduction in pain and discomfort: Many cerebral palsy patients experience pain due to involuntary movements and muscle spasms. DBS can alleviate this pain by reducing these uncontrollable movements, improving both physical comfort and emotional well-being.
5. Increased independence and social participation: As mobility and motor function improve, DBS helps patients perform daily activities like dressing, eating, and moving without constant assistance. This fosters greater independence, enhances social interactions, and allows for better participation in educational and work environments.
6. Reduced dependence on medications: With the improvement in motor control, DBS may reduce the need for medications like muscle relaxants, DBS is typically considered for cerebral palsy patients who have severe motor symptoms in the form of generalised dystonia, that are not well managed by traditional therapies like physical therapy, medications, or other treatments. A multidisciplinary team, including neurologists and neurosurgeons, assesses each case to determine if DBS is an appropriate option. Ideal candidates are those whose movement difficulties severely limit their daily activities and independence. Patients should be medically stable, with no significant cognitive impairment or psychiatric conditions that might complicate the procedure or recovery.
DBS offers hope to cerebral palsy patients who face severe mobility challenges. While it may not cure CP, DBS can improve motor function, independence, and overall quality of life. As research continues and more patients benefit from this advanced treatment, DBS may become a vital component in managing cerebral palsy and enabling patients to lead fuller, more active lives.
For ease of access Medanta has launched a dedicated Northeast Helpline Number: 0124-6930090. Currently available in Assamese, Nagamese, English and Hindi, the service will soon be extended to Bengali and Mizo, among other regional languages.