Stem Cell Therapy for Cerebral Palsy in India

Last Modified: December 27, 2019  |   Created on: December 8, 2019
Cell Therapy

At a glance

  • The cost of stem cell therapy for cerebral palsy in India is USD 7500 – 12000
  • Stem cell therapy for cerebral palsy has shown improvement in functional abilities of children with cerebral palsy
  • There are different types of stem cell treatments depending on the source and type of stem cells. A stem cell has the potential to develop into all kinds of cell types and form different tissues. They also have the capability to renew themselves by dividing continuously. 
  • Autologous bone marrow derived stem cell transplant is a safe, feasible and effective method of treatment.
Stem Cell Cerebral Palsy

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What is cerebral palsy?

Cerebral palsy is defined as a group of non-progressive brain malformation related disorders that affect movement and posture of the person. It is caused by damage to the developing brain during pregnancy or just after the baby’s birth, leading to a permanent physical condition. Cerebral palsy (CP) is one of the most common physical disabilities in children.

Children with cerebral palsy experience a range of movement problems including limited mobility, stiffness, weakness in limbs, shakiness, poor coordination and balance. It can cause other problems also, such as trouble with vision, hearing, speech, learning, epilepsy and cognitive thinking

How many types of cerebral palsy are there?

Cerebral palsy (CP) is classified on the basis of:

Parts of the body that are affected

  • Quadriplegia all four limbs – both arms and both legs – are affected. The muscles of the trunk, face and mouth may also be involved
  • Hemiplegia one side of the body is affected, including the arm, leg, and trunk
  • Diplegia either both legs or both arms are affected
  • Monoplegia only an arm or a leg is affected

Pattern of movement

  • Spastic CP This is the most common cerebral palsy type. There is tightness or stiffness in the muscles as the damaged parts of the brain does not send proper messages to the muscles
  • Dyskinetic CP Involves abnormal involuntary movements or postures. It can be
    • Dystonic involves frequent twisting or repetitive movements and may alter between rigidity and flaccidity
    • Choreoathetoid there is an excessive uncontrolled (involuntary) movement particularly in the arms, hands and feet, and around the mouth. Leads to an abnormal posture.
  • Ataxic (or ataxia) CP this is the least common type of cerebral palsy. Children with ataxia display signs of unsteady and shaky movements or tremor along with problems with balance. It involves the cerebellum.
  • Mixed CP This involves different parts of the brain.

What are the causes of cerebral palsy?

Any kind of abnormality that occurs during brain development at the fetal stage (pregnancy), during birth or after birth, can lead to brain damage. There are a number of possible causes for brain damage that can result in cerebral palsy.

Before birth

  • Reduced blood or oxygen supply to the fetus
  • Infection to the mother such as cytomegalovirus, rubella, chickenpox or toxoplasmosis
  • A trauma or injury to the baby’s head during pregnancy
  • Congenital disorders such as Down’s Syndrome, Rett Syndrome

During birth

  • Asphyxia, which is lack of oxygen supply to the brain in case of a difficult birth
  • A brain infection such as meningitis
  • A serious head injury or trauma during suction delivery
  • Choking or nearly drowning, resulting in lack of oxygen to the brain
  • A serious drop in blood sugar level
  • A brain stroke due to sudden blockage of blood flow in the brain

After birth

  • A head injury due to an external trauma after birth, causing concussion or hemorrhage
  • A brain infection, such as encephalitis and meningitis

Risk factors:

  • Premature birth, i.e. before the 37th week of pregnancy. There is a higher risk of brain damage in babies who are born at 32 weeks or earlier as the fetus has not fully developed.
  • Baby born with low weight
  • Multiple pregnancy (or twins)
  • The mothers of 35 years of age or older
  • Unusually low blood pressure or high blood pressure of the mother
  • Exposure to drugs and alcohol, stress, heavy metals including mercury poisoning from fish during pregnancy

How can Lyfboat assist you in getting stem cell therapy for cerebral palsy treatment in India?

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What are the symptoms of cerebral palsy?

The signs of early of cerebral palsy can be observed in children of up to 1 year of age. Delayed development is usually the initial indication for cerebral palsy with problems performing basic motor functions such as sucking/feeding, neck control, sitting without support, rolling, crawling, grasping, and others.

Signs that can be observed in early age include:
When the child is less than 6 months in age:

  • Difficulty in head and neck control when picked up
  • Stiff legs that the baby crosses or scissors when picked up
  • Shakiness in the arms or legs
  • Trouble while sucking or feeding
  • Lack of muscle tone resulting in ‘floppy body’ or hypotonia. Abnormal muscle tone can also be observed in children with CP as stiff or rigid muscles

When the child is more than 6 months in age:

  • Poor head control when picked up
  • Use one side of the body more than other: reach with only one hand and keep the other one in a fist
  • Difficulty in rolling over without help
  • Difficulty in the movement of upper limbs and bringing them together
  • Crawling abnormally in a lopsided manner and dragging the other side of the body
  • Not able to sit or stand without support
  • Lack of response to own name
  • Doesn’t make babbling sounds and say single words such as ‘mama’ or ‘papa’.

Common physical symptoms of cerebral palsy include:

  • Deformities of the upper and lower limbs causing a bent wrist, closed fist or a rigid flexed elbow
  • Severe malnourishment with a floppy body, known as hypotonia
  • Difficulty in walking
  • Difficulty in breathing due to poor neck control and lowered immunity.
  • Sensory problems including poor vision and hearing, along with cognitive difficulties.

Other symptoms that may occur in some people include pain, hip displacement, non-ambulation, speech difficulties, epilepsy, behavioral changes, poor bladder control, disturbed sleep cycles, vision and hearing impairments as well as difficulty in swallowing.

What is a stem cell therapy?

Stem cell therapy is a cellular therapy that is a part of Regenerative Medicine, the futuristic field of medicine that deals with the process of repairing or regenerating the damaged tissues in the body.

Stem cells are primitive undifferentiated cells that have the capability to turn into all other cell types with specialized functions. They have two distinct properties that make them unique: multiply perpetually to form new cells (self-renewal) and differentiate into specialized cells, such as muscle cells, heart cells, brain cells and others.

Stem cell therapy exploits these unique properties of stem cells to treat certain medical conditions or prevent their further deterioration. There are mainly three types of stem cells that can be used:

  1. Embryonic stem cells (ESCs)

    are the cells found in a developing embryo that is 5-7 days old. These stem cells are pluripotent, i.e. they have the ability to convert into all other cell types present in the human body.

  2. Adult stem cells

    can be found in the tissues of all the humans. They have matured beyond the embryonic stage. These are multipotent cells that can differentiate into a limited number of specialized cells. The function of adult stem cells is to regenerate and repair the damaged tissues in the body. They can be obtained from certain bones, such as the bone marrow of the hip bone.

  3. Umbilical cord stem cells

    are obtained from the discarded umbilical cord after the birth of a baby. Mothers may donate the cord after delivery, which is then stored in Cord blood banks for future use.

For a stem cell therapy, cells may be obtained from two sources:

  1. Autologous

    Stem cells are taken from the patient’s own body for transplantation. The benefits of this method are – the risk of rejection is neutralized as self cells are used and chances of side effects are minimized

  2. Allogeneic

    The stem cells are obtained from another person (donor) and transplanted into the patient. The donor needs to be tested for genetic compatibility before extracting the cells for transplant. Umbilical cord stem cells can also be used for the type of transplant.

What are the conventional treatment options for cerebral palsy?

There is no known cure for cerebral palsy. Treatment strategies that are currently being used are aimed at managing the symptoms, preventing further complications, and promoting functional independence in the patient. An integrated approach with therapies and medications is conventionally followed to achieve these milestones.

Therapies

  1. Physical therapy 
    Physical therapy or Physiotherapy is an important treatment method for managing cerebral palsy and physical disability associated with it. Exercises and muscle training can help enhance strength of muscles, flexibility, balance, prevent muscle contractures, relieve pain. All these contribute in increasing mobility and maximizing independence. The therapist uses special techniques such as stretching, gait training, and many other for this along with the appropriate aids and orthosis. They also help with managing the problems such as head and trunk control, rolling, and grasping.
  2. Occupational therapy
    It involves identifying the problems that the child is facing on a daily basis with normal tasks. The therapist helps the child gain some independence and enable them to carry out complex movements that are part of their daily tasks such as bathing, dressing, and other routine activities. They also educate the parents and caregivers about the possible modifications that can be done to support the child in functional activities.
  3. Speech and swallowing therapy
    Difficulty in speech and language development are the complications of cerebral palsy and many children experience trouble with making facial expressions and hand gestures. Speech therapy can help improve the oral motor skills and develop the speech and language skills in affected children. It involves teaching sign language or using special equipment such as computers for communication through pictures in children who cannot speak. In those who have hearing problems that causes delayed speech, the therapists provide guidance regarding hearing aids. There may also be problems with chewing and swallowing in children with cerebral palsy as their masticatory (chewing) muscles and pharyngeal (swallowing) muscles are weak. Swallowing difficulty can become life threatening because it can lead to severe choking or food entering the windpipe which leads to difficulty in breathing, or it may cause aspiration pneumonia of the lungs resulting in long term ailments and malnutrition. Speech therapists guide the children and caregivers through swallowing techniques, proper positioning and certain oro-motor exercises along with dietary changes (the consistency of food – soft/liquid/mashed). If the case is severe, a gastroenterologist may need to insert a feeding tube into the stomach through the nose or directly through the skin of the abdomen.

Medications

Medicines are given to lesser muscle tightness to manage difficult symptoms such as seizures, spasticity, pain, dystonia, drooling, improve functional ability, behavioural problems such as ADHD. 

Surgery

Children with cerebral palsy may require orthopedic surgery to improve movement and provide pain relief. The corrective surgeries such as tendon release, corrective osteotomy and others are recommended for children with contractures of muscles causing limited joint movement, joint and bone deformities such as scoliosis or dislocation of hip.

How does stem cell therapy work for patients with cerebral palsy?

The currently available treatment options for cerebral palsy can help patients in managing symptoms to a limited level. They cannot repair the actual brain damage.

Cell therapy is a promising regenerative medicine technique that can be a potential treatment option for patients with cerebral palsy. It was earlier believed that brain damage that occurs during the birth of the child is irreversible. With recent advances in technology and stem cell research, a potential for repairing the damaged brain tissue with stem cell therapy has been observed. Stem cells can be obtained from various sources for cell therapy, such as umbilical cord and bone marrow mononuclear cells (BMMC).

Autologous bone marrow-derived stem cells offers a completely safe and effective method for treatment. Research has shown that the transplanted stem cells migrate to the damaged area in the brain and show reparative effects on the affected tissues to repair the damage. They release certain trophic mediators that reduces the effects of damage in the particular areas. The transplanted stem cells have the ability to differentiate into different types of cells of the nervous system such as oligodendrocytes, glial cells and others.

The mechanisms by which stem may help in tissue repair and regeneration include:-

  • Replace the damaged neural cells
  • Release growth factors to promote recovery
  • Prevent cell death of neurons
  • Establish new blood vessels
  • Regenerate neural cells by stimulating cell multiplication and integration
  • Help in establishing new neural maps in the brain to promote learning new functions.

These mechanisms can ultimately help in restoring activity in the affected area, which results in improvements of clinical symptoms and improving the overall quality of life of the patients.

The benefit of using autologous Bone Marrow Mononuclear cells (BM MNCs) is that there are no adverse side effects and the risk of immune rejection is eliminated. As these cells are obtained from the patient’s own body, there will be no ethical issues for the use of these stem cells.

What happens during a stem cell therapy?

Stem cells can be isolated from different sources:

  • Cord blood – The child’s own cord blood or from a donor cord blood bank can be used for transplantation
  • Bone marrow – the soft, spongy inner part of certain bones is rich in stem cells. The patient’s own cells (autologous) or from a related or unrelated matched donor (allogenic) can be used for the therapy. Bone marrow aspiration is used to extract the cells from the bone marrow with a thin needle.
  1. The cell isolated from bone marrow are transferred to a stem cell lab. There the centrifuge machine is used to separate stem cells from the heterogenous mixture of cells in the bone marrow aspirate.
  2. Then the doctor injects the purified stem cells into the child. The injection may be given intrathecally – into the space around the spinal cord to reach the cerebrospinal fluid (CSF).

Stem cell therapy is accompanied by a variety of rehabilitation programs that are designed to improve or manage specific symptoms.
For more details about Autologous Stem cell therapy procedure, read stem cell therapy in India.

What can be expected after the treatment?

Intrathecal injected autologous bone-marrow derived stem cell therapy is a completely safe and effective method of treatment for children with cerebral palsy.

The aim of this comprehensive treatment approach is to guide and support patients suffering from a debilitating condition like cerebral palsy. The patients have been able to reach a fixed stage after cell therapy where they show remarkable improvements in the symptoms. 

Patients diagnosed with cerebral palsy display a range of physical and mental symptoms such as problems with speech, balance, movement of upper limb and lower limb, muscle tone and ambulation. 

Stem cell therapy has shown an overall symptomatic improvement in 91% of the patients. 

The improvements range from mild, moderate to significant. Regular rehabilitation after cell therapy under expert supervision of a therapist has been shown to play an important role in the overall success and improvement of symptoms.

The improvements are attributed to the repair of the underlying brain damage. This can be objectively be seen on a PET CT scan of the brain in concert with improvement in functional and achievement milestones in patients. Stem cell therapy in combination with standard treatment enhances the extent of development and improves the quality of life of affected children.

Stem cell therapy for cerebral palsy in India

India is a one-stop destination for people seeking medical treatment with excellent quality and economical prices. Stem cell therapy for cerebral palsy in India is a safe and effective treatment approach for improving as well as managing the symptomatic problems of the condition. Many hospitals that offer stem cell therapy for CP in India are internationally renowned and accredited for their hospitality services and quality of patient care. These medical facilities house the latest technology and advanced equipment required for delivering the best treatment. They provide a comprehensive rehabilitation program to ensure children with cerebral palsy can achieve the maximum benefits from the program.

The cost of stem cell therapy in India is remarkably lower than several other countries that provide the same treatment at 40-60% higher price. A person travelling from abroad can save a lot of money if they choose to undergo the procedure in India. And the best part is that the quality of treatment is at par with the best facilities of the world.

Vanshika Rawat

Written By Vanshika Rawat

Vanshika Rawat is an experienced content developer. She is very knowledgeable in the field of science and healthcare and has worked under brilliant scientists during her higher education. Vanshika obtained her degrees in Masters in Science and Bachelors in Science (Microbiology with Hons.) from renowned institutions - Panjab University and University of Delhi.

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