Ben Sheppard is an eight year old boy who has spastic cerebral palsy. Ben was in foster care until he was 5 years old and he didn’t receive proper treatment and therapy for his cerebral palsy during this time. He was adopted by Toronto natives Robyn and Norman 3 years ago, and they have been trying to help Ben do all the activities he loves, such as playing baseball. Ben throws the ball up the stairs and then tries to catch it as it rolls down. He could do this for hours.
Ben has a “get up and go” mindset and likes to be active. He wears orthotics on his feet that make his feet go into positions that his spasticity doesn’t want them to go in. But without the orthotics, Ben falls over. In school, Ben has to wear a soft helmet because he is constantly falling. With age, Ben wants to become increasingly active. But as Ben ages, his spasticity is becoming worse. Robyn and Norman say that Ben is spending more and more time in a wheelchair. In fact, walking can be very painful and challenging for the little boy.
When Robyn received a call from the school telling her that Ben had a seizure, she decided that she would do whatever it takes to get her son the best treatment in the world so he can live as normal a life as possible and take part in fun activities.
SURGERY FOR CEREBRAL PALSY
After doing a lot of research, Robyn and Norman found a hospital in St. Louis, Missouri that performs a surgery called selective dorsal rhizotomy (SDR). SDR is a surgery whereby the surgeon goes into the child’s spinal cord and selects the nerves that are causing spasticity and cuts them. Once these nerves are cut, the child’s spasticity should be gone or significantly decreased. Of course, it takes many months of aggressive physical therapy to maximize the benefits of SDR, and the physical therapy has to be continued throughout the child’s lifetime.
There are other surgeries and treatments for spastic cerebral palsy, but these treatments do not show a benefit that is as significant and long-lasting as selective dorsal rhizotomy. Indeed, SDR is a permanent treatment. In addition to aggressive physical therapy, there are numerous complementary treatments available to help children with cerebral palsy.
Unfortunately, selective dorsal rhizotomy is only offered in the United States. Robyn and Norman want to take their son to the physician who pioneered this groundbreaking surgery for children who have cerebral palsy. Dr. Tae Sung Park developed SDR and he is the surgeon with the most experience, having operated on over 3,000 children. The cost of the surgery is $55,000.00, and the Sheppards hope to raise $100,000.00 to cover the surgery, plus the expense of traveling and the intense physical therapy required post-surgery.
On July 20th, Toronto Blue Jays alumni are hosting a clinic to raise money for Ben’s surgery. The clinic is part of the Honda Super Clinic Series, and it is from 9 a.m. – noon at Whitby’s Iroquios Park. At the clinic, kids can run the bases with the Blue Jays and they will receive Blue Jays hats, t-shirts and baseball gloves.
WHAT IS SPASTIC CEREBRAL PALSY?
Spastic cerebral palsy is the most common type of cerebral palsy, occurring in about 70 – 90% of all cases. Normally, muscles coordinate in pairs; when one group of muscles contract (tighten), the other group relaxes. This allows free movement. In spastic cerebral palsy, complications in brain-to-nerve-to-muscle communication occur and muscle tension becomes abnormal. Muscles affected by spastic cerebral palsy do not work together. Instead, opposing muscle groups become active at the same time, which blocks coordinated movement. Thus, the muscles in children with spastic cerebral palsy are constantly stiff, or spastic. These children have stiff, jerky movements stemming from an abnormally high muscle tone, called hypertonia.
The main difference between spastic cerebral palsy and a normal pattern of movement is the “scissor gait.”
Scissor gait is characterized by the following:
- “Tip toe” walking
- Knees and thighs may cross or touch while walking
- Hips and pelvis are often locked, as if crouching while walking
- Ankles may be turned inwards while walking
- Arms and hands may go outwards from the body to provide balance
The degree of spasticity varies widely from child to child. Balance problems and / or stiffness in movement can range from barely noticeable to misalignments so pronounced that the child needs crutches or a cane to assist in being upright. Spasticity can be so severe that the child is relegated to a wheelchair. Above the hips, children with spastic diplegia typically retain normal or near-normal muscle tone and range of motion, though some spasticity may also affect the upper body. Additionally, because leg tightness often leads to instability when in an upright position, extra muscle tension usually develops in the upper body due to the upper body trying to compensate for the instability of the lower body.
Although it has its origins in a brain injury, spastic cerebral palsy can be thought of as a collection of orthopedic and neuromuscular issues because of how its symptoms manifest over the course of the child’s lifespan. Spasticity is simply a description of the movement disorder caused by the brain injury. An injury in the brain can cause spastic cerebral palsy without causing cognitive / intellectual problems. However, oftentimes a baby sustains a brain injury that causes damage to multiple areas of the brain, and the child can be left with spastic cerebral palsy as well as other conditions, such as intellectual disabilities and developmental delays. Hypoxic ischemic encephalopathy (a lack of oxygen in the brain that causes white matter injury) is a form of brain damage that can cause spastic cerebral palsy as well as other conditions in a baby, such as a seizure disorder.
WHAT ARE THE TYPES OF SPASTIC CEREBRAL PALSY?
Spastic hemiplegia is when one side of the body is affected. Generally, injury to muscles and nerves controlled by the brain’s left side causes a right body dysfunction, and vice versa. Typically, people that have spastic hemiplegia are the most able to walk compared to people with other types of cerebral palsy, although they generally have a limping instability on the affected side and are prescribed ankle-foot orthotics to help prevent the instability.
Spastic diplegia is when the lower extremities are affected, with little to no upper-body spasticity. The most common form of the spastic forms, most people with spastic diplegia are able to remain upright and walk, but are “tight” and have a scissors gait. Flexed knees and hips and moderate to severe adduction (limbs move closer to the body) are usually present. This adduction problem stems from tight adductor muscles and comparatively weak abductor muscles. Movement (gait) analysis is often done in early life on a regular basis, and assistive devices, such as walkers, crutches and canes, are often provided. Ankle and foot orthotics usually go on both legs rather than just one. In addition, these children are often nearsighted. Over time, the effects of the spasticity sometimes produce hip problems and dislocations. In 75% of spastic diplegics, strabismus (being cross-eyed) can be present as well.
Spastic monoplegia is when one limb is affected.
Spastic triplegia is when three limbs are affected.
Spastic quadriplegia is all four limbs more or less equally affected. Children with spastic quadriplegia are the least likely to be able to walk because their muscles are too tight and it is too much of an effort to do so. Some children with spastic quadriplegia also have hemiparetic tremors, an uncontrollable shaking that affects the limbs on one side of the body and impairs normal movement.
The spasticity itself can lead to very early onset of muscle-stress symptoms such as arthritis and tendinitis. Spastic cerebral palsy can be helped by the numerous medical treatments and therapies available.
REITER & WALSH: ADVOCATES FOR CHILDREN THROUGHOUT THE COUNTRY FOR OVER 25 YEARS
Hypoxic ischemic encephalopathy (HIE), exposure to toxins (such as too much bilirubin / untreated jaundice), traumatic brain injury, encephalitis, meningitis, periventricular leukomalacia (PVL), brain bleeds, or the presence of certain maternal infections (Group B Strep, chorioamnionitis, herpes simplex virus) during pregnancy can all cause spastic cerebral palsy.
Reiter & Walsh ABC Law Centers is a birth injury law firm that has been helping children throughout the country for over two decades. Attorney Jesse Reiter, the president and co-founder of the firm, has been focusing solely on birth injury cases for over 25 years. He is currently recognized as one of the best medical malpractice attorneys in America by U.S. News and World Report 2014, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation. The attorneys at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).
If your child was diagnosed with cerebral palsy, a seizure disorder, hypoxic ischemic encephalopathy (HIE), periventricular leukomalacia (PVL), intellectual disabilities or developmental delays, the award winning attorneys at ABC Law Centers can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our lawyers have numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case. Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our award winning lawyers are available to speak with you 24 / 7.
VIDEO: WHAT CAUSES CEREBRAL PALSY?
Watch a video of birth injury attorney Jesse Reiter discussing the numerous causes of cerebral palsy. A common cause of CP is a lack of oxygen to the baby’s brain during delivery, which can cause a brain injury called hypoxic ischemic encephalopathy (HIE).