Award Winning Birth Injury Lawyers Helping Children Affected by Periventricular Leukomalacia (PVL), Sepsis, Cerebral Palsy & Other Birth Injuries | Serving Michigan, Ohio, Washington, D.C. & All 50 States
A two year-old boy named Nolan who was born 3 months prematurely is defying his doctors and overcoming the challenges of periventricular leukomalacia (PVL) and cerebral palsy (CP) with alternative treatments and therapies. Since Nolan was born prematurely, he was at risk of experiencing numerous complications, and indeed, he was diagnosed with major infections, sepsis and meningitis while in the hospital.
Nolan’s doctors claimed he would never walk, roll, crawl, or swallow food and that he would basically be a vegetable for the rest of his life.
The little boy was born at 26 weeks, which means he was 3.5 months premature and weighed only 2 pounds at birth. After 2 weeks in the neonatal intensive care unit, Nolan got a staphylococcus infection and developed sepsis, meningitis and pneumonia. These major complications caused Nolan to stop breathing, turn grey, and almost loose his heart rate. The medical team had to resuscitate the tiny boy to get him breathing and get his heart rate up to normal. After being resuscitated, Nolan’s parents, Christian and Nicole, were told that their son had stopped breathing 2 more times during the night, and as a result of that, his brain had been starved of oxygen, which left Nolan with a 30 – 40% brain tissue damage and loss, predominantly on the left side of his brain. Nolan was diagnosed with periventricular leukomalacia (PVL) right away, and later, his doctors diagnosed him with quadriplegic cerebral palsy.
Christian and Nicole were devastated when they heard the diagnosis and they did not want to accept the doctors’ bleak prognosis. The determined parents immediately came up with a plan of action so that Nolan would be able to far surpass the doctors’ expectations. They enrolled Nolan in an early intervention program to start counteracting the effects of the cerebral palsy. Nolan has been receiving many different therapies, such as occupational therapy, physical therapy, speech therapy, aqua therapy, kinesiology and Vojta therapy.
VOJTA THERAPY FOR CEREBRAL PALSY TREATMENT
Vojta therapy has so far shown the largest developmental improvements for Nolan. In Vojta therapy, the therapist administers goal-directed pressure to defined zones on the body in a child who is lying on his stomach, back or side. The stimuli given lead to automatic and involuntary movements. The two movements the stimuli lead to are called reflex creeping and reflex rolling. Reflex creeping, which occurs when the child is on his stomach, causes the child to make a type of creeping movement. Reflex rolling begins from a supine (on back) lying position, and transforms the child’s body via a side lying position, into a so-called quadrupedal gait. In short, the manipulation of pressure points alerts hidden pathways in the brain to control basic movement.
After only 1 week of intensive Vojta therapy, Nolan had learned to hold his head upright, open his hands, reach out and play with toys, and, most excitingly, he started to roll himself. Since then Christian and Nicole have been practicing Vojta treatment with Nolan for 30 minutes at a time, four times a day. This past summer, the family actually moved to be close to a Vojta therapist so she could work intensively with Nolan until he learns to crawl.
THERASUIT / ADELI SUIT THERAPY FOR CEREBRAL PALSY TREATMENT
Christian and Nicole also decided to fly to the U.S. to try a revolutionary therapy called therasuit therapy or Adeli suit therapy. The Adeli suit is modeled from NASA space suits. The suit consists of the vest or shoulder pads, a wide belt to be worn around the hips, knee pads, and shoes specially adapted to connect them with the rest of the suit. All these elements of the suit are connected with each other through a system of elastic rubber bands. They consist of either rubber, plastic elements or metal springs. On the vest, shorts, knee pads and shoes, there are special attachments for the rubber bands. The rubber bands mirror the course of the human muscles: flexors, extensors, adductors and rotators of the trunk and lower extremities. It is possible to add additional rubber bands to correct the alignment of shoulder girdle, trunk, hips, knees and feet, as well as for much more precise functions.
The important aspect of the suit is that it does not limit the voluntary movements of the child, but it does require more effort in order to create desired movement. It all depends on the tension of the rubber bands. Through the adjustability of the bands, it is possible to externally influence the tension of certain muscle groups of the trunk and lower extremities. The suit is individually adapted to fit the child’s height and it does not affect the upper extremities. The tension of the rubber bands can be individually adjusted during therapy sessions to target the muscles the child is having the most difficulty moving.
Since his two-month long Adeli suit therapy, Nolan can now hold his head upright with no difficulty and his rolling has become consistent. He also started commando crawling, which his parents say is a miracle.
As a result of Nolan’s numerous therapies, he is becoming more and more mobile, and Christian and Nicole say that you don’t see the two year-old’s cerebral palsy anymore. In fact, Nolan can now eat toast, whereas before, he could only eat liquid food and was struggling to put on weight. Nicole says that Nolan can now see the world while sitting instead of lying on his back. Nolan is doing all the things his doctors said he wouldn’t do except walking, but the little boy’s parents haven’t given up hope on anything.
MISMANAGED BREATHING IN THE NICU: A LACK OF OXYGEN TO THE BABY’S BRAIN CAN CAUSE PERIVENTRICULAR LEUKOMALACIA (PVL) & CEREBRAL PALSY.
Nolan had premature lungs, a lung infection and sepsis, all of which likely caused him to have respiratory distress. Severe respiratory distress and impending respiratory failure are indications for a baby to have 1.) a breathing tube placed in his upper airway (intubation) and 2.) help from a breathing machine called a ventilator. Nolan was not intubated and mechanically ventilated when he stopped breathing and had a critically low heart rate. After the team resuscitated him, they still did not intubate him and give him full support from a ventilator. This caused Nolan to stop breathing 2 more times. The medical team’s failure to intubate and properly ventilate Nolan caused him to stop breathing and have heart problems a total of 3 times. This caused the little boy’s brain to be starved of oxygen for too long, which resulted in permanent brain damage in the form of injury and death of the very important white matter in his brain. This is called periventricular leukomalacia (PVL) and it caused Nolan to be diagnosed with quadriplegic cerebral palsy, which means all his limbs are affected by CP.
Had Nolan been intubated and receiving full or near-full support from the ventilator, he would not have stopped breathing those 3 times and he may not have experienced heart problems, which are often related to insufficient amounts of oxygen in the body, called hypoxia.
PERIVENTRICULAR LEUKOMALCIA (PVL)
Periventricular leukomalacia (PVL) refers to white matter brain injury, characterized by softening or death of white matter near the lateral ventricles, which are located in the top section of the brain and provide pathways for cerebral spinal fluid. White matter helps transmit messages throughout the largest part of the brain. When the white matter tissue softens and dies, cysts filled with fluid may be left behind. Lack of oxygen (hypoxia), and too little blood (ischemia) to the brain are the main causes PVL injuries. PVL can develop during birth due to birth injuries such as trauma, hypoxia and ischemia, and it can occur after birth, due to hypoxia / ischemia.
Causes of PVL
The younger and smaller a baby is, the more prone she is to developing PVL. Babies at the highest risk of developing PVL are those under 32 weeks of gestational age. PVL, however, can occur at any age, including at term, especially if the baby suffered a brain insult. Factors involved in the development of PVL are: 1.) decreased oxygen / blood flow to the periventricular region of the brain, and 2.) damage to the glial cells, which comprise most of the white matter and support neurons throughout the nervous system. These factors can create a cascade of events that leads to the development of PVL.
There are numerous events that can cause hypoxia / ischemia and resultant PVL. Fetal blood vessels have very thin walls, and the vessels providing nutrients to the periventricular region cannot maintain sufficient blood flow during periods of low oxygen. In addition, low blood pressure caused by birth trauma, fetal distress, and post-birth hypocarbia can lead to decreased blood and oxygen to the developing brain. These events can cause damage to the blood brain barrier, a network of cells that regulates the flow of nutrients to the brain. A damaged blood brain barrier can further contribute to greater levels of hypoxia. Injury to the blood brain barrier also can occur as a result of maternal infection during pregnancy, fetal infections, or infection of the newly delivered baby. Premature infants are especially susceptible to these insults because their cardiovascular and immune systems are not fully developed and they do not have the ability to auto-regulate brain blood flow.
Cerebral palsy is a group of disorders that cause a child to struggle with movement, balance, posture and coordination. CP is caused by an injury to the developing brain, which means a child can get it up until approximately age 3, although sometimes CP isn’t diagnosed until a child is 4 or 5 years of age, when certain developmental milestones are missed.
Often, the injury to the brain that causes cerebral palsy occurs during or near the time of birth. High bilirubin levels, improperly treated neonatal hypoglycemia, infections in the mother that travel to the baby during delivery, and oxygen deprivation (birth asphyxia / hypoxia) all can cause brain damage and resultant cerebral palsy. The brain can be deprived of oxygen when there is a restriction of blood flow in the brain (from decreased blood flow, a bleed, a clot, etc.), or when the oxygen supply to the baby is decreased or cut off, which causes decreased oxygen in the blood and brain.
Conditions that can cause oxygen deprivation and cerebral palsy include the following:
- Placental abruption
- Umbilical cord problems, such as a nuchal cord or umbilical cord prolapse
- Failure to quickly deliver a baby when fetal distress is evident on the fetal heart rate monitor (delayed emergency C-section)
- Anesthesia mistakes, which can cause blood pressure problems in the mother, including a hypotensive crisis
- Ruptured uterus (womb)
- Preeclampsia / eclampsia
- Placenta previa
- Oligohydramnios (low amniotic fluid)
- Premature rupture of the membranes (PROM) / premature birth
- Prolonged and arrested labor
- Intracranial hemorrhages (brain bleeds), which can be caused by a traumatic delivery. Forceps and vacuum extractors can cause brain bleeds. Sometimes intense contractions (hyperstimulation) caused by labor induction drugs (Pitocin and Cytotec) can cause head trauma. Mismanagement of cephalopelvic disproportion (CPD), abnormal presentations (face or breech presentation), and shoulder dystocia also put a child at risk of having a brain bleed.
- Hyperstimulation caused by Pitocin and Cytotec can also cause oxygen deprivation that gets progressively worse.
- Fetal stroke
- Improper management of the baby’s respiratory status after birth. This includes failure to properly manage apnea (periods of breathing cessation), failure to properly manage a baby on a breathing machine (which can cause overventilation injuries, such as hypocarbia and a hole or holes in the lungs), and failure to give proper amounts of surfactant, which helps with lung maturity and lung compliance in premature lungs.
COMPLICATIONS FROM PREMATURE BIRTH CAN CAUSE SEPSIS, MENINGITIS, PERIVENTRICULAR LEUKOMALCIA (PVL) & CEREBRAL PALSY
Being born prematurely poses many risks for a baby. Due to organs and body systems that are not fully developed, a premature baby is at risk for birth injuries such as the following:
- Intraventricular hemorrhages (brain bleeds)
- Cerebral palsy
- Seizure disorders
- Developmental delays and learning disabilities
- Intellectual & developmental disabilities
- Motor disorders
- Periventricular leukomalacia (PVL)
Doctors must promptly identify risk factors in the mother for premature birth and make every effort to prevent her baby from being born preterm. Progesterone and cervical cerclage are effective treatments used to help prevent preterm birth in mothers at risk.
If a mother goes into preterm labor, the doctor can give her medication called a tocolytic to temporarily stop the contractions. This does not remove the condition that is causing the preterm labor, however, but it will delay delivery for about 48 hours so that steroids (Betamethasone) can be given to the mother to help the baby’s lungs (and other types of tissue) mature.
In addition to betamethasone for lung maturity, magnesium sulfate can be given to the baby in utero to help protect the brain and prevent the neurological impairments for which preterm babies are at risk. After birth, surfactant should usually be given to a premature baby to help with lung maturity.
Baby Nolan developed sepsis while in the NICU. Sepsis is an infection in the bloodstream that can cause brain injury, cerebral palsy, meningitis, seizures and septic shock. Sepsis can affect almost all of the baby’s organs, including the lungs and brain. Sepsis must be promptly treated to prevent birth injuries as well as septic shock from occurring. When septic shock occurs, the baby’s blood goes into a space just outside the blood vessels. Here, the blood isn’t involved in circulation or gas exchange, and this can cause the baby to have a very low blood pressure and be severely deprived of oxygen.
AWARD WINNING BIRTH INJURY ATTORNEYS HELPING CHILDREN WHO HAVE PERIVENTRICULAR LEUKOMALCIA (PVL) & CEREBRAL PALSY
If you are seeking the help of a birth injury lawyer, it is very important to choose a lawyer and firm that focus solely on birth injury cases. Reiter & Walsh ABC Law Centers is a national birth injury law firm that has been helping children for almost 3 decades. Jesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy. Jesse and his partner, Rebecca Walsh, are currently recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation. The lawyers 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 a birth injury, such as periventricular leukomalacia (PVL), cerebral palsy, a seizure disorder or hypoxic ischemic encephalopathy (HIE), the award winning birth injury lawyers 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 nationally recognized birth injury firm has 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 firm’s award winning lawyers are available 24 / 7 to speak with you.