Summary
| Diagnosis | Sex | Age | Nationality |
|---|---|---|---|
| Cerebral Palsy | Male | 10 years | Poland |
| Injections | Cell type | Admission date | Discharge date |
|---|---|---|---|
| 8 | UCMSC | April 3rd 2024 | April 25th 2024 |
Medical history
The patient, diagnosed with cerebral palsy (CP) in 2015, has a complex medical history involving multiple interventions and therapies. The primary diagnosis includes severe brain injury due to pneumococcal meningitis at six months, leading to cerebral palsy with spasticity and central hypotonia, cortical vision impairment, and developmental delays. A previous stem cell treatment was administered in Poland and Thailand, alongside consistent physiotherapy, hydrotherapy, normobaric oxygen therapy, and regular PEG exchanges. Additionally, the patient has undergone surgeries and continuous rehabilitative therapy over the years. Medication currently includes anticonvulsants and supportive medications for gastrointestinal and neurological symptoms. A ketogenic diet implemented in 2021 has notably reduced seizure frequency, although tonic seizures remain a significant concern.
Condition On Admission
The patient’s symptoms include whole-body spasticity with a high level of motor impairment (GMFCS Level V), severe scoliosis, cortical vision impairment, dysphagia, and frequent chest infections requiring nighttime oxygen support. Epileptic tonic seizures occur mostly during sleep and are controlled partially by a ketogenic diet, which has reduced seizures by approximately 70%. The patient requires a feeding tube due to dysphagia and suffers from chronic constipation, gastroesophageal reflux, and episodes of aspiration pneumonia. The respiratory condition has worsened with the presence of pseudomonas in the airways, necessitating monitoring and occasional hospitalization for low oxygen saturation.
Treatment Schedule
Patient received 8 packs of umbilical cord derived stem cells (UCMSC) by intravenous (IV) injection and intrathecal injection via lumbar puncture (LP), as per the schedule below:
| Number | Date | Cell Type | Delivery Method | Side Effects |
|---|---|---|---|---|
| 1 | 2024-04-08 | UCMSC | Intrathecal Injection & Intravenous Injection | none reported |
| 2 | 2024-04-11 | UCMSC | Intrathecal Injection | none reported |
| 3 | 2024-04-15 | UCMSC | Intrathecal Injection & Intravenous Injection | none reported |
| 4 | 2024-04-18 | UCMSC | Intrathecal Injection | none reported |
| 5 | 2024-04-22 | UCMSC | Intrathecal Injection & Intravenous Injection | none reported |
Condition at discharge
The patient has shown several areas of improvement since the stem cell treatment, including reduced muscle tightness, better head movement, new vocalizations, less sensitivity inside the mouth, good sleep quality, shorter and weaker seizures, reduced gag reflexes, and overall improvements in general physical condition. Despite these gains, some symptoms such as balance, bladder control, and standing up showed no change, while others in physical and cognitive functioning still need support. The quality of life has moderately improved according to the parents’ assessment, although the doctor has not confirmed these improvements.
| Symptom | Parents’ Assessment of Improvement |
|---|---|
| Appetite | Significant improvement |
| Drooling | Moderate improvement |
| Head control | Moderate improvement |
| Involuntary movements | Moderate improvement |
| Learning disability | Moderate improvement |
| Limb muscle strength | Moderate improvement |
| Mood disorder | Significant improvement |
| Range of movement | Moderate improvement |
| Spasticity | Significant improvement |
| Speech (babbling for infants) | Significant improvement |
Condition 1 month after treatment
Since the initial treatment, there have been further improvements in the patient’s overall condition, including a noticeable increase in immunity, babbling, reduced seizures, and heightened awareness, which gives the impression of her being more present. Some small physical gains, such as improved head control, mild enhancements in movement range, and slight improvements in mood and muscle strength, have also been observed. Despite these gains, there are still areas where no progress has been made, and certain physical and communicative abilities remain limited. The quality of life has seen slight improvement, and the family continues to be satisfied with the outcome.
| Symptom | Parents’ Assessment of Improvement |
|---|---|
| Head control | Moderate improvement |
| Appetite | Small improvement |
| Drooling | Small improvement |
| Limb muscle strength | Small improvement |
| Mood disorder | Small improvement |
| Range of movement | Small improvement |
| Spasticity | Small improvement |
| Speech (babbling for infants) | Small improvement |
| Swallowing | Small improvement |
| Trunk muscle strength | Small improvement |
Condition 3 months after treatment
Three months after treatment, the patient continues to make incremental improvements in physical condition and responsiveness. Reflux and epilepsy are now under better control, and she responds to light and sound stimuli, shows family recognition, and engages more in daily activities. Sleep quality has improved, and the need for nighttime oxygen has decreased. Increased emotional expressiveness, such as crying when uncomfortable, suggests growing awareness and responsiveness. Overall, the quality of life shows slight improvement, which is now confirmed by her doctor, and the family remains satisfied with her progress.
| Symptom | Parents’ Assessment of Improvement |
|---|---|
| Appetite | Moderate improvement |
| Involuntary movements | Moderate improvement |
| Limb muscle strength | Moderate improvement |
| Trunk muscle strength | Moderate improvement |
| Drooling | Small improvement |
| Head control | Small improvement |
| Range of movement | Small improvement |
| Spasticity | Small improvement |
| Speech (babbling for infants) | Small improvement |
Condition 6 months after treatment
At the six-month mark after treatment, the patient has made notable strides in her social engagement and emotional expression. She actively seeks attention, demonstrates clear preferences through smiles and cries, and shows an increased desire for interaction, which was less pronounced before. The family reports that she recognizes them and expresses her likes and dislikes vocally and through laughter, marking significant progress in her communication skills. Overall, there has been a moderate improvement in her quality of life, as confirmed by her doctor, and the family is pleased with her development.
| Symptom | Parents’ Assessment of Improvement |
|---|---|
| Appetite | Moderate improvement |
| Mood disorder | Significant improvement |
| Drooling | Moderate improvement |
| Range of movement | Moderate improvement |
| Head control | Small improvement |
| Learning disability | Small improvement |
| Limb muscle strength | Small improvement |
| Speech (babbling for infants) | Small improvement |
| Spasticity | Small improvement |
| Swallowing | Small improvement |
