UNDERSTANDING CEREBRAL PALSY AND ITS HOMOEOPATHIC MANAGEMENT

Hema M. Parikh *_{MD (Hom)} ¹_, ,
Mrunalika Dikshit, _{MD (Hom)} ²
Prashant P. Tamboli, _{MD (Hom)}³

¹ Head, Dept of Paediatrics, Smt. Malini Kishore Sanghvi Hospital & Educational Complex, Karjan, Gujarat

² Co-ordinator, Lipoid Foundation Project, Smt. Malini Kishore Sanghvi Hospital & Educational Complex, Karjan, Gujarat

³ Head, Research Department, Dr. M. L. Dhawale Memorial Trust (MLDT), Mumbai

*Address of correspondence: Dr Hema Parikh

Email: drhmparikh@gmail.com

How to cite this article:

Parikh HM, Dikshit M, Tamboli PP. Understanding cerebral palsy and its Homoeopathic management.  Journal of Integrated Standardized Homoeopathy (JISH) 2019; 02(02)

Received on: May 21, 2019

Accepted for Publication: July 10, 2019

ABSTRACT:

 

The paper discusses the challenges involved in the treatment of Cerebral Palsy (CP).  The focus is on the holistic management of CP, integrating the processes of diagnosis, dynamic assessment of the status of the disability/ies and of the individual, Homoeopathic intervention and patient care / support. Co-morbidity with CP makes management more difficult. The change in the Quality of Life of these patients is a major concern needing special attention. Allopathy has very little to offer here. We attempted a multidisciplinary / interdisciplinary approach combined with Homoeopathy with its individualization and 4 case reports indicate the approach and the results obtained. In the rural set-up, we faced further challenges in this effort. The journey of creating a holistic multidisciplinary centre for the management of CP was a big challenge and its creation has become a boon for special children.

 

DISABILITY AND CEREBRAL PALSY

Disability is an umbrella term covering impairments, activity limitations, and participation restrictions. Impairment is a problem in body function or structure; activity limitation is a difficulty encountered by an individual in executing a task or action; while participation restriction is a problem experienced by an individual in involvement in life situations (1). Disability is not only a physical health problem, but also a complex phenomenon, reflecting the interaction between the disabled individual  and the society in which he or she lives. Those with disabilities need to be assisted with interventions to remove environmental and social barriers and to shore up the capabilities of the affected individual in the relevant areas.

Cerebral palsy (CP) is one of the most common motor disabilities in childhood (2). Population-based studies from around the world report that the prevalence of CP is 2/1000 live births in India and 2-6/1000 live births in the west. In India, the most common causes of physical handicap are polio, accounting for 60% and CP, accounting for 25%.

Here, we report on four children with CP managed by adopting a classical Homoeopathic approach and supported by the inter-disciplinary, multi-disciplinary interventions [Physiotherapy, Psychotherapy, and Orthosis]. The learning accrued from the management of these children will help us to draw some general guidelines for the holistic management of these children.

 

CEREBRAL PALSY: DEFINITION, TYPES, AND CO-MORBIDITIES

CP is defined as a “Dynamic disorder of posture and mobility, being the motor manifestation of a non-progressive brain damage (static encephalopathy) sustained during the period of brain growth in foetal life, infancy or childhood” (2). The age limit for brain damage to occur in a patient of CP is 5 years as outlined by the American Academy of Paediatrics. The condition affects the following

• Posture
• Movements
• Balance
• Muscle strength
• Coordination

Etiological factors include prenatal, perinatal, and postnatal causes. (2)  It is important to factor these into the assessment, as they may significantly impact the reversibility and prognosis e.g. Congenital malformation may have a different outcome compared to a birth injury due to perinatal stroke; the plan of management may significantly differ.

There are many ways of classifying Cerebral Palsy (2):

1. Neurology: Spastic, Ataxic, Dyskinetic, Hypotonic, and mixed
2. Neuroanatomical: Pyramidal [Spastic],

Extrapyramidal [dyskinetic]

Cerebellar [ataxic]

3 Topographical: Monoplegia, Diplegia, Triplegia, Quadriplegia, Double Hemiplegia

4 Etiological: Prenatal, Perinatal, Postnatal

5 Functional: The most widely used clinical functional classification used for CP is the Gross Motor Function Classification System (GMFM) (4)

Grade I: Walks without limitation

Grade II: Walks with limitation

Grade III: Walks using hand-held mobility device with limitation

Grade IV: Self mobility with limitation may use powered mobility

Grade V: Transported in a wheelchair

 

Therapeutic Classifications:

Class A: Not requiring treatment

Class B: Minimal bracing, minimal therapy

Class C: Bracing, service of CP treatment team

Class D: Long term institutionalization and treatment

 

The classification of disease helps to understand the current state and stage of disease. It also helps us to define the problem and scope for resolution, in relation to the assessment of the current functioning level. This will have direct implication on the Homoeopathic management. GMFM scales are objective parameters, widely used by physiotherapists to set goal and therapy plans. The GMFM helps to understand the follow-up assessment.

 

ASSOCIATED CO-MORBIDITY

CP is often accompanied by disturbances of sensation, perception, cognition, communication, and behaviour as well as epilepsy and secondary musculoskeletal problems (2). It is pertinent to note that the diagnosis of CP often comes as a mixed baggage making the assessment and management increasingly complex. The importance of instituting ancillary measures will become apparent on considering some of the conditions mentioned below. The Homoeopath can locate the characteristic data lurking amid these associated conditions.

 

• EPILEPSY (33%): This is seen in 90% of quadriplegia spastic CP & least in dyskinetic CP.
• MENTAL RETARDATION (75%) & LEARNING DIFFICULTIES: It is most commonly seen in spastic quadriparesis & is least in dyskinetic CP.
• SPEECH: These are more commonly involved in quadriplegic & dyskinetic CP. Aphasia, dysarthria & dyslalia are common among dyskinetic individuals.
• FEEDING DIFFICULTIES & ORODENTAL PROBLEMS: Feeding difficulty, drooling, swallowing difficulty because of loss of coordination and impaired Oro-motor control, along with teeth grinding, and dental caries.
• VISUAL PROBLEMS: Approximately 50% of patients have squint, refractory errors, blindness, and loss of conjugate vision. Strabismus, paralysis of gaze, cataracts, coloboma, and retrolental fibroplasias.
• SENSORY ASTEREOGNOSIA: Astereognosis and spatial disorientation are seen in one third of the patients. EARS: Partial loss of hearing is usual in kernicterus. Brain damage due to rubella may be followed by receptive auditory aphasia.
• LOCOMOTOR SYSTEM ABNORMALITIES: This includes joint contractures, decreased growth of limb, limb shortening, and subluxation of joints.
• APRAXIA
• VASOMOTOR IMBALANCE: The affected limb becomes cold, the capillary filling time increases, and the skin becomes shiny & thin.
• MISCELLANEOUS: Inadequate thermoregulation and problems of social & emotional adjustment are present in many cases. These children may have associated dental defects & are more susceptible to infections.

 

CHALLENGES IN MANAGEMENT:

CP (5) is a very complex disorder; there is currently no cure for the brain damage it causes, but the condition is not continuous or progressive. However, the effects of brain damage may become more pronounced as the child grows. Permanent tightening of joints is very common. Orthopaedic surgery may be required when severe muscle tightness and joint contracture develop. Early holistic treatment can avoid development to such a stage. A very important factor for positive outcome is support and motivation by the caregivers. Many questions arise while patients come hopefully to our centre for management. How much can Homoeopathy help in hopeless cases? Do we need inter-disciplinary management? What kind of

Management of CP differs from patient to patient. A Homoeopathic physician must face many hurdles to get the desirable results. The hurdles begin with getting the characteristics in the case; hence, proper case receiving becomes the first important step. Subsequently, creating a totality from limited data, remedy differentiation and deciding the posology are the other challenges. Having realistic expectations and understanding remedy response helps in remedy regulation. Knowledge of the role of other disciplines like psychology, physiotherapy, and occupational therapy is important to integrate these interventions seamlessly.

Parents come with lots of hopes, expectations, and enthusiasm, which reduce even with positive results due to the long-term treatment. Patient irregularity and drop-out is very painful for the treating team. Co-operation from the patient and the family goes a long way to reach the objectives. Hence, we need to orient the patient and the caregivers effectively about disease and the need of the long-term continuation of treatment. All this makes management of CP cases quite challenging.

 

CP CENTRE AT SUMERU:

The paediatric department of the Smt. Malini Kishore Sanghvi Hospital has been working in the villages of Karjan Taluka with the objective of Preventive, Promotive, and Curative care. In 2009, our social worker brought for treatment a 3-year-old girl with CP and rickets who was unable to walk. Within six months, she started running! This result changed the entire perspective of Homoeopathic intervention in CP.  A CP centre, “UMMEED”, with the tag-line “Hopes Lives here” was established on the 16^th of January 2016 with the support of the Lipoid Foundation, Germany. Currently, 209 patients with CP are under treatment in this centre. The centre is fully equipped with all the necessary facilities and follows a multidisciplinary approach for the holistic interdisciplinary management of the CP.

The four case experiences will highlight the issues as mentioned in the above paragraph. They will also demonstrate the approach taken by the physicians to overcome the challenges thrown by the disease for the Homoeopathic management of children with CP.

 

CASE 1:

Mast. G.M.M. (Case define number – 10617) is a 4-½-year-old boy brought by his mother on 3/4/18. The main complaints were unable to stand & even sit without support. He has spasticity of all extremities and there was continuous drooling of saliva, difficulty in deglutination & delayed milestones. He could drink only liquid food resulting in nutritional anaemia. There were prominent cracks at the corners of the mouth and recurrent Stomatitis. Along with this, there was a history of recurrent fevers at least once a month lasting for 4 to 5 days. He was born pre-term and there was a delay in the cry.

Clinical Diagnosis: Spastic quadriplegic cerebral palsy (Grade IV) + Global developmental Delay + Moderate Malnutrition with Nutritional Anaemia + Recurrent Stomatitis + Recurrent Viral Fever

His examination findings were:-

• Weight: 8 kg, HC: 45 cm, MAC: 13 cm, Dental caries+,
• CNS: conscious, alert, TONE: spasticity, hypertonia in all four limbs ,
• Power-3/5 in both UL, 3/5 in both LL, DTR +/+, plantar reflex ↓/↓

 

The parents were caring, cooperative, observant, and motivated; thus, the physician could get all the insightful details.

Though the child had grade IV CP, he was very much alert. He observed the parents and tried to follow whatever they did. The patient’s parents were religious and they prayed every day. He would try to imitate the rituals and took their blessings and from his elder brother every day. He also took blessings from the guests and insisted that his younger brother did the same. He does not eat anything given by strangers when parents were not around. He knows that his grandmother cannot hear properly so he claps loudly to call her. He is very affectionate and tries to take care of his parents. Whenever his father goes out for some work, he would call him around lunchtime and enquire about his meals. He is obstinate and gets angry if things go against his wish. The qualified mental symptoms were taken for formulating the totality.

 

TOTALITY

1. Startled from thunderstorm
2. Likes music
3. Conscientious, children in
4. Religious, children in
5. Precocity
6. Affectionate2
7. Mixing easily
8. Fasting <2 crying
9. Vomiting < smell of non veg2

PDF

1. Chilly
2. Craving-Sweets
3. Cr: Ice cream
4. Perspiration-Forehead

 

Looking at the totality, Carcinosin, Phosphorus, and Silicea came up for consideration. The Refined sensitivity in a child with disability, precocity, conscientiousness children in, along with Qualified Mental Symptoms helped in selecting the similimum, Carcinosin 200 one dose weekly was given.

 

Results

The results were beyond expectations. Obvious improvement was seen within the 1^st three months. By the end of 6 months, his spasticity reduced by more than 50%. He was able to sit without support in a frog-like position and was able to stand with support. His hypotonicity and drooling of saliva reduced and scissoring in the LL was present only while standing. He started making simple sentences.

On Sep 2018 at his last follow-up, the condition was as follows:

• CNS- TONE:- spasticity↓↓, hypertonia in all four limbs UL↓↓, LL↓ ,
• Power-4 /5 in both UL, 3/5 in both LL, DTR +/+, plantar reflex ↓/↓

He gained 2 kgs and there was no fever episode since the treatment was started.

Along with Homoeopathy, the patient was asked to follow a specific diet and encouraged to do physiotherapy at home. He was following up for physiotherapy, psychotherapy, and speech therapy every 15 days.

Carcinosin 200 one dose weekly to 1M one dose weekly was administered in the follow-up.

 

Learning

This was an advanced case with multiple deficiencies. However, the child did show a strong sensitivity response and an active mind. The family also was cooperative and supplied the necessary data to establish the individuality, which was the key for accurate Homoeopathic prescription. On reflection, why did we get these unexpected results? The heightened sensitivity was a pointer to the nature of the characteristics and hence indicated a susceptibility which was active but blocked. This needed to be modified. The rapid improvement testified to the integrated approach of the use of a dynamic force along with the required physical manipulation – both factors reinforcing each other.

CASE 2:

 

 

 

 

 

 

 

 

Master A.P (Case number 49256), a 5-year-old boy was brought by his parents on 29/9/2016 with Spasticity+3 in all four limbs. He couldn’t stand or walk. He was able to sit only for 15-20 min, and then would fall. There was continuous drooling from his mouth. His bowel / bladder control was not achieved. All milestones were delayed, Social smile had not developed and he was unable to recognize familiar persons. His understanding was very poor, there was no eye contact, and speech was monosyllabic since 1 year of age. Since birth, there was laughing / screaming without reason, and continuous nodding of head. The whole day, he remained only in one position. His birth weight was 2.1 kg and he had delayed birth cry. The child had not received proper ANC care. The child was dull during case taking. He did not react after urination and defecation. He continuously makes noise. He is sensitive to sudden loud noise. His sleep gets disturbed by the slightest noise.

Physical characteristics: Profuse and offensive3 perspiration. He is constipated with yellowish, round ball-like stool with occ. blood stained, offensive3 and great straining during passing stool. His urine was offensive3.

Observation: – During case taking, he slept in his mother’s lap with half-open eyes. He was dull, short, medium built; he had a large head without any expression.

Clinical Diagnosis– Quadriplegic spastic CP [Grade-4] + Severe Intellectual disability + Chronic Rhinitis.

 

Totality

• A/F- Birth Asphyxia
• Desire to make noise
• Dullness (non-responsive, remains at one place – mentally and physically)
• Sleep disturbed by slightest noise
• Sleeps with half open eyes
• Offensive discharges
• Hard ball like stool

 

After Repertorization, Opium, Sulphur, Alumina came up for consideration. Considering the cause (A.F- Asphyxia), offensive discharges, hard ball like stool, dullness and observation of half-open eyes with sensitivity towards noise, Opium was selected

First treatment: – Opium 30 3P / HS / Weekly — Opium 200 1P / HS / Weekly / with Physiotherapy and Psychotherapy.

 

Results

The results were encouraging, even though he did not attend physiotherapy regularly.

At the end of 1 year, he was sitting without support, stood with minor support for one hour, and walked 3-4 steps. His spasticity reduced by 50%. Drooling was absent. His irrelevant behaviour / laughing had stopped. Eye contact had developed. He was responding to his name and recognized his parents. He started mixing and playing with others. His general understanding improved and he started to speak new words. He was reacting after passing stool and urine. Opium 30 single dose to 3P / Weekly to 200 single doses was given. At present Opium 200 one dose weekly is going on. Parents are aware of his state, but since they stay far away, they visit the centre once / month for Medicine, Physiotherapy and Psychotherapy. They were also trained for home-based programme. Since the last 4 months (Feb 19), only the father is coming to collect the medicines.

 

Learning

The challenge in this case was the selection of medicine with limited data. The choice of Opium indicates the importance of observations and grand generalisation in the selection of the simillimum. The right simillimum can produce results much faster than expected. This patient continued Physiotherapy and counselling irregularly.

 

CASE 3:

Baby H.S. (Case define number – 7879), a 2-year-old Muslim girl, was brought to the hospital with C/O inability to stand and walk without support. She could only toe-walk with support. She could not use her upper limbs. She had GTC seizures 6-7 times / day for the duration of 1 min since the 3^rd day of birth. Her convulsions<+2 sleep during, <+2 night, <+2 laughing after. They started from the left side. At the age of 1 ½ years, her MRI report indicated Frontal Dysplasia [Hemi cortical]. She was taking 6 anti-epileptic drugs since 1 ½ years of age. She also suffered from recurrent upper respiratory infection (once/1-2 months, which lasts for 3-4 days & is better with Allopathic Rx). She could eat only liquid food; this resulted in malnutrition.

 

Clinical Diagnosis:-Hypotonic quadriplegic CP (Grade 3) + Generalized Tonic Clonic Epilepsy + Moderate Intellectual Disability + Chronic malnutrition.

When the mother was 7 months pregnant with the patient, her 1-year-old elder son died  due to acute illness, a shock for the whole family. The mother’s blood pressure was raised and she had an episode of convulsion. Pt’s nature is irritable. On teasing, she gets angry at the smallest of matters, throws things, and pulls her own hair and beats herself. She likes animals, company, and noise. She laughs at noise, and likes going outside and riding vehicles. She is fastidious and mischievous.

Examination:-O/E:–HC- 44.5 cm Height- 94.5 cm MAC- 13 cm Weight- 11.3 kg

SYSTEMIC EXAMINATION: CNS – mental status – Conscious,  Gait- Unable to walk without support, Tone –Decreased  Both LL & UL, Power – Grade 3/5 in both LL & Rt UL. Grade 2/5 Lt UL,   DTR- Absent B/L, Planter –Extensor B/L

Following RS and PDF were formulated considering the characteristics of the case.

RS

• Anger <+2 teased when-Throw things+2
• Beats people+2
• Likes Travelling/Riding
• Laughing from noise
• Likes animals++
• Fastidious+
• Mischievous+2
• Craving: Sweet+2
• Craving: Sour+2
• Perspiration profuse over nose, forehead
• Sleeps on back with one leg extended

 

 PDF

• Chilly
• Anger – Pull hairs+2
• Craving: Cold drinks+3
• Convulsion <+2 laughing
• Convulsion started left side
• Convulsions <+2 Sleep during
• Convulsion <+2 night

 

After Repertorization, Cuprum, Belladonna, Medorrhinum were considered. Considering the characteristics in the case, especially in the co-morbid conditions of convulsion, characteristic modality of convulsion laughing from and desire to pull hair, simillimum was selected. Cuprum Met 30 was administered once a week.

The major concern was epilepsy along with CP. The frequency & intensity of convulsions gradually reduced after 6 months of interdisciplinary management. At present, she gets 1-2 episodes/ 2-3 months only for a few seconds. She can walk and stand with an Ankle foot Orthosis. She has initiated standing without support and using her upper limbs for daily activity. There has been no episode of URTI after the initial 6 months. Her nutritional status also improved since she has started eating everything, the weight increasing from 11.3 to 12.5 kg after one year, and the mid-arm circumference increasing by 2 cm.

Cuprum Met 30 1P weekly to 30 3P weekly was administered. We are providing transportation to their village. Initially, they came once / 15 days for medicine and therapies, gradually it became once / month. Afterwards, they were very irregular because of severe illness of the grandparents. Her mother was the only person to bring her to the centre. They have stopped treatment from July 2018 because her mother conceived again. Since they dropped out, the team of doctors and MSWs have visited their home. They are very satisfied with the treatment but couldn’t come for regular follow up because of pregnancy. Patient’s state is the same as at the last follow-up.

 

 

 

 

 

 

 

 

 

 

Learning:

Identification of characteristics in the co-morbid condition is important. Susceptibility usually expresses the characteristics in some or the other form. Co-morbidity of epilepsy < laughing was the entry point for the selection of the remedy. The ankle-foot orthosis facilitated the process of recovery. Regular follow-up is the biggest hurdle, even with such a good result.

 

CASE 4:

Mast. M.R.I (Case Define No – 9205),  a 4-½-year-old Muslim boy was brought on 31/1/2017 with the complaints of being unable to sit, stand & walk without support, unable to stand up from sitting. He had dystonia of all extremities and stiffness on tactile stimulation. He could speak only mono and bi-syllabic words. His fine motor function was poor: he couldn’t eat on his own or with a spoon. There was also a history of recurrent upper respiratory tract infection since birth, once a month lasting for 4 to 5 days. He was born at term and there was h/o pre-eclampsia during the ante-natal period of the mother.

Clinical Diagnosis: Dystonic quadriplegic cerebral palsy (Grade 4) + recurrent upper respiratory tract infection

His examination findings were:-

• WT: 14 KG RR: 22/Min HR: 70/Min     Pallor: + HC: 49 cm                MAC: 15 cm
• CVS/RS/P/A: NAD
• CNS: TONE- Dystonia+ in 4 limbs Power: Grade 3/5 in 4 limbs,

DTR-+1B/L                                           Planter: Flexion B/L

He was lean, thin, fair with a smiling face and playful. He was sensitive3 to reprimand, would weep immediately if someone scolded him in a loud tone. He was attached3 to his father and his 2-year-old sister. He was very communicative / mixing but shy in front of strangers. He was obstinate especially for being taken out and if denied, would cry a lot. He loved to attend social and marriage functions. He had desire for company. He was fond of travelling / music. He had fear of being Alone+3, Dark+3, Mouse+, Frog+, and Monkey+. He always wanted to be in neat and clean clothes. If they became dirty, he would immediately ask for a change. He startled during sleep.

 

TOTALITY

 

1. Sensitive to Reprimands2
2. Company- desire2
3. Fond of Travelling 2
4. Fond of music2
5. Fear- dark2
6. Fear of alone 2
7. Fastidious 2
8. Obstinacy 2[ for going outside]
9. Timidity 2
10. Starts sleep during 2
11. Chilly
12. Cr-Sweet +3
13. -Choclate+2
14. – Ice Cream+2
15. Salivation sleep during3
16. Perspiration- Forehead 2
17. Perspiration- Nose2

 

In this case, Phos and Calc Phos were under consideration. But looking at the Sensitivity to reprimands, Timidity and his fears, Characteristic Physical general of craving sweets and ice cream, Calc Phos was selected as a simillimum.

ACTION: – CALC PHOS 30 3P weekly was started followed by CalcPhos 200 1P weekly.

Advised Physiotherapy / Psychotherapy / Diet

 

Results

 

The parents were quite co-operative for the treatment / follow up. The patient was improving in all aspects, but as per the feedback from the physiotherapist, the dystonia was not improving. The dystonia reduced after introducing Tub Bov 200 followed by Calc Phos. As per our advice, the patient got admitted once / month for 3-4 days considering the distance. During admission, therapies were given twice / day. They also followed regular home-based programme. By the end of 4 months, his episodes of recurrent URT infection had stopped.  His dystonia reduced by more than 50%. He was able to sit without support. He was able to stand and walk with major support. He was trying to eat by himself. After one year, he started to stand and walk with minimal support. He gained weight [4 kgs.]

 

 

 

 

 

 

 

 

 

Learning

Considering the diagnosis, the prognosis was poor. Hope and support from the parents, regular follow-up / Homoeopathic medication, physiotherapy, and psychotherapy have helped to achieve such a result. The importance of interdisciplinary approach was also very well focused here. The Intercurrent [Tub Bov] removed the block and facilitated  progress.

 

Discussion:

 

1. CP is one of the most challenging disorders to manage. The challenges are more as we are treating the effects of a pathology that has occurred earlier; the effects get more profound with advancing time. Looking at the entire phenomenon from the Homoeopathic perspective, we need to identify the factors that contribute to the faster pace and depth of the disease.
2. Susceptibility governs the progress and the expressions. Therefore, it is important that once the disease has been clinically understood, we need to assess the susceptibility very carefully for effective Homoeopathic management.
3. Proper case-taking, following the guidelines given by Dr. Hahnemann and various stalwarts, is a major contributing factor in the delivery of the result.
4. Empathy will greatly aid at this stage. Parents or care-takers come with different mind-sets. Some carry extreme hope and expect miracles, while some have a mind-set of frustration that nothing is happening. Therefore, receiving them well and getting characteristics requires skilled communication. Of course, they come with their baggage of past experience.
5. Case 1 indicated that parents shared all the characteristics. The case beautifully demonstrated the state of susceptibility that even though there was brain damage, the higher functions were preserved. The maturity of the child is innate and the susceptibility has expressed it very clearly.
6. Case 2 also indicated the importance of observations. The physician will get the characteristic information by following the guidelines and the discipline of case taking. This case also indicated the contrasting expressions of susceptibility that one side the child was dull and not responding but on the other side sleep got disturbed by the slightest noise. Once the physician was able to identify these expressions, the totality became clear and so did the simillimum.
7. The role of the care-takers is important in getting the desired results. Care-takers also include the Homoeopathic physician who by using his knowledge regulates the doses of the simillimum.
8. Various therapists like Psychologist, Physiotherapist, and Occupational therapist have a significant role. All these support therapies are required for the desired response.
9. The parents are the core care-takers; their motivation is most important.
10. Case numbers 3 and 4 demonstrate these aspects. Proper education and orientation of the parents / care-givers is needed. They all come with hope and expectations. It is the responsibility of the Homoeopathic physician to bring their expectations to a rational level and keep hope high.

A dedicated team at the CP centre at MKSH of physicians and therapists follow this principle diligently and thus keeps everyone’s UMMEED high, giving positive energy to everyone, reminding them all the time that “Hopes Lives here”.

 

CONCLUSIONS:

There is a definite role of Homoeopathy observed in the treatment of CP and co-morbidity especially with an inter-disciplinary approach. All therapists including the Paediatric Neurologist accepted that Homoeopathy can modify the state of co-morbidity (mental as well physical) and hasten the rehabilitation in cases of CP with supportive therapies.

Homoeopathy is an individualistic approach and that is how we can produce results in a lesser-known disorder. Each case is a new experience. The key to success is the selection of the simillimum. Accurate assessment of the susceptibility and understanding its expressions are most important.  Homoeopathic medicines along with a multidisciplinary approach have a big role to play in relieving the distress of children of CP and their families.

 

HOPE DEFINITELY LIVES AT UMMEEED CEREBRAL PALSY CENTER

 

Acknowledgements

We are thankful to the Lipoid Foundation, Germany for the generous grant for setting up the UMMEED Lipoid Centre at MKSH, Karjan, to enable us to treat a vast number of children with CP. We are thankful to the Sanghvi family who brought about this association. We are grateful to the numerous parents, care-givers and the child patients who enabled us to break new ground with the help of Homoeopathic medicines. It was only with the active intervention of the Physiotherapists and Psychologists, that holistic care became possible.

 

References:

1. Health topics Disabilities , https://www.who.int/topics/disabilities/en/
2. Gupta Ashok. Sharing in Textbook of Paediatric Neurology in Tropics, New Delhi, 2007
3. Corvera, Ida Sherri L.,BSN III –NM, July 12, 2009 Published in Education Health andMedicine,https://www.slideshare.net/bronzedchika/cerebral-palsy-1712524
4. Clinical Classification of Cerebral Palsy, Christian Chukwuukere Ogoke, March 14, 2018, reviewed 1^st June 2018, Published 5^th November 2018, https://www.intechopen.com/books/cerebral-palsy-clinical-and-therapeutic-aspects/clinical-classification-of-cerebral-palsy
5. Challenges of Cerebral Palsy Management April 3-5, 2014, University of Bridge port CT, sUSA
6. asee.org/documents/zones/zone1/2014/Students/PDFs/10.pdf