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01/01/2007 - Acupuncture treatment for Pediatric Cerebral Paralysis.

Earlier this year, I worked for six weeks in the pediatric department of a TCM Teaching Hospital in Chengdu, China. The following are my observations of the treatment delivered to infants with Cerebral Paralysis (CP) and their outcome.

Loose Scalp Sign (LSS)

It has been found that the scalp area around Baihui (Du 20) of patients with CP is generally loose and in some cases, the scalp can be pulled away from the parietal bones of the cranium. Patients also have the feeling of ‘separation’ between the scalp and the skull and on examination; the area feels like a hay cushion when pressed. Baihui is located on the top of the head, which is considered to be the converging point of all Yang meridians. CP patients suffer from an innate deficiency and consequent postnatal impairments which cause a failure of the Yang-Qi to rise with the attendant ‘hollowness’ of Baihui manifesting as a separation between scalp and skull. Some patients will display only the signs and symptoms of LSS with no other positive findings from medical tests. In these instances, resolving LSS is an important diagnostic tool and indicator of treatment progress. From the Western medical point of view, LSS is considered the result of an insufficient supply of blood to the local area. It has been found that needling in the local area of Baihui improves blood circulation, resolves LSS and shortens the treatment time.

Joint Needling

The skeletal joints of CP patients vary from flaccid to contracted. Some patients’ joints are extremely soft and flexible with an extraordinary range of joint movement. For example, the shoulder can be shrugged to the superior border of the ear, the cubital joint can move medially and laterally more than 30o and extend posteriorley more than 30o, the knees can overextend and the feet can dorsiflex to touch the anterior crest of the tibia. For these cases, satisfactory results were achieved by applying acupuncture to the affected joint with surrounding needling, reciprocal needling and broad needling. For patients with contracted muscles, needling the muscles controlling the joint movement proved to be beneficial.

Spinal Curvature Syndrome

Spinal Curvature Syndrome is usually a sign and symptom of CP due to hypoplasia of the skeleton and muscle. Acupuncture is delivered in the space between the diseased vertebra and the two neighboring vertebra (along the Dumai) and then Jiaji points are needled obliquely on both sides of the corresponding vertebra until tip of the needles touches the spine. A reducing manipulation is used on the convex side and a reinforcing manipulation on the concave side.

Fear

Some CP patients exhibit slow development of their neurological system. The signs and symptoms are usually; easily frightened, startled by sound and light and sensitive to external stimuli. Fear and nervousness disrupts a patients’ treatment and recovery considerably and for infants with CP, is often the most difficult to treat. The traditional points used for fear are Daling (PC7), Shenmen (HT7), Laogong (PC8), Shaoze (SI1) etc. The effect of these points was not as good as anticipated, so Dazhi and Dannangxue (both extra points) were added and produced excellent results.

Visual Disability

Visual disabilities, such as cortical blindness, primary atrophy of the optic nerve, strabismus and amblyopia, are the result of congenital defects, intrauterine or postpartum anoxia/ischemia, intracranial hemorrhage and kernicterus. Treatment consists of needling Jingming as the chief point. Most patients make progress within 20 treatments, with some recovering after 50 treatments.

Summary of pediatric cerebral paralysis treatment outcomes:

Male, 3ys, could shrug his shoulder above the top of his ear. The flaccidity of the shoulder was resolved after 100 treatments of surrounding needling on both sides.

Male, 9yrs, spinal back-protrusion from T9 to T12. This was successfully rectified after 15 treatments.

Female, 1yr, blind. The pupils were dim without luster when she came to the hospital. After 20 treatments, the pupils became brighter and after 50 treatments, she was able to see.

Female, 1yr, was diagnosed with primary atrophy of the optic nerve. The eye balls had horizontal nystagmus and were not able to follow objects. The main points used were Jingming, Binao (LI14), Biyan (arm-eye extra point), Erjian (ear-eye, extra point) and the herbal decoction Danzhixiaoyaosan 丹栀逍遥散. After 3 treatments, the nystagmus disappeared. After 10 treatments, her eyes could follow an object 60cm in front of her.

Female, 2 months, postpartum asphyxia in 1999. CT scan indicated severe cerebral hyperplasia. LSS was positive, her feet could dorsiflex to touch the anterior crest of the tibia, and she was diagnosed with Cerebral Paralysis. The patient responded well to comprehensive therapies consisting of acupuncture, Tuina and point injection. After 200 treatments, both her physical ability and intellect significantly improved. She is now studying in primary school.

Male, 1.5 yrs, full-term fetus and natural birth. This patient was diagnosed with CP without any positive CT evidence. Signs and symptoms included a weak neck and lumbar at 3 months old, unable to hold things in his hands, varus deformity of the right foot,unable to drink without choking, crying without any sound, LSS was positive mainly on occiput. After 10 treatments of acupuncture and Tuina; he could hold objects, the movement of his right foot increased, and he now cries loudly.

■ Xiaoji Jenny Li graduated from Chengdu University in 1994 with a Bachelors Degree in Traditional Chinese Medicine and is a registered acupuncturist practicing in Auckland. If you would like more information on treating pediatric cerebral paralysis, please contact Jenny at lixiaoji73@hotmail.com