Cerebral Palsy; Mother Role-Juniper Publishers
Global Journal of Intellectual & Developmental Disabilities (GJIDD)
Cerebral Palsy (CP) in newly born babies is not
uncommon; many causes share its incidence in all communities, pre-natal,
natal and post. The current vision and therapy trends are established
or settled irreversible brain damage and nothing but neuroleptics,
physical and psychological rehabilitations ± ortho-alignment
accordingly. According to my work CP is an active chronic intracellular
(neuron, galia, and endothelium and others) bacterial cerebritis focal
or global. Established intrauterine (pre-natal). Silent or dormant can
be evoked by many precipitating factors pre-or post natal.
Keywords: Cerebral palsy; Brucellosis; Asphyxia; Kernicterus; Brain atrophy; Basal ganglia; Atonia; HypotoniaIntroduction
Cerebral palsy (CP) is the clinical entity of being
with some degree of brain dysfunction due to focal brain damage which is
not detected radiologically or the diffuse or global brain atrophy
visible radiologically with clinical picture of intellectual, physical
dysfunctions or both. It is well known it either started intrauterine
(pre-natal), during delivery (natal) or after delivery (post-natal). It
is no idea to go through these causes. Here I want to stress on a fact I
concluded from my work on the bases of the nature behind this clinical
entity, the CP. It seems in the basic nature of this problem is the baby
acquire the pathology throughout its development, that means, no given
period is blamed to be the time of affection as is mentioned in the
classical teachings, that is, the mother getting momentary infection
whether viral or bacterial or any other factors. The case is that the
mother is harboring the infection already (before being pregnant) in
spite of she expresses it or not. My work showed this pathology is the
mother's affection with chronic Brucellosis.
Patient and Method
As the results of my interest in the biological bases
of Neurosurgical pathologies widen and deepen, a new concepts or
visions are obtained by me. This brought to take every case of CP under
this vision. For that the tonics and brain stimulators (neuroleptics)
which was used by me and the rehabilitation programs and even the
orthopedic managements are changed to a deeper and more thorough
clinical examination of the mother and the baby for any evidence of
being affected by any systemic illness which makes CP is one
complication of it, then trial treatment for Brucella, lastly PCR of
Trapezius muscle open biopsy taken from the new born but not from the
mother yet due to cost in my single case which underwent PCR test. This
took both genders over the past ten years, of any age, some come older,
either being neglected or treated by the classical treatment in some
period of their life. Of course the number is several tens of wide range
of affection. Due to the highly encouraging positive results by this
principle I went to apply this mode of management even with patients
their history or clinical examination would never show any hint on what I
am saying, still the outcome is the same positive as those show some
suggestions of being affected, I would like to do PCR for all patient
with or without signs and widen the range of screen test for all
intracellular bacteria we know but unfortunately I lack the financial
power to go on.
Results
The results of neuroleptics when I were in use to
manage CP was satisfactory but slow in results especially in onset of
response, with some sort of decline in cessation of its use or no
benefit after a while. When I started to use the anti-Brucella, the
first week obvious outcome is clear in many cases, which is; stop of the
newborn irritability (continuous crying especial at night that prevents
the whole family from sleeping) of course without analgesics,
anti-spasmodics or sedative of any kind direct or indirect (like
anti-histamines). The second dramatic response that takes about one
month as a range is the physical weakness or atonia improves,
intellectual improvements take more than a month to develop this in
comparism with the pretreatment condition as a rate qualitatively and
quantitatively. Due to financial difficulties one case of six months
female baby underwent Trapezius muscle open biopsy which showed
positivity for Brucella with PCR while mother not also due to
extra-cost.
Discuss the Analysis
As there are many classification and timed-causes for
the cerebral damage, I can summarize; On the biological bases from
similar diseases affection in my work which caused by chronic active
intracellular bacteria like Brucella, salmonella or many others who I
try my best to develop or upgrade the screen test with PCR or Mico-array
to detect the pathogenesis behind, that the CP scene is one of them, as
follow ; the developing fetus inside his mother's uterus catches the
infection through fetal-placental barrier from the body cells of the
infected mother. So, let us say the fetus, become a carrier like his
mother. Here the carrier is a relative condition, not means the patient
or the carrier is sound and not suffering by certain manner! She (the
mother) and it (fetus) are suffering but some are with a sub-clinical or
clinical but not recognized by the patient-community interaction. The
community is either the close people around the patient or the medical
side when the patient complains; she will be shut up with palliatives!
Or never complaining but her general condition shows ill health like
emaciated face. This last vision reflected on the fetus also when become
new-born. This carrier fetus during the nine months of intra-uterine
development is also in danger of other occasional affections whether
biological like viruses and bacteria or physical and chemical (metabolic
or so) stresses. These these conditions on the mother , the fetus or
both act as a activation to the dormancy of the intracellular bacteria
to act in certain manner or grade to start damaging the invaded tissues
of the fetus whether brain or the bodily cells which the later might
damage the brain in certain way (that means we need more work to see the
brain damage is a direct invasion of the mothers original infection
which is the intracellular Bacteria or it is a some cascade of complex
extra-cerebral events), all the above is prenatal. Natally, the stresses
that the fetus is subjected to during the period of given birth are
many and well known; these may act as precipitating factors to activate
the dormancy. Activation is beyond the scope of this article, it needs
extensive work. Postnatal meningitis is also well known, many lab tests
are under taken to show that CSF is sterile and other unfruitful tests
all due to a missed idea that this meningitis is mere activation to the
intra-uterine affection with Brucella (mostly) so PCR for tissue not CSF
should be considered. The failure of empirical treatment for this
meningitis in combinations antimicrobials including Vancomycin is
another practical proof on being Brucella in origin. As the fetus does
not subjected to the environmental source of affection or infection (do
not eat food stuff harboring the Brucella) this is logic evidence that
the affection is intra-uterine for all cases. Post-natal activation to
cause meningitis to the new born may be a complex of precipitating
factors one of them is the birth asphyxia or any cause for low PaO2.
Hence the two well known factors that are associated with CP causation
which are the birth asphyxia and Kernicterus are not the principal
causes in causation of the CP, they are an association factors, that is
if no brain cells harboring the invader we are talking about the CP will
not established. Yes, it looks strange and anti-traditional, but from
all the above and with anti-Brucella positive results give clue that the
CP is an ongoing brain affection as inflammation, or another damaging
events that affect brain structure and function whatever the time is
prolonged as the new-born grows up, this un-wanted dysfunction is
reversed by anti Brucella with any severity or prolongation. And either
of the two well known causes, the asphyxia and the premature high
bilirubin serum level that precipitates in new born basal ganglia is not
excluded from this concept.
This the only case which underwent PCR test; she is
six months having a general hypotonia since birth with mental
retardation according to her age milestone which appears on her face (Figure 1a), open Trapezius muscle biopsy for PCR (Figure 1c), showed Brucellosis (Figure 1d),
I put her a one month course on anti-Brucella (not mentioned textbooks
as a standard anti-Brucella which is Azothromycin and Cefixime according
to the body weight in a single daily dose) when she came in her first
visit after this first month I did not recognize her until I saw her
mother due to the remarkable change in her face (Figure 1b)
this in addition to stop of irritability and crying all the night with
start to have some activity to turn her body to a side and you see in
the picture she is lifting her left hand which was non due to severe
hypotonia (if I say she was with atonia I will be not so far). As this 6
months baby feeds only on her mother's breast feeding and the condition
started since birth so the logic is intra-uterine affection.
Conclusion
Cerebral palsy CP to high extent is due to
neuro-brucellosis or general systemic chronic brucellosis, but does not
mean that other intracellular bacteria are not embalmed, the fetus
acquire from the mother during pregnancy, the traditionally known causes
are either precipitating or aggravating factors.
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