Acupuncture is one of the oldest treatment modalities which have been successfully practiced in China for the last 4000 years (George T. Lewith (2)). Traditionally acupuncture has been used for various mental and physical disabilities. Especially in the last 35 years with the development of different forms of SCALP ACUPUNCTURE by Dr. Jiao Shunfa (Jiao Shunfa 1997 (3)), Dr Zhu’s Scalp Acupuncture (Zhu Mingqing 1992 (4)) and YNSA (Yamatomo’s New Scalp Acupuncture 1998 (5)) use of acupuncture in neurological and developmental disorders has increased to a greater extent. World Health Organization reviewed and standardized Scalp acupuncture in 1984. In 1988 WHO published the first standard pamphlet on Scalp acupuncture (WHO 1991 (6)). Many studies done all over the world on humans and animals show that Scalp acupuncture is very effective in treating developmental and neurological diseases in children and adults. Research shows that level of certain hormones in the body and cerebral blood flow improves (Xiang L (7)), (Gerhard Litscher (8)).

Low Level Laser Therapy (LLLT) is the use of low power therapeutic lasers to treat various diseases. Many research studies show that LLLT has various effects on cells and nervous tissue (Tunér, J. 2002 (9). LLLT is used to stimulate wound healing and tissue regeneration (J. Pineal Res. 2003 (10)). Some studies demonstrate that LLLT can be used safely on acupuncture points and different zones or areas on scalp (Harry Lazoura (11)).

Physiotherapy is widely used as an integral part of the treatment for C.P. all over the world. Hundreds of studies show that physiotherapy helps to a major extent in the treatment of C.P. (J. Parkes, 2000 (12)).
Magneto therapy is the use of magnets or magnetic fields to treat various diseases. Recent studies show a positive effect of magnet therapy in various neurological and developmental diseases like epilepsy (Seizure. 2003 (13)).

Color therapy is based on the fact that physiologic functions respond to specific colors. Using colored light for therapy has been in practice a very long time and we see it happening every day, whether we realize it or not. Research was also done to test the effects of colored light on muscles. When subjects were using a hand grip and exposed to blue light, their grip lightened, while other tests have shown that when muscles were exposed to red light the electrical activity in them increased (Therese M Donnelly 2000 (14)).

Methods & Materials Used:

This study was conducted at Anwar Shah’s First CP & Paralysis Clinic and Research Center in collaboration with the Department of Neurology Children Hospital Lahore, Pakistan and the Department of Neurosurgery Children Hospital Lahore, Pakistan for a period of 18 months from December 2003 till June 2005. In all 100 children with different types and etiology were treated. There were 54 boys and 46 girls. Their mean age was 3.2 years.

The history of every child was taken and a primary clinical assessment with initial measurements was done which included Head Circumference (H.C), Height and Weight.

CT scan and MRI were conducted to rule out surgical lesions in some cases. After primary assessment and initial measurements, the children were treated twice a week with ACULASER THERAPY.

In this study we used Laser acupuncture (body points, scalp areas and auricular points) Physiotherapy, Color-therapy and Magnetotherapy as main treatment modalities. Other treatment modalities were used an adjuvant to these.

We stimulated scalp areas first, (scalp areas may vary in size from 1 cm to 3 cm); this was followed by stimulation of body points (body points are small areas on the body measuring almost 1 cm) and auricular points. This study was conducted in very young children who had few and very thin head hair, older children who had thick head hair their parents were asked to shave their heads regularly so we could stimulate their scalp areas properly. We did not follow any single method or school of acupuncture. We actually combined 5-element acupuncture, auricular acupuncture and scalp acupuncture (Jiao Shunfa, YNSA and Dr Zhu) to treat many different cases of CP and associated neurological disorders.

In classical acupuncture treatment there is no specific formula or set of points to treat any disease and treatment may vary for the same http://premier-pharmacy.com/product/soma/ patient on subsequent sessions depending on the response. However, there are some generalizations which could be applied like for spasticity Liver 3 and Gall Bladder 34, for irritability and restlessness Heart 7, 5 (also for the improvement of speech) and Du 20, to increase cerebral blood flow Du 26, 16, 14, etc. On scalp we mainly stimulated motor areas, speech areas, visual areas, brain point, etc. On auricles we stimulated shenmen, sub cortex, back, limbs, etc.

We used 2 types of soft lasers with different wavelengths. For the stimulation of body and auricular points, we used red HJZ3A He-Ne laser with a wavelength of 632.8 nm 30 mW from the tube and estimated 20 mW at the tip. This laser is manufactured by Guoguang Electric Co of Chengdu, China. For scalp areas we used diode laser with a wavelength of 675 nm, 50 mW manufactured by Wen Zhou Electric Appliance Company Xinke province, China.

Each body and auricular point was stimulated for 25 seconds (4 J) while scalp areas were stimulated for 45 seconds (18 J).

In addition to the LLLT every child had a full session of physiotherapy. We used blue light for 20 minutes on face and body in epileptic cases and yellow light for 20 minutes on face and body in non epileptic cases during each treatment session.

We placed North Pole of 300 gauss magnet under right foot and South Pole under left foot for 5 minutes. South Pole of 300 gauss magnet was placed under the pillow (occipital lobe) for 5 minutes.

The response of every child was recorded on every visit to the center and physical measurements were done at 6 weeks interval. Photograph of each child with physical dysfunction were taken before, during and after treatment.

In addition to the treatment at the center their parents were taught the reflex massage which they performed daily at home.

Total No. of Children Treated:

In all 100 C.P. children with associated neurological disorders were treated:

• Children with Spasticity & Stiffness: 81
• Children with Epilepsy: 54
• Children with Cortical blindness: 18
• Children with Hearing difficulties: 45
• Children with Speech Disorder: 100
• Children with Hemiplegia: 46
• Children with Quadriplegia: 36
• Children with Paraplegia: 18

Male: female sex ratio:

Baby boys: 54

Baby girls: 46

Male: female sex ratio was 1.27:1

Age Distribution:

Minimum Age: 04 Months

Maximum Age: 16 years

Mean Age: 3.2 years

Response of C.P Children with Different Neurological Disorders

Response of C.P Children with Spasticity & Stiffness:

Out of 81 C.P. children with spasticity and stiffness 69 showed marked improvements as both stiffness and spasticity improved. This accounts for 85% success rate.

Response of C.P Children with Epilepsy:

Out of 54 C.P. children with epilepsy 34 showed marked improvements as both the frequency and intensity of epileptic fits decreased. This accounts for 63% success rate.

Response of C.P Children with Cortical Blindness:

Out of 18 C.P. children with cortical blindness 13 children showed improvement accounting for 72% efficacy rate.

Response of C.P Children with Hearing Difficulties:

Out of 45 C.P. children with hearing difficulties 31 showed marked improvements. This accounts for 69% improvement rate.

Response of C.P Children with Speech Disorder:

Out of 100 C.P. children with speech disorder 67 children improved showing 67 % improvement rate.

Response of C.P Children with Hemiplegia:

Out of 46 C.P. children with hemiplegia 32 children improved showing 69 % improvement rate.

Response of C.P Children with Quadriplegia:

Out of 36 C.P. children with quadriplegia 25 children improved showing 69 % improvement rate.

Response of C.P Children with Paraplegia:

Out of 18 C.P. children with paraplegia of the lower limbs 12 children improved showing 67 % improvement rate.

Possible Side Effects

Generally we did not experience any adverse effects of ACULASER Therapy like aggravation of epileptic fits or increase in spasticity and rigidity.

Few minor temporary complications occurred in C.P. children getting ACULASER Therapy. These temporary complications are:

1. Hyperactivity and Restlessness:
2. Disturbed Sleep:
3. Irritability:

All of these complications were probably related with increased cerebral blood flow. These complications settled in 2 weeks time.

Discussion

Cerebral Palsy (CP) is caused by ischemic insult to the developing brain during pregnancy, delivery, perinatal period and first few years of life ( Futagi Y, Shimizu H, 1982 (15)). A very large proportion of CP children suffer from associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders. Any one or multiple neurological disorders may affect CP children and compromise the quality of their life.

ACULASER Therapy aims at improving the blood flow to brain and other affected parts of the body. This is done by stimulating different body acupoints, ear points and scalp areas. In response when these acupoints and scalp areas are stimulated blood flow to brain and various affected parts of the body increases (this is demonstrated with the help of functional MRI or f MRI of the brain) (J. D. Lee , J. S. Chon, H. K. Jeong, 2003 (16)). In addition to this when Low Level Lasers (wavelength 632.5 nm Р915 nm) are applied on skin, this results in biostimulation of the body tissues resulting in increased blood flow and rapid healing of the tissues (Tun̩r, J. 2002 (8)). The combined effect of LLLT, acupoints and scalp areas stimulation results in increased blood flow to brain and different body parts thus improving the CP and its associated neurological disorders ( Jiao Shunfa 1997 (3), Zhu Mingqing 1992 (4), Tun̩r, J. 2002 (8), J. Pineal Res. 2003 (9), Parkes, 2000 (12)).

Studies conducted in different parts of the world involving unconventional treatment modalities like Acupuncture, Acupressure, Laser Acupuncture and Scalp Acupuncture show a very good success rate for the treatment of CP and other Neurological disorders. (Jiao Shunfa 1997 (3), Dr Liang 1984 (17), Dr Petra Fila 1997 (18), Dr Majid Fadaie 2002 (19)).

In our study, ACULASER Therapy was safe, effective, painless and aseptic; it gave rapid results in most cases. Most children complied easily with the treatment. Changes were observable almost in the first 2 -3 weeks of therapy. In some cases that were coming from far areas, we gave a break in the treatment for 4-12 weeks because of very severe heat in summer. These children maintained the degree of improvement during the break which they achieved with the treatment. We did not observe any regression or reversal of improvement in these children. The best results were in children <2 years of age and the second best group were <5 years of age which signifies that ACULASER THERAPY when instituted earlier gives better results. This is because the weight of the brain of a new born baby is 250 grams and it grows to 1000 grams at 1 year and then till the age of 7 years it reaches around 1300 – 1400 grams maximum. If the treatment is started at an early age when brain size is increasing rapidly, the chances of improvement and recovery are high.

Conclusion & Recommendations:

This study concludes that ACULASER Therapy is effective for the treatment of children suffering from CP of various types and associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders.

ACULASER Therapy not only addresses and improves the physical aspect in CP children but also the mental and cognitive aspects.

ACULASER Therapy if applied at proper time can improve the quality of life of the children suffering from CP and associated neurological disorders associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders.

We strongly recommend that further larger studies should be conducted to evaluate the effects of ACULASER Therapy and this should be adopted as a treatment option for CP along with other modalities.

References:

1. Nelson. Essentials of Pediatrics. Third edition, Behrman Kliegman. (1998),
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