Hyperbaric oxygen therapy for children with cerebral palsy is
unproven and has potential hazards - we do not recommend it.
Key points to remember:
* hyperbaric oxygen therapy is an established treatment for some
serious conditions such as carbon monoxide poisoning, decompression
sickness (the 'bends') and some wounds
* use of hyperbaric oxygen therapy in a range of conditions
including cerebral palsy is based on the theory that there are
inactive cells in the damaged brain that have the potential to
recover
* hyperbaric oxygen therapy for children with cerebral palsy is
unproven and has potential hazards - we do not recommend it
* if parents are planning to use this option for their child, they
should carefully consider the points in the section ‘What should
parents do?’
Parents who have a child with a disability, especially a severe
disability that significantly limits function and/or quality of life
may want to consider any therapy that offers hope of cure or
significant improvement.
What is hyperbaric oxygen therapy?
Hyperbaric oxygen therapy is the inhalation of 100 percent oxygen
inside a hyperbaric chamber. A hyperbaric chamber is a sealed room
where oxygen or air is pressurised to 25 – 75 percent above normal
air pressure at sea level. The child and a caregiver spend time
(usually one hour) in the chamber.
Cerebral palsy (CP)
Cerebral palsy is a permanent physical condition that affects
movement and posture and can cause a range of other problems. It is
caused by damage to, or lack of development in a part of the brain
that controls movement. Cerebral palsy is the most common physical
disability in childhood occurring in 1 in every 500 babies. Cerebral
palsy is often called ‘CP’ for short. For more information, see the
cerebral palsy page on this website.
Could hyperbaric oxygen therapy help children with cerebral palsy?
The theory underlying the use of hyperbaric oxygen therapy in
cerebral palsy is that there are cells within the damaged brain that
are living but are not active and are not functioning as they
should. The hope is that providing an increase in the supply of
oxygen to these cells will switch them on again and start them
functioning and so improve the child’s function. Studies in animals
have shown that there are changes in the electrical or metabolic
activity of brain cells.
HBOT Cerebral Palsy Benefits
There have been very few studies in children with cerebral palsy,
and no new studies have been published for more than 10 years. The
best study showed no significant difference between children given
hyperbaric oxygen therapy and children given room air at a similar
pressure.
There is no evidence that hyperbaric oxygen therapy is helpful for
children with cerebral palsy.
What happens in hyperbaric oxygen therapy for a child with cerebral
palsy?
First, an assessment is necessary to look for problems that could
happen to the child during hyperbaric oxygen therapy - see the next
section 'Can anything go wrong?'
Children who have ear problems may need to have an operation to
insert grommets (also called ventilation tubes) before treatment.
Grommets prevent ear pain or a burst ear drum in the hyperbaric
chamber. The operation involves a general anaesthetic with the
associated risks.
An adult must be with the child while they are in the chamber. The
adult is there to give help in an emergency such as an epileptic
seizure or vomiting. Once the child and their caregiver are in the
chamber, the chamber is closed and the pressure raised to the level
selected for the treatment.
Can anything go wrong?
Yes, things can go wrong.
Ear problems
Changes in pressure can result in pain or in damage to the ear drum.
In the published studies, ear problems were relatively common and in
one study over half the children needed an operation to insert
grommets.
Vomiting
If a child vomits in the chamber there is a higher risk of choking
on the vomit (aspiration). The high pressure tends to force the
vomit back into the airway.
Epileptic seizures
In the published studies up to 12 percent of the children had
seizures during treatment. There is the possibility of breathing in
vomit if the child vomits during a seizure.
Does it work?
The evidence from the studies published in the peer reviewed
literature is that hyperbaric oxygen therapy is not effective for
children with cerebral palsy. A recent analysis of 64 different
treatments for cerebral palsy gave a red light grading to hyperbaric
oxygen therapy. This grade indicated that the treatment should be
discontinued as it is ineffective and has potentially serious
harmful effects. Only 5 of the 64 treatments received this grade.
What should parents do?
Our advice is that hyperbaric oxygen therapy for children with
cerebral palsy is unproven and has potential dangers. We do not
recommend it.
Source
If parents are planning to use this option for their child, they
should carefully consider the following points:
Does my child have seizures (epileptic convulsions)? If yes, does my
child sometimes vomit during seizures?
Does my child have a tendency to vomit at other times?
Has my child had ear problems? If my child needs to have an
operation to insert grommets before having hyperbaric oxygen therapy
am I fully informed about the risk of a general anaesthetic?
If you answered yes to any of these questions, ask yourself whether
it worth risking your child's life for this unproven treatment.
Some other questions to consider
How will the treatment be given?
How much will this treatment cost? Remember that there is always
more than a dollar cost. Think about the disruption to the rest of
the family as a result of travelling overseas, the safety of the
destination, loss of earnings.
What qualifications do the people giving the treatment have?
What follow-up and treatment evaluation will they offer?