Tuesday, 29 June 2010

Agenesis of the Corpus Callosum.

What is the corpus callosum and what does it do?

The corpus callosum is a structure containing around 250 million nerve fibres, which connect the right and left hemispheres of the cerebral cortex. Their function is to facilitate communication and cooperation between the two hemispheres. This function is most readily observed in patients who have undergone surgical disconnection of the corpus callosum, (know as a split brain procedure), which is sometimes done in extreme cases of epilepsy to prevent the seizure signal from passing from one hemisphere to the other.

In a normally functioning individual, one hemisphere becomes dominant, - this developmental process, known as laterallisation is usually completed by around the sixth year of age and in most people it is the left hemisphere of the brain, which becomes dominant. however, in individuals who have undergone surgical disconnection of the corpus callosum, this left hemisphere dominance, which has masked the individuality of the right hemisphere is stripped away with interesting consequences.

Each hemisphere is still able to learn after the split brain operation but one hemisphere has no idea about what the other hemisphere has experienced or learned because their route of communication, the corpus callosum, is no longer functional.

Split brain operations have also managed to throw some light on the different desires of the two hemispheres. In one patient, the right hemisphere stated that he wanted to be an automobile racer while his left hemisphere wanted to be a draftsman.

These hidden differences are allowed to demonstrate themselves after a split brain operation because the two hemispheres are closer to existing independently. One hemisphere may not be able to suppress or influence differing opinions, emotions, or desires of the other because most of the communication between the two can no longer occur. As a result, conflicting hemispheric desires or opinions can cause split brain patients to exhibit some strange behaviors. One patient found his left hand struggling against his right hand when trying to pull up his pants in the morning. While the right hand tried to pull them up, the left was trying to pull them down. On another occasion, he was angry with his wife and attacked her with his left hand while simultaneously trying to protect her with his right!

What is agenesis of the corpus callosum?

Agenesis of the corpus callosum is a disorder where the structure either only partially develops, or fails to develop altogether.

The effects of the disorder range from subtle or mild to severe, depending on associated brain abnormalities. Intelligence may be normal with mild compromise of skills requiring matching of visual patterns. But children with the most severe brain malformations may have intellectual retardation, seizures, hydrocephalus, and spasticity. ACC does not cause death in the majority of children. learning difficulties do not worsen. Although many children with the disorder have average intelligence and lead normal lives, neuropsychological testing reveals subtle differences in higher cortical function compared to individuals of the same age and education without ACC.

Can ACC be treated?

We believe that the developmental problems, which are caused by ACC can be addressed in in a logical manner and that children with this disorder can make developmental progress when treated with a programme of neuro-cognitive therapy.

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Monday, 28 June 2010

The relationship crises of parents of children who have cerebral palsy.

Recently in an online review on Ohio.com, a play was reviewed called 'nervous smile.' The play was about parents of a child with cerebral palsy and the relationship problems their parents face as a consequence of their daughter's difficulties, with the father going off and having an affair and the parents ultimately giving up their daughter. I took issue with the play, (not the reviewer) for presenting false stereotypes of parents. This is my reply to the review.

I read your review of 'Nervous Smile; in Ohio.com and I must say not only was I disappointed by the incorrect stereotype it propagated about the parents of children with cerebral palsy, (parents having affairs, relationships in crisis, etc), but I was disappointed by your seeming blind acceptance of these false stereotypes.

I was father for sixteen years to a child and then young man who suffered profound cerebral palsy. Unfortunately, he passed away six years ago. I can understand you thinking that I am a lone voice, but please hear me out. During the sixteen years of his life and the four years since, I have striven to be come qualified in treating children with CP and other developmental difficulties and have now established an organisation called 'Snowdrop,'(http://www.snowdrop.cc), to do just that.

Parents of children who suffer cerebral palsy DO suffer more stress than many other people, after all, when dealing with a child who has multiple problems, cannot sleep, has trouble feeding, toileting, communicating, etc, it is difficult not to be stressed. However, the play and your article, falsely attribute relationship difficulties which arise from this. - This can be true, but the evidence tells an interesting story. The evidence informs us that the stress of dealing with the problems which cerebral palsy brings has the effect of intensifying the pattern of activity a relationship already has. This means that if the relationship between the parents is already suffering difficulties, the effect of the child's problems will be to intensify those difficulties. However, if the relationship between the parents is good, then the problems, which are brought by the child's difficulties have the effect of strengthening the relationship.

The sixteen years of caring for my own son and the stresses of the six years since his passing, have brought my wife, my two younger sons and myself closer together and motivated me to the point where I am now 'out there' helping other children and families.

I am sure your review of the play, was just that, a factual review of an acting performance and I am certainly not trying to say that it relects your personal opinion, but a positive story about the situation is needed to help restore some truth and balance to the perception which the general public has concerning these issues.

I thank you for your time in reading this and apologise if I have 'ranted' at all. It is just that these issues are very close to my heart.

Best Wishes.

Don't people jump to conclusions easily?

This subject is covered in our books which can be purchased from the Snowdrop website, from Amazon, or direct from Lulu, where they can be downloaded at a fraction of the cost.

Sunday, 27 June 2010

Injury to the Thalamus.

The thalamus sits just above the hypothalamus, below the cortex but above the brainstem. It receives auditory, somatosensory and visual signals from other regions of the brain and routes them through to the appropriate part of the cortex for further processing. As such it is a sort of central switching centre for sensory information on its way to the cortex. Axons from every sensory system (except olfaction) synapse here as the last relay site before the information reaches the cerebral cortex.

It is not difficult to imagine therefore, that injury to the thalamus can produce distortions of sensory perception, which we see in many forms of brain dysfunction, but particularly in cerebral palsy and autism. The problems associated with injury to the thalamus depend upon which area is affected. If the visual processing and receiving areas are injured, visual field dysfunction can result. If the touch perception areas are injured, there can be difficulties in feeling touch and, sometimes, acute pain syndromes. If the auditory perception areas are injured, auditory perception can be impaired. Strokes, known to the medical community as cerebrovascular accidents, can cause something called thalamic syndrome, which results in a burning or aching sensation over one half of the body, often accompanied by mood swings. Injury to the thalamus after a closed head injury can cause something called posttraumatic thalamic syndrome. With this condition, the person advances from overall generalised numbness to random episodes of pain (not stimulus related) or pain in response to non-painful (for normal populations) stimuli. Patients may also experience continuous or periodic unpleasant sensations (freezing, crushing, burning), outbursts of fear or anger, aphasia (a loss of the ability to speak or understand speech), abusive behavior, and/or signs of frontal lobe dysfunction.

More distortion of sensory processing, which can occur as a result of thalamic injury are as follows:

Sensory over-amplification. The particular sensory modality, (vision, hearing, touch, etc) can become oversensitive to stimuli from the environment. It is my belief that in this case, the thalamus, limbic system and reticular formation, which are acting as the brain’s ‘tuning system’ are malfunctioning and are not effectively regulating the level of incoming sensory stimuli. Indeed, in this case they would appear to be acting to over-excite the cortex, which would have the effect of amplifying the sensory stimuli. This could possibly cause the child to overreact, or to withdraw into himself as a defensive strategy from a world, which in sensory terms is simply overwhelming.

Sensory under-amplification. The particular sensory modality can appear to become under sensitive to incoming stimuli from the environment. In this case, I believe the thalamus and other two brain structures, acting as the tuning system, are acting to under-excite the cortex, which is having the effect of appearing to dampen down incoming sensory stimuli. This could influence the child to act as though he cannot see, hear or feel; - he may be deficient in this way, in one or more sensory modalities.

Internally focussed sensory tuning. In this case, the particular sensory modality appears to be ‘inwardly tuned.’. In this case the three brain structures, acting as the brain’s tuning system are exciting the cortex to attend to sensory information of the sensory system’s own making, or from within the child’s own body. Consequently, the child may have difficulties perceiving the ‘outside’ sensory world through this haze of internal stimulation.

Wide spectrum tuning. In this case, the three neurological structures are exciting the cortex and attempting to tune its attention to many incoming stimuli simultaneously. They seem unable to filter out background noise, sights, etc in order to allow the child to focus on one aspect of the environment. For this child, the world is absolute chaos and again, he often withdraws into himself.

Narrow spectrum tuning. In this case, the neurological structures are only exciting the cortex selectively, allowing the cortex to attend to limited, isolated sensory stimuli. This child may often seem ‘over-focussed’ on one particular aspect of his environment. He can for instance, become intensely interested with a spinning top or the particular features of one toy and will not play with anything else, to the point of seeming obsession. For this child, it appears his sensory tuning system is focussed too narrowly and he cannot spread his attention to incorporate several features of his environment simultaneously.

As we can see, brain-injury interferes with the maturation and development of the sensory system in a number of ways. Quite simply, it will have either stopped, slowed or distorted the child’s development.

There we have the bad news about what the effects of injury to the thalamus are for the child. The good news is that you can do something about it! If you are interested in more information about Snowdrop's treatment programmes, visit us at http://www.snowdrop.cc

You can read more about this by purchasing on of our books. They are available from the Snowdrop website, Amazon, or direct from Lulu

Saturday, 26 June 2010

The differing types of muscular stiffness produced by brain injury.

Many people see a brain injured child with his awkward gait, hampered by muscular stiffness and immediately attach the word 'spasticity' to the problem. This is understandable, but spasticity is only one form of muscular stiffness produced by brain injury and is produced by specific types of injury. It is usually injury to the upper motor system which is instrumental in producing spasticity, so one might expect a lesion in the motor cortex, the pyramidal tract, the cortico-spinal fibres, etc.

The simplest way to determine whether a child's muscular stiffness is indeed spasticity is to check for what is commonly referred to as the 'clasp - knife' effect. This is where there is initial resistance to movements of the limb, which then gives way under pressure and movement then becomes possible. This short video clearly demonstrates the clasp - knife effect in action.

The other type of stiffness is known as 'rigidity' and is produced by injury to structures below the cortex, such as the basal ganglia, midbrain and pons. In rigidity there is total resistance to movement and that resistance is continuous throughout the movement, - the limb does not give way.

Many children with spacticity do benefit from a procedure known as 'Selective Dorsal Rhizotomy, which can have the effect of reducing the spasticity and therefore allowing the development of more normal patterns of movement. However, children who in particular have injury to the basal ganglia, where rigidity may be a symptom, are not particularly good candidates.

It is therefore important that physicians are absolutely sure as to which parts of the brain are involved in producing muscular stiffness and whether that stiffness is indeed spasticity prior to any surgical procedure going ahead.

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The treatment implications of music's influence on the brain.

The potency of music and it's affect on memory is quite astonishing. Baroque music and Gregorian chant in particular, with a 60 beats per minute beat pattern, have been shown to activate both the left and right hemispheres of the brain. The simultaneous left and right brain action has a beneficial effect on learning and retention of information. The information being studied activates the left brain, while the music activates the right brain. Activities which engage both sides of the brain simultaneously, such as playing an instrument or singing, causes the brain to be more capable of processing information.

It is claimed that learning potential can be increased a minimum of five times by using this 60 beats per minute music. For example, the ancient Greeks sang their dramas because they understood how music could help them remember more easily.

A renowned Bulgarian psychologist, Dr. George Lozanov, designed a way to teach foreign languages in a fraction of the normal learning time. Using his system, students could learn up to one half of the vocabulary and phrases for the whole school term (which amounts to almost 1,000 words or phrases) in one day. Along with this, the average retention rate of his students was 92%. Dr. Lozanov's system involved using certain classical music pieces from the baroque period which have around a 60 beats per minute pattern. He demonstrated that foreign languages could be learned with 85-100% efficiency in a dramatically shorter time period, by using these baroque pieces. His students had a recall accuracy rate of almost 100% even after not reviewing the material for four years.

In 1982, researchers from the University of North Texas performed a three-way test on postgraduate students to see if music could help in memorizing vocabulary words. The students were divided into three groups. Each group was given three tests - a pretest, a post test, and a test a week after the first two tests. All of the tests were identical. Group 1 was read the words with Handel's Water Music in the background. They were also asked to imagine the words. Group 2 was read the same words also with Handel's Water Music in the background. Group 2 was not asked to imagine the words. Group 3 was only read the words, was not given any background music, and was also not asked to imagine the words. The results from the first two tests showed that groups 1 and 2 had much better scores than group 3. The results from the third test, a week later, showed that group 1 performed much better than groups 2 or 3. However, simply using music while learning does not absolutely guarantee recall but can possibly improve it. Background music in itself is not a part of the learning process, but it does enter into memory along with the information learned. Recall is better when the same music used for learning is used during recall. Also, tempo appears to be a key of music's effect on memory.

This knowledge has profound implications for children who suffer a range of learning and developmental difficulties, such as autism, cerebral palsy and others and the practice of including music as part of any developmental programme is always utilised by Snowdrop.

Anyone interested in more information on Snowdrop's programmes of rehabilitation for children with developmental disabilities such as autism and cerebral palsy should email infor@snowdrop.cc

Also, you can buy our books on Amazon

Friday, 25 June 2010

The Effect of Oxygen on the Brain.

How many of our children have suffered further brain injury through the administration of 100% oxygen? There is a good preventative lesson in this report, which might mean that Snowdrop type services would not be required by so many chidren.
The current practice of administering 100 percent oxygen to children, to prevent brain damage caused by oxygen deprivation, may actually inflict additional harm, researchers at UT Southwestern Medical Center have found.

Brain damage caused by oxygen deprivation, known as hypoxic-ischemic brain injury, is one of the most common causes of death and long-term neurological damage among infants and children. This can happen during birth trauma, near drowning and other crises.

The UT Southwestern researchers found that mice treated with less than a minute of 100 percent oxygen after a hypoxic-ischemic brain injury suffered far greater rates of brain-cell death and coordination problems similar to cerebral palsy than those allowed to recover with room air.

"This study suggests 100 percent oxygen resuscitation may further damage an already compromised brain," said Dr. Steven Kernie, associate professor of pediatrics and developmental biology and senior author of the study, which appears in the July issue of the Journal of Cerebral Blood Flow & Metabolism.

Most of the damage involved cells that create myelin, a fatty substance that insulates nerve cells and allows them to transmit electrical signals quickly and efficiently. Infants have much less myelin than adults; as myelin develops in children they become more coordinated. Areas of the brain with dense areas of myelin appear white, hence the term "white matter."

"Patients with white-matter injuries develop defects that often result in cerebral palsy and motor deficits," Dr. Kernie said.

Myelin comes from cells called glial cells, or glia, which reach out and wrap part of their fatty membranes around the extensions of nerve cells that pass electrical signals. The brain creates and renews its population of glial cells from a pool of immature cells that can develop into mature glia.

In their study, the researchers briefly deprived mice of oxygen, then gave them either 100 percent oxygen or room air, which contains about 21 percent oxygen, 78 percent nitrogen and 1 percent other gases.

After 72 hours, mice given 100 percent oxygen fared worse than those given room air. For example, they experienced a more disrupted pattern of myelination and developed a motor deficit that mimicked cerebral palsy.

The population of immature glial cells also diminished, suggesting that the animals would have trouble replacing the myelin in the long term.

"We wanted to determine whether recovery in 100 percent oxygen after this sort of brain injury would exacerbate neuronal injury and impair functional recovery, and in these animals, it did impair recovery," Dr. Kernie said. "Our research shows even brief exposure to 100 percent oxygen during resuscitation actually worsens white-matter injuries."

Dr. Kernie said adding pure oxygen to the damaged brain increases a process called oxidative stress, caused by the formation of highly reactive molecules. The researchers found, however, that administering an antioxidant, which halts the harmful oxidation process, reversed the damage in the mice given 100 percent oxygen.

"Further research is needed to determine the best possible concentration of oxygen to use for optimal recovery and to limit secondary brain injury," Dr. Kernie said. "Research is now being done to determine the best way to monitor this sort of brain damage in humans so we can understand how it correlates to the mouse models. There are many emerging noninvasive technologies that can monitor the brain."


Interesting isn't it? I wonder if they want to know why this happens?

When we try to administer high concentrations of oxygen to the brain, we actually cut the supply of oxygen the brain actually recieves. This is because high concentrations of oxygen act to constrict the cerebral arteries and veins. Constricted veins carry less blood and as blood carries oxygen, the individual concerned, who might already be in oxygen debt, has his oxygen supply further compromised.

Exactly the same problem is seen in epilepsy, which whether caused by pathology or physiology is a reflexive response to a compromised oxygen supply. The first thing a doctor will do is to supply the individual with oxygen, which very often just produces a bigger, better and more prolonged seizure! They then have to administer massive doses of anti – epileptic medication to undo the damage they have done through administering oxygen and to bring the seizure under control.

So what should be done instead of administering oxygen?

There is a great deal of research, which suggests that carbon dioxide is a good solution to this problem. The brain reacts to higher than normal levels of CO2 by dilating the cerebral arteries and veins. Dilated arteries carry more blood and as I previously pointed out, more blood = more oxygen. Obviously the timing, level and concentration of CO2 administration would need to be carefully controlled, but there is research, particularly with regard to epilepsy that CO2 could provide answers to some serious problems. http://www.medicalnewstoday.com/articles/73558.php

and this book are good sources, just for starters!

So, in summary, the evidence suggests that we should completely review our methods for delivering oxygen to the brain. The direct route of direct administration of oxygen, actually produces the opposite effect to that which is desired and can actually make oxygen deprivation worse, thereby exacerbating the potential for brain injury and worsening neurological symptoms like epilepsy. We need to devise a treatment whereby CO2 enriched air can be administered thereby helping to turn on the brain's own natural anticonvulsant systems and in turn affecting the cerebral vascular system so that it is able to deliver oxygen as necessary. In this way we could not only prevent the occurrence of some types of brain injuries, but we could help to ameliorate the symptoms of those already suffering the consequences of neurological damage.

One thing is certain though, no one should take it upon themselves to administer CO2 enriched air to their child or to anyone else. This should only be done under the guidance of someone who is suitably qualified.

Tuesday, 15 June 2010

Can a head injury cause autism?

With this blog, I am fortunate to have a statistical package which gives me the search term that a person has entered in Google, or another search engine, which has then directed them to the blog. One of the most common questions I see entered is "Can a head injury cause autism?"

The answer of course is, yes!

Of course, autism can be caused by the expression of certain genes and here we see it run in families, usually down the make line of inheritance. The mistake which has been made by scientists researching into the genetics of autism however, is to give the general population the impression that all autism has a genetic component, which of course it certainly does not!

There are many routes to autism, of which the genetic route is just one. Oxygen starvation is another and so is a head injury. Anything which causes a brain to dysfunction on a permanent basis by in some way altering the structural or functional integrity of the neurology can cause the various groups of symptoms, which we come to recognise as autism. How do I know this? Because I treat children who have autism which has been caused by oxygen starvation at birth and I treat children who have autism, who have suffered a head injury. I discuss this at length in my book, 'Autism. - A guide to understanding and helping your child.'

Whatever the cause of autism, treatment is the same. First of all to discover the child's level of ability in all areas of development. Then to investigate any distortions of sensory perception, repetitive or self stimulatory behaviour and practical problems. Then to create a developmental environment and activities within that environment, which will not only help to reduce any problems of sensory perception and repetitive, self stimulatory behaviours, but which will also stimulate the development of the child. For more information on Snowdrop programmes of rehabilitation for autism, email us at snowdrop_cdc@btinternet.com or visit the website at http://www.snowdrop.cc