WHAT'S NEW IN CEREBRAL PALSY

Among new researches bearing on cerebral palsy are the growth of brain cells in tissue cultures for experimentation; the use of polysaccharides to prevent the formation of a glial barrier to nerve growth after injury; observation of changes in reactions of neurons at various stages of development; the finding of hypernatremia and hyperchloremia in lesions of the frontal lobe and the thalamus; stimulation of cerebral blood flow by injection of sodium bicarbonate and retardation with ammonium chloride; and studies of serial sections of brains of palsied children who died.Study of development in the early months of life has made possible the detection of significant abnormalities in behavior early in life. Loss of hearing may be tested in very young children by measuring minute variations in electrical resistance of the skin upon auditory stimulation of the sympathetic nervous system.Conditions which have been described as having been confused with cerebral palsy are dislocation of a cervical vertebra, hereditary spastic paraplegia, transverse myelopathy, injury to the spinal cord or cauda equina by anomalous growths of the spine, and also encephalitis and meningitis.Sedation has proved a valuable adjunct to electroencephalographic study of cerebral palsy. Better criteria for abnormality in the young child should be determined and the application of them more clearly standardized.Simple exercises are useful for early training of palsied children to stimulate development. “Crossed laterality”—the dominant eye being contralateral to the preferred hand—has been counteracted by special training with great success in eliminating emotional and behavior problems and accelerating development.Recent studies indicate that only 50 per cent of cerebral palsy patients have normal or better intelligence.Subluxation of the hip joint, a common deformity associated with cerebral palsy, can sometimes be corrected by operation if detected at an early stage. Radical ablation of epileptogenic foci in the cortex is also being done in young patients if drug control of seizures fails. Frontal topectomy, cingulate gyrectomy or prefrontal labotomy may be advisable in cases in which proper response to drug therapy is not obtained.Improvement in behavior as well as control of seizures may follow the use of Benzedrine,® Dexedrine,® Dilantin® sodium, Mebaral® and phenobarbital. Alcohol, paraldehyde and chloral hydrate have been effective as relaxants.     

INDICATIONS FOR PULMONARY RESECTION IN INFANTS AND CHILDREN

Improvements in anesthetic and surgical techniques, and the availability of antibiotic drugs have made pulmonary resection a safe procedure for even newborn and very ill infants when it is necessary for treatment of bronchiectasis, abscess of the lung, tumors, and congenital cysts, both infected and noninfected.In a series of 34 infants and children upon whom lobectomy or pneumonectomy was done, all were cured of the disease which dictated the operation. There were no deaths.