Mumbai doctors give new lease of life to 3-year-old child living with cerebral palsy

For many parents a childrsquos first steps are a moment of joy For one family however their baby girlrsquos early steps were accompanied by worryDoctors in Mumbai successfully treated a threeyearold girl diagnosed with spastic diplegic cerebral palsy through a minimally invasive singlesession intervention and helped her move closer to a more natural way of walking The procedure was led by Dr Taral Nagda senior consultant ndash Paediatric Orthopaedics at Narayana Health SRCC Childrenrsquos HospitalHer journey had been delicate from the very beginning Born prematurely at seven months weighing just 1250 grams she had spent her earliest days in the NICU for three months as her tiny body learned to stabilise and grow As she got older there were small signs that things were not following the usual growth pattern She reached her milestones a little later than expected even walking independently which she did at 16 months Yet in so many other ways she was thriving Since her speech hearing and vision were completely normal her walking pattern stood out more sharply Her parents who watched her closely hoped it would settle as she grew up But it didnrsquotInstead they saw a clear pattern emergingmdashthe child walked mostly on her toes her feet rarely touching the ground fully This equinus gait as it is medically known brought her to the hospital On examination there was tightness in her calf muscles spasticity but more on the left side Further investigations were done to find out the reason A brain MRI revealed periventricular leukomalacia patches pointing to a hypoxic injury that had affected the areas of the brain responsible for controlling her legs The diagnosismdashspastic diplegic cerebral palsymdashfinally gave a name to what the child was experiencingBy this time she was already undergoing regular physiotherapy a routine that many families of children with cerebral palsy become familiar with since diagnosis But therapy alone may not be enough especially during periods of rapid growth The muscles which are tight struggle to keep up with growing bones and gradually pull the body into gait patterns that can become hard to reverseKeeping this in mind a team of doctors at the hospital planned a combination treatment with botulinum toxin injections to help relax the tight muscles and USGguided percutaneous myofascial release to physically release the tightness During the procedure 100 units of botulinum toxin were administered into the adductors hamstrings and calf muscles followed by a sutureless release under ultrasound guidance What stood out was how immediate the change wasmdashthe tightness eased and the alignment of her foot improved right then almost instantlyThe procedure itself was brief lasting about an hour and gentle on the childrsquos bodymdashwith no incision minimal discomfort and negligible blood loss A belowknee cast was applied to maintain this correction and after a short threeday hospital stay she was ready to go home Perhaps the most reassuring moment for her parents came when they saw the child start walking from the very next day after discharge with supportAt this stage in life the brain is still learning and adapting By correcting the way her muscles and joints move the intervention will help guide her brain towards more natural movement patterns reducing the chances of longterm complications and giving her better mobility as she growsExplaining the case Dr Nagda said ldquoIn children with spastic diplegic cerebral palsy the affected muscles often fail to keep pace with bone growth leading to tightness and abnormal gait patterns like equinus gait The key is to intervene at the right time before these changes become permanent contractures and before the childrsquos brain adapts to an abnormal walking pattern With a combination of botulinum toxin injections and USGguided percutaneous myofascial release we were able to correct the deformity in a single sitting restore more natural movement and support both the childrsquos physical development and emotional confidencerdquoSometimes the smallest changesmdashlike how a child places her feet on the groundmdashcarry the biggest implications for her future This case shows how timely intervention in cerebral palsy can gently change the trajectory helping a child not just walk better but grow with greater confidence ease and independence