Hyperbaric Oxygen Therapy

HBO therapy is a medical treatment that uses the administration of 100 percent oxygen at controlled pressure (greater than sea level) for a prescribed amount of time—usually 60 to 90 minutes. HBO therapy is commonly used to treat conditions such as burns and difficult healing wounds. HBO therapy facilitates healing in these conditions by increasing the amount of oxygen in the blood by up to 2000 percent, depending on the treatment depth. This in turn dramatically increases the amount of oxygen at the cellular level.

In the case of cerebral palsy in children, HBO therapy is administered at 1.5 ATA or equivalent to a depth of 16.5 feet below sea level. Some research has been completed using treatment depths up to 1.75 ATA, or 25 feet below sea level, with positive results. Each treatment lasts one hour and one or two treatments are prescribed each day, five or six days per week. The total number of treatments given in each case varies. It is common to administer 40 treatments in the first phase of treatment. The question of further HBO therapy is then resolved by the medical team involved in each case and is dependent upon a number of factors. However, many believe that if improvement is observed in the first phase of treatment, then a break of one to four weeks should be taken, followed by another 40 HBO treatments.

Promising Therapy
Why does HBO therapy show promise in helping cerebral palsy patients? First, let’s confirm some . . . facts. Cerebral palsy is the result of damage to motor areas in the brain. This in turn disrupts the brain’s ability to properly control the movement of the body’s muscles. What causes this damage? A National Institute of Neurological Disorders and Stroke (NINDS) study found that in most cases of CP, no direct cause for the damage could be found. In other words, cerebral palsy is a result of the brain not properly communicating with the muscles because the brain has been damaged for one reason or another.

Documentation now exists that clearly shows that HBO therapy can dramatically improve some CP symptoms. For example, a study in Brazil1 revealed a 50 percent reduction in spasticity of 94 percent (218 patients) of the patients involved in the study. Improvements have also been seen with vision, hearing, and speech. However, one should understand that improvement, if any, will vary from patient to patient.

Dormant Areas
Back to our question, “Why does HBO therapy show promise in helping cerebral palsy patients?” In order to answer this question we need to look at one of the terms that we use to describe the type of brain injury involved in cerebral palsy. The term is traumatic brain injury.

Traumatic brain injury (TBI) is a condition in which certain nerve cells in the brain may be permanently destroyed. Conditions such as stroke and cerebral palsy are forms of TBI. It is important to note that although some of the brain may be permanently damaged when TBI occurs, a much larger area surrounding the permanently damaged area may also be affected. This larger area may be in a dormant state because the amount of oxygen it receives has been reduced due to a decrease in blood flow. Swelling and a change in cell physiology can cause reduced blood flow.

Reduced blood flow—and the resulting decrease in oxygen levels at the cellular level—as well as the swelling of brain tissue are of particular importance when attempting to understand traumatic brain injury and cerebral palsy in children. This is because some researchers believe that the lack of oxygen and swelling of brain tissue plays a part in the inability of the myelin sheaths to develop.

Myelin sheaths are coverings that protect nerve fibers in the brain. These nerve fibers connect the brain to the spinal cord and they play an important role in impulse transmission. The process of myelination—that is, the action of the delicate myelin sheath cells as they envelop the brain’s nerve fibers—begins a month prior to birth and continues until about two years of age. If myelination does not properly occur, the nerve fibers are left exposed and they slowly deteriorate. This disrupts communication between the controlling nerve cells in the brain and the muscles. The result may be spasticity.

Given the presence of just a small amount of oxygen, the cells in the dormant area may remain in this suspended animation state for many years. The dormant area is often referred to as “not dead but sleeping.” This is where HBO therapy shows such promise. It is believed that the high oxygen levels that are attained in the body’s cells during HBO therapy cause a physiological change to the cells of this dormant area—effectively waking them up—thus, increasing the capacity for recovery. It is also believed that HBO therapy reduces swelling in the brain by constricting blood vessels, and provides an ideal internal environment for the growth of new brain tissue.

It should be remembered that HBO therapy is not a cure, but a method of ensuring that the most complete recovery possible takes place. The degree of improvement will vary from patient to patient because the amount and type of damage to the brain varies with each patient.

The SPECT Scan
Modern technology has been a positive factor in the treatment of cerebral palsy and other forms of traumatic brain injury. Specifically, SPECT imaging, or what is commonly termed the SPECT scan, is helping to identify those parts of the brain that are in a dormant state due to a lack of oxygen. As Dr. Philip James of the Wolfson Hyperbaric Medicine Unit at the University of Dundee in Scotland has stated, “Loss of function in the brain can be either due to tissue swelling, which is reversible, or tissue destruction, which is not.”2 When we combine what Dr. James said with what the SPECT scan can do, it is clear that the SPECT scan can help us identify those parts of the brain that stand a chance of being revived.

SPECT stands for Single Photon Emission Computed Tomography. The SPECT scan can give a clear picture of which parts of the brain are awake and working, which parts are dormant and sleeping, and which parts are lifeless and permanently damaged. This is of particular significance when considering HBO therapy because, to be blunt, the SPECT scan has the ability to indicate if HBO therapy is working or not by monitoring the change in brain tissue blood flow.

Let’s Sum Up
Some brain cells become dormant due to a lack of oxygen, which can be caused by reduced blood flow. Swelling can cause reduced blood flow. HBO therapy has been shown to reduce the swelling of brain tissue by constricting blood vessels. Also, HBO therapy dramatically increases the amount of oxygen at the cellular level, which, it is believed, may revive dormant, oxygen starved areas of the brain.

Thank you to the Chico Hyperbaric Center at for this page content.

HBOT VIDEO 1 (3.5 minutes)

HBOT VIDEO 2 (45 seconds)

Special thanks to the philanthropic contributions of Charlie Pabst from Charfish Design for his fabulous Maggie’s Month header, and Abe Fawson from GoodFront for his expertise in WordPress.

  1. […] and generosity given in support of Maggie, I wanted to keep you updated on her progress with the HBOT treatment! As you may know, the Royal Ball was in benefit of Maggie to raise the money needed for these […]

  2. […] Thank you so very much to those who were able to attend Princess Amerah’s Royal Ball! The event turned out to be such a beautiful success – raising $2,700 for Princess Maggie’s HBOT treatment! […]

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