Doctor challenges ‘no recovery’ diagnoses for cerebral palsy cases
Bad habits, not a bad brain, afflict many patients, says neuroscientist
TORONTO — Just sitting upright is a battle for two-year-old Jack Pankratz, and so his mother, Kim Kucher, offers a steady hand and lots of encouragement.
The toddler wobbles even in her arms, as he sways this way and that to look up at the ceiling or yank the corrective glasses off his head.
Jack was diagnosed with cerebral palsy at nine months — the result of a difficult birth in which he suffered oxygen loss to the brain. Doctors predicted permanent cognitive and physical disabilities.
More than a year later, Kucher says he’s already defying the odds with the ability to perform a daily regime of barrel rolls, walking drills and core strength exercises.
She credits this in large part to unconventional brain expert and neonatologist Dr. Karen Pape, who gave her something no other medical expert could: hope.
“With some of the medical opinions we were getting, it sort of seemed doom-and-gloom for Jack,” says Kucher.
She found much-needed support from neuroscientist Pape, a former director of the neonatal followup clinic at Toronto’s Hospital for Sick Children, who is challenging traditional notions of baby brain injuries.
“The basic mistake is assuming that there is no recovery,” Pape says of the most common childhood motor disability, which afflicted 42,679 Canadians in 2010-2011, according to Statistics Canada.
Pape outlines the theory in her book, The Boy Who Could Run But Not Walk, in which she argues against the prevailing belief that a cerebral palsy diagnosis inevitably means lifelong, permanent disability with no cure.
Instead, she says the typical limping gait associated with the condition is a bad habit formed by toddlers with an immature brain still recovering from intense trauma. And bad habits can be replaced by good ones.
The epiphany came after the mother of a former patient announced that her son had just made a competitive soccer team, despite the fact he still limped on the left side with one arm held up. So Pape asked the boy to run.
“And he just took off like a bat out of hell down to the other end of the hallway, running perfectly. And then he did a perfect pivot turn,” she says. “And he comes running back and right in front of me he does a perfect pivot turn on his damaged leg.”
It made no sense, until she considered the neuroplasticity in adults who had suffered a stroke and yet went on to a full recovery.
She concluded that this boy’s abnormal walk — something normal to him since he never learned to walk properly to begin with — hid the fact his brain had actually healed. And it was with this healed, more sophisticated brain, that he learned to run perfectly.