Understanding Periventricular Leukomalacia
Let’s unravel the mystery of brain
injury
Life’s tender beginnings
are meant to be beautiful and precious. However, in very rare cases, little
babies, especially premature infants, may develop a neurological condition
known as Periventricular Leukomalacia that impair motor control and cognitive function.
In this blog, we’ll help
you understand the intricacies of Periventricular Leukomalacia and its impact
on the developing brain.
What is Periventricular
Leukomalacia?
Periventricular
Leukomalacia (PVL) is a neurological condition that affects premature infants.
It is characterized by damage to the white matter that surrounds the cerebral
ventricles, the regions in the brain that are critical for cognitive function
and motor control. PVL is primarily caused by complications during premature
birth. Typically, due to insufficient oxygen or limited blood flow to delicate
brain regions, the damage can be extensive.
Although PVL is lifelong,
it can be managed with early intervention, supportive care, as well as
therapeutic approaches that focus on minimizing the brain injury’s impact on
the child’s development.
Causes of Periventricular Leukomalacia
The exact cause of PVL is
difficult to ascertain. However, research suggests that the condition is caused
by lack of oxygen and blood flow to the brain. As mentioned above, this is a
risk that is heightened during a premature birth, because the brains of
premature babies are extremely fragile and prone to injury. Other factors that
can be attributed to PVL include:
● Intraventricular hemorrhage (bleeding in
the brain)
● Rupture of membranes (in the amniotic sac)
during premature birth
● Uterine infections
Symptoms of Periventricular Leukomalacia
The most common symptoms of
PVL include:
● Vision trouble
● Difficulty in eye movements
● Trouble with gross and fine motor
movements
● Tight muscles
● Developmental delays (these become more
apparent as the milestone windows are surpassed)
Note: Infants and children
with PVL can exhibit all or some of the above mentioned symptoms. Early
detection is critical for early intervention and supportive treatments.
Although PVL primarily
affects premature infants, there have been instances of the impact of PVL
extending well into adulthood, resulting in late-onset or persistent symptoms. Periventricular Leukomalacia
symptoms in adults can be:
● Motor impairments
○ Abnormal gait
○ Balance and coordination difficulty
○ Muscle weakness and/or stiffness
● Cognitive impairment
○ Attention and concentration troubles
○ Executive function deficits
○ Memory problems
● Speech and communication difficulties
○ Trouble with articulation
○ Trouble with expressive language (verbal,
non-verbal, written)
○ Persistent language challenges
● Vision disturbances, particularly depth
perception or visual-motor integration
● Fatigue
● Difficulty in performing everyday tasks
● Difficulty in adapting to educational or
work environments
● Increased predisposition to secondary
conditions, such as joint issues or contractures because of restricted mobility
Therapeutic Approaches to PVL at
Plexus
The most widely prescribed
and recommended treatments for PVL include physiotherapy, speech therapy,
occupational therapy, and vision therapy.
At Plexus, we pride
ourselves on being India’s most advanced centre for the above mentioned
therapies. What’s more, we also offer PVL rehabilitation packages that are
tailored to suit your precious little one’s needs.
Stem
Cell Therapy for Periventricular Leukomalacia
Known for their
anti-inflammatory and immunomodulatory properties, mesenchymal stem cells
(MSCs) have shown incredible promise in managing PVL. By differentiating into
new nerve cells, MSCs have been known to promote neurogenesis, reduce
inflammation, and provide trophic support to tissue damaged by the condition.
At Plexus, we use MSCs sourced from the patient (adipose tissue, bone marrow,
etc.) or from umbilical cord tissue.
Read more about stem cell therapy at Plexus here.
Physiotherapy
for Periventricular Leukomalacia
The primary focus areas of
physiotherapy for PVL are enhancing strength, mobility and coordination, as
well as addressing any other unique challenges faced by the child. After a
tailored assessment, our highly trained physiotherapists will provide a personalized
program that may consist of a combination of the following targeted
interventions:
● Muscle tone management
● Gait training
● Balance and coordination enhancement
● Achievement of developmental milestones
● Assisted devices
Read more about Physiotherapy at Plexus here.
Occupational
Therapy for Periventricular Leukomalacia
Occupational therapy at
Plexus enhances the child’s functional abilities that are impeded by PVL. Our
programs are designed to foster independence and encourage meaningful
participation in daily life. To this end, we offer the following:
● Fine motor skill development
● Activities of daily living (ADL) training
● Sensory integration
● Cognitive skills enhancement
● Adaptive equipment
● Emotional support and counseling
● School readiness
Read more about Occupational
Therapy at Plexus here.
Speech
Therapy for Periventricular Leukomalacia
Following an early
communication assessment, our highly skilled speech and language therapists
will offer targeted interventions that address communication and language
challenges, as well as encourage effective expression. We help your child to:
● Hold conversations with others
● Speak clearly and intelligibly
● Develop higher self-esteem
● Confidently participate in school and
social settings
Read more about Speech and Language Therapy at
Plexus here.
Vision
Therapy for Periventricular Leukomalacia
While motor and cognitive
impairment are most commonly associated with PVL, there are rare instances of
the child’s vision and eye health being severely impacted too. For these cases,
vision therapy is recommended to promote optimal visual skills, as well as
improving overall functionality.
Following a visual
assessment, a visual therapist will create a therapeutic program that comprises
the following:
● Eye teaming and tracking exercises
● Binocular vision training
● Visual motor integration activities
● Sensory integration
● Visual field expansion
● Colour and contrast sensitivity training
● Assistive devices
Along with therapeutic
rehabilitation, medical interventions and support from family and caregivers
can greatly enhance the quality of life of these little lives affected by PVL.
If you wish to know more
about therapeutic programs, please reach out to our teams in Bangalore or
Hyderabad today.
WhatsApp +91 89048 42087
Call +91 78159 64668 (Hyderabad) | +91 82299 99888 (Bangalore)
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FAQs
Can a baby with PVL live a normal
life?
Early therapeutic
interventions like physical therapy, occupational therapy, speech therapy, and
supportive care can empower many children with PVL to lead fulfilling lives.
Can PVL be cured?
The treatment for PVL
focuses on managing symptoms and improving functionality. Early intervention
and therapies have been known to greatly enhance a child's quality of life.
What is the best treatment for
PVL?
Presently, the treatment
for PVL follows a multifaceted therapeutic approach involving physical, occupational, and speech
therapies. In order to address specific symptoms your child’s doctor may
prescribe certain medications too. Surgery is considered only in severe cases.
Your child’s doctor will be able to provide you with a personalized approach
based on your little one’s unique needs.
How serious is PVL?
PVL is a serious condition,
primarily affecting premature infants. There have been very severe cases of PVL
that have resulted in cerebral palsy, or other serious mental and physical
delays.
What causes PVL in babies?
Premature birth leading to
oxygen deprivation or blood flow issues during the perinatal period contribute
to white matter damage around the cerebral ventricles, leading to PVL in
babies.
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