Two years ago, Adam Leon, 16, couldnt raise his right arm.
He has cerebral palsy caused by a stroke before or just after birth that left his right arm and wrist stiff.
Then in January 2012, Adam started getting Botox treatments from Dr. Roberto Lopez-Alberola, a pediatric neurologist at the University of Miami Miller School of Medicine. Every three months, Lopez-Alberola injects the toxin into the affected muscles using electromyography to hear the nerves firing and target the right ones.
Actually its the nerve were paralyzing. The muscle that was previously very tight or spastic now becomes relaxed, Lopez-Alberola explained.
They put electrodes on my upper arms, and then the doctor injects the syringe full of the Botox, Adam said. The machine makes noises. [The targeted muscle] sounds like static, Adam said.
The injections, coupled with intensive physical therapy and workouts in a Kendall gym with a personal trainer, have enabled Adam to extend his arm.
I can carry groceries, I can turn doorknobs, it improves my balance, Adam said, adding that it takes a lot of brain power to learn to work unused muscles.
Before, I felt low. My arm was so stiff and everyone would look at me, but now its getting better, said Adam, who specializes in the mile run. He hopes to continue the treatment as long as it takes to get equality between my left and my right arms.
Adams therapy is one of several innovative treatments for cerebral palsy in South Florida.
Unfortunately, the Botox treatment, although its been used for over 15 years, it doesnt even yet have the FDAs approval for children. Yet in the rest of the world, its pretty much standard, Lopez-Alberola said. The injections, along with physical therapy, Lopez-Alberola said, have made a dramatic impact on the quality of life.
Lopez-Alberolas patients range from age 2 to early 20s. I have kids that play baseball, ride a bicycle, play gymnastics, he said.
Thomas Blood is hoping his daughter Ezabella, 6, will be able to walk and run with her friends one day. He was trying to arrange for surgery in St. Louis when he learned that Dr. Dean Hertzler was doing the same intricate surgery at Joe DiMaggio Childrens Hospital in Hollywood.
Ezabella, whose cerebral palsy affects her legs, had a selective dorsal rhizotomy in February in which a two-inch incision is made at the end of the spinal chord to expose the nerve rootlets that control the legs. With a microscope and a team of neurophysiologists, Hertzler examines each of the individual nerve fibers to figure out which of the sensory nerves are misfiring and cut them out.
We separate the bundles and test each nerve ending, Hertzler said. Usually because of the brain damage that has occurred from perinatal issues causing cerebral palsy, these nerves never formed normally so they have these very abnormal hyperactive circuits that are constantly firing and causing really spastic, increased muscle tone, Hertzler said.
The surgery, Hertzler said, can change a kid who has trouble just walking across the room because their legs are so spastic to someone who can walk almost normally.
Before their legs are almost locked into a posture thats very hard to move. After surgery you can freely move and bend their legs, Hertzler said.