Cerebral palsy (CP) is a group disorders of movement that takes place during infancy and early childhood. CP can be classified into 4 types, namely spastic, athetoid, ataxic, and hypotonic. The symptoms may vary depending on individuals. Common symptoms include muscle stiffness,  muscle weakness, difficulties in swallowing and speaking, tremors, bone deformities and developmental retardation. There may be problems with sensation, hearing, vision and touching.

In general, infants CP can be diagnosed based on early symptoms such as stiff bodies, difficulties in feeding and swallowing, poor sleeping, and no responses to external stimuli. Besides, around one-third of patients are complicated with cognitive disorders and epilepsy. The CP symptoms which mentioned above could occur after the birth, but would not get worse as patients getting older. Currently, commonly used treatments for managing CP include oral/IV medications, surgeries (orthopedic and neurological surgery), occupational and physical therapies, and electrotherapy. Even though CP does not progress with ages, patients’ tissues and joints would become stiffer if they don't take rehabilitation treatments. Unfortunately, there is no cure for CP at the moment.

The causes of CP can be classified into three types according to pregnancy, delivery and after birth period. First, the causes during pregnancy may include developmental delay, mother with drug poisoning, infections with German measles or Herpes zoster, or been in contact with radioactive substances. Second, the causes during delivery include fetal dystocia, brain haemorrhage, birth trauma and nuchal cord may occur. These damage may lead to hypoxic brain injury or encephalopathy. Third, CP can also develop after birth period when babies have severe jaundice, cerebrovascular disease, meningitis-induced neuronal injury, etc.

The main cause of CP is due to hypoxia damage of brain, containing 75% of all CP patients. There are two stages of damage in brain. The first stage is brain cells which unable to obtain the oxygen, leading to cell death and brain edema. The second stage is blood reperfusion. The blood reperfusion can transport nutrients and oxygen to ischemic sites. However, it also generates lots of ROS (Reactive oxygen species) and accumulation of glutamate excitotoxicity that destroy mitochondrial function of neural cells. This secondary damage of neural cells death affect nervous system development of infants before the one year old. Finally, it leads to irreversible neuromuscular functional damage.

According to WHO’s data, the incidence rate of CP is around 0.2% to 0.5%. Thus, roughly 400 to 1000 new patients with paediatric cerebral palsy can be estimated each year in Taiwan. The male to female ratio is between 3 to 5. Underweight preemies are especially high-risk with higher chance of having CP than normal babies. Due to CP is a movement disorder which often comes with other complications. It is not easy to take care of babies with CP, of which the families usually have to face huge pressure. Thus, parents who have CP babies need, not only psychological supports, but also substantial assistances from the society.

Among the causes of CP, current treatments, either the surgery or the medication, could target only one single cause to manage the situation, rather than cure all the symptoms. Therefore, it is necessary to develop new medications and therapies. Recently, many studies have shown that MSCs had multiple protection and modulation capabilities, such as promoting angiogenesis, promoting endogenous neural cell differentiation, immune-modulation, neuron-protection, anti-oxidative stress, and anti-apoptosis. These data suggest that treatments for CP by using MSCs-based drugs have tremendous potential.

Current treatments for CP include medications and surgeries, while each way has pros and cons. Medications can be classified into oral or IV (intravenous) delivery. The most used oral medication is muscle relaxant, however, it comes with side effects like fatigue and lethargy. The IV medications are neurotransmitter antagonists such as botulinum toxin and baclofen, which aimed at inhibiting abnormal signal transduction at neuromuscular junctions and reducing cramps. However, these drugs may cause muscle weakness and require injection every half-year. On the other hand, the main purpose of surgeries is to improve patients mobility and daily activities. Such surgeries include bone-correction, muscle-tendon and selective dorsal rhizotomy. Muscle weakness is a common sequelae that needs to be treated with physical therapies. Other therapies involve OT, PT, electrotherapy, splints and assistive devices. All the treatments which mentioned above should be conducted after doctors’ evaluations. Co-treatment is commonly used to manage the symptoms. By now, there is no treatment that can fully cure patients with CP.