The ability of the human brain to grow new cells, to repair damaged cells, and to re- organize the function of different parts of the brain are all characteristics of a process called neuroplasticity. This process of repair and reorganization is a new scientific fact, elegantly demonstrated by brain scanning techniques, such as functional MRI and PET scans. It is one of the most important medical discoveries of the past 50 years. It offers new hope to people with a wide variety of neurological problems and even provides hope of improved or restored brain function to the aging baby boomer. But it is a new truth and new truths are hard to swallow, particularly in the relatively conservative arena of medicine. The German philosopher, Arthur Schopenhauer, eloquently described the process of accepting a new truth.

“All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as self-evident.”

In the field of adult neurology, neuroplasticity has made it through the first 2 stages and is on its way to widespread acceptance. In Dr. Norman Doidge’s book, “The Brain That Changes Itself”, he describes cutting edge treatments that are changing lives now and slowly changing the standard approach to common brain problems such as stroke. The future for adults with brain injuries or disease is not what it used to be.

Unfortunately, for a child with cerebral palsy or other early-acquired brain injury, the future is still what it used to be. Commonly accepted medical wisdom states that cerebral palsy cannot be cured. Cerebral palsy, the “incurable” brain injury, ranks at the bottom of the heap in both public and private dollar funding available for either cure or care. This attitude is surprising. A poor outcome for the child with cerebral palsy is not what you would expect from animal studies. It has been demonstrated in many species that young animals recover faster and more completely than adult animals. If cerebral palsy truly cannot be cured, then we would have to believe that:

Adult rat brains recover
Baby rat brains recover better
Adult human brains recover
Baby human brains do not recover

What a paradox! Adult humans can recover, why not children? It is just not logical to hold to the belief that the young of the human species has different mechanisms of brain recovery than the adult. An adult human with a mild hemiplegic stroke, affecting one arm and leg, can expect to recover most, if not all, of their pre-stroke function. Complete recovery or cure has been documented in up to 30% of first time ischemic strokes. Based on current neuroscience, a child with a similar mild hemiplegic stroke should also have a great shot for cure. But they don’t! The child with a young growing brain has hemiplegic cerebral palsy for life. To add insult to injury, parents who want a cure for their children are deemed to be unrealistic or in denial of reality.

In the evolution of science, what we believe to be true will change, as new facts are uncovered. The new fact of human neuroplasticity is widely accepted by the scientific community and is the focus of innovative experiments in the fields of basic and applied neuroscience and cognitive psychology. Adult brains are capable of recovery and baby brains are also capable of recovery. To claim otherwise is both illogical and unsupported by current neuroscience knowledge. Not only do baby brains recover to some extent after an early insult, but they also continue to grow and change with experience throughout life. The problem that neuroplasticity presents is that this one concept changes many of the underlying assumptions of the field and demands an entirely new model of care for children. Neuroplasticity is a true “game changer” for the pediatric rehabilitation world.

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  1. I think child’s hemiplegia (connat.) is the most sophisticated clinical picture we know. The origin (fetal stroke), the diverse neuropathology (from “nothing” to the absence of a hemisphere, but first of all: the hypoperfusion of thalamus contralaterally; and the intrauterine onset of regeneration make it exceptionally hard to understand. The outlook of a certain child depends on genetics, upon early intervention (but not on the constraint) and on the degree of somatosensory neglect.

  2. I think that the statement “degree of somato-sensory neglect” is so crucial. My clinical observations continually confirm the concept of improved function/recovery in the presence of increased/improved somato-sensory input (in the context of purposeful and deliberate active movement).

  3. Karen,
    It is so refreshing to read your blog (I just found today).
    I’ve worked with babies and children for 37 years with neurological impairments and designed neuroplastic techniques. In addition, I teach a seminar “Neuroplasticity for Children” and have had positive responses.

    • Thank you for your comment Karen, Glad to add you to the growing number pioneers advocating for a new way of thinking about early brain, nerve or spinal cord injury in children.I sense that the tide of resistance is starting to change. All the best, Karen

    • Hi Karen

      We are parents to Millie (10 months) from the UK. Millie has a working diagnosis of HIE and severe cerebral palsy. She has a very weak gag and swallow. They used therapeutic hypothermia when she was born and she now opens her eyes, moves her hands and feet and vocalists. She is fed via NJ tube and is only 10 lbs in weight but is gaining daily. She produces excessive secretions which we suction many times in a day

      I work as a Resuscitation Officer for the UK NHS and my background is pre hospital care and anaesthetics. My wife is also am Anaesthetic Practitioner at the same hospital in north-east England

      We work very hard with her and use a lot of Anat Baniels techniques to good affect. Obviously we want Millie to reach team best potential possible and I was wondering if it would be possible (given your work with brain injured kids ) to contact you with a view to discussing Millie. Her full medical record would be made available to you

      Kind Regards

      • Unfortunately, I am no longer in clinical practise. In too many cases, people tend to give up too early in infants with significant brain damage.In adults with brain injury it takes 3-4 years for the brain to complete spontaneous recovery and in babies, it may take longer. Plus baby brains are actively growing. In The Boy Who Could Run But Not Walk,I write about ways to stimulate neuroplasticity and help the process along. I hope it helps.

      • Hi
        I just read your post. I have an 18 month old woth global delay. They are now telling me that she may have a rare genetic disorder but they do not know. Her Mri was normal but her brain is not functioning properly. Any advice or information you have to offer would be very much apprecied. Was there findings on your baby’s mri? My baby stopped breathing for minutes when she was 3 weeks old. The Drs at the emergency told our family that it just looked like she wasn’t breathing. The baby was turning blue my mother did cpr. They said it was a response to her severe acid reflux. She had low blood sugar when she was born and has low muscle tone and had excess mucus when little. We had to suction her many times a day or she wouldn’t have been able to breath. Hope to hear from you.

        • Dear Amy, Getting an accurate diagnosis is important . I would ask to see a genetic expert and possibly a metabolic one as well if the genetic screening does not give you an answer. Hope this helps.

          • Hi, thank you for your response. She had a micro array done and that’s normal. They also checked for sticklers syndrome and she doesn’t have that. They are lost here and have told me they think it’s genetic but rare and they have no idea of what to look for. Do you have any specific suggestions? Also metabolically is there something specific I can request? Thank you so very much

        • Hi Amy, what ever you do don’t give up. My daughter is now 21. The doctors labeled her with autism even though they knew she lost oxygen during labor, I had strep B infection and got sepsis during the last hour of labor. I know what happened, but because of fear of lawsuits. Nobody will ever fess up. Never give up. I still haven’t. The more you push your little one with early intervention the better. I have been refused any MRI’s for 20 years, because every doctor sees it as a waste of time and money. They say “she has autism. That’s it! Stop trying to make her better.” That infuriates me and I think that’s part of the problem within the medical field. Doctors just want to make everything black and white and it’s not right. If more doctors were willing to dig a little, take a look at the brain injured child to see what they can find. Maybe then data can be taken and we can get on the right track to recovery. Ask for a different MRI? I want one with contrast so I can see what part of my daughters brain is working or not. I want to know before I die. I need to be able to treat her with supplements at least. And if we can identify where and what damage is in the brain. Then maybe we can try to figure out a way to help. Even if it’s therapy. We need to know what road in therapy would work best. I wish doctors would stop with the autism spectrum diagnosis and look a little deeper or outside the box. There’s more to our kids and we need to know everything and anything we can do. Even if it helps a drop. Supplements, therapy and diet all help a little. I’ll take what I can get to bring any comfort to my daughter, but it would be nice if parents could get more advice from doctors instead of always doing my own trial, error and research. The best of luck to you, your little one and family.

  4. Hi Karen,
    I am blessed with a baby boy, yet with challenges. He is 18 mnths old now. He was born HIE2. His left hand and left are functional. Right hand and right leg are effected badly. Can you help us with some information about neuroplasticity.
    Syam Sundar

    • Thank you for your email. I am a strong advocate of active early intervention during the first 4-6 years of life. I would start by reading my book,The Boy Who Could Run But Not Walk, and then discuss your son’s diagnosis and treatment plan with your doctor. He should have a diagnosis given and start with a physical and occupational therapist. As well as chapter 11, What To Do in the First 4 Years, there are references in the chapter notes that may be of interest to your health care team.

  5. Hi Karen,
    I am blessed with a boy, he is 35 days old. The doctors have detected some injuries in his brain. My boy can eat, breath and also moves hands, legs. He has normal eye movement and turns his head around to see. Can we know how much the injuries will affect his future life? Also is there any chance for his recovery

    • Dear Asik, the best we can do early on is to have your doctor explain what they see on his brain scan. The second important factor is his clinical condition, which you describe as being quite normal. Ask to see an early intervention therapist to get started and I would remain optimistic.

  6. Hi Karen, I am writing about my right month old grandson who was almost killed by my daughter’s boyfriend when he was five weeks old. His skull was fractured almost all the way around his head. He has been diagnosed with severe cerebral palsy and the doctors say there is no chance of his brain ever being able to repair itself at all. A matter of fact they say that everywhere there is damage is and will continue to deteriorate. Do you think there is any hope of my precious boy being able to be happy? Sometimes he seems like any other baby and a day doesn’t go by that he doesn’t smile. The doctors say he is only smiling as a reflex, not because he is happy or even knows that he’s smiling. 🙁

    • Dear Shannon, I’m so sorry that your family has been hit by this tragedy. There is no way for me to comment on the potential for grandchild to recover, but I would take some comfort in the fact that he is smiling and is comfortable. Only time will tell when there is such severe damage. I’m sorry I cannot give you more positive news.

  7. Hello sir,my son 15 months old underwent collagen surgery and had cardiac arrest for which he resuscitated and he is now post cardiac arrest stabilization…MRI is is showing t2 flai intensities with restricted diffusion in bilateral basal ganglia,grey matter of bilateral high frontoparietal lobes..Sign of hypoxic ischemic injury…Please suggest any treatment for the brain…Will the infant brain get recover or not.. Waiting for ur reply..Thank you

    • Dear Rasmita, Your neurologist is the best source of information. In many cases there is some recovery from the early scans and I am sure they will be testing him as he recovers.Early therapy is recommended by a physical therapist once he is stable. I hope this helps.

  8. My son has grade 3 severe HIE , developed cp and epilepsy. At birth drs said he had zero brain activity and would have no quality of life. He was cooled for 2 days and was then as drs said taken off life support and expected to die with in hours . well he is now a very active and stubborn almost 2 year old with mild cp , just starting to try and walk. I am a very strong believer that babies brain can repair them selves and grow new pathways if they are kept stimulated as well have early intervention with OT PT infant development and speech . my sons team of doctors cant explain to me why he beat the odds cause its not written in their medical books or was taught to them . my son had the will to live and the strength in his genetics to keep fighting and not give up. I do believe his brain is repairing its self by making new pathways .

    • Thank you Laureli for sharing your inspirational story.I wrote my book to close the knowledge gap. There is so much now known about neuroplasticity, but many healthcare professionals have not yet learned about it. Silos of knowledge and information overload are the problem.I would send your NICU doctors a short video when your son gets up on his feet.

    • Hi Laureli,
      Your story is inspiring. My son is coming up 3 months and also has HIE grade 3. We had a similar thing to you, we were told after the cooling, EEG and MRI to turn off the ventilator as he had hours/days left were sent on to a hospice, For him to pass as he had global damage and couldn’t control his boy temp or breathe properly without assisted oxygen. However our boy decided to fight came off oxygen, heated mattress and no longer needs suctioning, he is still fed with an NG tube as his suck is weak. He’s also become more vocal even though he still does not cry. We got to come home after 5 weeks there just in time for Christmas. Did your boy cry at all? I’d love to talk to you about your story more and how your boy is doing now as I’ve not spoken to anyone who has had a similar story to ours.

  9. Hi Karen,

    I am aunt of baby boy ( 5 months old). When he was born he became hypoglycaemic and went in mild acidosis. Drs sent labs for metabolic disorders. After three months he was diagnosed with a rare metabolic disorder HIBCH deficiency( only 5 children had this condition). In this they cannot breakdown valine (amino acid) which leads to toxic metabolites accumulation in mitochondria. Because it was detected after three months and he was on normal milk the protiens caused some demage to his brain which according to doctors is irreversible. Before protien free milk he was very slow in movements but now he mives his legs and arms actively and rarely smiles when he is in mood( he never smiled before). But he still doesn’t roll on sides or hold his neck and he doesn’t make eye contact for longer periods. In the start I felt he doesn’t response when we are talking with him but now he starts moving his legs and arms when we talk to him which is a little achievement I think. I know that it is impossible to that he will be like other normal kids in future knowing that he had brain demage but I can’t give up on him. I have been searching on internet for months. I heard Pyrroloquinoline quinone (PQQ) is good for mitochondria specially in brain but there are no evidence. I don’t have idea of neuroplasticity but I think that’s what my next internet search is going to be. I am a pharmacist and everything in medical tells me that it’s impossible but I want to see my nephew grow up like normal kids. Please let me know what should I do?

    • Dear Milli, thank you for your message. I’m deeply sorry for all your little Matthew has gone through. I am thankful though they have found the underlying cause and he is being treated. Suggest you ask his doctors if there is any information on the long-term outcome of this very rare disorder. I do not have any idea what the future holds, but I always believe in giving the babies the benefit of the doubt. I suggest that he become involved in an early intervention program that you document any improvement in his movements to share with his entire health care team. Best wishes, Karen Pape

      • Hi Karen,
        Many thanks for replying. I want to ask you what kind of intervention programme should he be involved in ?

        • Milli, I would ask your doctors what is available where you live.Parent groups can also be quite helpful finding interested therapists. Good luck.

        • Hi Milli, you can look up your townships special services team for the school district. They can provide you with a consultant( usually an outside service from township) that can write a plan, put it in place and start early intervention before school starts. They can usually advise you on the services and best schools to look into. As hard as early intervention is on the child and the family. Never stop pushing. It’s worth the battle. Everything you do helps during early intervention. Start now, because you’re going to hit long waiting lists sometimes, especially if the service or school are great at what they do. The best of luck.

  10. Dear Milli my son is 2 months old. He was found unresponsive by my wife i did cpr and got him back breathing. We are on day 14 at childrens of alabama. The first mri showed some damage to the back of the brain. They did another one today that now shows damage all over. Drs are sayn cells are dead. His core temp has been dropen to around 92 and they have been keepn a heatn blanket on him to keeo it around 97. He conts to have subclinikle seizours. They are now sayin because if the mri that he will never be the same. I was told the cells wont re grow or cells cant heal them self. Is there any advice. Ive been reading abiut keeping the temp down today. But now im wondering is it to late.

    • Dear David, I am sorry for your situation, but I cannot offer an interpretation or opinion as this site does not provide specific information. That is the responsibility of your doctors and you should ask them for advice.I am afraid that only time will tell.

  11. Good morning,

    Our cousin’s 10-wk-old was admitted with sepsis and meningitis three days ago. He also suffered a series of seizures. His MRI indicates severe brain damage. What sort of hope is there for him to have any sort of quality of life? Where can we look for answers/hope?

    Thank you

    • Dear Aimee. I am so sorry to hear of your nephew’s illness.We know that the young brain may show significant recovery, but that is dependent upon how much of the brain is normal. I am afraid his family is in for a waiting period to see what happens next. I would encourage them to ask questions of their medical staff and stay as positive as possible.

  12. I am the grandfather of a premi, born at 23 weeks (1 lb. 3 oz.) and in the NICU on a respirator. His parents have been told that for the passed 20 days the brain scan show bleeding in the brain and white brain matter damage, the part responsible for respitory functions. The medical staff do not believe he will ever be able to breath on his own and there is discussion to take him off life support. As you can imagine, we are desperate and depressed. I only wish that medical/science could be further ahead to be able to help stop the bleeding and help regenerate the damage brain matter. However, we are dealing with traditional medical practices here that won’t allow for the hope we would like. It doesn’t look good. Sorry to be so grim about this case but don’t know how else to put it.

    • This is a terrible situation. At 23 weeks, the chances of intact survival or even survival itself are borderline. My thoughts and hopes for a good outcome are with you.

  13. Hi Karen I’m a first time mom I’m 23 my son is 7 weeks old and was diagnosed with HIE . Doctors havnt told me the saverity of it because they say it’s too early to tell but he was deprived of ogygen at birth . I was in labour for 29 hours till they decided to give me an emergency c section . When he was born he was a bit off on color he was grayish but responded and they decided to take rush him to radys children’s in San Diego they started to cool him 2 to 3 hours from when he was born and didn’t get any seizures while getting warmed up . He had an infection so he had respiratory issues and was incubated for about a week so he had to be tube feb but picked up on his feedings after that . He does use a slow flow nipple but does fine. He got an MRI done and it came back normal . he was discharged out the nicu at 1 month and 1 day and my only concern is he has very little head strength and i don’t know if that’s due to the fact that he was in the nicu and wasn’t using his muscle strength till now that he is home or because he has brain damage that can cause CP , witch is my biggest concern .do u have any advise ?? Do u know if at 1 month it’s too early to tell if a baby has CP? I have an app with a neurologist next month . Ithank you !

    • It sounds as if you had great care and an appropriate response to yor son’s difficulties after birth. I would wait for the neurologist appointment.If his head control is not improving at home, ask for a referral to a PT.

  14. Hi Karen, I had MCMA (same placenta and same sac) twin girls born at 32 weeks, now 13 weeks old. One of my girls had a stroke in utero and now has a grade 4 IVH on the right side of her brain. This was picked up on a routine head ultrasound completed four days after birth. She has good movement in both her left arm and leg. I have been doing physio every week and continue with these exercises and handling techniques at home every day. Both twins are breast fed and sleep well. She has had two follow up ultrasounds after the initial ultrasound and MRI. On the second ultrasound growth or similar were forming in the space were the brain cell had died. One month later she had another ultrasound and the growth cant be seen and brain matter has now filled this space. the left vertical is still larger then the right yet there is no signs of Hydrocephalus. What are you thoughts on recovery with such early intervention? and possibilities of not having CP or in any case the level CP of what it could be.
    Thank you

    • Thank you for your comment.This is the largest study about outcome in Grade III and IV bleeds that I have been able to find.
      Annemieke Brouwer et al, “Neurodevelopmental Outcome of Preterm Infants with Severe Intraventricular Hemorrhage and Therapy for Post-Hemorrhagic Ventricular Dilatation”, The Journal of Pediatrics, 153 (2008): 648-654.

      If you go to Pub Med, the abstract is free and you can purchase the paper. They had roughly 45% of children with Grade IV
      that were cognitively and motor normal at 2 years corrected age.

  15. Hi Karen,
    I have an 8 month old son who has severe brain damage. We left him one day to my mother in law and when we came back my son was on “sleeping on the bed” I found him seizing. We rushed him to the er where they told us he had a brain bleed. We were told that he had 2 fractures in the back of his head. He didn’t get any oxygen to his brain which caused a strike & now his front two lines are damaged. His right side of the brain is also severely damaged. The MRI showed that the right side of his brain was shrinking, they told us our son wouldn’t be able to ever move his left side. But he is now moving his hand and here n there he moves his leg. I was just wondering, do you ever think his front 2 lobes will ever heal? He is only a baby and I believe baby’s brain can take over another part of his brain, I need hope.. the doctors say he won’t do that much improvement and being basically a vegetable will be the quality of life for him, please I need help.. I need to know how to give my son the proper care, his fight isn’t over yet

  16. I had come across a child who is not behaving as a normal child. This happened after his bigger brother blocked her nose while playing with her. This happened when the child was 1 year 4 months old. The child is now 14 years old but is not doing well in school and her growth is slow too. She is slowly picking things up.

    Will she be doing Ok after some time?

    • Dear Clement, It is impossible for me to predict the outcome from a distance. Unfortunately, I no longer see patients as I am clinically retired.
      I would ask at the the child’s school to do a learning assessment. This ususally means some testing with a psychologist.
      I have found it very helpful in many cases.

  17. My grandson died a month ago they said it was encephilutus. He was only 6 months old. When he got to hospital he started getting zeasors and his ehole body was pulling together. Its hard to understand the same morn8ng he was still smiling and giving kisses to his mom. He was such a bundle of love. 4 hours before his brain died his eyes started to dilute. I know he didnt made it but i need to know could there be a possibility that he wouldve made it… our hearts is broken and we dont understand what happened. People try to comfort us and told us that he is better off dead because that brain damage is servere

    • I am so sorry for your loss.Encephalitis in small children is a terrible disease and it does take the children quickly.Treatment rarely, if ever works.
      Your family should have a meeting when they are ready with the doctor from the hospital to have them explain it to them.It is not much, but understanding how severe this illness can be may help.

  18. Hello Karen,

    We were blessed with a baby boy. He is 45 days old.

    When he was born, he inhaled meconium so he couldnt breath at all. Moreover, umbilical cord was wrapped around his neck twice. Doctors put him on 100% Oxygen. Then then incubated him for oxygen and put him under hypothermia to bring down his body temperature. After 3 days doctors removed him from the hypothermia but he was still incubated.

    On day 10 they did the mri of the brain and found viral infections. So they repeated the mri on day 30 to see the changes. So on second mri what they found is that there is some damage in the brain. I don’t know how first mri shows viral infection and second mri showed damage. The damage described to me is as follows ” tiny spots on top both side of the brains are dead ” and connection between two hemisphere has extremely extremely small damage.

    When the doctors removed him the incubation, he had side effects.
    1) He got very low fever due to bacteria
    (S. epi and coliform).which they treated with antibiotics for few weeks
    2) Moreover, he had a blood clot near the heart so they gave him the blood thinner injection. since then the blood clot is gone
    3) And finally, his liver is bruised. which they did the ultrasound and found to be very smalle then before.

    I am so worried that i keep thinking about the brain damage and looking for hope. I rarely sleeps, rarely do anything.

    my son eats well, sleeps well, cries, laugh, do kaka regularly. He weight is average.

    Please help me!!

  19. I have read the previous blogs and have to ask this question. Is it possible for infant brains to heal or not? My granddaughter was 4 days old when she was involved in a tragic car accident. She was having seizures they gave her phenobarbatol to stop them. It did. They have since discontinued it and no more seizures. MRI showed that the cerebellum is fine. The cerebrum suffered bleeding and both sides of the brain was damaged. They did she could live but she would have no quality of life. So, is there any chance medically for more? Spiritually I have faith for God’s intervention. Do you know of a case that has ever recovered?

    • Tina, I am so sorry to read your story.I would keep talking to the neurologist about what to expect.The amount of recovery depends on the amount of brain that is involved in the damage.Your doctors should be able to give you a pretty accurate read on this.

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