Mikey’s battle: Family helps son overcome cerebral palsy due to abuse

From Geisinger media

Colleen and James Stipeck became foster parents to Mikey when he was just a baby. The couple had three kids of their own and had recently decided to start fostering — and they didn’t hesitate even after hearing what Mikey had been through.

“They called and said they had an infant around 3 months old that was going to be released from the hospital and we said, ‘Absolutely,’” Colleen said.

When Mikey was just 6 weeks old, he was transferred to Geisinger Janet Weis Children’s Hospital with skull fractures, a rib fracture, a broken forearm and several brain injuries from being abused by his mother.

The trauma caused respiratory failure, bleeding in Mikey’s brain and brain damage that resulted in seizures, cerebral palsy, developmental delay and feeding difficulties.

“Overall, Mikey is a fairly typical survivor of infantile abusive head trauma. While about 25% to 30% of infants die from such injuries, most infants do not,” said Paul Bellino, MD, director of the Division of Child Protection and Advocacy for Geisinger. “Children who present in a state of extremis, such as in Mikey’s case, almost universally have serious, long-standing neurological consequences.” 

As he got older, Mikey’s legs became spastic and stiff, making it hard to balance and walk. He needs a hand getting to his feet, and a pull-behind walker helps him balance. The Stipecks took him to an orthopaedic specialist for Botox injections that helped alleviate some of the stiffness, but they had to be repeated every few months.

“It was a lot for him to get the injections, and his doctor said he thought Mikey would make a good candidate for a neurosurgery procedure called a selective dorsal rhizotomy that could help with his condition,” Ms. Stipeck said.

They were referred to Cameron Brimley, M.D., Geisinger pediatric neurosurgeon.

“Cerebral palsy can cause the brain and the spinal cord to not communicate the way they are supposed to. Dorsal rhizotomy decreases the sensory and reflex input from the legs to the spinal cord and allows the brain to have better control over movement,” Dr. Brimley said. “Decreasing the sensory input allows the patient’s legs to be more relaxed and less spastic.”

The procedure takes about four hours. During that time, a team stimulates and monitors the sensory nerves in the spinal cord to see which are the most aggressive. Dr. Brimley then cuts those nerves by 50% to 80% to decrease the sensory input.

After having the procedure, Mikey spent nearly a week in the pediatric intensive care unit, followed by intensive physical therapy four to five days a week.

Already, Mikey balances more effectively and has more endurance when walking.

“He’s able to do things on his own and walk further distances,” Colleen said. “We hope that someday he will be able to walk unassisted with just arm crutches. He says he wants to run. That is a big motivator for him.

“I see this surgery as being life-changing for him,” she added. “He has more work to do, but the gains we are seeing so far have been amazing.”

Dr. Brimley is pleased with the outcome of the surgery and the difference it’s made for Mikey.

“Seeing abuse victims is one of the hardest parts of my job. It’s sad and discouraging, but it allows us the opportunity to see these kids and hopefully get them in a better place,” Dr. Brimley said. “Mikey has been very blessed to have such a wonderful family.”

Although child abuse is not a medical condition, it has medical consequences, according to Dr. Bellino.

“Raising awareness and educating our communities on the social aspects that predispose children to child abuse can help bring the problem to light,” Dr. Bellino said.