Before G Therapy	After G Therapy

History and findings before G Therapy:

He is the first twin - delivered at full term by normal delivery with birth weight of 5½ lbs and normal Apgar scores. Jaundice was noticed on the second day of life and an exchange transfusion was carried out. His serum bilirubin had risen to a maximum on 32 mg/dl. He was kept in the NICU for 15 days during which he had one episode of convulsion. No other neonatal complication. He had marked hypertonia at discharge from the hospital and parents were explained the likelihood of delayed motor and mental milestones. He was put on regular OT/PT programme from 3rd month of life. He has taken speech therapy for nearly eight years yet speech is very difficult to understand, can make sounds of words – but complete syllables or words not possible even now. His milestones were as follows : Social smile 6 months, neck holding at 1½ years, coming to sit on own 2years, standing balance – 3½ years, independent walking at 5yrs. Sphincter control at 3 years. Understands spoken language from 3years of age.

• Neurologically, he had marked involuntary movements involving the eyes, facial muscles, neck and trunk.
• Vision and hearing was good.
• Chewing and swallowing possible.
• Has learnt to drink water from a glass.
• Fine coordinated activities of the hand viz eating with hand or spoon, holding a glass of pencil are very slow and abnormal.

Before starting G. Therapy at age of 9 years :

• He had difficulty in standing up from sitting position, sitting or standing still was impossible due to continuous athetoid movements, a very slow dancing gait, climbing the stairs – literally clinging to the railings with both hands, walking on a foam bed was not possible, climbing on to a swing was not possible.
• Could not sit crossed leg.
• Was feeding himself but it was a very slow and laborious process. Used to hold the glass of water with clawed fingers.
• Speech making some sounds.
• Holds pencil abnormally but is able to write many words in English. Understanding of spoken language very good – going to school for handicapped children since the age of 4 years.
• He was taking L-dopa for a long time but involuntary movements remained the same and hence L-dopa also discontinued.

Improvements after G-Therapy :

• Gradual and encouraging improvements were noted starting almost after two months of G-Therapy. Hence the mother has been taking G-Therapy regularly for her children till date.
• She had stopped G-Therapy for one year and she noticed that the involuntary movements increased and hence decided to restart the treatment.

She feels the G-Therapy makes her boys more steady and look normal.

The following improvements were noted on the serial video recordings of Siddharth in June 92, Aug 92, Dec 92 and Apr 93:

June 92: Sitting posture is better - less bending, Able to sit crossed leg momentarily. He is able to run and climb on to the swing and stand on the swing.

Aug 92 : Gait is better, Is able to climb steps holding the railing with one hand only. Previously could not run on the foam mattress but now can run on the foam mattress without losing balance. Hand-mouth coordination is better.

Dec 92 : Involuntary movements have reduced. Facial expressions are better. Climbing stairs using one hand only. Coming to stand from sitting posture is easy. Can kick the ball. Pincer grasp slightly better and steady. Holding the glass with fingers semiextended, ( initially fingers were clawed ). Able to pronounce few words ‘easy’, ‘mamu’, ‘van’.

Apr 93: Can sit crossed leg easily. Able to remove his shoes. He is much steadier in his gait. (marked reduction in involuntary movements).

Dr. Sabiha A. Sayed
MBBS DCH 65084

Latest assessment 2002 :

Both twins - Siddharth and Gaurav are under G Therapy since 1992 and have shown remarkable progress. Gaurav, who also suffered from Bilirubin Encephalopathy is now on G Therapy for last 10 years. He has recently passed the 10th standard Board Examination in India. He can operate computer very easily and is a good artist too.