In August, the world held its collective breath as conjoined Guatemalan twins Maria Teresa and Maria de Jesus Quiej-Alvarez endured 22 hours of surgery at UCLA Medical Center in Los Angeles, California. The one-year-old girls were born craniopagus, meaning joined at the head -- a condition that affects only an estimated two percent of conjoined twins, and often makes separation surgery difficult, if not impossible.

As the Quiej-Alvarez girls recuperate in Los Angeles following their complex, 22-hour surgery, another set of craniopagus twins face a similar situation in Dallas, Texas, and John Upledger, DO, OMM and the Upledger Institute are lending helping hands.

Fifteen-month-old Egyptian boys Ahmed and Mohamed Ibrahim arrived in Dallas in late June for a battery of diagnostic tests to detrmine if separation was feasible. The twins' visit was arranged by Dr. Kenneth Salyer, a renowned craniofacial surgeon and founder of the World Craniofacial Foundation, which provides financial and emotional support to families and children with craniofacial and cleft deformities.

At Dr. Salyer's request, Dr. Upledger and a team of therapists from the Upledger Institute traveled to Dallas for three weeks, administering CranioSacral Therapy to the boys. Even after the first session, improvements were noted:

"CranioSacral Therapy has already helped these boys tremendously," commented Sally Fryer, PT, CST, one of the Upledger team members in Dallas. "When I first evaluated them, there were some obvious neurological signs, such as sensitivity to movement, decreased mobility and guarded physical reactions. The larger twin was weaker and more passive, and the smaller boy was trying to get up on his hands and knees and initiate rolling, but he couldn't.

"By the end of the first CranioSacral Therapy session, the twins were smiling and playing with each other, imitating sounds and overall much more animated. After just three weeks of treatments, they were both pushing up into a crawling position, initiating movements independently of each other and laughing. And the little one finally started eating and having daily bowel movements.

"We've even seen some cleavage start to form between their heads. Before, it was a flat area with a slight indentation. Now, you can see a ring around their skulls, almost like they're attempting to separate from each other. Even without surgery, we've witnessed miraculous changes."

As we go to press, the Ibrahim twins are scheduled to take part in an outpatient program at Upledger Institute HealthPlex Clinical Services in Palm Beach Gardens, Florida from September 16-20. Dr. Upledger and his team will provide five days of intensive CranioSacral Therapy, designed to "release membranous and structural restrictions around the brain and spinal cord, and encourage the central nervous system to function at peak efficiency."

Dr. Upledger is encouraged by the results thus far, and optimistic about the twins' chances for separation:

"Despite their connection, these are clearly two very different little boys. We found their craniosacral systems to be quite independent of each other, and from the first round of treatments, we saw them reacting much more independently, both physically and emotionally. Just to get the little one to start eating and eliminating regularly was a major achievement. Now, the more CranioSacral Therapy we can [perform] on them, the more all their systems will have the opportunity to separate on the inside -- and that could have a major effect on the outcome of the surgery."