Cerebral palsy causes. Cerebral palsy: causes and forms of cerebral palsy similar diseases

Analyzing the factors and causes of cerebral palsy, it is worth paying attention to the difficulty of determining one specific cause. Pathology leads to a complex of adverse factors that occur in the prenatal and birth period.

Causes of pathology

Structural disorders of neurons are the basis of any form of cerebral palsy. A complex of unfavorable factors can affect any period of brain formation - both during pregnancy and even after childbirth.

In boys, the disease proceeds with more severe consequences and occurs 1.3 times more often than in girls.

According to statistics, 80% of cases of pathology occur during pregnancy and childbirth, while only 20% of cases occur in the postpartum period.

Consider the main reasons:

Characteristics of the causes of cerebral palsy

The reasons discussed above can be grouped into three groups depending on the nature of the pathology - acquired or not.

One way or another, the influence of provoking factors should be complex.

Symptoms of cerebral palsy

Exactly movement disorders most often presented the main symptoms of cerebral palsy. Depending on the age of the child, the severity and type of the violations under consideration are determined, so the following stages of pathology should be considered:

The distribution of the main symptoms is also based on this classification.

Signs of cerebral palsy at an early stage

It is rare to diagnose cerebral palsy at an early stage, as motor skills are inherently scarce at this age. However, some signs may be the basis for diagnosis:

Identification of even minor deviations requires examination of the child every 3 weeks. In the future, the dynamics of changes is monitored.

It is after the first 6 months of life that most of the symptoms can be detected, including:

The clinical form of the disease directly affects which symptoms will be paramount.

spastic form

This form is the most common and is determined by violations of tone in the limbs and muscle strength. Among the subtypes of the spastic form Little's disease spastic tetraplegia and hemiplegia.

Spastic diplegia

By 12 months, the symptoms are most pronounced. In all limbs, there is an increased tone, in connection with which a forced position is formed. There are also other symptoms:

Patients are able to serve themselves, learn and adapt in society, since mental impairments are not pronounced. All this is possible only with the functioning of the hands and with proper treatment.

Spastic tetraplegia

Pathology is characterized by a pronounced violation of the movements of the upper limbs, while all four limbs are affected. This form is the most severe, as it is accompanied by the following disorders:

The optic nerves atrophy, high tendon reflexes are observed. Children do not know how to walk and sit, the spine deforms over time. Lifelong outside care is required.

hemiplegia

Muscle weakness is characteristic of only one side - right or left. In the hand, paresis is more pronounced. Such children learn self-service skills a little later, they know how to walk and sit.

Signs of hemiplegia appear in 32% of cases diagnosed with cerebral palsy in children.

Affected limbs move inharmoniously.

Minor mental disorders, convulsive seizures are also characteristic. A decrease in intelligence is observed only with frequent convulsive seizures.

Dyskinetic form

Hyperkinesis, characteristic of this form of cerebral palsy, is noticeable after the first 12 months of life. Among the involuntary movements:

• grimacing;
• twisting of the body;
• imitation of throws and hand swings;
• worm-like movements with fingers.

Uncontrollable screams and sounds appear due to involuntary contraction of the muscles and larynx. Muscle tone decreases, but periodically rises suddenly ( dystonic attacks). Motor skills are formed with a delay, words are pronounced indistinctly, slowly, there is a violation of articulation. The level of intelligence is almost in line with the norms.

Ataxic form

This form is characterized by damage to the frontal lobes or cerebellum. Muscle tone is reduced, accuracy and coordination of movements are impaired. Often there are hyperkinesis, trembling in the limbs. A staggering gait is also characteristic. Mental abilities can reach oligophrenia, but sometimes they are not disturbed at all.

When identifying symptoms characteristic of several of the forms described above, it is worth talking about a mixed form.

The use of a rehabilitation spiral suit in parallel with the main treatment in 87% of cases gives a positive result: it accelerates mental development and improves motor skills.

Prevention of cerebral palsy involves pregnancy planning, rehabilitation of foci of chronic infections, timely examination and competent management of pregnancy, an individual approach to childbirth if necessary. Diagnosis of the pathology in question is not yet a verdict. If parents are actively involved in the rehabilitation of the child, and treatment is started in a timely manner, the child will have a chance to work successfully in the future, start a family and raise their own children.

For such results to become a reality, treatment must be continuous, and diagnosis early.

Treatment involves attending sessions massage to normalize muscle tone, taking medications, doing physiotherapy exercises. Used to correct motor skills Vojta therapy, bobath therapy and other special techniques. Classes with a psychologist and a speech therapist are required. In some cases, surgery helps.

Sometimes the pregnancy does not end as expected, the baby is born with a developmental pathology, for example, cerebral palsy (cerebral palsy). It should be noted...

cerebral palsy: what is it? Causes, forms and treatment of the disease

By Masterweb

Sometimes the pregnancy does not end as expected, the baby is born with a developmental pathology, for example, cerebral palsy (cerebral palsy). It should be noted that the disease is not inherited, but occurs during childbearing or during childbirth. Cerebral palsy is a disease that is a series of syndromes that have arisen due to brain damage, the signs of the disease are associated with a violation of the human motor sphere.

History of disease detection

Cerebral palsy was identified and studied in the early 19th century by the British physician Little, which is why cerebral palsy is also called "Little's disease." The British scientist and physician believed that the main cause of cerebral palsy is pathological labor activity, during which the child experiences severe oxygen starvation (hypoxia). Sigmund Freud also studied cerebral palsy at one time. He suggested that the cause of the disease is damage to the central nervous system of the child during fetal development. This assumption was proven in 1980. But subsequent studies have revealed that complicated labor activity is the most common cause of cerebral palsy.

General characteristics of the state

Currently, doctors say that cerebral palsy occurs immediately after birth or during pregnancy. The causes of illness are many. But mainly it is damage to the central nervous system and related neurological problems. With the disease, a wide variety of disorders of motor functions are observed. Muscle structures are most affected, this manifests itself in impaired coordination. Motor activity is impaired due to damage to brain structures. The localization and volume of these lesions determine the form, nature and severity of muscle disorders, which may be single or in combination. Options for major muscle disorders:

• Muscle tension.
• Movements of involuntary chaotic character.
• Various gait disorders.
• Limited mobility.
• Muscle contractions.

In addition to impaired motor function, cerebral palsy may be accompanied by hearing and speech impairment. In addition, very often the disease is accompanied by epilepsy, deviations in psychological and mental development. Children have disturbances in the sphere of sensations and perception.

Cerebral palsy does not progress, since brain damage is point, it does not spread and does not capture new areas.

The reasons

Cerebral palsy is caused by damage to certain parts of the brain that are developing. This damage can occur during pregnancy, when the baby's brain is just beginning to form, during childbirth, in the first years of life. In most cases, the exact cause is very difficult to establish. In the scientific literature, the causes of cerebral palsy are divided into several groups:

• Genetic causes (damage to the chromosomes of the mother or father, may occur due to aging of the body).
• Oxygen starvation of the brain (placental insufficiency both during childbirth and during the period of bearing a baby). Factors in the development of oxygen deficiency: placental abruption, long or, conversely, rapid labor, cord entanglement, abnormal fetal presentation.
• Infectious diseases, for example, encephalitis, meningitis cause cerebral palsy. It is especially dangerous if the infection occurs with a high temperature.
• Toxic effects on the child (work in hazardous industries, smoking, drugs, alcohol).
• Physical impact (if the child was exposed to x-rays or radiation).
• Mechanical causes, a consequence of birth trauma.

Also, the factors that give rise to cerebral palsy are:

• premature birth.
• Small birth weight.
• Large baby weight or large fetus.
• Chronic diseases of women.
• Multiple pregnancy.

The risk of developing the disease increases if several factors that affect the baby's brain and nervous system act at once.

Factors in the development of the disease in the first days of life can be:

• Hemolytic disease (a congenital ailment that develops due to the incompatibility of the blood of the mother and child).
• Asphyxia of the child during labor.
• Entry of amniotic fluid into the respiratory tract of the fetus.
• Defects in the development of the respiratory system.

Children's cerebral palsy is a consequence of the influence of various factors that lead to disruption of the normal functioning of the child's brain. The greatest influence is oxygen starvation, which develops due to premature detachment of the placenta, the gluteal position of the fetus, rapid or prolonged labor, entanglement of the umbilical cord. Risk factors are Rh-conflict of mother and baby, infections.

Sometimes the cause of the development of cerebral palsy is considered various pathologies of the vascular system. This is an erroneous opinion, since the vessels of the child are elastic and soft, they cannot burst without a reason. That is why vascular damage in a child can occur only as a result of a severe injury.

It is important to timely establish the cause of the development of cerebral palsy, as this determines the further tactics of working with the child and his treatment.

signs

Symptoms of cerebral palsy are divided into late and early. Early scholars include:

• Lagging behind the child in physical development (does not hold his head, does not crawl, does not sit, does not walk by the due date).
• The reflexes that are characteristic of infants are preserved with the growing up of the child (limb movements are chaotic for a long time, grasping reflex, stepping reflex).
• The child uses only one hand, this is clearly noticeable during the game or at home.
• The child is not interested in toys.
• If you put the child on his feet, he gets up only on his toes.

Late signs of cerebral palsy are:

• Deformation of the skeleton, in the affected area the limb is much shorter.
• Impaired coordination, low mobility of the child.
• Frequent spasms of the limbs.
• Gait is difficult, mostly on toes.
• Swallowing problems.
• Salivation.
• Problems with speech.
• Myopia, strabismus.
• Disease of the gastrointestinal tract.
• Involuntary defecation and urination.
• Emotional and psychological problems.
• It is difficult for children to write, read, count.

The degree of disability depends on the level of development of the child and the efforts of relatives. The higher the level of intelligence, the less violations of motor functions in the baby.

Forms

There are two classifications of the disease - the first is based on the age of the baby, the second on the form of the disorder.

By age, the disease is divided into:

• Early - symptoms appear before 6 months of a baby's life.
• Residual initial - the disease is detected from 6 months to 2 years.
• Residual later - after 2 years.

Regarding the forms of cerebral palsy classify:

• Spastic tetraplegia - areas of the brain that are responsible for motor function are affected. This happens, as a rule, in the prenatal period of a child's development due to oxygen deficiency. This type of cerebral palsy is one of the most severe and serious forms of the disease. The disease manifests itself in the form of problems with swallowing, impaired formation of sounds and their reproduction, paresis of the muscles of the limbs, problems with attention, visual impairment, strabismus, mental retardation.
• Spastic diplegia is the most common form of the disease, accounting for about 75% of all cases. As a rule, it is detected in children who were born as a result of premature birth. The disease manifests itself in the form of damage to the lower extremities, delayed mental and mental development, problems with speech. But, despite all the manifestations of the disease, patients with cerebral palsy of this type successfully study at school, are adapted in society. They do certain types of work.
• Hemiplegic form is more often seen violations in the movement of the upper limbs. The cause of this form of cerebral palsy is cerebral hemorrhage or heart attacks in the brain. Such children have good learning abilities, they can learn a number of actions, but their speed will not be great. Children who suffer from this form of the disease often have mental retardation, lag in speech development, mental problems, and frequent epileptic seizures.
• The dyskinetic form is the cause of hemolytic disease (a congenital disease that develops during the Rhesus conflict of the blood of the mother and baby). Such children have involuntary body movements, paresis and paralysis appear in all parts of the body. The positions of the limbs are not normal. At the same time, this type of cerebral palsy is considered the mildest form. Children can study at school, not be inferior in intellectual abilities to their peers, they can graduate from a higher educational institution, live a normal life in society.
• Ataxic form - the main causes of the disease are fetal hypoxia or trauma to the frontal lobes of the brain. A sign of this form is paresis of the vocal cords and muscles of the larynx, trembling of the limbs, and involuntary movements. As a rule, children suffer from mental retardation. With proper work with the child, he can learn to stand and even walk.
• Mixed form - when the patient has symptoms of several forms of the disease.

It should be noted that in newborns it is difficult to reliably diagnose the form of cerebral palsy, characteristic signs are detected by 6 months of a baby's life.

Condition Diagnostics

The disease is diagnosed on the basis of the identified characteristic signs. Conditioned reflexes and muscle tone are checked, in addition, an MRI of the brain is done. If there is a suspicion of brain damage, an EEG and ultrasound are performed.

Timely diagnosis is very important for a small patient. It is important to recognize the disorder. Children should be examined even in the maternity hospital, doctors pay special attention to children:

• With little weight.
• Born prematurely.
• Having defects and anomalies of development.
• Diagnosed with neonatal jaundice.
• Born as a result of difficult and prolonged childbirth.
• with infectious diseases.

Cerebral palsy is diagnosed by a neurologist, but he can additionally prescribe other tests to clarify the diagnosis.

Features of children with cerebral palsy

The main cause of cerebral palsy is a change in the structure of the brain, and the main symptoms are impaired motor activity. Movement disorders occur due to a disruption in the transmission of signals from the brain to the muscles. ICP is characterized by the presence of speech, motor, emotional, mental disorders. They are associated with damage to different muscle groups and brain tissues.

The developmental difficulties of such children are due to the enormous difficulties during the execution of complex or coordinated movements. Such children have limited independence, the ability to move freely, and only a partial ability to self-service.

Any movements of children are slow, which is why there is a disproportion between thinking and understanding of the surrounding reality. Logical thinking and abstract knowledge in such children are perfectly formed, and the idea of ​​the world around them is formed only in the conditions of the child's constant movement, as a result of which muscle memory is developed.

Children with cerebral palsy are not able to study for a long time, they learn a smaller amount of information compared to their peers. These children have difficulty with counting, it is very difficult for them to learn mathematical operations.

Emotionally, they are vulnerable, impressionable, very attached to their parents and guardians.

They, as a rule, have a speech disorder, which is why the circle of communication with peers is always limited.

Treatment and rehabilitation of cerebral palsy

The goal and main task of all therapeutic measures is to reduce the manifestations of the signs and symptoms of the disease. It is impossible to completely cure the disease, but it is possible, with the right method, to ensure that the child acquires the necessary skills and abilities for life.

To choose the nature of treatment, the doctor needs to know the form of cerebral palsy, concomitant diseases and the severity of the disease.

As medicines, as a rule, anticonvulsants are prescribed, relaxing.

Currently, there are no universal methods for the treatment of cerebral palsy. The following methods have worked well:

• Massage.
• Physiotherapy.
• Medical drugs that are aimed at normalizing muscle tone (Dysport, Mydocalm, Baclofen).

The following methods and techniques have a positive effect in the treatment of the disease:

• Bobath-tarapiya.
• Voight method.
• Load suit "Gravistat" or "Adeli".
• Pneumosuit "Atlant".
• Logopedic classes.
• Auxiliary devices (chair, walker, standers, exercise machines, bicycles).

Successfully used balneotherapy, hydrotherapy in the pool. It is easier for a child to move in the water, he first learns to walk in the water, after that it is easier for him to perform the same actions on the ground. Water procedures are completed with hydromassage.

Mud therapy has a good effect, which has a stimulating effect on nerve cells and relieves muscle tone. In addition, hypertonicity is well normalized with the help of electrophoresis, magnetotherapy, paraffin therapy.

If the changes in the structure of the muscles could not be corrected, then they resort to surgical treatment of cerebral palsy. Operations are aimed at performing plastic surgery of muscles and tendons. If it is possible to correct disorders in the tissues of the nervous system, then neurosurgical interventions, spinal cord stimulation, and removal of damaged areas are carried out.

According to reviews, cerebral palsy should be treated as early as possible, as the condition may worsen due to the gradual development of an orthopedic problem. It can be curvature of the spine, flat feet, clubfoot, hip dysplasia, and others. If you miss the time, you will have to treat not only cerebral palsy, but also correct orthopedic disorders by putting on spacers, splints, splints.

Principles of working with children

With children who suffer from cerebral palsy, it is necessary to deal with both doctors and teachers. It is better to start working from an early age of children - from 1 to 3 years old. It is necessary to take them to classes where they will be taught to speak, perform daily activities, and teach self-care skills. Such training centers for cerebral palsy develop the ability to interact and communicate with peers.

In working with such children, much attention is paid to the development of speech and behavior in society. Each child has an individual approach that takes into account the age, form of pathology. Education of children, as a rule, is carried out in groups in the form of a game, which is led by a competent specialist. The movements of each child are carefully observed, incorrect movements are corrected, and correct ones are encouraged.

To develop the correct movement skills, special devices and devices are used to support the head, limbs, and torso in the desired position. The child trains and explores the surrounding space.

Exercise therapy and massage

Massage with cerebral palsy begins to be carried out from 1.5 months. The course is conducted only by a specialist who can assess muscle tone, the frequency of sessions, the degree of impact. It is not recommended to massage yourself.

Physiotherapy exercises include a complex of therapy, classes should be regular. The complexity of the exercises is set for each child individually, taking into account age, abilities, level of mental and emotional development. The load should increase gradually, as the child's condition improves.

As a rule, with cerebral palsy perform the following exercises:

• Stretching.
• Decreased muscle tone.
• Strengthening individual muscle groups.
• Endurance exercises.
• For balance.
• To increase muscle strength.

Complications

Cerebral palsy does not progress over time. But the danger of the disease is that additional pathologies develop against its background. Complications of cerebral palsy:

• Disability.
• Eating problems.
• Epilepsy.
• Delayed growth and development.
• Scoliosis.
• Incontinence.
• Salivation.
• Psychological and mental disorders.

Prevention of cerebral palsy

During pregnancy, you must strictly monitor your health. It is important to eliminate bad habits, regularly go to appointments with your doctor, strictly follow his recommendations. Timely diagnose conditions dangerous to the fetus, for example, hypoxia. The doctor should correctly assess the condition of the mother and choose the right way of delivery.

Disability

Disability in cerebral palsy is assigned depending on the severity and forms of the disease. Children can receive the status of "child with cerebral palsy", and after 18 years - the first, second or third group.

To obtain a disability, it is necessary to undergo a medical and social examination, as a result of which it is established:

• The degree and form of the disease.
• The nature of the lesion of the musculoskeletal system.
• The nature of speech disorders.
• Degree and expressiveness of mental defeats.
• degree of mental retardation.
• The presence of epilepsy.
• The degree of loss of vision, hearing.

Parents of a disabled child can receive the necessary means of rehabilitation and vouchers to a sanatorium at the expense of the state budget.

Special tools that make life easier for a child

Such devices and special equipment can be obtained at the expense of the state budget. This is only possible if the doctor has entered a list of them in a special rehabilitation card, and the ITU commission, when confirming disability, has recorded all the funds as necessary for the rehabilitation of the child.

Such devices are divided into 3 groups:

• Hygienic purposes: toilet chairs, bathing chairs. These devices are equipped with special seats, comfortable belts for fixing the child.
• Devices intended for movement: wheelchairs for children with cerebral palsy, parapodium, walkers, standers. All these devices allow the child to move in space and explore it. A child who is not able to walk on his own will need a stroller (cerebral palsy is the diagnosis in which this item is often extremely necessary), and more than one. For moving around the house - a home option, and for walking along the street, respectively, a street one. A stroller (cerebral palsy), for example, "Stingray" is the most lightweight, equipped with a removable table. There are very convenient and comfortable strollers, with electric drive, but their price is quite high. If your child can walk but cannot balance, he will need a walker. They train coordination of movements well.
• Devices for the development of the child, medical procedures, training: splints, tables, exercise equipment, bicycles, special toys, soft rollers, balls.

In addition, a child with cerebral palsy will need special furniture, shoes, clothes, dishes.

live fully

Many children with cerebral palsy successfully adapt in society, some manifest themselves in creativity. So, for example, a seven-year-old boy with cerebral palsy (severe form), who cannot walk at all, but loves to sing very much, has become a real star. The Internet literally blew up the video where he made a cover of the track "Minimal" by rapper LJ. Cerebral palsy-diagnosis does not interfere with creativity and self-realization at all. The rapper himself visited this talented child, their joint picture is very popular among fans of both LJ and the boy Sergei.

Kievyan street, 16 0016 Armenia, Yerevan +374 11 233 255

Cerebral palsy is a serious chronic disease. combines, which are associated with a violation of the motor function of a person. Most often, the disease affects the fetus during its intrauterine development.

Cerebral palsy is non-progressive, which means that the disease does not spread inside the body, does not affect healthy areas of the nervous tissue, it damages certain areas of the brain pointwise.

Appears at the age of 5 - 7 months.

The atonic-astatic form of cerebral palsy becomes more pronounced after seven months. Differential diagnosis of this form is quite complicated, due to the similarity of its symptoms with the symptoms of other diseases.

Until the age of six months, the baby may not notice any violations, and only as it grows, symptoms gradually appear. Most often they are associated with mental development disorders, neurological disorders occur. The child has outbreaks of unreasonable aggression, increased excitability. There are motor disorders, loss of balance.

The hyperkinetic form of the disease is determined somewhat later - by the beginning of the second year of life.

Additional diagnostics is carried out using the following instrumental methods:

• ultrasound examination of the brain;
• craniography, etc.

The results of the study allow obtaining information about the depth of changes in the nervous system, determining the degree and severity of damage to a particular part of the brain, and identifying other disorders.

To make a diagnosis of cerebral palsy, it is sufficient to have specific movement disorders in a child at the initial stage of the development of the disease. As additional measures, research is being done, which allows you to assess the type of damage and determine the specific location of the brain lesion.

Such a study is necessary in order to exclude the presence of other diseases with similar symptoms. For the same purpose, differential diagnosis is carried out.

Cerebral palsy is not a progressive disease, its symptoms do not increase over time, and the patient's condition does not worsen over time. If the opposite happens, then most likely the disease has a different nature.

The following diseases have the same symptoms as in cerebral palsy:

• traumatic and non-traumatic brain damage;
• early autism;
• phenylketonuria;
• spinal cord injury;
• schizophrenia, etc.

The prevalence of various forms of violation

It is a common disease. According to approximate estimates, for one thousand healthy children there are up to 3 patients with cerebral palsy. If we consider the data on the prevalence of forms of cerebral palsy, it can be noted that

• spastic diplegia is the leader among all forms,
• second place - hemiparetic form,
• the third is double hemiplegia,
• fourth - atonic-astatic form,
• and, finally, the hyperkinetic form of the disease has the fifth place in the prevalence of cerebral palsy.

Hyperkinetic form of cerebral palsy - the lot of girls

Boys are much more likely to suffer from spastic diplegia and double hemiplegia; girls are more likely to have hyperkinetic form of cerebral palsy.

If we compare the overall ratio of boys and girls diagnosed with cerebral palsy, it turns out that boys make up 58.1%, girls - 41.9%.

Cerebral palsy is an incurable disease, but this does not mean that it should not be treated at all.

Patients need the help of both doctors and teachers so that they can achieve the maximum possible positive results with this disease and can adapt to the environment as much as possible. For these purposes, it is necessary to identify the disease as early as possible and begin its treatment.

Cerebral palsy is not considered an independent disease.

This term is used to refer to a whole range of movement disorders that arise as a result of brain damage in utero.

Pathology is congenital, its first signs can be seen already in children of the first days of life. The most complete and detailed clinical picture is manifested in infants, that is, before the child reaches 1 year of age. We will talk about what cerebral palsy is in children in the article.

How does autism manifest itself in a child? Learn about it from ours.

Concept and characteristics

Cerebral palsy (infantile cerebral palsy) is a pathology that occurs as a result of damage to the areas of the brain responsible for child's physical activity.

The disease develops in the prenatal period, when the brain is just being formed.

During the first years after the birth of a child, in the presence of certain negative reasons, the disease progresses, acquiring more and more new manifestations.

However, as the baby grows older, the development of the pathology stops, that is, the brain damage does not worsen. A movement disorder amenable to partial correction.

Brain damage can manifest itself in 2 ways:

• nerve cells of an initially healthy brain undergo pathological changes;
• the structure of the organ itself is disrupted.

The manifestations of cerebral palsy are very diverse, in some children the motor activity of the legs is disturbed (the most common scenario), in others - hands, in others, coordination of movements suffers.

Such differences depend on what kind of brain damage occurs, and in what period of time they occurred (under the influence of negative factors, the part of the brain that suffers most actively formed at the time of adverse conditions).

Causes

Why was a child born with cerebral palsy? root cause- disruption of the brain, in particular, its departments responsible for the ability to move.

A variety of adverse factors that occur both in the prenatal period, and at the time of birth and in the first months of a baby's life can lead to such a lesion.

How is it developing?

In children born ahead of schedule, the immaturity of the brain and its structures is noted.

This can lead to improper development of the organ, and, as a result, the occurrence of cerebral palsy.

oxygen starvation in the prenatal period contributes to the occurrence of brain damage, however, if there are no other abnormalities in the development of the child, this phenomenon does not have any visible effect (provided that the lack of oxygen was insignificant).

If the child has a low birth weight, its organs, including the brain, are not fully formed; during hypoxia, some areas of the brain die off, and hollow areas appear in their place.

Accordingly, the functionality of the organ is impaired, which leads to impaired motor activity of the body.

Classification of pathology

There are several varieties of cerebral palsy, which differ from each other in their characteristic features, feature set.

Depending on the age of the child considered to be an early form(the first signs appear immediately after birth and up to 6 months of age), initial residual (6-24 months), late residual (over 2 years).

According to the severity are distinguished:

1. Easy a form in which slight deviations in motor activity are observed. At the same time, the child is able to do without the help of strangers, can independently dress, eat, play, attend children's educational institutions.
2. middle form when the baby needs outside help in the implementation of complex tasks. Nevertheless, such a baby can attend general educational institutions and study successfully.
3. heavy a form in which the child cannot do without help, because in this case he is not able to perform even the simplest actions.

Companions of the disease

Cerebral palsy in a child can manifest itself not only in violation of motor function, or its complete absence. It is possible to have and other unpleasant moments, such as:

• involuntary convulsions;
• (formation of pathological fluid in the brain area);
• decreased vision and hearing;
• (difficulties in pronunciation of sounds, lack of speech, stuttering);
• difficulties in learning to write, count, read;
• behavioral disorders, emotional disorders.

Why does a child develop a cleft palate? find out right now.

Symptoms and signs

A child with cerebral palsy exhibits the following symptoms:

Complications and consequences

DPC leads to the development of such serious complications as:

1. Musculoskeletal disorder(pathological bending of the arms, which in severe cases can provoke dislocation of the joints, deformity of the foot, when the baby moves only on tiptoes, curvature of the spine and persistent violation of posture, as a result of which the child's body loses its symmetry).
2. Speech disorders until its complete absence.
3. mental retardation, problems with adaptation in the team.

Diagnostics

After the baby is born, the child must be examined by a doctor. This allows you to identify the pathology at an early stage of its development and start treatment as soon as possible. Children who have increased risk of developing cerebral palsy.

These are premature babies with low birth weight, suffering from congenital anomalies in the development of internal organs, born as a result of a difficult birth, having a low score according to the Apgar criterion.

The doctor carefully examines the child, checking the severity of congenital reflexes, muscle tone.

If any deviations are found, appoint hardware research:

• ultrasound of the brain;
• CT, MRI.

differential

Cerebral palsy in the first days of a child's life can manifest itself in the form of signs characteristic of other diseases, the treatment of which is carried out using fundamentally different methods and means.

That is why differential diagnosis is of particular importance. It is important to distinguish cerebral palsy from such ailments as amino acid metabolism disorders, mucopolysaccharidosis, neurofibromatosis, and hypothyroidism.

Tasks of treatment and rehabilitation

Properly selected therapy is aimed at solution of the following tasks:

1. The need to encourage a small patient to develop skills of movement, self-care, movement of arms and legs;
2. Prevention of the development of contractures (flexion of the limbs), violations of posture;
3. Creation of the necessary conditions for the mental development of the child, the acquisition of speech, writing and social skills.

Therapy that allows partially restore motor activity, should be comprehensive, including various methods of treatment and correction. The choice of this or that method is carried out by the doctor.

For the treatment of pectus excavatum you will find on our website.

Medical

The child is assigned anticonvulsants funds (Valparin, Epilim), if there are convulsions, as well as drugs that help eliminate spasms of muscle tissue (Diazepam).

Usage nootropics and other drugs to improve brain activity in cerebral palsy does not give any results, since brain damage in this case is irreversible.

Self-medication with such means can only hurt a child. All drugs used for therapeutic purposes should be prescribed only by the attending physician.

Massage and exercise therapy

Massage and special exercises that promote strengthening muscle tone, restoring posture, preventing curvature of the spine, the child needs to do throughout his life.

At first, a specialist should work with the baby, since the complex of massage movements and strengthening exercises is developed individually for each child suffering from cerebral palsy.

Pathological posture correction

The changes that occur in the body of a child with cerebral palsy lead to disorders of the musculoskeletal system, as a result of which the body is not able to take a physiological position.

In this case incorrect postures are formed that need correction. Otherwise, it is possible to develop a persistent violation of posture, the formation of contractures. For correction, various medical devices are used, such as splints, splints, bandages.

Correction of contractures with a surgical method

Contracture- formed as a result of an incorrect position of the body, persistent flexion of the limbs.

This pathology needs to be corrected, otherwise even more serious consequences may develop, such as significant joint deformity, its dislocation.

For correction use 2 types of surgery: the Achilles tendon or muscle tissue in the lumbar region can be surgically affected.

Other ways

Depending on what manifestations of cerebral palsy are observed in a child, for more successful treatment, it is possible to use other methods, such as:

1. Physiotherapy, helps to relax muscles, eliminate painful spasms.
2. Classes with speech therapist allow to eliminate (or reduce) speech disorders.
3. Socialization child (communication with peers) will help him quickly adapt to the team.
4. Communication with animals(horses, dolphins) allows you to normalize the emotional state of the child, improve his motor activity.

Rehabilitation centers

cerebral palsy is a disease manifested in very young children. Numerous reasons lead to its development, which can have a negative effect both in the prenatal period of fetal development and after the baby is born.

Symptoms of pathology are very diverse, damage affects not only motor function. The disease negatively affects the emotional, intellectual, mental development of the child. Therefore, the disease must be identified and treated as early as possible.

About, how to recognize cerebral palsy in a child you can learn from the video:

We kindly ask you not to self-medicate. Sign up to see a doctor!

Infantile cerebral palsy (CP)- non-progressive lesion of the central nervous system, underdevelopment of the brain, which is manifested by motor disorders (paralysis, twitching, speech impairment), imbalance, possibly intellectual disorders, epilepsy.

Causes of cerebral palsy

Cerebral palsy occurs with intrauterine development disorders (infection during pregnancy, cytomegalovirus, toxoplasmosis, herpes, late toxicosis of pregnant women, maternal and fetal incompatibility by the Rh factor, violation of autoimmune mechanisms of embryonic development matters). Premature labor, prolonged or rapid labor, labor with the fetus in the wrong position, birth trauma, jaundice increase the risk of the disease. All of the above leads to hypoxia (oxygen starvation) and asphyxia (suffocation) of the fetus. As a result of a lack of oxygen, the laying and development of the child's brain is disrupted.

It is impossible to determine the exact cause of the disease.

Risk factors are somatic and endocrine diseases of the mother (epilepsy, dementia, hypothyroidism), bad habits - alcohol, drugs, a long period of infertility, age under 18 and over 40 years, stress.

Symptoms of cerebral palsy

The disease can manifest itself from the first minutes of life, and maybe during the first months, depending on the severity of the damage to the nervous system. Symptoms of cerebral palsy depend on the degree of underdevelopment of the brain and the location of the affected structures. The severity of symptoms can range from mild to very severe and disabling.

Delay in the development of motor skills in a child, lack of movement, unnecessary movements, poor head retention, convulsions, and a significant lag in speech development are serious symptoms and require immediate referral to a pediatric neurologist.

Most often affected areas of the brain responsible for movement, muscle tone, balance. The brain cannot correctly issue commands and control the muscles. Such a violation manifests itself in the form of paralysis, increased muscle tone, involuntary twitches and movements. The child lags behind in development - he does not move or moves his limbs poorly, he starts holding his head late, rolls over, is interested in toys, sits down, crawls, walks. It cannot be put on legs - the child leans on toes and does not stand on the whole foot, does not hold a toy in his hand, cannot consciously raise a limb, open his fist, move his foot. An increase in muscle tone limits the movement of the child up to a general inability to move.

One limb, one-sided arm-leg, two arms, two legs can be paralyzed. Paralyzed limbs lag behind in development - they remain shorter and thinner than healthy ones, skeletal deformities, joint contractures appear, which further impairs movement. As a result of brain damage, coordination of movements is impaired - gait suffers, the child may fall, make frilly movements, nod his head, and make uncontrolled movements with his limbs.
The baby may have epileptic seizures (loss of consciousness and convulsions).

Perhaps the development of strabismus, nystagmus (twitching of the eyeballs), impaired vision, hearing, mentality, respiration, gastrointestinal tract. Violated learning, behavior.

The structure of the brain and the affected area in cerebral palsy

Depending on the localization of the affected brain structures, according to the International Classification of Diseases, seven groups of cerebral palsy are distinguished:

1 Spastic diplegia (Little's disease);
2 Spastic cerebral palsy (double hemiplegia, tetraplegia);
3 Children's hemiplegia;
4 Dyskinetic cerebral palsy;
5 Ataxic cerebral palsy;
6 Mixed forms of cerebral palsy;
7 cerebral palsy, unspecified.

Diagnosis of cerebral palsy

The diagnosis is made on the basis of a neurological examination and instrumental methods of examination:

Electrophysiological study of muscle potentials and evaluation of peripheral nerves;
- Electroencephalography - functional assessment of brain biocurrents.
- It is also necessary to consult an oculist, an otolaryngologist, a psychiatrist, an epileptologist, an orthopedist.

It is necessary to differentiate (distinguish) cerebral palsy from degenerative-dystrophic progressive diseases, brain tumors, chromosomal diseases, neuromuscular diseases (Werdnig-Hoffmann spinal amyotrophy, congenital myopathies), Oppenheim's myotonia, hereditary lipid metabolism disorders, hepatocerebral dystrophy (Wilson-Konovalov's disease). ), Shtrumpel's spastic paraplegia, the consequences of meningitis suffered in the first year of life.

Given the variety of symptoms and the severity of the listed diseases, self-diagnosis is unacceptable. We can talk about the life of the child, its duration and quality.

Treatment of cerebral palsy

Treatment of cerebral palsy should be started as early as possible and carried out continuously. The disease is incurable, but when treated from an early age, the most favorable development of the child is possible.

In the first years of life, it is most possible to compensate for the defect, reduce the manifestations of spasticity, and consequently, skeletal deformities, contractures, and improve adaptability to normal movements, balance, and self-service.

The child should be observed by a pediatrician, neurologist, orthopedist, speech therapist, psychologist, rehabilitologist. The efforts of all specialists and parents should be aimed at the maximum possible social adaptation of the child. The therapeutic effect should be directed to the daily life of the child, to satisfy his desire to move independently - to take a toy, eat, dress, sit, stand, walk. For each child, an individual training program should be developed by physiotherapists, possibly using assistive devices and special equipment.

Treatment of cerebral palsy should be comprehensive and include drug therapy, constant physical therapy, orthopedic and surgical methods of treatment, psychological assistance, speech development, and spa treatment. The child practically needs to be taught to perform all available movements and maintain them.

Drug treatment of cerebral palsy consists of neuroprotectors, antioxidants, vascular drugs, brain metabolites, muscle relaxants, and vitamins. Cerebrolysin is widely used intravenously, cortexin intramuscularly, ceraxon intravenously - syrup - tablets, somazine - intravenously - syrup, actovegin intravenously - tablets, solcoseryl intravenously, piracetam intravenously - tablets. Injections of these drugs are prescribed by a neurologist. Glycine, neurovitan tablets are prescribed in courses. To relieve spastic muscle tension, depending on the severity, either injections of mydocalm are given, or tablets are prescribed - mydocalm, baclofen or other muscle relaxants. It is possible to introduce drugs into biologically active points of the limbs and face - ATP, prozerin. In especially severe cases, it is possible to use injections of botulinum toxin - Botox, Dysport. The drug is injected into the affected muscle (tense muscle) with a special needle at several points. The procedure is effective, but requires repetition after 6 months.

If a child has epileptic seizures, self-medication is not only unacceptable, but also life-threatening. The selection of antiepileptic drugs is individual, depending on the type of seizure, frequency and severity, age, concomitant diseases. Valproic acid preparations, toparamat, lamotrigine are used. Only a doctor does this. Self-administration and withdrawal of the drug are unacceptable.

Drug treatment of cerebral palsy is symptomatic, it is possible to use painkillers, antispasmodics, antidepressants and tranquilizers.

But the patient with cerebral palsy needs to be engaged in physiotherapy exercises constantly, gradually winning back more and more movements from the disease, adapting to his body and the world around him. Attending classes of rehabilitologists, parents will have to learn both massage techniques and therapeutic exercises, because this treatment will have to be repeated and repeated daily. Therapeutic physical training is also game moments - from “take a candy and bring a ball” to playing the piano and exercising on sports equipment, gymnastic balls, pillows, ladders, walkers.

Physiotherapeutic methods of treatment - balneotherapy, mud and heat treatment, ozocerite, electrophoresis of medicinal substances, electrical stimulation of muscles and nerves.

Surgical treatment of cerebral palsy recommended for severe contractures. Apply plaster bandages and surgical treatment. Orthopedists - surgeons can lengthen tendons and muscles, bones (Achilleoplasty, Arthroplasty), transplant tendons, cut tendons to relieve spasticity, perform nerve operations. The intervention is aimed at the prevention and treatment of contractures, dislocations and subluxations of the joints, to increase the stability of the limb

Balneotherapy- in warm water, muscle tone decreases, hyperkinesis (twitching) decreases, and the volume of active movements increases. Assign iodine-bromine, valerian, coniferous, turpentine, oxygen, radon, sea, pearl baths, hydromassage, swimming. Modern baths "Aquadelicia", "Aquamanus", "Aquapedis" provide an opportunity for underwater massage with jet aeration, chromo-color therapy and ozonation. Four-chamber galvanic baths "Verishofen" combine the possibility of exposure to warm water and galvanic or pulsed current and a medicinal substance - bischofite, turpentine, nicotinic acid, sage, coniferous extract.

Climatic color dynamic quantum - camera combined with laser shower and pool. In the pool, horizontal or vertical traction of the spine, the development of joints, an underwater shower - a massager, a cascade shower - a waterfall are carried out.

Hardware programmed development of joints, simulators of active mechanotherapy with biofeedback are modern methods of treating patients with paralysis.

The complex use of such procedures is highly effective.

Sanatorium - resort treatment - Evpatoria, Saki, Truskavets, Odessa and others, where the most effective methods can be prescribed by treatment methods:

Stage plastering;
- orthopedic-surgical correction;
- massages;
- physiotherapeutic procedures - electrophoresis, magnetotherapy, electrosleep, interdin, myoton, phototherapy, darsonvalization, ultrasound; Electrophoresis is carried out with prozerin, nicotinic acid, fastum - gel;
- acupuncture;
- mud treatment;
- laser therapy;
- shiatsu - therapy - massage of biologically active points;
- classes with a speech therapist;
- in Evpatoria - dolphin therapy - communication and swimming with dolphins;
- Montessori therapy. The Montessori method forms in children a broad outlook, internal motivation to learn new things, the ability to concentrate on work, observation and independence;
- the Bobath technique - helping the child to "self-organize" with the use of aids and special equipment.

Since 2003, an international clinic for rehabilitation treatment has been operating at the balneological resort of Truskavets according to the method of Professor V. Kozyavkin - one of the most effective methods for treating patients with cerebral palsy. These are a system of intensive neurophysiological rehabilitation, biomechanical correction of the spine and large joints, the use of space technologies for the treatment of children, the Spiral suit, physiotherapeutic methods, exercise therapy, and exercise equipment.

The "spiral" suit is used to form the correct stereotype of movements. By stimulating the body's compensatory capabilities and activating brain plasticity, this system creates a new functional state in the body of a patient with cerebral palsy, which opens up opportunities for the child's rapid motor and mental development. Muscle spasticity decreases, new motor skills are acquired. The costume is shown in the photo.

The child is fixed under the armpits, by the pelvis and hips and suspended from the net. The physiotherapist swings the child, turns him, holding the hands, then the legs. The child himself holds on to the rings. In this position, the brain receives the correct signal from the muscles and “in flight” movements are mastered. The technique is recognized by the European Parliament and Russia. Professor Kozyavkin V. is the first Ukrainian to receive the "Vocation" award, which is given to the best doctors in Russia. His method of rehabilitation of patients with cerebral palsy is recognized as one of the four most effective in the world. Statistical analysis of more than 12 thousand patients showed the high efficiency of this system. Normalization of muscle tone was noted in 94% of patients, the formation of proper head control skills in 75% of patients, sitting skills were acquired in 62%, the appearance of independent walking was recorded in 19% of previously non-walking patients, 87% were able to unclench a spastic hand clenched into a fist.

New technologies are being developed, Russian scientists have developed an orthopedic pneumo-suit that fixes the joints, stretches the muscles, strains the muscles from the outside, and a corrected signal enters the brain, and when doing physical therapy, the limbs begin to move correctly, but its cost is tens of thousands of rubles.

Debbie Elnathan's new invention for her son with cerebral palsy is being prepared for general sale in Europe, but it is not known when it will go on sale and how much it will cost. But the idea itself can be adopted. The development allows the child to be in an upright position and walk with the parent.

Unfortunately, cerebral palsy is incurable. The severity of persistent consequences and disability will depend on the volume of brain damage, timely and long-term painstaking treatment. With intact intelligence and the possibility of independent movement, children with cerebral palsy can study in ordinary schools and universities, and work. For severe cases, there are special boarding schools, where education is combined with treatment, taking into account the individual capabilities of the child, professional orientation is carried out in order to prepare for a profession that corresponds to the psychophysical capabilities and interests of the patient.

Prevention of cerebral palsy

Prevention of cerebral palsy is to protect the health of the expectant mother, the exclusion of bad habits, monitoring the course of pregnancy.

Consultation of a doctor on the topic of cerebral palsy:

Question: can cerebral palsy occur in adults?
Answer: Cerebral palsy can also occur in an adult - after a severe traumatic brain injury, stroke, multiple sclerosis, neuroinfection. And although the cause of the diseases is different - the manifestation is the same - paralyzed limbs, high muscle tone, impaired movement, self-service.

Question: when should treatment be started?
Answer: treatment is most effective in the first month, year, three years after the disease. Then comes a period of persistent consequences and treatment is symptomatic.

Question: if time is lost, what to do?
Answer: if time is lost, whether in a child or an adult, treatment is still necessary, although much less effective. Conduct courses of drug therapy prescribed by a doctor, massage, physiotherapy, spa treatment. The goal of treatment remains - maximum adaptation to one's motor defect, self-service, movement, reduction of speech defect, reduction in the number of epileptic seizures.
The use of all kinds of "folk" methods instead of traditional methods can lead to a loss of time, worsen the manifestations of the disease - start the deformation of the skeleton, joints, miss the possibility of surgical correction.

Question: Is cerebral palsy hereditary?
Answer: not sure. It is believed that cerebral palsy is a polyetiological disease. There are hypotheses about a hereditary component in the causes of brain damage. Cerebral palsy is more common in boys and is more severe, which they try to explain by the presence of a hereditary factor of cerebral palsy linked to sex. But there is no clear evidence yet. Perfectly healthy people give birth to sick children, and sick children give birth to healthy ones. Now in the most developed countries they have learned to nurse premature babies with very low weight, but, unfortunately, this contributes to the growth of patients with cerebral palsy.

Question: What is the life expectancy of patients with cerebral palsy?
Answer: Cerebral palsy is not a progressive disease. It leads to disability, but not death. Patients die from associated diseases.

Doctor neurologist of the highest category Svetlana Valentinovna Kobzeva