girl 2 years 1 month walks on tiptoes Mom also walked for a long time, neurologists say that everything is fine The child developed normally everything was on time

Hello, Lyubov Nikolaevna!

My son is 2 years and 2 months old. He still walks on his toes very often. At all appointments, neurologists reassured me: “Nothing, everything will go away on its own. The child will outgrow it. Nothing special happens.” So I believed that my baby didn’t have any problems - it’s so nice to hear! The neurologist prescribed massage for my son until he was one year old. After each session we were told that there was significant improvement. But my child still stood on his toes. And when he walked, he was also on his toes. I turned to another neurologist and the child was diagnosed with “ pyramidal insufficiency" The new neurologist prescribed us a lot of medications and massage again. But when I saw that the child was being massaged the same way as before, I fell into despair. Fortunately, we found out about Nikolai Borisovich Nikonov and turned to him for help.

My daughter is 3.5 years old. She walks on her toes almost all the time. The neurologist prescribes massages for us, we wear orthopedic shoes, take medications - but none of this helps. I just don't know what to do. We have been struggling with the problem for two years now, but no results! The doctors leave me in shock. Every time they give us a new diagnosis and discharge us different treatment. It feels like they are pointing their finger at the sky - what if it helps! Friends advised me to turn to Nikolai Nikonov for help.

My son is almost seven years old. Ever since he learned to walk, he always walks on his toes. The orthopedist says that he does not see any problems in his area. A neurologist diagnoses pyramidal insufficiency. We take prescribed medications and vitamins, and get massages at the clinic three times a year. We also periodically do paraffin wraps, hydromassage, ozokerite and magnetic therapy. Recently we also visited a psychologist. There we were told that we have a reincarnation of the soul, and that is why the child is absent-minded, “having his head in the clouds.” Wherever we turned! I have already come to terms with the fact that my child is special. But he's growing up. And he begins to react painfully to caustic remarks from classmates and neighbors - he worries and often cries. I decided to look for a real specialist. And then, fortunately for us, we found the clinic “Emendo” and Nikolai Borisovich.

My son is 1 year and 8 months old. He still doesn't talk and walks on his toes almost all the time. The neurologist, having learned that Maxim did not speak, did round eyes and told us that everything was very bad and that a child at that age should speak at least 10 words. I even forgot to say that the boy walks on his toes. The neurologist tapped him with a hammer and said there was no problem. I bought orthopedic slippers for my son. But the problem was not solved. He continued to walk on his toes. I was very worried and started looking good specialist who could help. So I found Nikolai Borisovich, who was able to solve both of our problems at once. Therefore, I advise: do not waste your time. Contact him immediately.

My baby is eight months old. His fontanelle has already closed, he has no teeth yet. The baby behaves very restlessly, often wakes up at night and cries - almost choking. He is capricious a lot. When he cries, his chin trembles, he clenches his fists until he trembles. The pregnancy was not entirely successful, and the newborn son was diagnosed with a cystic choroid plexus on an ultrasound of his head. Then it was removed. But the neurologist says that my child is very excitable and therefore he may have a headache and high blood pressure. I can see for myself that my baby is suffering a lot. We were assigned a lot different medications. But I didn’t see any improvement from taking the medications. Doctors are constantly prescribing new ones. I was advised to contact Nikolai Borisovich and start doing Emendic massage.

My child started walking at 9 months. Before this I hardly crawled. Doctors said that the baby went too early. But I didn’t attach any importance to these words. After all, Dima didn’t have any problems then. My appetite was always good and my growth was normal. And when we were one year old, the neurologist said that everything was fine with him. But when Dima turned two, I began to notice his bouncing gait. I began to observe and noticed that Dima often walked on tiptoe. He also runs mostly on his toes. We turned to a neurologist and were diagnosed with pyramidal insufficiency. We immediately turned to massage therapist Nikolai Borisovich Nikonov for help at the Emendo clinic.

My daughter Dasha is now 1 year and 9 months old. Dasha crawled and began to sit on her own when she was 8 months old. I went at one year. Developmentally, everything is fine with us, but we have problems with gait. Dasha walks unsteadily, often stumbles and runs very strangely - as if throwing her legs forward. He often walks on his toes. The orthopedist did not find any problems with us. Ultrasound, ECHO-EG and EEG also showed no abnormalities. The neurologist simply recommended finding a good specialist. That's why we came to Nikolai Borisovich for help.

Doctors do not designate pyramidal insufficiency syndrome in children as an independent diagnosis. This is a set of symptoms indicating a malfunction nervous system child. The disease often manifests itself in children under one year of age. It is difficult to identify the syndrome in children: its symptoms are similar to those of other diseases, such as meningitis, encephalopathy, and mental disability.

Signs

Pyramidal insufficiency is a lesion of the cells of the medulla oblongata, which has pyramidal cells and is responsible for gross motor skills of the limbs. This can happen under the influence various factors, infectious diseases.

The signs of pyramidal insufficiency in children are quite definite:

• tremor of the limbs, chin;
• awkward use of fingers;
• throwing back the head;
• walking on tiptoe.

When the child is 2-3 months old, pyramidal insufficiency, manifested in the form of hypertonicity, does not cause complications. Problems begin when the child gets on his feet at the age of one year. The vertical position causes him discomfort; he stands on his toes and moves around like that.

To diagnose pyramidal insufficiency in children, you can perform an independent test:

• Place your baby on his stomach.
• Bend his knees.
• Feel the muscles in your calves. With pyramidal insufficiency in children, they will be very tense, while the thigh muscles are in optimal condition or relaxed.

When toned, the hips become too flexed or difficult to straighten.

Complications

Treatment of pyramidal insufficiency in children should be carried out. But you should be careful when taking medications. Sometimes a massage is enough for the tone to return to normal.

It is impossible to assume that the baby will “outgrow” the disease or that it will go away on its own. Lack of therapy for 2-3 years will provoke an incorrect distribution of the load on the muscles and a shift in the center of gravity.

These complications are the reason for the appearance of:

• diseases of the legs, joints;
• back problems;
• osteochondrosis, curvature of the spine;
• displacement of vertebral discs;
• headaches;
• pain in the neck area.

Is there hope for parents whose children are affected by pyramidal insufficiency? This is not a sentence, and childhood this condition is well treated. Doctors may diagnose pyramidal insufficiency, while the term refers to a syndrome, or group of symptoms. For treatment you should look for the real reason and carry out complex therapy.

Causes and treatment

The causes of pyramidal insufficiency lie in various areas:

• infectious disease of the mother during pregnancy;
• fetal hypoxia;
• severe intrauterine illnesses of the baby;
• genetic abnormalities;
• tumors;
• wrong lifestyle and bad habits pregnant mother, affecting the condition of the fetus.

It is not always possible to eliminate the cause.

As diagnostic measures doctors prescribe:

• Brain MRI;
• X-ray and others.

Based on the information collected, a diagnosis is made and treatment is prescribed. Doctors are limited to prescribing massage, vitamin complexes, sedative medications. Vitamin therapy consists of taking vitamins B and C. They have a beneficial effect on the nervous system and support the immune system.

It should be understood that complex treatment does not give 100% results. It all depends on the degree of development of the disease. On early stages you can get by with a massage, although it negative side is that the muscles are not fixed.

An endemic massage, which is designed to relieve swelling in the leg muscles, can improve the child’s condition. Cells get rid of them faster harmful substances, are filled nutrients, their work is normalized.

Massage sessions have a beneficial effect on children with pyramidal insufficiency. Kids are active, cheerful and even ahead of their peers in development. Massage is an excellent prevention of spinal curvature.

In case of pyramidal insufficiency, paraffin therapy provides an effect. The procedure is paraffin applications on your feet to warm up your extremities. Paraffin is heated to a liquid state and applied to the baby’s feet. It is safe and does not cause burns. Paraffin therapy stimulates blood flow to the extremities. Often paraffin treatment precedes a massage, which makes the treatment more effective.

There are many treatment options. To choose the right one for your child, you should go to the clinic and consult with a specialist. He will tell you how to treat pyramidal insufficiency.

The pyramidal system is responsible for all the abundance of human movements. When it is deficient, neurons are disinhibited and an excess number of nerve impulses appears.

Pyramidal cells or Betz cells are located in the 5th layer of the cerebral cortex. Pyramidal deficiency is diagnosed using magnetic resonance imaging and computed tomography of the brain. Magnetic resonance imaging is an indispensable method of examination when seizures and symptoms of epilepsy occur. Computed tomography of the brain is performed in cases where it is impossible to conduct an MRI study. Pyramidal deficiency can be diagnosed using electromyography. This is a way of researching the neuromuscular system by recording and analyzing the electronic potential of muscles. EEG study(electroencephalography) makes it possible to identify the cause of seizures. The method makes it possible to detect the occurrence of epileptiform activity and diffuse delta waves. Ultrasound ( ultrasound examination) brain helps to identify signs of overestimated intracranial pressure in the brain, which can have an irritating effect and cause paralysis.

If a pathological focus develops or the blood supply in the area is disrupted pyramid system central paralysis occurs. Pyramidal deficiency is also determined by electromyography, which examines the neuromuscular system. Virtually everything central palsies and paresis in diseases of the brain is accompanied by obvious or hidden convulsions, which further increase the area of ​​brain damage.

The disease manifests itself in the form of increased muscle tone, as well as reflexes and tendon reflexes. Right-sided pyramidal deficiency is accompanied by oculomotor and visual disturbances, lowering the mind. There is a gait disturbance, ataxia of coordination tests, intention tremor, scanned speech, and nystagmus.

The causes may be tumors, inflammatory processes, congenital pathologies and hemorrhages that cause a disease such as pyramidal deficiency. Healing in this case is symptomatic.

Pyramidal deficiency has identical symptoms to brain dysfunction syndrome, different types encephalopathies, with cerebrospinal fluid hypertension syndrome, so making a diagnosis is sometimes difficult. Depending on the location of the lesion, it is likely different manifestations diseases. Alternating syndromes appear when there are disorders in the brain stem. Paresis occurs with damage projection zones cerebral cortex. Damage in the area spinal cord accompanied by hemiplegia on the side opposite to the lesion.

Healing pyramidal deficiency should be focused on the underlying disease. More important is the restoration of motor activity during paralysis. You need to adhere to the principle of increasing physical activity. Therapy for pyramidal deficiency involves taking drugs such as Cerebrolysin, nootropil, glutamic acid, encephabol, aminalon. These tools do better metabolism nerve cells. To normalize the conduction of nerve impulses, it is recommended to take dibazol and proserin. Vitamins E and B, baclofen, mydocalm and lioresal normalize muscle tone. Excellent results in the treatment of pyramidal deficiency are obtained by exercise therapy, reflexology and acupressure aimed at reducing muscle tone. In parallel, physiotherapy, balneotherapy and orthopedic measures are carried out. In the presence of injuries to the brain and spinal cord, as well as tumors, neurosurgical treatment is prescribed. Surgery prescribed when acute disorders functions cerebral circulation, malformations cerebral vessels, with the formation of intracerebral hematoma, stenosis or thrombosis of extracerebral arteries.

In general, all issues related to the field of child neurology are very complex and it is not at all easy for uninitiated people to understand. Well, you must admit that most parents are capable of curing sniffles in a child, but what to do if the baby begins to throw back his head or walks on his toes? After all, you most likely will not be able to figure this out and find the reason on your own. But an experienced neuropathologist, unfortunately, is a rarity, and sometimes it is almost impossible to find one. Often, an appeal to a neurologist ends with a referral for a massage and an endlessly long list of medications, most of which are scary to take even on your own, and not what to give to a child. In addition, many diagnoses, such as pyramidal insufficiency, although they sound very smart, cause quite a bit of suspicion.

It makes no sense to argue with a neurologist, even if he is wrong, especially since he still will not admit that he was wrong, and will simply drown you in a huge amount of specific terminology. This is quite standard defensive reaction any doctor to whom his mistakes are pointed out by an ordinary “mortal”.

Pyramidal insufficiency is a diagnosis that does not exist.

It’s up to you to follow your doctor’s instructions or not, but in order for you to make a really right decision, let’s try to figure out what kind of disease this is - pyramidal insufficiency, or as it is also called - pyramidal insufficiency.

First, let's figure out where this name came from - pyramidal. Medulla oblongata responsible for execution complex reflexes. It is part of the brain and connects it with the spinal cord. It consists of many anatomical cells - pyramids, hence the name - pyramidal. As a result of damage to part of these pyramidal cells, some kind of movement disorder may occur. If we talk about what pyramidal insufficiency is, then everything is much more complicated here, since neither international classification diseases, this diagnosis is not mentioned in textbooks and reference books on child neurology. It simply doesn't exist. However, this does not stop most neurologists from giving it to thousands of children.

Treatment of pyramidal insufficiency.

It should be noted that pyramidal insufficiency is far from the only non-existent diagnosis. It means that the child has some problems in the motor sphere, but to understand the reason for their appearance, that is, make a diagnosis, which means prescribe correct treatment, is possible only if there are a number of others, accompanying symptoms. But in most cases, the diagnosis of pyramidal insufficiency is made when there are no other symptoms, or they have not yet manifested themselves, which means there is no point in prescribing treatment. However, treatment is prescribed, and it’s good if it’s just a massage, which most likely will not harm your baby in any way. But if you have already visited a neurologist, then you probably know that most of the medications they prescribe are far from harmless; this is not ascorbic acid or even an aspirin tablet.

Therefore, if your neurologist tells you, “Mom, go home, you are completely healthy child" Do just that, maybe you were just lucky and found a good doctor.

I think there is no point in treating a non-existent disease. But do not forget that the diagnosis of pyramidal insufficiency, although it is a so-called “excuse”, does not mean that there is no problem at all, therefore, watch the child at home for some time, perhaps some symptoms will appear additional symptoms, the presence of which will help the doctor diagnose correct diagnosis and prescribe treatment that will be effective and really help eliminate the problem.

In addition, most of the symptoms that are most often used to diagnose pyramidal insufficiency, such as.

Ballerina's symptom, walking on tiptoes or on tiptoes, equinus planting of the feet - all these are names of one pathology - pyramidal insufficiency syndrome. The violation may be caused huge number reasons, but is invariably accompanied by moderate/severe muscle dystonia with hypertonicity of the foot and leg. Pyramidal insufficiency with bilateral dystonia, as usual, is monitored in newborns and babies in the first year of life, and is less often diagnosed in children 2-3 years of age.

Why does pyramidal insufficiency occur?

The medulla oblongata is responsible for difficult reflexes. It is part of the brain and connects the terminal to the spinal cord. The organ consists of anatomical cells - pyramids. Hence the name – pyramidal.

When these cells are damaged, movement disorders occur. It is worth noting that in medicine there is no diagnosis of “pyramidal or pyramidal insufficiency”. However, it is given to many children and not always for good reason.

The cause of pathology in a child is perinatal mechanical or ischemic injury cervical spine spinal cord. When the blood circulation of the cervical thickening and the brain stem is disrupted, a daring deviation of the muscle tone of the flexors in the limbs is formed.

The severity depends on the severity of the lesion. The arms become stiff, and with more widespread ischemia, disturbances are also observed in the legs - when the baby is placed on his legs, he unwaveringly rests on his toes (distal parts of the foot).

Symptoms and signs

Key signs of pyramidal insufficiency:

• Trembling chin;
• Hand tremors;
• Throwing the head back;
• Poor grasp reflex;
• Difficulty holding objects;
• Curling your toes in a standing position;
• Walking on your toes.

In children up to 2-3 months this state does not cause concern because they have normal muscle hypertonicity. When the vertical position of the body becomes physiologically intensified, and the baby does not walk normally, it is necessary to determine muscular dystonia - the main symptom of pyramidal insufficiency or spastic paresis of the lower extremities.

The diagnosis is confirmed by the presence of high tendon reflexes, the Babinski reflex persisting for 2-3 months, revival of the tendon reflexes of the hands, delayed reduction of others (mechanical gait, mechanical crawling, Moro, etc.).

Pyramidal insufficiency syndrome can be detected in an infant using the original test: the baby is placed on his stomach, the shin is bent halfway at the knee, and the calf muscles, examine the tone of the buttocks. In a typical state, muscle tension is identical.

If there is a violation, the calf muscles are tense, the buttocks are in a state of hypotension or typical tone. The pathology often affects the rectus femoris muscles: the legs bend immeasurably hip joints, when you bring them to the tummy, they are difficult to straighten for a child lying on his back.

Features of deviation

Pyramidal insufficiency, diagnosed in children, poses a threat because it entails functional disorders called syndrome motor disorders(SDN). In such children, attitudinal reflexes and motor skills are formed late, that is, their development will be delayed (the child will sit up late, crawl, walk, etc.).

Essentially, such a diagnosis means a violation motor sphere, but treatment can be prescribed only on the basis of other signs and later finding out the reasons for the violation.

Almost invariably, the diagnosis of “pyramidal insufficiency” is made when other signs of pathology have not appeared or are absent at all. That is, prescribing any treatment is unsuccessful.

Tumors, inflammatory processes, some congenital pathologies and infections, hemorrhages are the main causes of deficiency, or rather, it is their symptom and a secondary disorder. Considering which part of the body has stopped moving normally, the neurologist correctly determines the affected area of ​​the pyramidal system.

The main method of diagnosis is computed tomography. The procedure allows you to correctly identify the lesion in a matter of minutes.

In any case, before prescribing treatment, the doctor must make an accurate, or, one might say, officially present diagnosis. For example, movement disorders can be caused by minimal brain dysfunction, encephalopathies, and liquor hypertension syndrome.

True neurological pathologies may occur:

• birth injuries;
• congenital diseases of the nervous system;
• brain damage as a result of hypoxia during childbirth (oxygen deficiency);
• infectious diseases;
• tumors;
• abscesses in the spinal cord or brain;
• disturbances in the production and outflow of cerebrospinal fluid;
• encephalitis and meningitis, causing hydrocephalus.

All of the above pathologies have characteristic features and certain methods of treatment, it is therefore impossible to prescribe any important medical measures on the basis of each movement disorder alone. For example, throwing the head back is one of the signs of meningitis, but no one makes a diagnosis based on this sign alone.

Treatment of children with pyramidal insufficiency

If none of the listed diagnoses is confirmed, then the violation can be eliminated without medications. Mainly assigned different procedures physiotherapy. Massage is widely used. We need both the support of a qualified expert and the involvement of parents.

An experienced massage therapist will relieve tone and strengthen muscles. Massage courses traditionally take place every six months. Parents are required to do special preventive exercises with their child every day.

Gymnastics, swimming, exercises for coordination of movements have a beneficial effect on the body as a whole and on motor activity in particular.

This applies to both adults and children. Vitamins and medications that improve energy metabolism may be prescribed. It is worth noting that it is necessary to choose special orthopedic shoes when the baby tries to walk. It should have a rough back and a closed front.

If any disease is found that has led to the disorder, treatment is directed both at its elimination and at secondary disorders; it is necessary to stop the signs of pyramidal insufficiency, exclusively in children.

The following drugs may be prescribed:

• Improving metabolic processes in nerve cells, say, Nootropil, Encephabol, Cerebrolysin, Aminalon, glutamic acid;
• To improve the conduction of a nervous impulse, Dibazol and Proserin are prescribed;
• Vasoactive agents for microcirculation;
• Substances that normalize muscle tone (eg. Baclofen, Mydocalm, Lioresal);
• Vitamin E and group B.

Acupressure and relaxation massage, exercise therapy, reflexology help reduce tone. Orthopedic measures and balneotherapy may also be required. In all cases, treatment methods may differ.

TO surgical interventions resorted to when injuries/tumors of the brain or spinal cord are diagnosed, severe violations cerebral circulation that cannot be eliminated conservative ways(thrombosis, stenosis of extracerebral arteries, malformations of cerebral vessels, intracerebral hematoma, etc.).

If there is the slightest doubt about the disease, parents should immediately seek diagnosis and treatment from an expert. Health to you and your children!