We will talk about why a child’s central nervous system is affected and how to help the baby in this article.

What is it

The central nervous system is a close “ligament” of two important links - the brain and spinal cord. The main function that nature assigned to the central nervous system is to provide reflexes, both simple (swallowing, sucking, breathing) and complex. The central nervous system, or rather its middle and lower sections, regulates the activity of all organs and systems and ensures communication between them. The highest section is the cerebral cortex. It is responsible for self-awareness and self-awareness, for a person’s connection with the world, with the reality surrounding the child.

Disturbances, and consequently damage to the central nervous system, can begin during the development of the fetus in the mother’s womb, or can occur under the influence of certain factors immediately or some time after birth.

Which part of the central nervous system is affected will determine which body functions will be impaired, and the degree of damage will determine the extent of the consequences.

Reasons

In children with central nervous system disorders, about half of all cases occur due to intrauterine lesions; doctors call this perinatal pathologies of the central nervous system. Moreover, more than 70% of them are premature children who were born before the due obstetric period. In this case, the main root cause lies in the immaturity of all organs and systems, including the nervous system; it is not ready for autonomous work.

Approximately 9-10% of toddlers born with lesions of the central nervous system were born on time with normal weight. Experts believe that the state of the nervous system in this case is influenced by negative intrauterine factors, such as prolonged hypoxia, which the baby experienced in the mother’s womb during gestation, birth injuries, as well as a state of acute oxygen starvation during a difficult delivery, metabolic disorders of the child, which Infectious diseases suffered by the expectant mother and complications of pregnancy began even before birth. All lesions that resulted from the above factors during pregnancy or immediately after childbirth are also called residual organic:

• Fetal hypoxia. Most often, babies whose mothers abuse alcohol, drugs, smoke or work in hazardous industries suffer from a lack of oxygen in the blood during pregnancy. The number of abortions that preceded this birth is also of great importance, since the changes that occur in the tissues of the uterus after termination of pregnancy contribute to the disruption of uterine blood flow during subsequent pregnancies.

• Traumatic causes. Birth injuries can be associated both with incorrectly chosen delivery tactics and with medical errors during the birth process. Injuries also include actions that lead to disruption of the child’s central nervous system after childbirth, in the first hours after birth.
• Fetal metabolic disorders. Such processes usually begin in the first - early second trimester. They are directly related to disruption of the functioning of the organs and systems of the baby’s body under the influence of poisons, toxins, and certain medications.
• Infections in the mother. Diseases that are caused by viruses (measles, rubella, chickenpox, cytomegalovirus infection and a number of other ailments) are especially dangerous if the disease occurs in the first trimester of pregnancy.

• Pathologies of pregnancy. The state of the child’s central nervous system is influenced by a variety of features of the gestation period - polyhydramnios and oligohydramnios, pregnancy with twins or triplets, placental abruption and other reasons.
• Severe genetic diseases. Typically, pathologies such as Down and Edwards syndromes, trisomy and a number of others are accompanied by significant organic changes in the central nervous system.

At the current level of development of medicine, CNS pathologies become obvious to neonatologists already in the first hours after the baby is born. Less often - in the first weeks.

Sometimes, especially with organic lesions of mixed origin, the true cause cannot be established, especially if it is related to the perinatal period.

Classification and symptoms

The list of possible symptoms depends on the causes, degree and extent of damage to the brain or spinal cord, or combined damage. The outcome is also influenced by the time of negative impact - how long the child was exposed to factors that affected the activity and functionality of the central nervous system. It is important to quickly determine the period of the disease - acute, early recovery, late recovery or the period of residual effects.

All pathologies of the central nervous system have three degrees of severity:

• Easy. This degree is manifested by a slight increase or decrease in the baby’s muscle tone, and converging strabismus may be observed.

• Average. With such lesions, muscle tone is always reduced, reflexes are completely or partially absent. This condition is replaced by hypertonicity and convulsions. Characteristic oculomotor disturbances appear.
• Heavy. Not only motor function and muscle tone suffer, but also internal organs. If the central nervous system is severely depressed, convulsions of varying intensity may begin. Problems with cardiac and renal activity can be severe, as can the development of respiratory failure. The intestines may be paralyzed. The adrenal glands do not produce the necessary hormones in the required quantities.

According to the etiology of the cause that caused problems with the activity of the brain or spinal cord, pathologies are divided (however, very arbitrarily) into:

• Hypoxic (ischemic, intracranial hemorrhages, combined).
• Traumatic (birth injuries of the skull, birth spinal lesions, birth pathologies of peripheral nerves).
• Dysmetabolic (kernicterus, excess levels of calcium, magnesium, potassium in the child’s blood and tissues).
• Infectious (consequences of infections suffered by the mother, hydrocephalus, intracranial hypertension).

The clinical manifestations of different types of lesions also differ significantly from each other:

• Ischemic lesions. The most “harmless” disease is grade 1 cerebral ischemia. With it, the child demonstrates central nervous system disorders only in the first 7 days after birth. The reason most often lies in fetal hypoxia. At this time, the baby can observe relatively mild signs of excitement or depression of the central nervous system.
• The second degree of this disease is diagnosed if disturbances and even seizures last more than a week after birth. We can talk about the third degree if the child has constantly increased intracranial pressure, frequent and severe convulsions are observed, and there are other autonomic disorders.

Typically, this degree of cerebral ischemia tends to progress, the child’s condition worsens, and the baby may fall into a coma.

• Hypoxic cerebral hemorrhages. If, as a result of oxygen starvation, a child has hemorrhage inside the ventricles of the brain, then in the first degree there may be no symptoms and signs at all. But the second and third degrees of such hemorrhage lead to severe brain damage - convulsive syndrome, the development of shock. The child may fall into a coma. If blood enters the subarachnoid cavity, the child will be diagnosed with overexcitation of the central nervous system. There is a high probability of developing acute dropsy of the brain.

Bleeding into the underlying substance of the brain is not always noticeable at all. Much depends on which part of the brain is affected.

• Traumatic lesions, birth injuries. If during the birth process doctors had to use forceps on the baby’s head and something went wrong, if acute hypoxia occurred, then most often this is followed by a cerebral hemorrhage. During birth trauma, the child experiences convulsions to a more or less pronounced degree, the pupil on one side (the one where the hemorrhage occurred) increases in size. The main sign of traumatic injury to the central nervous system is increased pressure inside the child's skull. Acute hydrocephalus may develop. The neurologist testifies that in this case the central nervous system is more often excited than depressed. Not only the brain, but also the spinal cord can be injured. This most often manifests itself as sprains, tears, and hemorrhage. In children, breathing is impaired, hypotension of all muscles, and spinal shock are observed.
• Dysmetabolic lesions. With such pathologies, in the overwhelming majority of cases, the child has increased blood pressure, convulsive attacks are observed, and consciousness is quite clearly depressed. The cause can be determined by blood tests that show either a critical deficiency of calcium, or a lack of sodium, or another imbalance of other substances.

Periods

The prognosis and course of the disease depends on what period the baby is in. There are three main periods of development of pathology:

• Spicy. The violations have just begun and have not yet had time to cause serious consequences. This is usually the first month of a child’s independent life, the newborn period. At this time, a baby with lesions of the central nervous system usually sleeps poorly and restlessly, cries often and for no apparent reason, he is excitable, and can flinch without a stimulus even in his sleep. Muscle tone is increased or decreased. If the degree of damage is higher than the first, then reflexes may weaken, in particular, the baby will begin to suck and swallow worse and weaker. During this period, the baby may begin to develop hydrocephalus, which will be manifested by noticeable head growth and strange eye movements.

• Restorative. It can be early or late. If the baby is aged 2-4 months, then they talk about early recovery, if he is already from 5 to 12 months, then about late recovery. Sometimes parents notice disturbances in the functioning of the central nervous system in their baby for the first time in the early period. At 2 months, such toddlers hardly express any emotions and are not interested in bright hanging toys. In the late period, the child noticeably lags behind in his development, does not sit, does not walk, his cry is quiet and usually very monotonous, without emotional coloration.
• Consequences. This period begins after the child turns one year old. At this age, the doctor is able to most accurately assess the consequences of a central nervous system disorder in this particular case. Symptoms may disappear, but the disease does not go away. Most often, doctors make such verdicts per year for such children as hyperactivity syndrome, developmental delay (speech, physical, mental).

The most severe diagnoses that can indicate the consequences of central nervous system pathologies are hydrocephalus, cerebral palsy, and epilepsy.

Treatment

We can talk about treatment when lesions of the central nervous system are diagnosed with maximum accuracy. Unfortunately, in modern medical practice there is a problem of over-diagnosis, in other words, every baby whose chin trembles during a monthly examination, who eats poorly and sleeps restlessly, can easily be diagnosed with “cerebral ischemia.” If a neurologist claims that your baby has damage to the central nervous system, you should definitely insist on a comprehensive diagnosis, which will include an ultrasound of the brain (through the fontanel), computed tomography, and in special cases, an x-ray of the skull or spine.

Each diagnosis that is in some way associated with lesions of the central nervous system must be diagnostically confirmed. If signs of a central nervous system disorder are noticed in the maternity hospital, then timely assistance provided by neonatologists helps to minimize the severity of possible consequences. It just sounds scary - damage to the central nervous system. In fact, most of these pathologies are reversible and subject to correction if detected in time.

For treatment, medications that improve blood flow and blood supply to the brain are usually used - a large group of nootropic drugs, vitamin therapy, anticonvulsants.

Only a doctor can name an exact list of medications, since this list depends on the causes, degree, period and depth of the lesion. Drug treatment for newborns and infants is usually provided in a hospital setting. After relief of symptoms, the main stage of therapy begins, aimed at restoring proper functioning of the central nervous system. This stage usually takes place at home, and parents bear a lot of responsibility for following numerous medical recommendations.

Children with functional and organic disorders of the central nervous system need:

• therapeutic massage, including hydromassage (procedures take place in water);
• electrophoresis, exposure to magnetic fields;
• Vojta therapy (a set of exercises that allows you to destroy reflex incorrect connections and create new - correct ones, thereby correcting movement disorders);
• Physiotherapy for the development and stimulation of the development of sensory organs (music therapy, light therapy, color therapy).

Such exposures are allowed for children from 1 month and must be supervised by specialists.

A little later, parents will be able to master the techniques of therapeutic massage on their own, but for several sessions it is better to go to a professional, although this is quite an expensive pleasure.

Consequences and forecasts

The future prognosis for a child with lesions of the central nervous system can be quite favorable, provided that he is provided with prompt and timely medical care in the acute or early recovery period. This statement is true only for mild and moderate lesions of the central nervous system. In this case, the main prognosis includes full recovery and restoration of all functions, minor developmental delay, and subsequent development of hyperactivity or attention deficit disorder.

In severe forms, the prognosis is not so optimistic. The child may remain disabled, and deaths at an early age are not excluded. Most often, lesions of the central nervous system of this kind lead to the development of hydrocephalus, cerebral palsy, and epileptic seizures. As a rule, some internal organs also suffer; the child simultaneously experiences chronic diseases of the kidneys, respiratory and cardiovascular systems, and marbled skin.

Prevention

Prevention of pathologies from the central nervous system in a child is the task of the expectant mother. At risk are women who do not give up bad habits while carrying a baby - smoking, drinking alcohol or using drugs.

All pregnant women must be registered with an obstetrician-gynecologist in the antenatal clinic. During pregnancy, they will be asked to undergo so-called screening three times, which identifies the risks of having a child with genetic disorders from that particular pregnancy. Many gross pathologies of the fetal central nervous system become noticeable even during pregnancy; some problems can be corrected with medications, for example, disturbances in uteroplacental blood flow, fetal hypoxia, and the threat of miscarriage due to a small detachment.

A pregnant woman needs to monitor her diet, take vitamin complexes for expectant mothers, not self-medicate, and be careful about various medications that have to be taken during pregnancy.

This will avoid metabolic disorders in the baby. You should be especially careful when choosing a maternity home (the birth certificate that all pregnant women receive allows you to make any choice). After all, the actions of personnel during the birth of a child play a large role in the possible risks of traumatic lesions of the central nervous system in the baby.

After the birth of a healthy baby, it is very important to regularly visit the pediatrician, protect the baby from injuries to the skull and spine, and get age-appropriate vaccinations that will protect the little one from dangerous infectious diseases, which at an early age can also lead to the development of pathologies of the central nervous system.

In the next video, you will learn about signs of a nervous system disorder in a newborn, which you can determine yourself.

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Pathologies of the central nervous system in newborns

Pathologies of the central nervous system (CNS) in newborns are a large group of spinal cord/brain lesions. Such lesions can occur during fetal development, during childbirth and in the first days of life.

Causes of development of central nervous system pathologies in newborns

According to statistics, up to 50% of newborn children are diagnosed with perinatal pathologies of the central nervous system, because doctors often include transient disorders in the functioning of the central nervous system in this concept. If we look at the statistics in more detail, it will become clear:

• 60-70% of cases of diagnosing pathologies of the central nervous system in newborns occur after the birth of a premature baby;
• 1.5 - 10% of cases - for full-term children born in a timely and natural way.

A factor provoking the appearance of pathological changes in the functioning of the central nervous system in newborns can be absolutely any negative impact on the fetus during its intrauterine development. In general, doctors identify several main causes of the condition in question:

1. Fetal hypoxia. We are talking about oxygen starvation, when an insufficient amount of oxygen from the mother’s body enters the child’s blood. Hypoxia can be triggered by harmful work practices (it’s not for nothing that pregnant women are immediately transferred to lighter work), infectious diseases suffered before pregnancy, and a woman’s bad habits (especially smoking). The number of previous abortions also greatly affects the oxygen supply to the fetus - artificial termination of pregnancy provokes future disruption of blood flow between the mother and the fetus.
2. Newborn injuries. We are talking about injury during childbirth (for example, when applying forceps for medical reasons), in the first hours/days of a newborn’s life. It is physical trauma that is considered the least likely cause of the development of pathologies of the central nervous system in newborns.
3. Dysmetabolic processes in a newborn. Disturbances in the metabolic processes of the fetal body can occur due to maternal smoking, drug use, alcohol consumption, or forced use of potent medications.
4. Maternal infectious diseases during the period of bearing a child. Pathological damage to the central nervous system occurs when the fetus is directly exposed to viral agents or pathogenic microorganisms.

Please note: Regardless of whether the above factors were present, CNS pathologies in newborns are more often diagnosed in the case of premature birth, in premature infants.

Classification of CNS pathologies in newborns

Depending on what reasons provoked the development of disorders in the central nervous system of the newborn, doctors also classify them. Each type is characterized by specific symptoms and nosological forms.

Hypoxic lesions

Oxygen starvation of the fetus can lead to the following damage to the central nervous system in newborns:

1. Cerebral ischemia. The nosological form of this pathology manifests itself in different degrees of severity - cerebral ischemia of 1, 2 and 3 degrees of severity. Clinical symptoms:

• 1st degree cerebral ischemia – depression or excitation of the central nervous system is observed, lasting no more than 7 days after birth;
• cerebral ischemia of the 2nd degree - depression/excitation of the nervous system lasts more than 7 days, short-term convulsions may be observed, increased intracranial pressure and disorders of the autonomic-visceral type are recorded;
• cerebral ischemia of the 3rd degree - powerful convulsions, up to epileptic seizures, dysfunction of the brain stem, constantly increased intracranial pressure.

Please note: Grade 3 severity of the pathological condition in question is characterized by progressive depression of the central nervous system - in some cases, the newborn enters a comatose state.

1. Intracranial hemorrhages of hypoxic origin. Nosological forms are varied:

• intraventricular hemorrhage of the 1st degree - specific neurological symptoms, as a rule, are completely absent;
• intraventricular hemorrhage of the 2nd degree - convulsions may develop, the newborn often falls into a coma, progressive intracranial hypertension, shock, apnea are noted;
• intraventricular hemorrhage of the 3rd degree - deep depression of the central nervous system (coma), shock and apnea, prolonged convulsions, high intracranial pressure;
• subarachnoid hemorrhage of the primary type - doctors diagnose hyperexcitability of the central nervous system, focal clonic convulsions, acute hydrocephalus;
• hemorrhage into the substance of the brain - the appearance of specific symptoms depends only on the location of the hemorrhage. Possible: intracranial hypertension/focal seizures/convulsions/coma, but in some cases even such a serious disturbance of the central nervous system is asymptomatic.

1. Combination of ischemic and hemorrhagic lesions of the central nervous system. The clinical picture and nosological forms of this condition will depend only on the location of the hemorrhage and the severity of the pathology.

Traumatic lesions

We are talking about birth injuries that caused the development of pathological disorders in the central nervous system. They are divided according to the following principle:

1. Intracranial birth injury. It can manifest itself in several nosological forms:

• hemorrhage of the epidural type - the condition is characterized by high intracranial pressure (the very first sign), convulsive syndrome, in rare cases, doctors record pupil dilation on the side of the hemorrhage;
• subdural hemorrhage - divided into supratentorial (asymptomatic, but partial convulsions, pupil dilation from the hemorrhage, progressive intracranial hypertension may appear) and subtentorial (acute increase in intracranial pressure, progressive cardiac/respiratory disturbances, central nervous system depression leading to coma);
• intraventricular hemorrhage – characterized by convulsions (multifocal), cardiac/respiratory failure, central nervous system depression, hydrocephalus;
• hemorrhagic infarction - the course may be asymptomatic, but may manifest itself as convulsions, depression of the central nervous system with transition to coma, high intracranial pressure;
• subarachnoid hemorrhage - doctors diagnose acute external hydrocephalus, hyperexcitability and convulsions.

1. Spinal cord injury during childbirth. There is a hemorrhage in the spinal cord - a tear, a stretch. It can either be accompanied by a spinal injury or occur without this moment. The clinical picture is characterized by impaired functioning of the respiratory system, dysfunction of the sphincters, motor disorders and spinal shock.
2. Trauma to the peripheral nervous system during childbirth. Nosological forms and symptoms:

• damage to the brachial plexus - there is flaccid paresis of the proximal part of one or both arms in the case of the proximal type, flaccid paresis of the distal upper extremities and Claude Bernard-Horner syndrome in the distal type of damage. Total paralysis may develop - paresis of the total part of the arm or both arms is observed at the same time, a disruption of the respiratory system is possible;
• damage to the phrenic nerve - often occurs without any significant symptoms, but respiratory problems may occur;
• traumatic damage to the facial nerve - when a child screams, the mouth tilts to the healthy side, the nasolabial folds are smoothed out.

Dysmetabolic disorders

First of all, doctors consider transient metabolic disorders:

• kernicterus – characterized by the “setting sun” symptom, convulsions, opisthotonus and apnea;
• hypomagnesemia – convulsions and hyperexcitability are noted;
• hypernatremia – increased blood pressure, rapid breathing and heart rate;
• hyperglycemia – depressed consciousness, convulsions, but often this disorder is asymptomatic and is detected only after laboratory tests of the newborn’s blood and urine;
• hypercalcemia – convulsions, tachycardia, increased blood pressure, tetanic muscle spasms;
• hyponatremia – low blood pressure, depression of the central nervous system.

Newborns may develop dysmetabolic disorders of the central nervous system against the background of toxic effects on the fetus’s body - for example, if the mother was forced to take potent medications and did not exclude alcohol, drugs and tobacco. In this case, the clinical picture will be as follows:

• seizures are rare, but this syndrome may be present;
• hyperexcitability;
• depression of the central nervous system, turning into coma.

CNS lesions in infectious diseases

If during pregnancy a woman was diagnosed with cytomegalovirus infection, toxoplasmosis, rubella, herpes infection or syphilis, then the likelihood of having a child with pathologies of the central nervous system increases significantly. There are some infectious diseases that can contribute to the development of problems in the central nervous system after the birth of a child - sepsis, Pseudomonas aeruginosa infection, streptococcal and staphylococcal infections, candidiasis and others.

With lesions of the central nervous system of infectious etiology, the following symptoms will be identified:

• intracranial hypertension;
• hydrocephalus;
• focal disorders;
• meningeal syndrome.

Periods of the course of central nervous system pathologies in newborns

Regardless of the reasons for the development of central nervous system lesions in newborns, experts distinguish three periods of the disease:

• acute – occurs in the first month of a child’s life;
• restorative - can occur from 2 to 3 months of the baby’s life (early) and from 4 months to 1 year (late);
• outcome of the disease.

Each of the listed periods has characteristic features that may be present individually, but more often appear in original combinations individually for each child.

Acute period

If a newborn has mild damage to the central nervous system, then hyperexcitability syndrome is most often diagnosed. It manifests itself as a sharp shudder, disturbances in muscle tone (it can be increased or decreased), trembling of the chin and upper/lower limbs, unmotivated crying and shallow sleep with frequent awakenings.

If the central nervous system is of moderate severity, there will be a decrease in muscle tone and motor activity, and a weakening of swallowing and sucking reflexes.

Please note: By the end of the first month of life, hypotonicity and lethargy are replaced by increased excitability, uneven coloring of the skin appears (marbling of the skin), disturbances in the functioning of the digestive system are noted (constant regurgitation, flatulence, vomiting.

Very often, the acute period of the disease is accompanied by the development of hydrocephalic syndrome - parents may note a rapid increase in head circumference, protrusion of the fontanel, divergence of cranial sutures, restlessness of the newborn and unusual eye movements.

Coma can occur only with very severe damage to the central nervous system in newborns - this condition requires immediate assistance from medical workers, all treatment measures are carried out in the intensive care unit of a medical institution.

Recovery period

If up to 2 months the child looked absolutely healthy, the parents did not note any strange/unusual syndromes, then the recovery period may occur with pronounced symptoms:

• facial expressions are very poor - the baby rarely smiles, does not squint, does not show any emotions;
• no interest in toys or any other objects;
• the cry is always weak and monotonous;
• baby babble and “humming” either appear with a delay or are completely absent.

Please note: It is the parents who should pay attention to the above symptoms and report them to the pediatrician. The specialist will prescribe a full examination of the child and refer the little patient for examination to a neurologist.

Outcome of the disease

By the 12th month of a child’s life, symptoms of central nervous system pathologies in newborns almost always disappear, but this does not mean that the lesions described above have disappeared without any consequences. The most common consequences of damage to the central nervous system in newborns include:

• hyperactivity syndrome accompanied by a lack of attention - memory impairment, learning difficulties, aggressiveness and hysterical attacks;
• delayed speech, psychomotor and physical development;
• cerebroasthenic syndrome– characterized by weather dependence, restless sleep, sudden mood swings.

But the most severe, complex consequences of central nervous system pathologies in newborns are epilepsy, cerebral palsy and hydrocephalus.

Diagnostic measures

For correct diagnosis, it is very important to conduct a proper examination of the newborn and monitor his behavior/condition in the first hours of the baby’s life. If pathological lesions of the central nervous system are suspected, it is advisable to prescribe a comprehensive examination:

• ultrasonic– study the state of the blood vessels of the brain, “working” with a sensor through the fontanelle;
• computed tomography– the study allows not only to confirm the expected diagnosis, but also to assess the degree of damage to the central nervous system of the newborn;
• X-ray of the brain and/or spinal cord– used only in cases of extreme necessity.

Methods of treatment and rehabilitation

Help for newborns with central nervous system pathologies is necessary in the first hours of life - many disorders are completely reversible, and rehabilitation/treatment can be started immediately.

First stage of help

It consists in restoring the functionality of vital organs and systems - let us recall that in almost all types/forms of pathologies of the central nervous system of newborns, cardiac/respiratory failure and problems in the functioning of the kidneys appear. Doctors use medications to normalize metabolic processes, relieve a newborn from convulsive syndrome, relieve swelling of the brain and lungs, and normalize intracranial pressure.

Second stage of assistance

Very often, after emergency measures are provided to a newborn with central nervous system pathologies, visible signs disappear in the maternity hospital, and the child’s condition often returns to normal. But if this does not happen, the patient is transferred to the neonatal pathology department and treatment/rehabilitation continues.

The second stage of assistance involves the prescription of medications that act to eliminate the cause of the pathologies in question - for example, antiviral and antibacterial agents. At the same time, therapy is prescribed aimed at restoring brain activity, stimulating the maturation of brain cells, and improving cerebral circulation.

Third stage of assistance

If the newborn shows significant improvements in the condition, then it is advisable to switch to non-drug treatment. We are talking about massages and physiotherapeutic procedures, the most effective of which are considered:

• therapeutic exercises;
• “position” therapy - installation of splints, “collars”, styling;
• a specially designed cycle of exercises in water;
• hydromassage;
• simulation of weightlessness;
• Voight therapy;
• vibration massage;
• paraffin therapy;
• alternating magnetic field;
• color therapy and light therapy;
• electrophoresis.

Please note: The third stage of assistance, if the first two are successfully completed, is prescribed to full-term babies at the 3rd week of life, and to premature babies a little later.

Rehabilitation period

Doctors discharge a child with diagnosed pathologies of the central nervous system for outpatient treatment only if the dynamics are positive. Many experts believe that it is the rehabilitation period outside of a medical institution that plays a big role in the further development of the child. A lot can be done with medications, but only constant care can ensure the mental, physical and psychomotor development of the baby within normal limits. Required:

• protect the baby from sharp sounds and bright lights;
• create an optimal climate regime for the child - there should be no sudden changes in air temperature, high humidity or dry air;
• If possible, protect the baby from infection.

Please note: with mild to moderate damage to the central nervous system in newborns, doctors do not prescribe drug therapy at the second stage - usually it is enough to provide urgent medical care and restore the normal functioning of vital organs and systems. If severe central nervous system lesions are diagnosed in newborns, some medications are prescribed in courses at an older age, during outpatient treatment.

Prevention of central nervous system pathologies in newborns

Most often, the pathologies in question are easy to predict, so doctors strongly recommend taking preventive measures even at the stage of pregnancy planning:

• cure all previously diagnosed infectious diseases;
• carry out vaccination for medical reasons;
• give up bad habits - quit smoking, stop drinking alcohol and drugs;
• undergo a full examination by specialized specialists;
• normalize hormonal levels.

Secondary prevention is considered to be the provision of full assistance when pathologies of the central nervous system have already been identified in newborns, and the prevention of the development of severe consequences.

When a child is born with central nervous system pathologies, you should not panic and immediately register the newborn as disabled. Doctors are well aware that timely medical care in most cases gives positive results - the child fully recovers and in the future is no different from his peers. Parents will just need a lot of time and patience.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category.

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What is PPCNSL in newborns and its consequences

Perinatal pathology of the NS is a general definition of functional or structural disorders of the cerebral hemispheres, the source of which was various phenomena during prenatal development. Actually, it includes antenatal, intranatal and early neonatal development, which begins at 28 weeks.

In order to protect your child as much as possible from pathologies, it is important to answer the question “What is PCPNS?” It is the answers to these questions that will allow us to understand how to prevent an undesirable future for a child.

Modern ideas about PPCNS

In modern medical practice, the disease of perinatal encephalopathies does not exist, however, due to the complexity of diagnostic and therapeutic measures, domestic specialists continue to use this term to define the disease.

Hypoxic ischemic damage to the central nervous system is a common source of various neurological abnormalities in children. Suspicious symptoms appear from the first days of life, but by the end of the 12th month they become more pronounced.

After this period, the neurologist is obliged to identify damage to the central nervous system, as well as develop a treatment strategy for the child. The brain of a small patient is extremely plastic, which allows for highly effective treatment.

Remember that the consequences of perinatal damage to the central nervous system will manifest themselves at all periods of life, so it is important to carry out therapy to improve future functioning.

Classification of PPCNS today

The medical literature describes two ways of causing damage to the central nervous system:

• Hypoxic ischemic damage to the central nervous system during pregnancy – intrauterine;
• Acute fetal hypoxic syndrome that occurs during pregnancy;

If the first class of pathologies arises due to the anatomical and morological characteristics of a woman during pregnancy, then acute labor hypoxia is most often of traumatic origin.

Perinatal damage to the nervous system is caused by multiple sources, which significantly affect the health of the baby. Sometimes such disorders do not in any way manifest themselves in the baby’s functionality, but develop in the future into serious diseases of a different origin.

The combination of two factors can sometimes lead to catastrophic consequences. This condition is called perinatal damage to the central nervous system of mixed origin. Perhaps, in some cases, a single manifestation of each cause would not lead to the development of pathology, but their simultaneous appearance leads to significant complications.

Intrauterine disorders of the central nervous system largely depend on the mother, her health and lifestyle, and responsibility for postnatal disorders lies on the shoulders of doctors delivering babies.

Common causes of pathologies

As with any other pathology, it is important to understand the causes of the disease so that effective treatments can be developed. Perinatal pathology of the nervous system can be caused by the following reasons:

• Somatic disorders in the maternal body, which are accompanied by chronic intoxication;
• The presence of an acute infectious disease or exacerbated chronic processes during pregnancy;
• Poor nutrition or physiological immaturity of the maternal body;
• Tendency to hereditary pregnancy disorders;
• Unfavorable environment;
• Pathological situations during delivery;

As you can see, there are many different reasons that could potentially ruin the health of your unborn child. Hypoxic ischemic damage to the central nervous system is an extremely difficult prognostic pathology, the development of which is almost impossible to predict or prevent.

Early delivery can also lead to adverse consequences. The metabolic processes of immature babies are not adapted to the independent functioning of the body, which is difficult when they are artificially “gestated.” That is why hypoxic ischemic damage to the central nervous system can appear after childbirth.

Prognostic course of the disease

Ischemic damage to the central nervous system in newborns can be accurately diagnosed after the first months of their life. An experienced doctor is able to assess not only the extent of brain damage, but also make a relatively accurate prognosis of its condition.

The outcome of PPCNSL can be of two types: complete recovery with minimal impairment of the central nervous system or severe manifestations that will require long-term or lifelong treatment by appropriate medical specialists. Each clinical case requires an individual approach in order for the effectiveness of treatment to be maximum.

In general, manifestations of cerebral ischemia in newborns have various consequences, characterized by:

• Full restoration of health;
• Inhibition of mental, motor or speech activity;
• Neurotic deviations;
• Post-traumatic abnormalities;
• Autonomic-visceral dysfunctions;
• Hydrocephalic syndrome;

Some deviations can ruin a patient’s future for the rest of his life, but some (for example, movement disorder syndrome) can only slightly limit the level and quality of a child’s life activity with proper treatment.

Remember that often in late childhood and adolescence, perinatal hypoxic damage to the brain can be complicated by neurotic syndromes and an inability to adapt to the surrounding society. Children will have a negative attitude towards peers with central nervous system disorders of hypoxic origin. Such actions will negatively affect the internal state of the latter.

Diagnostic measures

To make a diagnosis of perinatal CNS lesions, irrefutable data from a clinical examination are required, and all other examinations are only auxiliary and do not play a major role.

In addition, additional methodology in the study of the central nervous system has only clarifying properties to determine a more accurate source of pathology of ischemic origin, as this will allow the selection or development of organ and regionally specific therapy.

The following methodology is used as diagnostic measures to determine the origin of the source of the problem:

• Neurophysiological procedures;
• X-ray diagnostic procedures;

Unfortunately, today there is no single unified method that will accurately determine the source of the problem. Each method is important and unique in its own way. It is based on certain properties of nerve tissue, which allows for a comprehensive study of pathological processes in it.

It is unacceptable to independently prescribe and carry out any diagnostic measures on your own. Although many methods are relatively safe for your baby, they can make him feel uncomfortable or anxious, which can adversely affect his mental health.

Diagnostic methods are aimed at identifying excitation in various parts and assessing it. It is important to identify the pathological origin of nerve impulses so that treatment is as accurate and effective as possible.

Therapeutic measures

Brain damage most often leads to disability of a small patient, which makes him unfit for life in modern society. Fortunately, there are modern therapeutic measures that can compensate for the baby’s pathological condition.

The general complex of treatment procedures consists of several stages:

• Drug therapy;
• Massage treatments;
• Physical therapy exercises;
• Physiotherapy;

Relatively non-standard methods of assistance are often used in the form of acupuncture and intensive pedagogical work. Extremely high demands are placed on treatment, since doctors often do not have enough time for treatment, so it is unacceptable to waste it in vain.

The greatest effectiveness is shown by physical therapy, massages and other methods of physical influence. Pharmacological therapy is used for the symptomatic treatment of seizures, hydrocephalus, etc.

There are a huge number of treatment tactics, and only an experienced pediatric neurologist can choose the best one. Often, the doctor may change the treatment plan in order to identify only the most effective techniques, which will be actively included in further therapy.

Common syndromes

CNS disorders can be general in nature, but they often manifest themselves in the form of a set of symptoms (syndrome complexes):

• Increased ICP;
• Disorders of nerve-reflex conductivity;
• Epileptic seizures;
• Minimizing brain activity;

Despite the fact that these syndromes have quite unpleasant manifestations, modern medicine is able to effectively hide them and subject them to at least minimal treatment. Pharmacological drugs can stabilize the patient's condition, allowing him to lead a relatively normal life.

So, despite the fact that pregnancy and childbirth are physiological processes, there are a number of different complications that can ruin the life of your heir.

Perinatal pathologies of the nervous system are rare, but it is impossible to calculate and predict their occurrence. Even if you are faced with a similar pathology, do not despair!

A competent medical specialist, using all the achievements of modern medicine, is able to stabilize the baby’s condition so that he can lead a normal life. Remember that only together with your child will you be able to overcome all the difficulties encountered on your common path in life.

The information on the site is provided solely for popular informational purposes, does not claim to be reference or medical accuracy, and is not a guide to action. Do not self-medicate. Consult your healthcare provider.

Hypoxic-ischemic damage to the central nervous system in newborns represents a significant problem in modern neonatology, because according to statistics, almost Every tenth newborn baby has certain signs of impaired brain activity due to. Among all pathological conditions of the neonatal period, hypoxic brain damage takes first place. The disease is especially often diagnosed in premature babies.

Despite the fairly high frequency of the pathology, effective measures to combat it have not yet been developed, and Modern medicine is powerless against irreversible structural damage to the brain. None of the known drugs can restore dead nerve cells in the brain, but research in this area continues, and the latest generation of drugs are undergoing clinical trials.

The CNS (central nervous system) is very sensitive to a lack of oxygen in the blood. In a growing fetus and newborn child, immature brain structures need nutrition even more than in an adult, so any adverse effects on the expectant mother or the fetus itself during pregnancy and childbirth can be detrimental to the nervous tissue, which subsequently manifests itself in neurological disorders.

example of hypoxia due to insufficiency of uteroplacental blood flow

Hypoxia can be severe or mild, it lasts for a long time or several minutes during childbirth, but it always provokes disorders of brain function.

In the case of mild damage, the process is completely reversible, and some time after birth the brain will restore its function.

With deep hypoxia and asphyxia (complete cessation of oxygen supply to the brain), organic damage develops, often causing disability in young patients.

Most often, brain hypoxia occurs in the prenatal period or during childbirth with a pathological course. However, even after birth, hypoxic-ischemic changes can occur if the baby’s respiratory function is impaired, blood pressure drops, blood clotting disorders, etc.

In the literature you can find two names for the described pathology - hypoxic-ischemic damage to the central nervous system And hypoxic-ischemic encephalopathy (HIE). The first option is more often used when diagnosing severe disorders, the second - for mild forms of brain damage.

Discussions regarding the prognosis for hypoxic brain damage do not subside, but the accumulated experience of neonatologists shows that the child’s nervous system has a number of self-defense mechanisms and is even capable of regeneration. This is also evidenced by the fact that Not all children who have suffered severe hypoxia have severe neurological abnormalities.

In severe hypoxia, the immature structures of the brainstem and subcortical nodes are primarily affected; with prolonged, but not intense hypoxia, diffuse lesions of the cerebral cortex develop. One of the factors protecting the brain in a fetus or newborn is the redistribution of blood flow in favor of stem structures, therefore with prolonged hypoxia, the gray matter of the brain suffers to a greater extent.

The task of neurologists when examining newborns who have suffered from hypoxia of varying severity is to objectively assess the neurological status, exclude adaptive manifestations (tremor, for example), which may be physiological, and identify truly pathological changes in brain activity. When diagnosing hypoxic damage to the central nervous system, foreign specialists are based on the stages of the pathology, while Russian doctors use a syndromic approach, pointing to specific syndromes in a particular part of the brain.

Causes and stages of hypoxic-ischemic damage

Perinatal damage to the central nervous system in newborns is formed under the influence of unfavorable factors in utero, during childbirth or during the newborn period. The reasons for these changes may be:

• Disorders, bleeding in pregnant women, pathology of the placenta (thrombosis), delayed fetal development;
• Smoking, drinking alcohol, taking certain medications during pregnancy;
• Massive bleeding during childbirth, entanglement of the umbilical cord around the fetal neck, severe bradycardia and hypotension in the baby, birth injuries;
• After childbirth - hypotension in the newborn, congenital heart defects, disseminated intravascular coagulation syndrome, episodes of respiratory arrest, pulmonary dysfunction.

example of hypoxic-ischemic brain damage

The initial moment of development of HIE is a deficiency of oxygen in the arterial blood, which provokes metabolic pathology in nervous tissue, the death of individual neurons or entire groups of them. The brain becomes extremely sensitive to fluctuations in blood pressure, and hypotension only worsens existing lesions.

Against the background of metabolic disorders, tissue “acidification” occurs (acidosis), edema and swelling of the brain increases, and intracranial pressure increases. These processes provoke widespread necrosis of neurons.

Severe asphyxia also affects the functioning of other internal organs. Thus, systemic hypoxia causes acute renal failure due to necrosis of the tubular epithelium, necrotic changes in the intestinal mucosa, and liver damage.

In full-term infants, post-hypoxic damage is noted mainly in the area of ​​the cortex, subcortical structures, and brain stem; in premature infants, due to the maturation of the nervous tissue and vascular component, periventricular leukomalacia is diagnosed, when necrosis is concentrated mainly around the lateral ventricles of the brain.

Depending on the depth of cerebral ischemia, several degrees of severity of hypoxic encephalopathy are distinguished:

1. The first degree is mild - transient disorders of the neurological status, lasting no more than a week.
2. HIE of the second degree - lasts longer than 7 days and is manifested by depression or excitation of the central nervous system, convulsive syndrome, temporary increase in intracranial pressure,.
3. A severe form of hypoxic-ischemic damage is a disorder of consciousness (stupor, coma), convulsions, manifestations with brainstem symptoms and disruption of the functioning of vital organs.

Symptoms of hypoxic-ischemic damage to the central nervous system

Damage to the central nervous system in newborns is diagnosed in the first minutes of a baby’s life, and the symptoms depend on the severity and depth of the pathology.

I degree

In mild cases of HIE, the condition remains stable; on the Apgar scale, the child is rated at least 6-7 points; a decrease in muscle tone is noticeable. Neurological manifestations of the first degree of hypoxic damage to the central nervous system:

1. High neuro-reflex excitability;
2. Sleep disorders, anxiety;
3. Trembling of the limbs, chin;
4. Possible regurgitation;
5. Reflexes can be either increased or decreased.

The described symptoms usually disappear during the first week of life, the child becomes calmer, begins to gain weight, and severe neurological disorders do not develop.

II degree

With moderate brain hypoxia, signs of brain depression are more obvious, which is expressed in deeper disorders of brain function. Typically, the second degree of HIE accompanies combined forms of hypoxia, which is diagnosed both during the intrauterine growth stage and at the time of birth. In this case, muffled fetal heart sounds, increased rhythm or arrhythmia are recorded, and the newborn scores no more than 5 points on the Apgar scale. Neurological symptoms include:

• Suppression of reflex activity, including sucking;
• A decrease or increase in muscle tone, spontaneous motor activity may not appear in the first days of life;
• Severe blueness of the skin;
• Rising ;
• Autonomic dysfunction - respiratory arrest, increased heart rate or bradycardia, disturbances in intestinal motility and thermoregulation, tendency to constipation or diarrhea, regurgitation, slow weight gain.

intracranial hypertension accompanying severe forms of HIE

As intracranial pressure increases, the baby's anxiety increases, excessive sensitivity of the skin appears, sleep is disturbed, tremor of the chin, arms and legs increases, bulging of the fontanelles becomes noticeable, horizontal nystagmus and oculomotor disorders are characteristic. Signs of intracranial hypertension may include seizures.

By the end of the first week of life, the condition of a newborn with the second degree of HIE gradually stabilizes against the background of intensive treatment, but the neurological changes do not disappear completely. Under unfavorable circumstances, the condition may worsen with brain depression, decreased muscle tone and motor activity, exhaustion of reflexes, and coma.

III degree

Perinatal damage to the central nervous system of severe hypoxic-ischemic origin usually develops during a difficult second half of pregnancy, accompanied by high hypertension in the pregnant woman, impaired renal function, and edema. Against this background, a newborn is already born with signs of malnutrition, intrauterine hypoxia, and developmental delay. The abnormal course of labor only aggravates the existing hypoxic damage to the central nervous system.

In the third degree of HIE, the newborn has signs of severe circulatory disorders, there is no breathing, tone and reflexes are sharply reduced. Without urgent cardiopulmonary resuscitation and restoration of vital functions, such an infant will not survive.

During the first hours after birth, a sharp depression of the brain occurs, a coma sets in, accompanied by atony, an almost complete absence of reflexes, dilated pupils with a reduced reaction to a light stimulus or its absence.

Inevitably developing cerebral edema is manifested by generalized convulsions, respiratory and cardiac arrest. Multiple organ failure is manifested by increased pressure in the pulmonary artery system, decreased urine filtration, hypotension, necrosis of the intestinal mucosa, liver failure, electrolyte disturbances, and blood coagulation disorders (DIC).

A manifestation of severe ischemic damage to the central nervous system is the so-called post-asphyxial syndrome - babies are inactive, do not cry, do not respond to pain and touch, their skin is pale bluish, and a general decrease in body temperature is characteristic. Important signs of severe brain hypoxia include swallowing and sucking disorders, which make natural feeding impossible. To save the lives of such patients, intensive care in intensive care is necessary, but the unstable condition still persists until the 10th day of life, and the prognosis often remains poor.

A feature of the course of all forms of HIE is considered to be an increase in neurological deficit over time, even with intensive therapy. This phenomenon reflects the progressive death of neurons that have already been damaged during a lack of oxygen, and also determines the further development of the baby.

In general, ischemic-hypoxic damage to the central nervous system can occur in different ways:

1. Favorable with rapid positive dynamics;
2. Favorable course with rapid regression of neurological deficit, when by the time of discharge the changes either disappear or remain minimal;
3. Unfavorable course with progression of neurological symptoms;
4. Disability during the first month of life;
5. Latent course, when after six months motor and cognitive disorders increase.

In the clinic, it is customary to distinguish several periods of ischemic encephalopathy of newborns:

• Acute - first month.
• Restorative - within one year.
• Period of long-term consequences.

The acute period is manifested by the whole gamut of neurological disorders from barely noticeable to coma, atony, areflexia, etc. During the recovery period, the syndrome of excessive neuro-reflex excitability, convulsive syndrome, and possibly delayed intellectual and physical development come to the fore. As the child grows, the symptoms change, some symptoms disappear, others become more noticeable (speech disorders, for example).

Treatment and prognosis for HIE

Diagnosis of HIE is established on the basis of symptoms, data on the course of pregnancy and childbirth, as well as special research methods, among which neurosonography, echocardiography, CT, MRI of the brain, coagulogram, ultrasound with Dopplerography of cerebral blood flow are most often used.

Treatment of ischemic lesions of the central nervous system in newborns is a big problem for neonatologists, since no drug can achieve regression of irreversible changes in nervous tissue. Nevertheless, it is still possible to at least partially restore brain activity in severe forms of pathology.

Drug treatment for HIE depends on the severity of the specific syndrome or symptom.

For mild to moderate degrees of the disease, anticonvulsant therapy is prescribed; severe forms of perinatal encephalopathy require immediate resuscitation measures and intensive care.

With increased excitability of the nervous system without convulsive syndrome, neonatologists and pediatricians usually limit themselves to monitoring the child, without resorting to specific therapy. In rare cases, the use of diazepam is possible, but not for a long time, since the use of such drugs in pediatrics is fraught with a delay in further development.

It is possible to prescribe pharmacological agents that have a combined nootropic and inhibitory effect on the central nervous system (pantogam, phenibut). For sleep disorders, the use of nitrazepam and herbal sedatives is allowed - valerian extract, mint, lemon balm, motherwort. Massage and hydrotherapy have a good calming effect.

In case of severe hypoxic lesions, in addition to anticonvulsants, measures to eliminate cerebral edema are necessary:

• - furosemide, mannitol, diacarb;
• Magnesium sulfate.

Respiratory and palpitation disorders require immediate resuscitation measures, artificial ventilation, administration of cardiotonic drugs and infusion therapy.

Diuretics occupy the main place in treatment, and diacarb is considered the drug of choice for children of all ages. If drug therapy does not lead to the desired result, then surgical treatment of hydrocephalus is indicated - shunt operations aimed at dumping cerebrospinal fluid into the abdominal or pericardial cavities.

For convulsive syndrome and increased excitability of the central nervous system, anticonvulsants can be prescribed - phenobarbital, diazepam, clonazepam, phenytoin. Newborns are usually given barbiturates (phenobarbital), and infants - carbamazepine.

The syndrome of movement disorders is treated with drugs that reduce hypertonicity (mydocalm, baclofen); for hypotonicity, dibazol and galantamine in low doses are indicated. To improve the patient’s motor activity, massage, therapeutic exercises, physiotherapeutic procedures, water and reflexology are used.

Delays in mental development and speech development according to the child’s age become noticeable by the end of the first year of life. In such cases, nootropic drugs (nootropil, encephabol) and B vitamins are used. Special classes with teachers and defectologists who specialize in working with developmentally delayed children play a very important role.

Very often, parents of children who have suffered perinatal encephalopathy are faced with the prescription of a large number of different drugs, which is not always justified. Overdiagnosis and “reinsurance” by pediatricians and neurologists lead to the widespread prescription of Diacarb, nootropics, vitamins, Actovegin and other drugs, which are not only ineffective for mild forms of HIE, but are also often contraindicated due to age.

The prognosis for hypoxic-ischemic lesions of the central nervous system is variable: Regression of brain disorders with recovery, progression with disability, and a low-symptomatic form of neurological disorders - minimal brain dysfunction are possible.

Long-term consequences of HIE are epilepsy, cerebral palsy, hydrocephalus, and mental retardation (oligophrenia). Oligophrenia is always persistent and does not regress, and the somewhat delayed development of the psychomotor sphere during the first year of life may pass over time, and the child will be no different from most of his peers.

Video: about hypoxic-ischemic damage to the central nervous system and the importance of timely treatment

When a baby is born, its internal organs and body systems are not yet fully formed. This also applies to the central nervous system, which is responsible for the normal social functioning of a person. For the formation process to be completed, a certain period of time is required.

In recent years, the number of central nervous system pathologies in infants has increased significantly. They can develop during the prenatal period, and also appear during childbirth or immediately after it. Such lesions, which negatively affect the functioning of the nervous system, can cause serious complications and even disability.

What is perinatal CNS damage?

Perinatal lesions of the central nervous system, abbreviated as PPCNS, are a number of pathologies that are related to disruptions in the functioning of the brain and developmental abnormalities in its structure. Similar deviations from the norm are observed in children during the perinatal period, the time frame of which ranges from the 24th week of pregnancy to the first 7 days of life after birth, inclusive.

Currently, PPCNSL in newborns is a fairly common phenomenon. This diagnosis is established in 5-55% of children. The wide range of indicators is due to the fact that often lesions of the central nervous system of this kind resolve easily and quickly. Cases of severe forms of perinatal damage occur in 1-10% of children who were born on time. Premature babies are more susceptible to the disease.

Classification of the disease

In modern medicine, it is customary to classify deviations in the normal functioning of the central nervous system in accordance with the reasons that caused this or that pathology. In this regard, each disorder has its own forms and symptoms. There are 4 main pathological types of central nervous system lesions:

• traumatic;
• dismetabolic;
• infectious;
• hypoxic genesis.

Perinatal lesions in the newborn

Perinatal lesions of the central nervous system are those that develop during the perinatal period, the main part of which occurs in the prenatal period. The risk of depression of the central nervous system in a child increases if during pregnancy a woman suffered:

• cytomegalovirus infection (we recommend reading:);
• toxoplasmosis;
• rubella;
• herpetic infection;
• syphilis.

The baby may receive intracranial trauma and injuries to the spinal cord or peripheral nervous system during childbirth, which can also cause perinatal lesions. Toxic effects on the fetus can disrupt metabolic processes and negatively affect brain activity.

Hypoxic-ischemic damage to the nervous system

Hypoxic-ischemic damage to the nervous system is one of the forms of perinatal pathology, which is caused by fetal hypoxia, that is, insufficient oxygen supply to the cells.

A manifestation of the hypoxic-ischemic form is cerebral ischemia, which has three degrees of severity:

• First. Accompanied by depression or stimulation of the central nervous system, which lasts up to a week after birth.
• Second. In addition to depression/excitation of the central nervous system that lasts more than 7 days, convulsions, increased intracranial pressure and autonomic-visceral disorders are added.
• Third. It is characterized by a severe convulsive state, dysfunction of the brain stem, and high intracranial pressure.

Disease of mixed origin

In addition to ischemic genesis, hypoxic lesions of the central nervous system can be caused by hemorrhages of non-traumatic origin (hemorrhagic). These include hemorrhages:

• intraventricular type 1, 2 and 3 degrees;
• subarachnoid primary type;
• into the substance of the brain.

The combination of ischemic and hemorrhagic forms is called mixed. Its symptoms depend solely on the location of the hemorrhage and the severity.

Features of the diagnosis of PPCNSL

After birth, children are required to be examined by a neonatologist, assessing the degree of hypoxia. It is he who can suspect perinatal damage based on changes in the condition of the newborn. The conclusion about the presence of pathology is confirmed or refuted in the first 1-2 months. During this entire time, the baby is under the supervision of doctors, namely a neurologist, pediatrician and an additional specialist with a narrow focus (if required). Deviations in the functioning of the nervous system require special attention in order to be able to correct them in a timely manner.

Forms and symptoms of the disease

Perinatal damage to the central nervous system of a newborn can occur in 3 different forms, each characterized by its own symptoms:

1. light;
2. average;
3. heavy.

Knowing the symptoms that indicate inhibition of the central nervous system, you can make a diagnosis in the early stages and promptly treat the disease. The table below describes the symptoms that accompany the course of the disease for each of its forms:

PPCNS form	Characteristic symptoms
Lightweight	high excitability of nerve reflexes; weak muscle tone; sliding squint; trembling of the chin, arms and legs; wandering movements of the eyeballs; nervous movements.
Average	lack of emotions; weak muscle tone; paralysis; convulsions; increased sensitivity; spontaneous motor activity of the eyes.
Heavy	convulsions; renal failure; disruptions in bowel function; problems with the cardiovascular system; impaired functioning of the respiratory system.

Reasons for development

Very often, the cause of the development of PPCNSL is fetal hypoxia during the intrauterine period.

Among the reasons leading to perinatal damage to the central nervous system in an infant, it is worth noting four main ones:

1. Fetal hypoxia during the intrauterine period. This deviation is due to a lack of oxygen entering the baby’s blood from the mother’s body. Provoking factors are harmful working conditions of the pregnant woman, bad habits such as smoking, past infectious diseases and previous abortions.
2. Injuries caused during childbirth. If a woman has weak labor, or the baby is delayed in the pelvis.
3. Violation of metabolic processes. They can be caused by toxic components that enter the pregnant woman’s body along with cigarettes, alcoholic beverages, narcotic substances and potent medications.
4. Viral and bacterial infections that enter the mother's body during pregnancy, abbreviated as IUI - intrauterine infections.

Consequences of the disease

In most cases, by the time the child is one year old, almost all the symptoms accompanying damage to the nervous system have passed. Unfortunately, this does not mean at all that the disease has receded. Usually after such an illness there are always complications and unpleasant consequences.

After undergoing PCNSL, parents may experience child hyperactivity

Among them are:

1. Hyperactivity. This syndrome is characterized by aggressiveness, tantrums, learning difficulties and memory problems.
2. Developmental delay. This applies to both physical and speech and mental development.
3. Cerebroasthenic syndrome. It is characterized by the child's dependence on weather conditions, mood swings, and restless sleep.

The most serious consequences of inhibition of the central nervous system, which lead to disability of the baby, are:

• epilepsy;
• cerebral palsy;
• hydrocephalus (we recommend reading:).

Risk group

The widespread diagnosis of perinatal damage to the nervous system in a newborn is due to many factors and conditions affecting the intrauterine development of the fetus and the birth of the baby.

In pregnant women who led a healthy lifestyle and the baby was born at term, the likelihood of PPCNS is sharply reduced to 1.5-10%.

The following children fall into the high-risk group, which is 50%:

• with breech presentation;
• premature or, conversely, post-term;
• with a high birth weight exceeding 4 kg.

The hereditary factor is also significant. However, it is difficult to predict exactly what may cause CNS depression in a child and depends more on the situation as a whole.

Diagnostics

Any disturbances in brain activity are difficult to diagnose at an early stage. Babies are diagnosed with perinatal damage to the central nervous system during the first months of life, based on the presence of problems with the motor and speech apparatus, as well as taking into account violations of mental functions. Closer to the year, the specialist should already specify the type of disease or refute the previously made conclusion.

Disturbances in the functioning of the nervous system pose a serious danger to the health and development of the child, so it is important to diagnose the problem in time in order to carry out proper treatment. If a newborn baby behaves uncharacteristically and the first symptoms of illness appear, parents must take him to the doctor. First, he performs an examination, but such a procedure alone may not be enough for an accurate diagnosis. Only an integrated approach will identify the disease.

If there is the slightest suspicion that a child is developing PPCNS, it is necessary to immediately show a doctor

For this reason, the following clinical and laboratory tests are usually additionally prescribed:

• neurosonography (we recommend reading:);
• CT – computed tomography or MRI – magnetic resonance imaging of the brain;
• Ultrasound – ultrasound diagnostics;
• X-ray examination;
• echoencephalography (EchoES), rheoencephalography (REG) or electroencephalography (EEG) - methods of functional diagnostics (we recommend reading:);
• Consultative examination by an ophthalmologist, speech therapist and psychologist.

Treatment methods depending on symptoms

Treatment of any pathologies of the central nervous system in newborns must be carried out in the first months of life, since at this stage almost all processes are reversible, and impaired brain functions can be completely restored.

In the first months of life, PPCNS is easily treated

For this purpose, appropriate drug therapy is carried out, which allows:

• improve nutrition of nerve cells;
• stimulate blood circulation;
• normalize muscle tone;
• normalize metabolic processes;
• relieve your baby from seizures;
• relieve swelling of the brain and lungs;
• increase or decrease intracranial pressure.

When the child’s condition has stabilized, physiotherapy or osteopathy is carried out in combination with medications. The therapeutic and rehabilitation course is developed individually for each case.

Intracranial hypertension

Intracranial hypertension syndrome manifests itself as an increase in comparison with the norm, swelling of the large fontanel and divergence of the sutures of the skull (we recommend reading:). The child is also nervous and easily excitable. If such symptoms appear, the baby is prescribed diuretics and dehydration therapy. In order to reduce the likelihood of hemorrhages, it is recommended to take a course of Lidaz.

Plus, the baby is given special gymnastic exercises that help reduce intracranial pressure. Sometimes they resort to acupuncture and manual therapy to correct the outflow of fluid.

The complex treatment of PCNSL necessarily includes general strengthening gymnastic exercises.

Movement disorders

When diagnosing movement disorder syndrome, treatment consists of a series of measures aimed at eliminating the problem:

• Drug therapy. Drugs such as Galantamine, Dibazol, Alizin, Proserin are prescribed.
• Massage and physical therapy. For children under one year old, a minimum of 4 courses of such procedures are required, each of which consists of approximately 20 sessions with specially selected exercises. They are selected depending on what is subject to deviations: walking, sitting or crawling. Massage and exercise therapy are carried out using ointments.
• Osteopathy. It consists of performing a massage of internal organs and influencing the desired points of the body.
• Reflexology. It has proven itself to be the most effective method. Its help is resorted to in cases where SDN leads to a delay in the maturation and development of the nervous system.

Increased neuro-reflex excitability

One of the possible manifestations of perinatal damage in the acute phase is increased neuro-reflex excitability.

Being a mild form of the pathology, it is characterized by:

• decreased or increased muscle tone;
• extinction of reflexes;
• shallow sleep;
• causeless shaking of the chin.

Massage with electrophoresis helps restore muscle tone. In addition, drug therapy is carried out, and treatment can be prescribed using pulsed currents and special baths.

Epileptic syndrome

Epileptic syndrome is characterized by periodic epileptic seizures, which are accompanied by convulsions, which are shuddering and twitching of the upper and lower extremities and head. The main goal of therapy in this case is to get rid of the convulsive state.

Finlepsin is prescribed if a child has a convulsive syndrome

A course of the following medications is usually prescribed:

• Difenin;
• Radodorm;
• Seduxen;
• Finlepsin;
• Phenobarbital.

Minimal brain dysfunction

Minimal brain dysfunction, better known as attention deficit hyperactivity disorder, is a low-symptom form of neurological disorder. Treatment with medications is mainly aimed at eliminating specific manifestations, while methods of physical influence, namely massage or physical education, can more effectively correct the pathological condition of the child.

Recovery period

The recovery period plays an important role in the full recovery of the baby.

At the stage of rehabilitation during the first year of life, the main focus is not drug therapy, but all kinds of procedures that help activate those functions that have been impaired and restore normal functioning of the central nervous system.

These include:

• electrophoresis with medications;
• therapeutic ultrasound;
• physical therapy and gymnastics;
• acupuncture;
• swimming lessons;
• impulse currents;
• massage;
• balneotherapy;
• thermal procedures;
• pedagogical methods of correction;
• therapy through music.

In addition, parents must create certain living conditions for their child with PPCNS.

A newborn baby has not yet fully formed organs and systems, and it takes some time to complete formation. It is during the growth of the baby that his central nervous system also forms and matures. The baby's nervous system helps regulate its normal existence in the world.

In some cases, damage to the central nervous system of newborns can be diagnosed, which has recently occurred quite often. Suppression of the nervous system can cause serious consequences and leave the child disabled.

Features of the structure of the nervous system of a newborn

An infant differs from an adult not only in external differences, but also in the structure of its body, since all systems and organs are not fully formed. During the period of brain formation, unconditioned reflexes are clearly expressed in a child. Immediately after birth, the level of substances that regulate hormones responsible for the functioning of the digestive system increases. At the same time, all receptors are already quite well developed.

Causes of CNS pathology

The causes and consequences of damage to the central nervous system of newborns can be very different. The main factors that provoke disruption of the functioning of the nervous system are:

• lack of oxygen, or hypoxia;
• birth injuries;
• disruption of normal metabolism;
• infectious diseases suffered by the expectant mother during pregnancy.

Lack of oxygen, or hypoxia, occurs when a pregnant woman works in hazardous work, with infectious diseases, smoking, or previous abortions. All this disrupts general blood circulation, as well as oxygen saturation of the blood, and the fetus receives oxygen along with the mother’s blood.

One of the factors leading to damage to the nervous system is considered to be birth trauma, since any injury can provoke a disruption in the maturation and subsequent development of the central nervous system.

Disruption of normal metabolism occurs for the same reasons as lack of air. Drug addiction and alcoholism of the expectant mother also lead to dysmetabolic disorders. In addition, taking potent medications can affect the nervous system.

Infectious diseases suffered by the expectant mother while carrying a child can be critical for the fetus. Among such infections it is necessary to highlight herpes and rubella. In addition, absolutely any pathogenic microbes and bacteria can provoke irreversible negative processes in the child’s body. Mostly, problems with the nervous system occur in premature babies.

Periods of CNS pathologies

The syndrome of damage and depression of the nervous system combines several pathological conditions that occur during fetal development, during labor, and also in the first hours of a baby’s life. Despite the presence of many predisposing factors, only 3 periods are distinguished during the disease, namely:

• spicy;
• restorative;
• outcome of the disease.

In each period, damage to the central nervous system in newborns has different clinical manifestations. In addition, children may experience a combination of several different syndromes. The severity of each ongoing syndrome allows us to determine the severity of damage to the nervous system.

Acute course of the disease

The acute period lasts for a month. Its course directly depends on the degree of damage. With a mild form of the lesion, shuddering, increased excitability of nerve reflexes, trembling of the chin, sudden uncontrolled movements of the limbs, and sleep disturbances are observed. The child may cry very often for no apparent reason.

With moderate severity, there is a decrease in motor activity and muscle tone, weakening of reflexes, mainly sucking. This condition of the baby should definitely alert you. By the end of the first month of life, existing signs may be replaced by hyperexcitability, almost transparent skin color, frequent regurgitation and flatulence. Often, a child is diagnosed with hydrocephalic syndrome, characterized by a rapid increase in head circumference, increased pressure, bulging of the fontanel, and strange eye movements.

At its most severe, coma usually occurs. This complication requires being under the supervision of a doctor.

Rehabilitation period

Damage to the central nervous system in newborns during the recovery period has the following syndromes:

• increased excitability;
• epileptic;
• motor disorders;
• mental retardation.

With prolonged violation of muscle tone, mental development delays and the presence of motor function disorders often occur, which are characterized by involuntary movements provoked by contraction of the muscles of the trunk, face, limbs, and eyes. This prevents the child from making normal, purposeful movements.

When mental development is delayed, the baby begins much later to hold his head up on his own, sit, walk, and crawl. He also has poor facial expressions, decreased interest in toys, a weak cry, and a delay in the appearance of babbling and humming. Such delays in the development of a child’s psyche should definitely alert parents.

Result of the disease

By about a year, damage to the central nervous system in newborns becomes obvious, although the main symptoms of the disease gradually disappear. The result of the pathology is:

• developmental delay;
• hyperactivity;
• cerebroasthenic syndrome;
• epilepsy.

As a result, the child may become disabled.

Perinatal CNS damage

Perinatal damage to the central nervous system in newborns is a collective concept that implies a disruption in the functioning of the brain. Similar disorders are observed in the antenatal, intranatal and neonatal periods.

Antenatal begins from the 28th week of intrauterine development and ends after birth. Intrapartum includes the period of childbirth, from the beginning of labor to the moment of birth of the child. occurs after birth and is characterized by the baby’s adaptation to environmental conditions.

The main reason why perinatal damage to the central nervous system occurs in newborns is hypoxia, which develops during an unfavorable pregnancy, birth injuries, asphyxia, and infectious diseases of the fetus.

The cause of brain damage is considered to be intrauterine infections, as well as birth injuries. In addition, there may be damage to the spinal cord that occurs due to trauma during childbirth.

Symptoms largely depend on the period of the disease and the severity of the lesion. In the first month after the birth of a child, an acute period of the disease is observed, characterized by depression of the nervous system, as well as hyperexcitability. Muscle tone gradually normalizes. The degree of recovery largely depends on the extent of the damage.

The disease is diagnosed in the maternity hospital by a neonatologist. The specialist conducts a comprehensive examination of the baby and makes a diagnosis based on the existing signs. After discharge from the maternity hospital, the child is under the supervision of a neurologist. To make a more accurate diagnosis, a hardware examination is performed.

Treatment should be carried out from the first hours after the birth of the child and diagnosis. In the acute form, therapy is carried out strictly in a hospital setting under the constant supervision of a doctor. If the disease is mild, treatment can be carried out at home under the supervision of a neurologist.

The recovery period is carried out comprehensively, and at the same time, together with medications, physiotherapeutic methods are used, such as physical therapy, swimming, manual therapy, massages, and speech therapy classes. The main goal of such methods is to correct mental and physical development in accordance with age-related changes.

Hypoxic-ischemic damage to the central nervous system

Since it is often hypoxia that provokes damage to the nervous system, every expectant mother should know what leads to hypoxia and how it can be avoided. Many parents are interested in what hypoxic-ischemic damage to the central nervous system is in newborns. The severity of the main signs of the disease largely depends on the duration of the child’s hypoxia in the prenatal period.

If hypoxia is short-term, then the violations are not so serious; oxygen starvation that continues for a long time is more dangerous. In this case, functional disorders of the brain or even death of nerve cells may occur. To prevent nervous system disorders in infants, a woman must be very attentive to her health while carrying a child. If you suspect the presence of diseases that provoke fetal hypoxia, you should immediately consult a doctor for treatment. Knowing what it is - hypoxic-ischemic damage to the central nervous system in newborns, and what the signs of the disease are, you can prevent the occurrence of pathology with timely treatment.

Forms and symptoms of the disease

Damage to the central nervous system in newborns can occur in several different forms, namely:

• light;
• average;
• heavy.

The mild form is characterized by the fact that in the first days of a child’s life, excessive excitability of nerve reflexes and weak muscle tone may be observed. A sliding squint or irregular, wandering movement of the eyeballs may appear. After some time, trembling of the chin and limbs, as well as restless movements, may be observed.

The average form has symptoms such as lack of emotions in the child, poor paralysis. Convulsions, excessive sensitivity, and involuntary eye movements may occur.

The severe form is characterized by serious disorders of the nervous system with its gradual suppression. This appears in the form of seizures, kidney failure, disturbances in the functioning of the intestines, cardiovascular system, and respiratory organs.

Diagnostics

Since the consequences can be quite dangerous, it is therefore important to diagnose disorders in a timely manner. Sick children generally behave uncharacteristically for newborns, which is why when the first symptoms of the disease appear, you should definitely consult a doctor for examination and subsequent treatment.

Initially, the doctor examines the newborn, but this is often not enough. At the slightest suspicion of pathology, the doctor prescribes a computed tomography scan, ultrasound diagnostics, and x-rays. Thanks to comprehensive diagnostics, it is possible to identify the problem in a timely manner and carry out treatment using modern means.

Treatment of central nervous system lesions

Some pathological processes occurring in the baby’s body may be irreversible in an advanced stage, and therefore require urgent measures and timely therapy. Treatment of newborns should be carried out in the first months of their life, since during this period the baby’s body is able to completely restore impaired brain functions.

Deviations in the functioning of the central nervous system are corrected with the help of drug therapy. It contains drugs that help improve the nutrition of nerve cells. During therapy, drugs that stimulate blood circulation are used. With the help of medications, muscle tone can be reduced or increased.

To help sick children recover faster, osteopathic therapy and physiotherapeutic procedures are used in combination with medications. To carry out a rehabilitation course, massage, electrophoresis, reflexology and many other techniques are indicated.

After stabilization of the child’s condition, an individual program of supportive complex therapy is developed and regular monitoring of the baby’s condition is carried out. Throughout the year, the dynamics of the child’s condition are analyzed, and other therapy methods are selected to promote rapid recovery and development of the required skills, abilities and reflexes.

Prevention of central nervous system damage

In order to prevent the occurrence of a serious and dangerous disease, it is necessary to prevent damage to the infant’s central nervous system. To do this, doctors recommend planning your pregnancy in advance, undergoing the required examinations in a timely manner and giving up bad habits. If necessary, antiviral therapy is carried out, all necessary vaccinations are given, and hormonal levels are normalized.

If damage to the baby’s central nervous system does occur, then it is important to provide assistance to the newborn from the first hours of his life and to constantly monitor the baby’s condition.

Consequences of central nervous system damage

The consequences and complications of central nervous system damage in a newborn child can be very serious, dangerous to health and life, and they are expressed in the form of:

• severe forms of mental development;
• severe forms of motor development, cerebral palsy;
• epilepsy;
• neurological deficit.

Timely detection of the disease and proper therapy will help get rid of serious health problems and prevent complications from occurring.

Pathologies of the central nervous system (CNS) in newborns are a large group of spinal cord/brain lesions. Such lesions can occur during fetal development, during childbirth and in the first days of life.

Causes of development of central nervous system pathologies in newborns

According to statistics, up to 50% of newborn children are diagnosed with perinatal pathologies of the central nervous system, because doctors often include transient disorders in the functioning of the central nervous system in this concept . If we look at the statistics in more detail, it will become clear:

• 60-70% of cases of diagnosing pathologies of the central nervous system in newborns occur after the birth of a premature baby;
• 1.5 - 10% of cases - for full-term children born in a timely and natural way.

A factor provoking the appearance of pathological changes in the functioning of the central nervous system in newborns can be absolutely any negative impact on the fetus during its intrauterine development. In general, doctors identify several main causes of the condition in question:

1. Fetal hypoxia. We are talking about oxygen starvation, when an insufficient amount of oxygen from the mother’s body enters the child’s blood. Hypoxia can be triggered by harmful work practices (it’s not for nothing that pregnant women are immediately transferred to lighter work), infectious diseases suffered before pregnancy, and a woman’s bad habits (especially smoking). The number of previous abortions also greatly affects the oxygen supply to the fetus - artificial termination of pregnancy provokes future disruption of blood flow between the mother and the fetus.
2. Newborn injuries. We are talking about injury during childbirth (for example, when applying forceps for medical reasons), in the first hours/days of a newborn’s life. It is physical trauma that is considered the least likely cause of the development of pathologies of the central nervous system in newborns.
3. Dysmetabolic processes in a newborn. Disturbances in the metabolic processes of the fetal body can occur due to maternal smoking, drug use, alcohol consumption, or forced use of potent medications.
4. Maternal infectious diseases during the period of bearing a child. Pathological damage to the central nervous system occurs when the fetus is directly exposed to viral agents or pathogenic microorganisms.

Please note:Regardless of whether the above factors were present, CNS pathologies in newborns are more often diagnosed in the case of premature birth, in premature infants.

Classification of CNS pathologies in newborns

Depending on what reasons provoked the development of disorders in the central nervous system of the newborn, doctors also classify them. Each type is characterized by specific symptoms and nosological forms.

Oxygen starvation of the fetus can lead to the following damage to the central nervous system in newborns:

1. Cerebral ischemia. The nosological form of this pathology manifests itself in different degrees of severity - cerebral ischemia of 1, 2 and 3 degrees of severity. Clinical symptoms:

Please note:Grade 3 severity of the pathological condition in question is characterized by progressive depression of the central nervous system - in some cases, the newborn enters a comatose state.

1. Intracranial hemorrhages of hypoxic origin. Nosological forms are varied:

• intraventricular hemorrhage of the 1st degree - specific neurological symptoms, as a rule, are completely absent;
• intraventricular hemorrhage of the 2nd degree - convulsions may develop, the newborn often falls into a coma, progressive intracranial hypertension, shock, apnea are noted;
• intraventricular hemorrhage of the 3rd degree - deep depression of the central nervous system (coma), shock and apnea, prolonged convulsions, high intracranial pressure;
• subarachnoid hemorrhage of the primary type - doctors diagnose hyperexcitability of the central nervous system, focal clonic convulsions, acute hydrocephalus;
• hemorrhage into the substance of the brain - the appearance of specific symptoms depends only on the location of the hemorrhage. Possible: intracranial hypertension/focal seizures/convulsions/coma, but in some cases even such a serious disturbance of the central nervous system is asymptomatic.

1. Combination of ischemic and hemorrhagic lesions of the central nervous system. The clinical picture and nosological forms of this condition will depend only on the location of the hemorrhage and the severity of the pathology.

We are talking about birth injuries that caused the development of pathological disorders in the central nervous system. They are divided according to the following principle:

1. Intracranial birth injury. It can manifest itself in several nosological forms:

• hemorrhage of the epidural type - the condition is characterized by high intracranial pressure (the very first sign), convulsive syndrome, in rare cases, doctors record pupil dilation on the side of the hemorrhage;
• subdural hemorrhage - divided into supratentorial (asymptomatic, but partial convulsions, pupil dilation from the hemorrhage, progressive intracranial hypertension may appear) and subtentorial (acute increase in intracranial pressure, progressive cardiac/respiratory disturbances, central nervous system depression leading to coma);
• intraventricular hemorrhage – characterized by convulsions (multifocal), cardiac/respiratory failure, central nervous system depression, hydrocephalus;
• hemorrhagic infarction - the course may be asymptomatic, but may manifest itself as convulsions, depression of the central nervous system with transition to coma, high intracranial pressure;
• subarachnoid hemorrhage - doctors diagnose acute external hydrocephalus, hyperexcitability and convulsions.

1. Spinal cord injury during childbirth. There is a hemorrhage in the spinal cord - a tear, a stretch. It can either be accompanied by a spinal injury or occur without this moment. The clinical picture is characterized by impaired functioning of the respiratory system, dysfunction of the sphincters, motor disorders and spinal shock.
2. Trauma to the peripheral nervous system during childbirth. Nosological forms and symptoms:

• damage to the brachial plexus - there is flaccid paresis of the proximal part of one or both arms in the case of the proximal type, flaccid paresis of the distal upper extremities and Claude Bernard-Horner syndrome in the distal type of damage. Total paralysis may develop - paresis of the total part of the arm or both arms is observed at the same time, a disruption of the respiratory system is possible;
• damage to the phrenic nerve - often occurs without any significant symptoms, but respiratory problems may occur;
• traumatic damage to the facial nerve - when a child screams, the mouth tilts to the healthy side, the nasolabial folds are smoothed out.

First of all, doctors consider transient metabolic disorders:

Newborns may develop dysmetabolic disorders of the central nervous system against the background of toxic effects on the fetus’s body - for example, if the mother was forced to take potent medications and did not exclude alcohol, drugs and tobacco. In this case, the clinical picture will be as follows:

• seizures are rare, but this syndrome may be present;
• hyperexcitability;
• depression of the central nervous system, turning into coma.

CNS lesions in infectious diseases

If during pregnancy a woman was diagnosed with, or, then the likelihood of having a child with pathologies of the central nervous system increases significantly. There are some infectious diseases that can contribute to the development of problems in the functioning of the central nervous system after the birth of a child - streptococcal and staphylococcal infections, and others.

With lesions of the central nervous system of infectious etiology, the following symptoms will be identified:

• intracranial hypertension;
• hydrocephalus;
• focal disorders;
• meningeal syndrome.

Periods of the course of central nervous system pathologies in newborns

Regardless of the reasons for the development of central nervous system lesions in newborns, experts distinguish three periods of the disease:

• acute – occurs in the first month of a child’s life;
• restorative - can occur from 2 to 3 months of the baby’s life (early) and from 4 months to 1 year (late);
• outcome of the disease.

Each of the listed periods has characteristic features that may be present individually, but more often appear in original combinations individually for each child.

If a newborn has mild damage to the central nervous system, then hyperexcitability syndrome is most often diagnosed. It manifests itself as a sharp shudder, disturbances in muscle tone (it can be increased or decreased), trembling of the chin and upper/lower limbs, unmotivated crying and shallow sleep with frequent awakenings.

If the central nervous system is of moderate severity, there will be a decrease in muscle tone and motor activity, and a weakening of swallowing and sucking reflexes.

Please note:By the end of the first month of life, hypotonicity and lethargy are replaced by increased excitability, uneven coloring of the skin appears (marbling of the skin), disturbances in the functioning of the digestive system are noted (constant regurgitation, flatulence, vomiting.

Very often, the acute period of the disease is accompanied by the development of hydrocephalic syndrome - parents may note a rapid increase in head circumference, protrusion of the fontanel, divergence of cranial sutures, restlessness of the newborn and unusual eye movements.

Coma can occur only with very severe damage to the central nervous system in newborns - this condition requires immediate assistance from medical workers, all treatment measures are carried out in the intensive care unit of a medical institution.

Recovery period

If up to 2 months the child looked absolutely healthy, the parents did not note any strange/unusual syndromes, then the recovery period may occur with pronounced symptoms:

• facial expressions are very poor - the baby rarely smiles, does not squint, does not show any emotions;
• no interest in toys or any other objects;
• the cry is always weak and monotonous;
• baby babble and “humming” either appear with a delay or are completely absent.

Please note:It is the parents who should pay attention to the above symptoms and report them to the pediatrician. The specialist will prescribe a full examination of the child and refer the little patient for examination to a neurologist.

Outcome of the disease

By the 12th month of a child’s life, symptoms of central nervous system pathologies in newborns almost always disappear, but this does not mean that the lesions described above have disappeared without any consequences. The most common consequences of damage to the central nervous system in newborns include:

• accompanied by a lack of attention - memory impairment, learning difficulties, aggressiveness and hysterical attacks;
• delayed speech, psychomotor and physical development;
• cerebroasthenic syndrome– characterized by weather dependence, restless sleep, sudden mood swings.

But the most severe, complex consequences of central nervous system pathologies in newborns are epilepsy, cerebral palsy and hydrocephalus.

Diagnostic measures

For correct diagnosis, it is very important to conduct a proper examination of the newborn and monitor his behavior/condition in the first hours of the baby’s life. If pathological lesions of the central nervous system are suspected, it is advisable to prescribe a comprehensive examination:

Methods of treatment and rehabilitation

Help for newborns with central nervous system pathologies is necessary in the first hours of life - many disorders are completely reversible, and rehabilitation/treatment can be started immediately.

First stage of help

It consists in restoring the functionality of vital organs and systems - let us recall that in almost all types/forms of pathologies of the central nervous system of newborns, cardiac/respiratory failure and problems in the functioning of the kidneys appear. Doctors use medications to normalize metabolic processes, relieve a newborn from convulsive syndrome, relieve swelling of the brain and lungs, and normalize intracranial pressure.

Very often, after emergency measures are provided to a newborn with central nervous system pathologies, visible signs disappear in the maternity hospital, and the child’s condition often returns to normal. But if this does not happen, the patient is transferred to the neonatal pathology department and treatment/rehabilitation continues.

The second stage of assistance involves the prescription of medications that act to eliminate the cause of the pathologies in question - for example, antiviral and antibacterial agents. At the same time, therapy is prescribed aimed at restoring brain activity, stimulating the maturation of brain cells, and improving cerebral circulation.

Third stage of assistance

If the newborn shows significant improvements in the condition, then it is advisable to switch to non-drug treatment. We are talking about massages and physiotherapeutic procedures, the most effective of which are considered:

Please note:The third stage of assistance, if the first two are successfully completed, is prescribed to full-term babies at the 3rd week of life, and to premature babies a little later.

Doctors discharge a child with diagnosed pathologies of the central nervous system for outpatient treatment only if the dynamics are positive. Many experts believe that it is the rehabilitation period outside of a medical institution that plays a big role in the further development of the child. A lot can be done with medications, but only constant care can ensure the mental, physical and psychomotor development of the baby within normal limits. Required:

• protect the baby from sharp sounds and bright lights;
• create an optimal climate regime for the child - there should be no sudden changes in air temperature, high humidity or dry air;
• If possible, protect the baby from infection.

Please note:with mild to moderate damage to the central nervous system in newborns, doctors do not prescribe drug therapy at the second stage - usually it is enough to provide urgent medical care and restore the normal functioning of vital organs and systems. If severe central nervous system lesions are diagnosed in newborns, some medications are prescribed in courses at an older age, during outpatient treatment.

Most often, the pathologies in question are easy to predict, so doctors strongly recommend taking preventive measures at the stage :

Secondary prevention is considered to be the provision of full assistance when pathologies of the central nervous system have already been identified in newborns, and the prevention of the development of severe consequences.

When a child is born with central nervous system pathologies, you should not panic and immediately register the newborn as disabled. Doctors are well aware that timely medical care in most cases gives positive results - the child fully recovers and in the future is no different from his peers. Parents will just need a lot of time and patience.

Tsygankova Yana Aleksandrovna, medical observer, therapist of the highest qualification category.