Cerebral palsy (infantile cerebral palsy) is a collection of neurological abnormalities resulting from damage to brain structures in the first weeks of a child's life or in the womb. The main component of the clinical picture is movement disorders. In addition to them, there may be speech and mental deviations, disturbances in the work of the emotional-volitional area, epileptic seizures may be observed.

Cerebral palsy is not a progressive disease, but most often the symptoms of this disease persist throughout the life of people and make them disabled. In the process of growing up, many people believe that the symptoms of the disease progresses, but this is not so. You can simply not notice many deviations while the child is still very small and cannot, for example, eat or move on his own, does not yet speak the first words, etc.

With cerebral palsy, various kinds of motor disorders are traced. The structure of the muscular system is most affected, coordination of movement suffers. The structure, nature and neglect of muscle disorders can be determined based on the concentration of brain lesions and the extent of their damage. In addition, visual, auditory and speech pathologies are observed. Subsequently, the child may experience disturbances in sensation and cognition, urinary incontinence and defecation, difficulty in breathing and the process of eating food, the formation of bedsores from constantly lying down, and so on.

Despite the fact that modern medicine develops more and more and becomes more effective, the prevalence of cerebral palsy does not decrease and is about 1.6 per 1000 children. It should be noted that boys are much more likely to suffer from this deviation than girls.

Cerebral palsy and the causes of their occurrence can be divided into 6 groups:

1. physical pathologies.
2. Genetic.
3. Mechanical.
4. Ischemic.
5. Intoxication.
6. Infectious.

The physical causes of cerebral palsy appear due to various influences: x-ray exposure, magnetic field, radiation damage.

The genetic origin of cerebral palsy has not been reliably established, but experts talk about the likelihood of hereditary disorders in the chromosomes. Genetic causes are various chromosomal abnormalities that provoke the development of paralysis; it is possible to establish the likelihood of such an outcome even in the womb using genetic mapping.

Mechanical changes in the child's body may appear as a result of trauma, which led to disturbances in the functioning of the brain. After the birth of the child, it is necessary to assess the likelihood of any motor deficiencies. As early as possible, it is necessary to diagnose the child's motor skills, the presence of defects in cerebral tissues and assess how the child moves his limbs, what position he occupies, whether he can roll over on his own, etc.

The ischemic etiology of cerebral palsy is fetal hypoxia, fetoplacental insufficiency, lack of oxygen in case of toxicosis and diseases of internal organs.

Intoxication causes are the result of poisoning, the consequences of the action of toxins. If any complications occur during a woman's pregnancy, this can lead to the accumulation of toxic substances that affect the fetus and its development. A similar situation can be provoked by drug treatment of female toxicosis.

Infectious causes in newly born children may occur due to the presence of diseases such as meningitis, meningoencephalitis and encephalitis. Brain tissues become inflamed, which is fraught with their atrophy. Infectious diseases are accompanied by high fever, an increase in the number of leukocytes in the blood plasma and the presence of cerebrospinal fluid. All these factors affect the subsequent motor instability of the child.

Risk factors

There is a list of factors that can provoke the appearance of a terrible disease in an unborn child:

• the age of the child's mother. There is a risk in mothers under 18 and 30 and older who give birth for the first time, have late toxicosis and do not follow a healthy lifestyle;
• infectious diseases. The highest percentage of risk is congenital rubella, which can harm the fetus in 16 - 50% of cases out of 100. Other children whose mothers suffered from congenital toxoplasmosis, meningitis, and cytomegaly can also get congenital brain damage. Viral diseases, herpes, Escherichia coli, etc. are also dangerous;
• constant stress during pregnancy. Under stress, a whole portion of hormones is released into the body, their excess can develop a spasm of the umbilical cord and uterine vessels;
• the threat of miscarriage: placental abruption and intrauterine bleeding;
• maternal endocrine diseases. It can be hypertension, arterial hypertension, diabetes mellitus. All this can lead to the threat of miscarriage;
• poor diet, smoking and alcohol abuse;
• harm from drugs;
• late toxicosis;
• intracranial trauma during childbirth, asphyxia;
• erythrocyte antigen incompatibility.

Signs of cerebral palsy - symptoms of the disease

There are three stages of the course of the disease:

1. Early (0 to 5 months)
2. The initial stage (from 5 months to 3 years).
3. Late (from 3 years and older).

As a result of studying the stages, early manifestations of cerebral palsy and their late symptoms are distinguished. Early signs of the disease include:

• children's reflexes, for example, grasping, which persist after six months;
• developmental delay, for example, the child cannot crawl, walk, roll over, sit, etc.;
• using only one hand.

Early symptoms may be completely imperceptible until a certain age, and may be very pronounced, depending on the degree of damage to the brain tissue. If a child has unhealthy muscle tone, for example, then this may show up as either excessive relaxation or resistance. If the tone is relaxed, i.e. lowered, limbs dangle, the child cannot hold a pose. If tense - elevated, then the limbs take a forced, not always comfortable position. Due to this pathology of muscle tone, cerebral palsy has the following character:

• sudden movements;
• slowness and worm-likeness;
• excessive dynamics;
• aimlessness;
• uncontrolled motor reflexes.

All other symptoms of cerebral palsy are correlated with late ones. These include:

• skeletal deformity. The affected side in this case has a shortened limb. As a consequence, if the problem is ignored, a violation of posture, scoliosis, curvature of the pelvic bones may develop;
• hearing impairment. The child is unable to recognize the sounds around him, which threatens the late development of speech and other skills;
• speech disorder. Expressed in the inability to form sounds by coordinating the lips, larynx and tongue. This occurs as a result of damage to muscle tone. At the same time, speech is incoherent and difficult;
• visual problems. Myopia, farsightedness or strabismus develops;
• swallowing disorder. There is no interaction of the muscles responsible for the swallowing process, which creates great difficulties with the process of eating and drinking, salivation;
• violation of the anatomical structure of the jaw - these are pathological problems in the structure of the dentition, damage to the teeth by caries, weakness of the enamel;
• urinary incontinence and defecation. When the work of the muscles is uncontrolled, the implementation of these processes becomes problematic;
• convulsions. This symptom can be observed immediately after the birth of a child or some time after the development of cerebral palsy;
• mental retardation. This symptom is shown only at a part of sick children;
• impaired coordination and muscle tone. Movements and motility of the child are loose, clumsy, discoordinated. Cerebral palsy is manifested by such disorders:
• excessive muscle tension;
• involuntary contraction of muscle tissue;
• no response to loud sound;
• strabismus, myopathy;
• does not reach the object by hand after 4 months;
• does not sit independently after 7 months;
• cannot pronounce words after a year;
• uses only one of the two upper limbs after 12 years;
• walking on toes, not on a full foot;
• difficulty walking, stiffness.

Forms

Forms of cerebral palsy are classified according to many features proposed by various scientists and consisting of various factors. Currently, only one classification of cerebral palsy is used, which was proposed by Semenova K.A.

Consider all forms of cerebral palsy separately:

• Cerebral palsy of spastic diplegia is the most common form. These types of cerebral palsy are characterized by a curved spine, impaired functioning of the muscles of the legs, arms and face, while almost not affected, and deformed joints. In addition to physical development, mental development also suffers. Syndrome of pseudobulbar dysarthria may develop. Characteristics of the disease: impaired speech, hearing, intelligence. The diagnosis - a spastic form of cerebral palsy - is very difficult and can lead to not the most pleasant consequences, but the social adaptation of the child can help in this.
• - Another type of form of cerebral palsy. It is extremely severe and is accompanied by a complete dysmotility, both in the legs and in the hands. The child cannot fully bend or straighten the limbs, the muscles are constantly in good shape, and asymmetry of movements is observed. In more than half of the cases, mental retardation is observed. These children are completely bedridden and cannot stand or sit. Such patients are not trained, which cannot be said about the next form of the disease.
• The hyperkinetic form of cerebral palsy (also known as the dyskinetic form) is a change in muscle tone that causes impulsive automatic twitches and movements that increase with emotional overexcitation. During sleep, muscle activity stops; during wakefulness, muscle tone is constantly changing. Such patients begin to sit late, but do not walk for the rest of their lives. They are characterized by illegible speech, auditory impairment, but at the same time intelligence is preserved. If spastic symptoms are added to these symptoms, then the disease is diagnosed as cerebral palsy spastic hyperkinetic form.
• The atactic form of cerebral palsy is the dominance of motor disorders and imbalance of balance. In the early years of life, only muscular hypotonia can be seen. Ataxia becomes clearer as the functions and motor activity of the upper limbs form.

There are also mixed forms, because. it is not always possible to diagnose one of them due to the diffuse nature of the disease. With this form, there is a mixing of the symptoms of several types of cerebral palsy.

In the neonatal period, it is sometimes difficult to diagnose and determine cerebral palsy, the form of which is not clear. Therefore, in this classification there are clarifying data, taking into account the age limits of a person. For an earlier age, they are characteristic, for an older one - spastic, atactic, hyperkinetic, mixed.

Diagnosis and treatment

Diagnosis of cerebral palsy covers the following stages of analysis:

• ultrasound of the brain;
• CT and MRI;
• Electroencephalogram.

The main goal of the treatment of cerebral palsy is the elimination of malfunctions in the motor system, speech barriers, and the correction of mental development. Treatment is selected individually, taking into account all the characteristics of each individual organism, because today there is no universal treatment. Methods that accompany positive results:

• physiotherapy;
• medicines that normalize muscle tone;
• massage.

The following methods are also effective:

• Voight method;
• pneumosuit Atlant;
• load suits;
• classes with a speech therapist;
• walkers, bicycles and other exercise equipment.

If the methods do not give changes, they perform a surgical operation, perform plastic surgery of the muscle structure and tendons, and give the tissues the correct shape. In this way, contractures and damaged areas are removed, and the spinal cord is stimulated.

Analyzing cerebral palsy, the causes of which may be different, it can be noted that a very effective non-traditional method - animal therapy - treatment with the help of positive emotions from communicating with animals (horses and dolphins).

Ekaterina Morozova

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The term, known in medicine as cerebral palsy, means not one disease, as it might seem to someone, but a whole complex of diseases with disorders in various body systems.

The very first signs of cerebral palsy (note - not to be confused with infantile palsy) can appear immediately after the baby is born. But, in most cases, the disease is detected a little later (but still in infancy).

What is the cause of the disease, and what does it represent?

What is cerebral palsy in a child - the main risks and consequences of cerebral palsy

The disease, which was given the name of cerebral palsy in science (note - cerebral palsy), is primarily characterized by early development: in the process of development in the mother's abdomen, at the time of childbirth or during the first months of life.

Regardless of the reasons for the development of the disease, there is a malfunction in the work of individual areas of the brain or their complete death.

The disease is characterized...

• early development.
• Damage to brain structures (approx. - spinal or brain).
• Violation of motor / muscle activity.
• Possible disorders of the psyche, hearing and vision, as well as speech and coordination of movements.

It should be noted that cerebral palsy is not a genetic or contagious disease.

At the same time, despite the severity of the disease, it is amenable to rehabilitation, which allows to correct the symptoms and improve the quality of life of the child for his socialization to the extent possible.

It is noted that the highest percentage of cases is observed among boys.

What are the possible consequences of cerebral palsy?

First of all, note the orthopedic consequences of the disease. With respect to motor activity disorders, they become primary complications, with the timely elimination of which it is quite possible to put the child on his feet in a short time.

Dystrophic processes in the skeletal muscles: this complication is of the greatest importance. In the absence of proper treatment, it leads to deformation of the joints and bones - which, in turn, lead to impaired movement in general and provoke pain.

Other possible complications of the disease include:

1. Pathological muscle tone.
2. The appearance of seizures.
3. Having difficulty swallowing.
4. The appearance of uncontrolled movements.
5. Violation of the processes of urination / defecation.
6. developmental delay.
7. The appearance of problems with vision, speech and hearing.
8. Having emotional problems.

It is worth noting that the symptoms of cerebral palsy will not necessarily be pronounced - it all depends on the case. Signs of the disease can be barely noticeable - or they can be expressed in absolute disability, in accordance with the degree of damage to the central nervous system.

It is important to say that with cerebral palsy, despite the fact that it is chronic, there is no progression.

The aggravation of the condition of a sick child can be observed only with the appearance of secondary pathologies. For example, with hemorrhages, with epilepsy or somatic manifestations.

The main causes of cerebral palsy - who is at risk?

The key reason for the development of the disease is considered to be a developmental disorder - or complete death - of a specific area of ​​\u200b\u200bthe brain, acquired before - or immediately after - birth.

There are more than 100 factors that can affect the development of cerebral palsy. All these factors, potentially detrimental to the infant's nervous system, are combined in medicine into 3 groups.

Namely, the factors that are relevant to…

• The course of pregnancy.
• The very birth.
• The adaptation period of a newborn outside the womb during the 1st month of life (sometimes up to 2 years).

The reasons for the 1st group of factors include:

1. late toxicosis.
2. The threat of miscarriage.
3. Rh-conflict of mother and fetus (note - with a negative mother's Rh).
4. Fetal hypoxia.
5. Infectious diseases transferred during pregnancy. The most dangerous are rubella (if the mother did not suffer from it in childhood), syphilis, as well as toxoplasmosis.
6. Injuries sustained by the mother during pregnancy.
7. Somatic diseases.
8. Early detachment of the placenta.
9. Fetoplacental insufficiency.

The reasons for the 2nd group include:

1. Injuries to the baby's head, which he received when passing through his mother's narrow pelvis.
2. Other birth trauma
3. Breech presentation of the fetus.
4. Violation of generic activity.
5. Too much breast weight.
6. premature birth.
7. And the most dangerous factor is rapid childbirth.

The causes of the 3rd group were identified:

1. Asphyxia of newborns.
2. Hemolytic disease (note - occurs against the background of the Rhesus conflict).
3. Aspiration of amniotic fluid.
4. Disturbances in the development of the respiratory system.
5. Medical stimulation of labor and acceleration of labor through the puncture of the amniotic sac.
6. Severe illnesses suffered by the child (approx. - herpes infection, meningitis or even encephalitis).
7. Baby head injury.
8. Postponed poisoning (in a child) with lead.
9. Cases that could lead to brain hypoxia (note - blockage of the respiratory tract of the crumbs by something, drowning, etc.).

According to statistics, almost half of babies with cerebral palsy were born prematurely. Unfortunately, vulnerability is the highest due to the incomplete development of systems and organs, which, alas, significantly increases the risk of oxygen starvation.

As for asphyxia during childbirth, it accounts for less than 10 percent of all cases of cerebral palsy.

Latent infections in the mother are considered the most common cause of the development of the disease (note - the degree of their toxic effect on the fetal brain is extremely high).

It is important to note that most of the listed risk factors cannot be called absolute.

In addition, the consequences of these factors can be, if not prevented, then at least minimized.

Forms of cerebral palsy

Experts identify several forms of cerebral palsy, differing primarily in the area of ​​brain damage, as well as manifestations of the disease and other factors:

• Hyperkinetic. The causes of this form include Rh conflict, hypoxia, fetal poisoning with toxins, trauma at birth, fetal nutritional deficiency, etc. This form of the disease has 3 stages of development. At an early stage (note - lasts 3-4 months), convulsions, malfunctions of the respiratory system and arrhythmia are noted. The initial stage (approx. - lasts 5-48 months) is characterized by pronounced muscle hypertonicity, and the late stage - atrophy of individual muscles and consolidation of motor activity disorders. This form of the disease is considered the most susceptible to treatment.
• Atonic-static. With this form of the disease, low intelligence, a complete lack of interest in the outside world, and even aggressiveness are noted. Signs of the form are underdevelopment of speech and optic nerves, tremor of the limbs, high muscle tone, inability to walk and even sit, and so on.
• Spastic diplegia. This form is the most common. It is characterized by damage to both sides of the body with emphasis on the legs, extremely rapid deformation of the joints, paresis of the vocal cords, impaired development of the psyche and body systems, mental retardation, etc. Treatment in this case is practically useless, but there are methods that help the child adapt to the world.
• Spastic tetraparesis. The main signs are a decrease in the activity of all limbs with their subsequent deformation, pain and spasms, mental retardation, and so on. The form of the disease needs continuous treatment in order to avoid a serious deterioration in health.
• Attack. This form also has several stages of development. And if at an early stage only a violation of posture and partial violations of the norm of movements can be noted, then at a severe stage the child is no longer able to serve himself and move at all. Unfortunately, the symptoms do not appear immediately.
• Spastic-hyperkinetic. In this case, they speak of a mixed form of the disease, which is expressed in the manifestation of spastic symptoms in hyperkinetic disease. Symptoms of the disease appear at an older age after a violation in the development of any body system.
• Right-sided hemiparesis. A type of disease in which there is paralysis of the entire right side of the body. Causes are usually serious infections, trauma, stroke, tumor, diabetes, or meningitis. Usually the disease manifests itself already in adulthood.

Each form of cerebral palsy has its own characteristics, causes of development, symptoms and methods of treatment.

The development of the disease can proceed in completely different ways - but it is important to recognize the signs in time and start treatment immediately, in order to avoid irreversible consequences.

Persistent treatment and regular exercise can give a tangible result in almost any form of cerebral palsy.

All information in this article is provided for educational purposes only, may not be appropriate for your specific health circumstances, and does not constitute medical advice. The site сolady.ru reminds you that you should never delay or ignore going to the doctor!

Cerebral palsy (CP) is a disorder caused by permanent damage to the brain of a child during the prenatal period, childbirth or in the early stages of development. The most common problems relate to the coordination of movements of varying severity or muscle weakness. In some cases, there are convulsions, problems with vision and hearing. Often, children with cerebral palsy acquire the ability to roll, sit, crawl, and walk at a later age than their healthy peers. Approximately one-third go to convulsive seizures. Symptoms of the disease may become more noticeable as the child grows older, but this does not mean that the disease is progressing.

According to statistics, most often cerebral palsy is found in premature babies or for other reasons with low birth weight (42% of all cases of cerebral palsy), twins or triplets (11%). In addition, it is observed slightly more often in boys than in girls - 57% versus 43%.

Cerebral palsy can be diagnosed as early as one month of age, but this is very rare. This is due to the fact that the clinical signs of pathology develop in parallel with the development of the human nervous system. Therefore, the diagnosis of cerebral palsy, as a rule, requires several visits to a pediatrician and a pediatric neurologist, who, based on the dynamics of the child's motor development, may suspect deviations. In addition, diagnostic time frames are often needed for different types of cerebral palsy.

In most cases, cerebral palsy in newborns (the first 4 weeks of life) cannot be detected, but the pathology is already noticed in infants (children under one year old).

Often, parents are the first to notice signs of cerebral palsy in a child under one year old. In fact, in 70-80% of cases, the parents themselves initially pay attention to developmental deviations. However, physicians should do regular and appropriate check-ups on all infants and young children.

If there is any suspicion that the baby's brain has suffered anoxia, which may be caused by problems with the placenta, uterine disease, infectious disease, prolonged, rapid, or severe labor, then an MRI should be performed shortly after birth to evaluate any potential damage to the brain. brain. MRIs should be performed at regular intervals so that doctors can monitor the severity of cerebral ischemia.

Signs of cerebral palsy in a child

The range of severity of cerebral palsy symptoms is usually comparable to the severity of the brain injury.

Early signs of cerebral palsy

1. Delayed motor development.

The most common early sign of cerebral palsy in infants under one year of age is motor delay. Parents notice that the child:

• late starts to hold his head or does it poorly;
• does not pay attention to bright sounds and toys, does not try to reach the toys;
• does not roll over from back to stomach and from stomach to back;
• does not sit without support;
• does not try to crawl, stand at a support, try to walk by hands and on his own, or falls behind in these skills in terms of time.

1. Reflexes of the newborn.

Certain reflexes that a newborn child has normally fade with age. But in children with cerebral palsy, the physiological reflexes of the newborn persist for a very long time (Galant reflex, Moro reflex, grasping reflex, proboscis reflex, and others). In order to check them and you need a mandatory visit to a pediatric neurologist at 1, 3 and 6 months.

Examples of some of the reflexes that newborns should have and disappear after a few months. Their longer presence may be a sign of cerebral palsy

1. Dysfunction of the muscles of the mouth and face

Cerebral palsy in children under one year old primarily affects muscle tone, gross and fine motor functions. Early signs of cerebral palsy are associated with dysfunction of the muscles of the mouth and face. Parents themselves can detect problems with feeding, swallowing the child and the ability to express emotions on the face.

1. Posture and body coordination

The child cannot sit up without the support of the hands. Since the strength of contractions of different muscles is different, then he has a distortion in the setting of the trunk, head and limbs, while the latter are very often located asymmetrically relative to each other.

1. visual impairment

The child has a lack of interest and eye contact with parents and bright objects. Very often there is strabismus.

1. Hearing impairment.
2. convulsions(also associated with hypoxic brain damage).

Later signs of cerebral palsy

1. Impaired general motor function.

Limitation of the degree of mobility in general, the possibility of lifting, crawling, standing, balancing the body.

1. Violation of fine motor skills.

The child cannot grasp small objects and hold them between the index finger and thumb. Hold and use pencils, turn pages.

1. Mental retardation (not typical for all forms of cerebral palsy).
2. Violation of speech (due to the uncoordinated work of the muscles of the mouth, tongue and facial muscles).
3. Joint contractures (incomplete flexion or extension).
4. hearing loss
5. Violation of defecation and urination.

Signs of cerebral palsy in and infants by week

2 months and older

• Difficulty in head control when lifting.
• Stiff legs that cross or "scissor" when raised.
• Stiff or trembling hands and/or feet.
• There are problems with feeding (poor sucking, stubborn tongue, difficult biting in the supine or prone position).

6 months and older

• Continues to have poor head control when lifting.
• Can only extend one hand, clenching the other into a fist.
• There are problems with eating.
• May not roll over without assistance.

10 months and older

• Moves with difficulty, pushing with one arm and leg while dragging the opposite arm and leg.
• Doesn't babble.
• Unable to sit up and sit on their own.
• Doesn't respond to own name.

12 months and older

• Doesn't crawl.
• Unable to stand without support.
• He does not look for things that are hidden so that he can see it.
• Doesn't say single words like "mom" or "dad".

Diagnostics

Diagnosis of cerebral palsy is a very time-consuming and complex process. In addition to monitoring the child, ultrasound of the brain, EEG, EchoEG, and MRI of the brain are necessary.

Treatment

In the treatment of cerebral palsy, the main principle is that the earlier the diagnosis is diagnosed, the greater success in treatment can be achieved. In children, the regenerative capacity is much higher than in adults.

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

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

Appears at the age of 5 - 7 months.

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

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

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

Additional diagnostics is carried out using the following instrumental methods:

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

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

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

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

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

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

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

The prevalence of various forms of violation

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

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

Hyperkinetic form of cerebral palsy - the lot of girls

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

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

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

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

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

Causes of cerebral palsy

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

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

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

Symptoms of cerebral palsy

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

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

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

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

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

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

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

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

Diagnosis of cerebral palsy

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

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

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

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

Treatment of cerebral palsy

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

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

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

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

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

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

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

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

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

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

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

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

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

The complex use of such procedures is highly effective.

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

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

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

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

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

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

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

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

Prevention of cerebral palsy

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

Consultation of a doctor on the topic of cerebral palsy:

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

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

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

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

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

Doctor neurologist of the highest category Svetlana Valentinovna Kobzeva