Cerebral palsy

Children's cerebral palsy is one of the most severe neurological diseases in which the brain is affected or not fully developed, and various impairments of motor activity occur. As a rule, in this disease, the child has reflex muscle contractions, speech disorders, balance, as well as epileptic seizures, a decrease in the ability to learn, understand, adapt.

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Causes of the child cerebral palsy

This disease was described back in 1860 by Dr. William Little and for a long time was called Little's disease. After long observations, Dr. Little concluded that the disease develops because of the oxygen starvation of the fetus in the course of labor. In 1897, the well-known psychiatrist Sigmund Freud suggested that the cause of the disease could be in the fetal brain development in the womb. However, this theory was rejected until the 1960s of the twentieth century. In 1980, specialists established that trauma from childbirth leads to the development of cerebral palsy only in 10% of cases, and in most cases the causes remain unknown. From this moment, scientists began to study the fetal development period more carefully from the 28th week and up to 7 days of the already born child.

Children's cerebral palsy provokes many factors that disrupt the normal development of the child's brain.

The main reason is considered to be oxygen starvation, in which the brain receives insufficient oxygen (in the womb or at birth) and irreversible processes begin.

Lack of oxygen can be caused by separation of the placenta from the uterus before the due date, improper fetal position in the womb, rapid or protracted labor, pathological processes that disrupt the circulation in the umbilical cord. The risk factors for developing cerebral palsy also include cases when the imperfect central fetus system is attacked by microorganisms, for example, in case of birth before the due date, incompatibility of the blood group or Rh factor of the mother and child, viral diseases during pregnancy, etc.

Specialists pay special attention to two main reasons, in their opinion, for the development of the disease: measles rubella, borne by a pregnant woman and incompatibility by blood of the mother and child. As can be seen, the main causes are not related to heredity, but are related to the course of pregnancy and the birth process. Doctors in this case diagnose congenital cerebral palsy.

Less common is the acquired infantile cerebral palsy, which develops as a result of cerebral infections or craniocerebral injuries of the newborn. As a rule, the acquired cerebral palsy develops at the age of up to two years.

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Symptoms of the child cerebral palsy

Children's cerebral palsy can manifest from the first days of life or in a few months. In severe lesions, symptoms are evident from the first minutes of life, with mild disorders, the disease can make itself felt after a while. Symptoms of the disease and their severity also depend on the severity of the disease and areas of brain damage. In some cases, symptoms are mild, in other, more severe cases, lead to disability.

As a rule, when a child develops motor skills, the child develops later than the prescribed period, the movements can be completely absent, and be unnecessary, the child does not hold his head well, convulsions appear, and the speech development progresses with a significant lag. When these symptoms occur, you should immediately contact a specialist.

Usually affects those areas of the brain that are responsible for movement, muscle tone, balance, because of what the brain can not send the appropriate signals and control the muscles. With such violations appears increased muscle tone, paralysis, reflex muscle contractions (twitching). The development of the child does not correspond to the accepted norms, he either does not move his hands (feet) completely or completely, begins to hold the head, turn over, show interest in surrounding things, sit down, walk, etc. Much later than their peers.

In cerebral palsy, the child does not become completely on the entire foot, but rests on the socks, is unable to hold the toy in his hand, the motion of the foot, the squeezing and unclamping of the cam occurs unconsciously.

With increased muscle tone, the child's movements are severely limited, in some cases he completely loses the ability to move.

Paralysis can hit the left or right side, only one or both limbs.

Paralyzed limbs remain underdeveloped (thinner, weaker, less healthy), as a result of paralysis, deformation of the skeleton, violation of movements in the joints can occur, which leads to large disturbances in motor activity.

Because of the brain damage, coordination of movements is disrupted, which is expressed by frequent falls, nodding, involuntary movements, etc. Also, in the infantile cerebral paralysis, the child may experience epileptic seizures, develop strabismus, twitch the eyeball, have hearing problems, mental disorders, diseases of the digestive tract.

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Forms

Children's cerebral palsy according to ICD 10 refers to diseases of the nervous system (G00-G99). In the classification of diseases is under the code G80 in the section Cerebral palsy and other paralytic syndromes (G80-G83).

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Children's cerebral palsy in the preschool age

Children's cerebral palsy is a progressive disease. With proper treatment, the child's condition improves over time, but the child's psychological maturation falls short. First of all, cognitive activity is disrupted. For children with cerebral palsy, a peculiar development of the psyche is characteristic, which is associated with organic brain damage at an early age and with impairments in motor, speech, and sensory functions. An important role for mental development is the restriction of motor activity, social ties, the conditions of upbringing and education.

Most children have a low ability to learn because of the lack of spatial representations (the ability to distinguish spatial features, relationships, the ability to correctly express them, orientation in spatial relations). The main value for the spatial analyzer is the motor analysis.

Because of motor failure in cerebral palsy, problems with eyesight, speech, the orientation in the space of the child lags behind, and at school age, usually severe severe disorders occur.

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Diagnostics of the child cerebral palsy

Children's cerebral palsy may not appear from the first days of life and watching the development of a newborn pediatrician should periodically inspect the child to timely diagnose the disease.

At an early age, motor disorders in a child can be transient and the final diagnosis is usually made towards the end of the second year of life, when pronounced motor disorders are manifested.

Diagnosis of the disease is mainly aimed at monitoring possible deviations in physical and intellectual development. In addition, if suspicion of cerebral palsy is assigned to magnetic resonance imaging.

Instrumental analysis includes complete information about the child's illnesses, as well as information on the course of pregnancy and mother's diseases during this period. As a rule, parents report about the delay in development, but sometimes some deviations can be detected by the doctor at a scheduled examination.

For the diagnosis is extremely important physical examination, which assesses the general condition, vision, hearing, muscular function, the duration of the reflex of newborns.

With the latent form of the disease, tests and development tests will help diagnose and determine the degree of developmental delay.

Diagnosis is assisted by complex diagnostic measures.

To exclude other possible pathologies or diseases, computer tomography and ultrasound examination of the brain can be used to assess the state of the brain.

After the final diagnosis, the doctor can prescribe an additional examination that will help to identify other diseases that can develop in parallel with cerebral palsy.

[16], [17], [18], [19], [20], [21], [22], [23]

Treatment of the child cerebral palsy

Children's cerebral palsy should begin to be treated from the moment of diagnosis and continue uninterrupted. Despite the fact that the disease is incurable, with timely and proper treatment it is possible to significantly improve the condition and quality of life of the child.

In the first years of life, the treatment of cerebral palsy is based on the reduction of convulsions, muscle tone, improvement of joint movements, and the like. As a result, the child reduces the risks of deformation of the skeleton, improves the ability to maintain balance, keep the head, perform normal limb movements, and acquire self-service skills.

A child with cerebral palsy should be observed at a pediatrician, neurologist, speech therapist, orthopedist, psychiatrist, rehabilitation specialist. The integrated approach of all specialists will make it possible to adapt the child to life as much as possible.

For each child, a specialist develops his own program of classes, in some cases it requires the use of additional equipment (simulators, stairs).

Treatment should be combined several methods, usually prescribed medication, regular medical gymnastics, surgical treatment, the help of a speech therapist, a psychologist, treatment in a sanatorium.

If possible, the child with cerebral palsy should be taught how to make the movements available to him, and to teach the skills of self-service.

To drug treatment is the appointment of drugs that prevent neuronal damage in the brain, antioxidants, vascular drugs, vitamins, etc.

Often, in cases of cerebral palsy, intravenous injections of cerebrolysin, ceraxon, somazine, piracetam, solcoyril, intramuscular cortexin, piracetam, ceraxon, neurovitamin or glycine (course) are often given to children.

All drugs are prescribed by a neurologist. To reduce spasm in muscles, drugs are used to reduce muscle tone (midokalm, baclofen). In severe disease, injections of prozerin or ATP into active points or administration of botulinum toxin (dysport, botox) are prescribed. The drug prescribed by a specialist is injected into a muscle cramped muscle with a special needle (at several points), the procedure is quite effective, but six months later a second injection is required.

In epileptic seizures drugs are administered individually, taking into account the age, severity and frequency of seizures, concomitant diseases. Usually appointed toparamate, valproic acid, lamotrigine.

Medications are prescribed to reduce severe symptoms of the disease, in some cases, requiring the appointment of painkillers, antispasmodics, antidepressants, antipsychotics.

Therapeutic exercise is shown to children with cerebral palsy daily. During the gymnastics there is a gradual improvement, the child learns new movements, he starts to gradually adjust to his own body and the world around him.

During the classes parents should learn how to do massage and gymnastics on their own, as these movements are necessary for the child every day.

In exercise therapy also includes games, for example, bring or take an item, exercise on simulators or with special adaptations.

Physiotherapy methods include balneotherapy, drug electrophoresis, electrical stimulation of muscles, nerves, thermal radiation, etc. These methods help to reduce muscle tone, twitching, develop joints, stretch the spine. Often, to enhance the effect, several procedures are assigned.

In severe disorders in the movements of the joints, an operation is performed to lengthen the tendons, muscles, transplant or trim the tendons to reduce spasm, and surgery on the nerves.

The most effective method of treatment of cerebral palsy is dolphin therapy, which must be under the supervision of a specialist. As practice shows, dolphins quickly find contact with a sick child, contribute to the development of analyzers, in particular visual and tactile.

When the animal touches an animal, reflex functions are improved, which are responsible for the work of the nervous systems. With their fins, dolphins create a kind of water massage, and water reduces the load on the joints, trains the muscles.

Massage in children's cerebral palsy

Children's cerebral palsy is usually accompanied by increased muscle tone, spasms, etc. Massage with cerebral palsy shows a positive result, it improves the outflow of lymph and blood, improves metabolism, increases the muscle mass and the adaptive capabilities of the child.

In cerebral palsy, massage helps to relax tensioned muscles, stimulate weakened muscles.

The specialist performs massage on a specific muscular group, often performed in conjunction with breathing exercises.

During the massage, various methods are used, taking into account the general condition of the child, the severity of the disease,

A session is held after the thermal procedures and taking medications, the child should be in a position where the muscles are as relaxed as possible.

In cerebral palsy, classical, segmental and acupressure massage is used.

Classical massage is aimed at maximum relaxation of tense muscles, tone of weakened muscles. With this massage use stroking, rolling, pinching, rubbing movements.

Point massage is recommended from an early age, when violations in the work of muscles are expressed minimally. Most of the points are located in the tendon area. The maximum efficiency this type shows after a classical or segmental massage.

Segmental massage is aimed at affecting the muscles of the hands, legs, shoulder girdle, pelvis. During the massage, use vibration, kneading, stroking, rubbing, as well as sawing or drilling.

Prevention

Children's cerebral palsy can be tried to prevent with the help of the health of the future mother. Women planning to become mothers and pregnant women should give up bad habits, regularly undergo scheduled examinations with a doctor, follow all recommendations, observe safety measures during epidemics (wear a gauze dressing, do not attend places of large crowds, etc.), avoid injuries, contact with toxic substances, X-ray, electromagnetic, radioactive radiation.

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Forecast

Children's cerebral palsy, unfortunately, is an incurable disease. However, the correct tactics of treatment, daily physical exercises will help to maximally adapt the child to normal life.

With insignificant brain damage, children diagnosed with cerebral palsy have a habitual life on a par with their peers.

Children's cerebral palsy, depending on the degree of brain damage, timely diagnosis, as well as the tactics of treatment and the implementation of all the recommendations of specialists, may not affect the child's usual life.

With the preservation of intelligence, children with cerebral palsy learn in ordinary educational institutions, master the professions, go in for sports, dance, handwork, etc.

If the disease affects both physical and mental activity, children can study in specialized institutions where treatment is combined with training, taking into account the individual capabilities of each child.

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