home Audience 4 Perinatal encephalopathy of hypoxic ischemic origin. Perinatal encephalopathy in newborns: how to recognize and what to do? Severe form of PEP, signs, manifestations

Perinatal encephalopathy of hypoxic ischemic origin. Perinatal encephalopathy in newborns: how to recognize and what to do? Severe form of PEP, signs, manifestations

AEDs in newborns - what is it?

Increasingly in modern medicine upon examination in maternity hospital or when visiting children's clinics, newborns are diagnosed with perinatal encephalopathy, abbreviated as PEP. What lies behind this incomprehensible phrase? How dangerous is this and why does PEP occur in infants? This is exactly what is worth understanding.

Perinatal encephalopathy is a fairly common diagnosis in newborns, which includes all kinds of abnormalities in the structure and functions of the brain, increased neuro-reflex excitability.

Prerequisites

Various factors may be prerequisites for establishing such a diagnosis. Firstly, the personal indicators of the expectant mother are taken into account:

age period;
presence of bad habits;
environmental indicators of the area of residence;
heredity;
diseases at the gene level;
various infections, especially sexually transmitted infections and many others.

Next, the period of pregnancy and childbirth is considered if the mother experienced severe toxicosis, weakness labor activity, long anhydrous period, long drug treatment, entanglement of the fetus with the umbilical cord, if immaturity or prematurity of the child is diagnosed, and so on. Taken together, all these factors tend to cause fetal hypoxia (lack of oxygen, prolonged or short-term oxygen starvation), and as a result, improper functioning of the central nervous system. nervous system.

What characterizes the presence of PEP in newborns?

So, the baby was born. What characterizes the presence of PEP in newborns? First of all, when examining the baby, the doctor checks whether there are any deviations in the reaction, whether the newborn’s reflexes are working correctly. If even the slightest disturbances are observed, then a record with a diagnosis of PEP may already appear in medical card. Subsequently, the presence of PEP may be indicated by lethargy or, conversely, severe excitability of the baby, severe crying, frequent regurgitation, stool failure or constipation, difficulty sleeping, anxiety, and much more. The most complex consequences may include cerebral palsy, hydrocephalus, epilepsy, and autonomic dysfunction.

Treatment of perinatal encephalopathy

Doctors, when first diagnosing perinatal encephalopathy in a child, take a number of comprehensive measures aimed at a quick cure. But with a prolonged illness, they switch to taking certain medications, vitamins, physical therapy, physical therapy exercises, and massage. Parents with their baby can also turn to homeopaths, who have proven themselves in the treatment of neurological disorders. And of course, all these actions are carried out under the constant supervision of medical specialists in this field and with regular examinations that will show improvements or deterioration of the child’s condition. It is worth consulting several specialists if you experience controversial issues, since often when diagnosing PEP, “overdiagnosis” occurs, when doctors conduct an examination without taking into account external and internal circumstances. In a cold room, the baby may feel stiff and inactive, sleepy state– lethargic and whiny; if the baby is frightened or makes a lot of noise, the baby’s sleep may be disturbed and he may become more restless, which may negatively affect the results of the examination, but will not in any way affect his proper development.

The main thing in this matter is not to panic and not give up. At proper treatment With care and love, the baby will be able to recover quickly.

Perinatal encephalopathy (PEP in newborns, PEP in children, PE) - This common name brain lesions of different etiologies or unspecified origins that occur in perinatal period(from the 28th week of pregnancy, including the period of childbirth and the first 7 days of life). The term PEP, PE, perinatal encephalopathy was proposed by Yu. A. Yakunin and co-authors in 1976. There is a certain convention in it: currently, only pathology of the antenatal and intranatal periods is included here, excluding intracranial birth trauma. A synonym for PEP is cerebral encephalopathy in children.

Causes

The cause of damage to the nervous system may be intrauterine hypoxia, which causes asphyxia of the fetus and newborn; infections of various etiologies; traumatic, toxic, metabolic, stress effects; immunological abnormalities in the “mother - placenta - fetus” system. Often the cause of PE is several generalized factors.

Polyetiology PERINATAL ENCEPHALOPATHY PEP predetermines various mechanisms of brain damage. Primary damage to cerebral structures under the influence of toxic, metabolic and other influences and secondary cerebral disorders due to hypoxic factors are possible. Antenatal hypoxia leads to a slowdown in the growth of brain capillaries and increases their permeability and vulnerability. The permeability of cell membranes also increases. Brain ischemia occurs with intracellular acidosis and neuronal death. Posthypoxic ischemic perinatal encephalopathy can and often develops in children.

Classification

Perinatal encephalopathy classified according to etiology, period of illness, severity, level of damage, clinical manifestations neurological disorders, possible outcomes.

Etiological factors are:

1) hypoxia (asphyxia);

2) trauma (except intracranial birth);

3) infection;

4) intoxication;

5) metabolic disorders;

6) endocrine and hormonal effects;

7) autoimmune conflict;

8) stressful effects;

9) unspecified and unclassified factors.

PEP periods

There are 3 periods of illness:

1) acute - up to 1 month;

2) subacute (early recovery) - up to 3 - 4 months;

3) late recovery - from 4 months to 1 - 2 years.

Perinatal encephalopathy severity

There are 3 degrees of severity of PEP:

1) light;

2) average;

3) heavy.

Levels of nervous system damage with PEP

Highlight different levels lesions:

1) meninges and liquor pathways;

2) cerebral cortex;

3) subcortical structures;

4) brain stem;

5) cerebellum.

Perinatal encephalopathy syndromes

In the acute period, a number of clinical syndromes are identified:

1) increased neuroreflex excitability;

2) general depression (lethargy, adynamia);

3) hypertensive;

4) hypertensive-hydrocephalic;

5) convulsive;

6) coma.

Perinatal encephalopathy, recovery period syndromes

Syndromes of recovery periods of perinatal encephalopathy in children are:

1) asthenoneurotic (cerebrasthenic);

2) autonomic-visceral dysfunctions;

3) motor disorders (central and peripheral paresis, paralysis, hyperkinesis);

4) convulsive;

5) hydrocephalic;

6) psychomotor development delay (PMDD), delay mental development(ZPR), motor development delay (MDD);

7) pre-speech delay and speech development, speech disorders;

8) mental disorders.

Perinatal encephalopathy consequences, consequences of hypoxia in children

Possible outcomes and consequences of perinatal encephalopathy, hypoxia, intrauterine hypoxia (lack of oxygen) are varied:

1) recovery;

2) delay in the rate of mental and speech development;

3) encephalopathy, manifested by scattered focal microsymptoms, moderate intracranial hypertension, asthenoneurotic syndrome, neurosis- and psychopath-like conditions;

4) gross organic forms of damage to the nervous system with pronounced motor, mental, and speech disorders (cerebral palsy, mental retardation, epilepsy, progressive hydrocephalus).

Symptoms, signs in children, newborns

The clinical picture of perinatal encephalopathy of different etiologies is largely similar and depends on the period of the disease.

In the acute period, mild, moderate and severe forms are distinguished.

Mild form of PEP, symptoms, signs

Light form perinatal encephalopathy (PEP) is manifested by a syndrome of increased neuroreflex excitability: general anxiety of the newborn, changing muscle tone, increased spontaneous motor activity, revitalization of the knee and basic unconditioned reflexes of the newborn (sucking and swallowing reflexes may be slightly reduced). From focal symptoms convergent strabismus and horizontal nystagmus. Cerebrospinal fluid has normal composition, but often her blood pressure is elevated. The morphological basis of the above changes is a violation of hemocerebrospinal fluid dynamics, which is often reversible during the first month of life.

Moderate form of PEP, symptoms, signs

Moderate form perinatal encephalopathy (PEP) is characterized by a general depression of brain activity, manifested by a decrease and then a selective increase muscle tone, predominantly in the flexors, decreased spontaneous motor activity and basic unconditioned reflexes. Against this background, focal neurological disorders are determined: ptosis, anisocoria, convergent strabismus, nystagmus, asymmetry of nasolabial folds, impaired sucking and swallowing, asymmetry of tendon-periosteal reflexes. The protective reflex of the newborn, the support reflex and automatic gait are often absent, spontaneous shudders occur, generalized or focal convulsions may be observed, hypertension syndrome with general hyperesthesia, high-pitched screaming, sleep disturbance, bulging and tension of the large fontanelle, positive symptoms Willy, Graefe. Gradually, divergence of the cranial sutures and the formation of hydrocephalus may occur. Cerebrospinal fluid pressure is usually increased. There is dilation of the veins in the fundus and stagnation phenomena, sometimes with pinpoint hemorrhages. In the blood it is often determined metabolic acidosis. The above changes are based on cerebral edema with pinpoint hemorrhages, especially in the soft tissue. meninges And lateral ventricles. Neurological disorders can sometimes partially regress within 2 to 4 months.

Severe form of PEP, signs, manifestations

Severe form of perinatal encephalopathy manifests itself as a precomatous or comatose state. The general lethargy and adynamia of the child are sharply expressed. The cry is weak or the child makes no sounds at all. Severe symptoms of damage to the cranial nerves are determined: convergent or divergent strabismus; constriction or dilation of the pupils with anisocoria, the reaction of the pupils to light is sharply reduced or absent; possible defeats facial nerve, nystagmus, lack of sucking and swallowing. Breathing is more often disturbed (arrhythmia, apnea), changes in pulse are noted (bradycardia is more often detected). Tendon-periosteal reflexes and basic reflexes of the newborn period are sharply reduced or not evoked, often absent defensive reaction to painful stimuli. Intracranial hypertension and convulsions, predominantly tonic in nature, are observed. The severity of neurological disorders depends on the degree of coma (moderate, deep, extreme), although the degree comatose state in a newborn it is sometimes difficult to determine.

A characteristic sign of extreme coma

Characteristic a sign of extreme coma - pupil dilation, immobility eyeballs. In this case, severe disorders of the rhythm and frequency of breathing, apnea, tachycardia, and a sharp decrease in blood pressure are possible. The fundus reveals swelling with small foci of hemorrhage and pallor of the optic discs. Bioelectrical activity of the brain is sharply depressed, difficult venous drainage, metabolic acidosis is determined in the blood.

Generalized cerebral edema

The basis of the severe form of PE is generalized cerebral edema, often in combination with intracranial hemorrhages, mainly in the pia mater, lateral ventricles, and brain matter.

The child’s serious condition lasts from several weeks to 2 months. With adequate treatment, regression occurs neurological disorders with the outcome in a certain form of neurological pathology or recovery with various defects.

Asthenoneurotic syndrome

During the recovery period after PE acute stage most common asthenoneurotic syndrome , manifested by the child’s emotional and motor restlessness, sleep disturbance and autonomic-visceral dysfunction. The syndrome of movement disorders is initially manifested by an increase in muscle tone, tendon-periosteal reflexes, a decrease or, in case of hyperkinesis, an increase in spontaneous motor activity. A very unfavorable prognosis is the long-term preservation of tonic labyrinthine and cervical reflexes, the absence in the first 2-3 months of the upper Landau righting reflex, as well as the support reflex and automatic gait. The presence of these disorders is characteristic of a delay in the development of motor skills at the level of the brain stem, which creates the prerequisites for the formation of (cerebral palsy).

Seizures in children

During the recovery period, convulsions may continue or may appear for the first time. If seizures in children are repeated without visible external influences, gradually becoming more complex in their manifestations, then there is a threat of developing such a formidable disease as epilepsy.

Hypertension syndrome

Residual cerebral organic failure, RCON treatment, symptoms of RUON treatment in Russia, in Saratov

"Residual cerebral organic failure " is a diagnosis that is often found in modern pediatric neurology. The abbreviated name of the diagnosis is RTC, (some write incorrectly RUON). Sarklinik conducts treatment of residual cerebral organic failure in children in Russia any age, RCSC treatment in Russia. New methods make it possible to comprehensively restore the functioning of a child’s nervous system. If your child's medical record diagnosis by a neurologist, contact Sarclinic as soon as possible for effective treatment; the earlier the therapy is carried out, the higher its effectiveness.

. There are contraindications. Specialist consultation is required.

Photo: Logray | Dreamstime.com\Dreamstock.ru. The people depicted in the photo are models, do not suffer from the diseases described and/or all similarities are excluded.

One of the most terrible diseases– encephalopathy in children, which can have both congenital form(perinatal), and acquired during life. The disease itself is a diffuse brain disorder, which in children manifests itself in an accelerated form of development.

Consequences of encephalopathy in children

As it became known only recently, the perinatal form of the disease in newborns can be inherited. However, this information is unspecified. Symptoms in the youngest children are not as pronounced as in adults, and therefore it is rarely possible to diagnose the disease in time and take measures to eliminate it. The most a terrible consequence encephalopathy in newborns is a lack of supply to the brain nutrients(for example, when the bilirubin form of encephalopathy occurs). Consequently nerve cells acquire signs of dystrophy, die off, due to which they stop developing important departments and body functions.

Treatment should also be aimed at eliminating swelling of the brain. It is the increase in brain size that leads to enlargement of the head in children whose skull has not yet formed to the proper extent. Consequences - hydrocephalus, Down syndrome, cerebral palsy, and this is not the entire list, may occur unspecified reason anomalies.

Types of encephalopathy

The childhood form of the disease is no different from the adult form according to the classification - encephalopathy can be congenital hereditary or developed in the womb, so to speak, perinatal and acquired due to the influence of harmful factors on the brain area. The symptoms of both forms of encephalopathy in newborns or adult children are similar.

Not only non-compliance with the diet during pregnancy can lead to illness, but also birth injury – similar cases Residual encephalopathy accounts for about 8-10% of all registered cases.

The children's nervous system is very unstable and delicate, especially when receiving traumatic brain injuries, there is a risk of developing consequences even some time after treatment has been provided. Compare: if a child can only get a concussion from jumping high altitude or sudden braking while running, what could cause a rupture of the vessel?

Discirculatory or toxic

This form of brain disease differs from residual disease in that it can cause organic changes in neurons due to the effects of vascular diseases or the entry of toxins into the blood. This may be due to an unspecified reason, or due to the following factors:

Vascular insufficiency.
Arterial or venous aneurysm.
Blood diseases - toxicoplasmosis, leukemia, bilirubin deficiency or elevated level, etc.
Viruses and infectious diseases– from jaundice (Botkin’s disease) to hepatitis, influenza with complications, pneumonia.
Diseases of other organs, etc.

Signs of encephalopathy begin to appear in children with sleep disorders: the child has trouble falling asleep and is capricious. His perception deteriorates, his psyche suffers. All these are symptoms of the so-called pseudoneurasthenic syndrome. It causes dizziness and unsteadiness when walking, problems with blood pressure, failure of the brain to perform the work of the organs of hearing or vision. Since the children's nervous system is quite fragile, there may be sudden changes moods - tearfulness, increased activity or consequences of epileptic encephalopathy in children.

If treatment is not prescribed on time, perinatal or other encephalopathy that is not specified during the diagnostic process will lead to more harmful abnormalities in the functioning of the brain. Stagnation of consciousness will become permanent; for children it is like being in prostration. Frequent fainting, asymmetry of tendon reflexes, and increased muscle tone in newborns and older children are possible. Finally, symptoms will often manifest as vegetative-vascular dystonia and lability. As for emotional state, it is accompanied by deterioration of attention and memory in children.

Perinatal

Another form of brain disease is encephalopathy, which appears either in the last 12 weeks of pregnancy or during childbirth. The cause may be unspecified - stress, trauma, poor nutrition, and the specific disease suffered expectant mother. For example, anemia or pneumonia.

To prevent encephalopathy in newborns, it is recommended to monitor your diet, go for walks fresh air and completely relieve yourself of stress. You should also be careful with drinking coffee, chocolate, especially alcohol and cigarettes - even passive smoking provokes a disease such as perinatal or a form of residual encephalopathy of the brain in newborns. By the way, even if the disease could not be avoided (birth trauma), treatment in the first weeks of life is quite easy, and the chances of completely getting rid of the consequences by 12 months of life are 90-95%.

Bilirubin

This form of cerebral encephalopathy occurs due to a hemolytic disease, which is caused by incompatibility of blood groups between mothers and children. If bilirubin, which has not been processed by the liver, is elevated in the blood - above 0.1-0.2 grams per 1 liter, then it leads to toxic poisoning, that is, to the entry of hazardous substances into the brain area.

Bilirubin disease encephalopathy can be caused by causes of jaundice:

Sepsis.
Birth injuries or injuries received during the life of children.
Toxoplasmosis.
Tendency to diabetes mellitus mother.
Heredity in children.
Unfinished treatment of intrauterine jaundice.

Symptoms or what happens as a result of damage to the brain, its subcortical nuclei, and cerebellum: tissue metabolism is disrupted, which leads to an inevitable decline in immunity and failure of body functions, as with later residual encephalopathy in children.

The clinical picture divides symptoms into three phases:

Signs of food poisoning appear, such as weakness, nausea, decreased skeletal muscle tone. However, conventional treatment for poisoning does not help: babies continue to regurgitate frequently and may refuse to eat.
Symptoms present in kernicterus appear - bent joints, clenched hands. The neck bends painfully, bilirubin encephalopathy can lead to an increase in body temperature and even respiratory failure.
A false effect occurs, which actually indicates that the treatment does not produce results. Usually, a short-term improvement is replaced by a return of symptoms in an intensified form - to cerebral palsy, a mask-like face, overstrain of the back muscles, and rolling of the iris behind the eyelid.

Treatment of the disease

Every doctor will advise you to start a complex of preventive and therapeutic measures already when the primary symptoms of encephalopathy appear. So, in addition to medications, a special diet is prescribed, in which it is necessary to eliminate as much as possible the consumption of table salt, polyunsaturated fats, cholesterol, and chocolate. Instead, consume more iodine-containing foods, vitamins and ascorbic acid.

Perinatal encephalopathy is a brain lesion that has various causes and manifestations. This is a huge variety of symptoms and syndromes, manifestations and features: children with severe perinatal encephalopathy require special attention and mandatory medical supervision. Perinatal injuries of this nature account for about half of the pathologies of the nervous system in children and often become the causes of epilepsy, cerebral palsy, and brain dysfunction.

Perinatal posthypoxic encephalopathy

PPE (transient encephalopathy of newborns) implies the appearance of disorders of the child’s brain that arose before or during childbirth. The most important factors contributing to the occurrence of PPE are birth injuries, neuroinfections, fetal intoxication and oxygen deprivation.

Symptoms also occur in large newborns, premature babies, and if the child was born entwined with the umbilical cord. The diagnosis is indicated by high fetal weakness on the Apgar scale, the absence of a sucking reflex in children, heart rhythm disturbances and constant nervous agitation.

About the diagnosis "hypoxic-ischemic perinatal encephalopathy" we're talking about when multiple disorders are noticed in the prenatal period. This leads to a pathology in the supply of oxygen to the fetal tissues, but the brain is primarily affected.

Perinatal encephalopathy in newborns

Immediately after birth, a child with brain damage attracts attention with restless behavior, frequent spontaneous flinching and regurgitation, excessive lethargy and stiffness, and increased reactions to sound and light.

Throwing back the head with uncontrollable crying, poor thermoregulation, and disturbed sleep often resolve during the first week of life. CNS depression syndrome in newborns manifests itself in the form of lethargy, lethargy, and often different muscle tone, leading to asymmetry of the body and facial features.

If the symptoms do not disappear during the first month of life, but acquire a new color and strength, doctors diagnose perinatal encephalopathy.

Types of encephalopathy in children

Residual form Brain damage is diagnosed if, in the presence of previous birth injuries, the child suffers infections, inflammation, and also with poor blood supply to the brain. Such children suffer, often with mental problems, decreased intelligence, and learning difficulties.
Encephalopathy- damage to brain tissue caused by impaired blood supply. The causes are osteochondrosis, hypertension, increased blood pressure, and dystonia.
Ischemic encephalopathy is expressed in poor blood supply to the brain and destructive processes, going in certain tissue foci. Excessive smoking, stress and alcohol abuse lead to this diagnosis.
Toxic encephalopathy results from brain poisoning toxic substances for infections, poisoning chemicals and alcohol. Severe poisoning of brain tissue leads to epileptic seizures.
Radiation encephalopathy appears as a result of exposure to ionizing radiation on the brain of patients.
Encephalopathy of mixed origin characterized by the presence of extensive complaints and symptoms; only a doctor can make a correct diagnosis based on tests and brain studies.

Severity

During PE it is customary to distinguish several periods.

The period after birth and up to the 1st month of life is considered acute. Lasts up to a year or two recovery period. What follows is the outcome of the disease.
Each period is characterized by a special course and presence various syndromes, sometimes combinations of manifestations are noted.

Each syndrome requires appropriate treatment and correctly prescribed medications.

Even mild manifestations of brain disorders should be carefully examined - untreated disorders are fraught with developmental delays and adverse outcomes. When the severity of brain damage is severe or moderate, qualified inpatient treatment is necessary.

Mild disorders can be treated on an outpatient basis under the supervision of a neurologist.

Video of Dr. Komarovsky talking about the difference between perinatal encephalopathy and normal physiological reflexes of newborns:

Causes of perinatal encephalopathy

Risk factors, contributing to the appearance of this group of brain lesions:

Availability chronic diseases mothers;
Eating disorders;
Maternal alcohol intake and smoking;
Autoimmune conflict;
Previous infectious diseases during pregnancy;
Borderline age of the woman in labor;
Stress;
Pathology during pregnancy and childbirth (toxicosis, rapid labor, trauma during childbirth);
Prematurity of the fetus;
Unfavorable environmental conditions.

Symptoms of the disease

Prolonged crying;
Frequent regurgitation;
Throwing of limbs;
Restless shallow sleep at night and short sleep during the day;
Lethargy or hyperactivity;
Inadequate reaction to light and sound stimuli;
Lack of sucking reflexes;
Muscle tone disorders.

These and many other symptoms need to be carefully studied by your doctor.

In more late age the child has frequent Bad mood, absent-mindedness, sensitivity to weather changes, difficulty getting used to child care facilities.

Main syndromes of perinatal encephalopathy

Hypertensive-hydrocephalic syndrome manifested by the presence of excess fluid inside the brain, this leads to changes in intracranial pressure. The diagnosis is made based on observation of the size of the head and the condition of the large fontanel. Also manifestations of the syndrome are restless sleep, monotonous crying, increased pulsation of the fontanel.
Syndrome increased excitability more often makes itself felt by increased motor activity, problems with falling asleep and staying asleep, frequent crying, a decrease in the threshold of convulsive readiness, and increased muscle tone.
Convulsive syndrome known as epileptic and has a variety of forms. These are paroxysmal movements of the body, shudders, twitching and spasms of the limbs.
Comatose syndrome manifests itself as severe lethargy, decreased motor activity, depression of vital functions, and absence of sucking and swallowing reflexes.
Vegetative-visceral dysfunction syndrome expressed by increased nervous excitability, frequent regurgitation, disorders of the digestive system, enteritis, stool disorder, abnormal skin condition.
Movement disorder syndrome manifests itself in the direction of a decrease or increase in muscle tone, which is often combined with developmental disorders, making it difficult to master speech.
Cerebral palsy has a complex structure: these are disorders of fine motor skills, lesions of the limbs, speech dysfunction, visual impairment, mental retardation and reduced ability to learn and social adaptation.
Hyperactivity syndrome is expressed in children’s reduced ability to concentrate and attention disorders.

Diagnostics

The diagnosis is made based on clinical data and information about the course of pregnancy and childbirth. The following modern and effective methods are used for diagnosis.

Neurosonography reveals intracranial brain damage.
Doppler sonography studies the amount of blood flow in brain tissue.
An electroencephalogram, by recording the electrical potentials of the brain, allows one to determine the presence of epilepsy, delay age development at various stages.
Video monitoring helps to evaluate the characteristics of children’s motor activity based on video recordings.
Electroneuromyography allows you to study the sensitivity of peripheral nerve fibers.
Available types of tomography are used to assess structural changes in the brain.

Most often, objective information about the disease is obtained using neurosonography and electroencephalography. Sometimes an examination is prescribed by an ophthalmologist, who examines the fundus and the condition of the optic nerves, and identifies genetic diseases.

Treatment of encephalopathy in children

If the symptoms are moderate and mild, doctors leave the child for home treatment and give recommendations to parents on how to maintain the condition.

But severe damage to the nervous system and an acute period require inpatient treatment. In any case, you need to choose individual mode, massage, physical therapy, herbal medicine methods and homeopathic remedies.

Drug treatment

When prescribing treatment, the severity of the diagnosis is taken into account. To improve blood supply to the brain, a newborn is prescribed piracetam, actovegin, and vinpocentine.

Drug therapy is prescribed by a doctor.

For severe motor dysfunctions, emphasis is placed on the drugs dibazole and galantamine, with increased tone Prescribe baclofen or mydocalm. To administer drugs, various options for oral administration and the electrophoresis method are used. Massages, physiotherapy, and daily special exercises with the child are also indicated.
For epileptic syndrome, taking anticonvulsants in doses recommended by a doctor is indicated. Anticonvulsants are prescribed for serious indications and severe epilepsy. Physiotherapy methods are contraindicated for children with this syndrome.
For psychomotor development disorders, medications are prescribed that are aimed at stimulating brain activity and improving cerebral blood flow - these are nootropil, actovegin, cortexin, pantogam, vinpocetine and others.
For hypertensive-hydrocephalic syndromes, appropriate drug therapy is prescribed based on the severity of symptoms. In mild cases, the use of herbal remedies (decoctions of bearberry and horsetail) is indicated; in more complex cases, diacarb is used, which increases the outflow of liquor.
For particularly severe patients, it is rational to prescribe methods of neurosurgical therapy. Hemodialysis, reflexology, ventilation, and parenteral nutrition are also used. Children with PEP syndromes are often prescribed B vitamins.

Treatment at home

It is important to pay special attention to children with perinatal encephalopathy from the first days of life. Parents should tune in to the need to introduce hardening, massage, swimming, and air baths.

Therapeutic massage and complexes special gymnastics help improve body tone, develop motor functions of the hands, train and strengthen the baby’s health. If a child has been diagnosed with muscle tone asymmetry, massotherapy irreplaceable.

Parents should be prepared for the fact that at times of increased stress, all syndromes may worsen. This happens when children go to kindergarten or school, when the weather and climate change, during intensive growth child. Childhood infections may also influence symptoms.

Admission required vitamin complexes , you should allocate enough time for walks in the fresh air, activities and exercises. Also needed balanced diet and a calm, balanced environment in the house, absence of stress and sudden changes in daily routine.

The better the quality of treatment a child receives, the more attention is paid to such children from birth and in the first years of life, the lower the risk of severe consequences of brain damage.

Consequences and possible prognosis of the disease

The most common consequences of perinatal encephalopathy can be: delayed development of the child, brain dysfunction (expressed in lack of attention, poor learning ability), various dysfunctions of internal organs, epilepsy and hydrocephalus. Vegetative-vascular dystonia may occur.

About a third of children recover completely.

A woman's adherence to a daily routine, rules of conduct during pregnancy and personal hygiene, and abstinence from smoking and alcohol can reduce the risk of brain damage in newborns.

Adequately performed childbirth, qualified health care and observation by a neurologist, timely diagnosis and treatment reduce the risk of the consequences of perinatal encephalopathy.

Perinatal encephalopathy and can it be cured:

Perinatal encephalopathy- a collective diagnosis in pediatric neurology, recording various disorders of the structure and function of the brain that arise in the perinatal period of a child’s life. The diagnosis of perinatal encephalopathy was usually based on one or more sets of any signs (syndromes) of a probable disorder of the nervous system, for example, hypertensive-hydrocephalic syndrome, muscular dystonia, hyperexcitability syndrome.

The perinatal period begins at the 28th week of the child’s intrauterine life and ends by the 7th superinatal period in newborn full-term infants or by the 28th day in premature infants. This term does not imply any specific pathology, i.e. cannot be considered a diagnosis as such. This is a signal that the child has “something wrong with the brain” due to some kind of damage.

Causes of perinatal encephalopathy

The cause of damage to the nervous system may be intrauterine hypoxia, which causes asphyxia of the fetus and newborn; infections of various etiologies; traumatic, toxic, metabolic, stress effects; immunological abnormalities in the "mother - placenta - fetus" system. Often the cause of perinatal encephalopathy is several generalized factors.

Symptoms of perinatal encephalopathy

The clinical picture of damage to the child’s nervous system in the newborn period with the above diseases of the mother proceeds as follows: acute condition with symptoms of central nervous system depression, seizures and others neurological manifestations, respiratory and circulatory disorders. In the acute period of diseases, depending on the severity of neurological disorders, three can be distinguished: clinical forms: mild, moderate and severe In the structure of perinatal encephalopathy, a large place is occupied by intranatal lesions: acute asphyxia (hypoxia of the fetus and newborn, intracranial birth injury). Often, intrapartum injuries occur against the background of a previous disorder of fetal development.

In the early postnatal period (after childbirth), newborns experience secondary purulent meningitis, brain abscesses, cerebral hemorrhages and other complications.

Secondary damage to the nervous system in newborns most often occurs during purulent-septic conditions, neurotoxicosis, and hyperthermia. Emerging hematoliquorodynamic disorders, hypoxia and hypercapnia can lead to metabolic disorders, respiratory and circulatory disorders, contributing to the appearance of seizures, disorders of consciousness and other neurological changes.

Main manifestation syndromes of perinatal encephalopathy

The recovery period of hypoxic encephalopathy includes the following syndromes:

Convulsive seizures in newborns are characterized by short duration, sudden onset, lack of pattern of repetition and dependence on the state of sleep or wakefulness, feeding regimen and other factors. Convulsions are observed in the form of small-amplitude tremor, short-term cessation of breathing, spasm of the eyeballs and the “setting sun” symptom, automatic chewing movements, trembling feet. These convulsions are sometimes similar in nature to the spontaneous movements of a child, which makes diagnosis difficult.

Treatment of encephalopathy in children

Perinatal encephalopathy in children can be treated quite successfully only if you promptly seek help from specialists: complete healing without consequences for the child’s health is provided during the first year of life. In view of this circumstance, future parents need to know the causes of such a disease as perinatal encephalopathy, its symptoms and possible consequences. It is necessary to ensure constant monitoring by a specialist - often only experienced doctor may notice the first signs of perinatal encephalopathy in the first months of the child’s life (impaired muscle tone, frequent regurgitation, enlarged fontanelles, inadequate reaction to sound, light, impaired thermoregulation, etc.).

The worst thing that perinatal encephalopathy brings with it is its consequences, in particular - delayed motor or mental development of the child, minimal brain dysfunction (lack of attention, perseverance), autonomic visceral dysfunction (impaired functions of internal organs), hydrocephalus (dropsy of the brain) , epilepsy.

Quite often, the diagnosis of perinatal encephalopathy in children is made unreasonably, and the prescribed drug treatment can lead to additional complications in young patients. PEP therapy without drugs is quite possible, for example, in the office of an osteopathic doctor.

Drug treatment

Only real, objectively identified and clearly defined consequences perinatal lesions nervous system may require the use of medications, but this is always symptomatic treatment, i.e. aimed at specific problems: for spasticity - drugs to relax muscles, for cramps - anticonvulsants, etc. However, most children are prescribed a variety of drugs and combinations of drugs with unproven effectiveness.

Here is a list of the most common irrational prescriptions in pediatric practice.

So called vascular drugs. These include drugs various groups(cinnarizine, cavinton, sermion, etc.).

Preparations containing hydrolysates of amino acids, neuropeptides, etc. - Cerebrolysin, Actovegin, solcoseryl, Cortexin, etc.

So-called “nootropic” drugs that “improve brain nutrition”: piracetam, aminalon, phenibut, pantogam, picamilon, etc.

Homeopathic remedies.

Varied herbal preparations, including valerian, motherwort, well-known to the population, as well as lingonberry leaf, bear's ears, etc.

Attention! Claims about "improving brain nutrition" represent an old medical myth or a publicity stunt. The above drugs are routinely prescribed to most patients diagnosed with PEP, however they SHOULD NOT be used in the treatment of children! They have not been adequately tested in newborns and children early age, accordingly, it is impossible to judge their effectiveness and/or safety. Use of drugs with unproven effectiveness in best case scenario may turn out to be useless, and then it is a waste of time, which in many diseases, for example, epilepsy, works against the patient. In the worst case, this practice is fraught with unpredictable disorders, including life-threatening ones ( allergic reactions up to anaphylactic shock, disorders of the heart, liver, kidneys, brain, peripheral nerves, etc.). Let us also recall that due to incorrect diagnosis, many conditions that are normal for a child (for example, trembling of the chin, “Graefe’s symptom”) are taken as manifestations of the disease and are “successfully treated” with time in combination with useless medicine.

Many common drugs should be used extremely limitedly, according to strict indications. So, for example, the use of Diacarb can be justified in case of hydrocephalus (not in case of “hydrocephalic syndrome” - it does not exist!), and a child with such a diagnosis should be under the supervision of a neurosurgeon. It is unacceptable to prescribe phenobarbital in children with “hyperexcitability” and “sleep disorders”. The use of this drug is only possible for seizures (although there are more modern and usually more effective drugs), since it has been proven to cause delays in the development of cognitive functions in a child.

Breast-feeding

Breastfeeding is necessary for your baby! Even the highest quality and most expensive adapted milk formulas place additional metabolic stress on the baby’s body. It has been scientifically proven that breastfed children “overcome” infantile problems (neurological, intestinal, etc.) faster and have a higher rate of emotional and physical development.