home Audience 4 Perinatal encephalopathy in newborns. Perinatal encephalopathy in children - what is it and what are the consequences? Postpartum encephalopathy in children

Perinatal encephalopathy in newborns. Perinatal encephalopathy in children - what is it and what are the consequences? Postpartum encephalopathy in children

Perinatal encephalopathy- these are disorders of the central nervous system of newborns and children in the first months of life, developed in connection with brain damage before the birth of the child (in utero) or during childbirth. The perinatal period is usually called the period of time from the 28th week of pregnancy to the 8th day of life.

Causes of perinatal encephalopathy

Risk factors are considered:

Birth of the first child before 18 years of age or over 30 years of age.
Frequent medical abortions.
Long-term infertility.
Repeated miscarriages.

Factors operating during pregnancy:

Mother's illnesses during pregnancy (hypertension, anemia, kidney disease, surgical operations during pregnancy, acute diseases, etc.).
Toxicoses of pregnancy.
Threat of miscarriage.
Stress.
Bad habits: smoking, alcohol, drug use.
Occupational and household hazards: work at a chemical plant associated with radiation and vibration, heavy lifting.
Use of medications.
Radiation exposure.
Intrauterine infection.
mother and fetus.
Polyhydramnios.
Multiple births.
Pathology of the placenta (premature aging of the placenta, etc.).
Prematurity or post-term pregnancy.

Pathology during childbirth:

Premature placental abruption.
C-section.
Inconsistency of the fetal head with the mother's birth canal (narrow pelvis).
Breech presentation of the fetus.
Birth of twins.
Fast (less than 6 hours) or slow (more than 24 hours) labor.
Excessive stimulation of labor with medications.
Early labor (short period of pushing).
Weakness of labor.
General anesthesia.
Rupture, entanglement or prolapse of the umbilical cord.
Birth injury.
Aspiration (inhalation) of amniotic fluid by the fetus during labor.

Factors operating in the first days after birth:

Purulent infections.
Hemolytic disease of the newborn.
Congenital malformations in a newborn.
Surgical operations.

Periods of illness:

Acute period (up to 1 month).
Early recovery period (up to 4 months).
Late recovery period (from 4 months to 12-24 months).
Outcome of the disease.

Symptoms of perinatal encephalopathy

The clinical picture of the disease can be very diverse. It depends on which part of the brain is damaged and how much it is damaged, the age of the child, the damaging factor and the duration of its impact.

Therefore, doctors have identified a number of clinical syndromes that occur with PEP. All syndromes, of course, will not be present in a child, but there may be one, a leading one, or a combination of several.

Clinical syndromes:

Acute period syndromes (in a child up to a month old).

Comatose syndrome;

- syndrome of general depression of the central nervous system (lethargy);

- convulsive syndrome;
- syndrome of increased neuro-reflex excitability.

Syndromes of the recovery period (in a child after a month to 1-2 years).

Cerebrasthenic syndrome;
- syndrome of vegetative-visceral disorders;
- hypertensive-hydrocephalic syndrome;
- convulsive syndrome;
- movement disorder syndrome;
- delay in the rate of development (motor, mental and speech).

Syndrome of increased neuro-reflex excitability. Clinically manifested by anxiety, tremor (trembling) of the chin, arms, legs, shuddering, prolonged loud crying, poor sleep. The syndrome of increased neuro-reflex excitability is observed in the acute period in children with mild brain damage and subsequently usually develops into cerebrasthenic syndrome of the recovery period.

Syndrome of general depression of the central nervous system. Occurs in children with moderate brain damage. In such children, everything is reduced: muscle tone, reflexes, motor activity. They are lethargic, depression of consciousness is possible. The severity of manifestations varies: from slight lethargy to significant depression of consciousness.

Comatose syndrome. This is extreme oppression with complete loss of consciousness. It is observed in children with extensive hemorrhages in the cranial cavity and cerebral edema due to birth trauma and severe asphyxia. Children with comatose syndrome are usually in the intensive care unit on a ventilator, and a serious fight is being waged for their lives.

Movement impairment syndrome. It is characterized by an increase or decrease in motor activity, changes in muscle tone, the appearance of hyperkinesis (excessive, unfocused, unnecessary movements), and impaired coordination of movements. From the mouth of a neurologist, such characteristics of the condition as “hypertonicity” or “ ” may sound.

Hypertensive-hydrocephalic syndrome. See the chapter “Hypertensive-hydrocephalic syndrome”.

Convulsive syndrome. Characterized by the appearance of seizures in a child. See the chapter “Convulsions” for details.

Cerebrasthenic syndrome. Occurs with mild brain damage. Against the background of normal mental and physical development of the child, general motor restlessness is noted. Sudden mood swings, sleep disturbances (shallow, restless sleep, difficulty falling asleep), shuddering.

Syndrome of vegetative-visceral disorders. Indicates damage to the autonomic nervous system (see), which is responsible for the functioning of internal organs.

It is characterized by the following changes:

Changes in skin color (marbling or occasional blue discoloration).
Violation of thermoregulation:

Cold hands, feet, nose;
- the child gets cold easily;
- periodic unmotivated rises in temperature.

Regurgitation, pylorospasm (see “Pylorostenosis. Pylorospasm”).
or diarrhea.
Intestinal colic.
Heart rhythm disturbances (arrhythmias, tachycardias, see “Arrhythmias”).

Delayed development (motor, mental and speech). The child lags behind his peers in development: he sits up later, walks, begins to speak, etc. There are certain age-specific norms for the pace of a child’s neuropsychic development.

Outcomes of perinatal encephalopathy in children

Recovery.
Developmental delay (physical, mental, motor, speech).
. Mild encephalopathy, characterized by moderate or mild manifestations of hypertensive-hydrocephalic syndrome, asthenia, neurosis-like conditions, etc. For details, see the chapter “Minimal cerebral dysfunction.”
Severe lesions of the central nervous system:

Cerebral palsy, " ";
- mental retardation;
- epileptic syndrome (see "");
- progressive hydrocephalus (see “Hypertension-hydrocephalic syndrome”).

Treatment and prevention of perinatal encephalopathy

Treatment of a child with perinatal encephalopathy complex and depends on the severity and clinical manifestations of the disease. The main treatment is prescribed by a neurologist. We list only the areas that are used in the therapy of a child with PEP.

Drug therapy. Depends on the prevailing syndromes:

For seizures - anticonvulsants.
For hypertensive-hydrocephalic syndrome - diuretics.
Drugs that improve brain nutrition.
Drugs that improve blood circulation in the brain.
Vitamins, etc.
Courses of drug treatment are selected by the doctor individually for each patient.

It will not be an exaggeration to say that a neurologist is the most frequently requested specialist for children in the first year of life, and the phrase “You need to show your child to a neurologist” is heard from pediatricians much more often than we would like.

If there is not enough oxygen

What makes her say it? Firstly, information about how the pregnancy and childbirth went. Makes you wary:

severe manifestations of toxicosis (especially late);
suspicion of intrauterine infection;
maternal anemia (hemoglobin below 100 units);
weakness of labor, long anhydrous period, use of drug stimulation or obstetric forceps during labor;
umbilical cord entanglement; the child’s weight is too high or, conversely, signs of immaturity and prematurity;
breech birth, etc.

In a word, everything that can lead to fetal hypoxia during childbirth, that is, to a lack of oxygen, almost inevitably leading to temporary pregnancy. Viral infections in a woman during the period of pregnancy, disturbed ecology of her home or place of work can also damage her work.

There is no direct relationship between the level and duration of oxygen starvation: sometimes a child’s brain tolerates a serious oxygen deficiency without much harm to itself, but it happens that a small deficiency causes quite significant harm.

In addition to clarifying the circumstances of pregnancy and childbirth, there are certain clinical signs that alert the pediatrician. The child is too lethargic or, more often, excited, screams a lot, his chin trembles when screaming, he often spits up, and reacts to worsening weather. Or, in addition to all this, his tummy is swollen, his stool does not improve in any way - it is green, frequent, or, on the contrary, he has a tendency to constipation.

Having compared all this data, making sure that the baby is fed correctly, the pediatrician refers such a child to a neurologist - a specialist aimed at studying the condition of the central and peripheral nervous system. The task is to find out to what extent the hypoxia present during childbirth left its unpleasant mark.

Diagnosis of PEP. Just don't panic!

This is where the reason why this article was actually started often begins - parents are gripped by fear. How is it that our child is not right in the head?! This fear goes back to our general mentality, which says that having deviations in the nervous system is, first of all, shameful.

You convince, you say that these deviations are most likely temporary, that the sooner we help the child, the faster he will cope with them... Most parents, heeding the pediatrician’s assurances, go to a neurologist and return with a note that usually reads as follows:

PEP(perinatal encephalopathy), recovery period, SPNRV(syndrome of increased neuro-reflex excitability).

What is written in parentheses is deciphered by the author of the article - unfortunately, neurologists diagnose PEP, SPNRV and do not often deign to explain incomprehensible abbreviations. They write for themselves and for the pediatrician, and both parties understand each other perfectly. But not the parents.

How scary is this? Most often, with this question, they run to the pediatrician, who at this moment serves as a translator from an incomprehensible medical language into everyday language.

And everything would be fine if not for one sad fact: some parents they don't do anything at all. This is facilitated by compassionate people around them, reassuring them with approximately the following words: “Yes, doctors write this to every second person. They wrote to us, but we did nothing and are growing!”

And they really do grow and grow. But parents do not try to connect their inaction with pronounced manifestations of exudative diathesis in the child, symptoms of gastrointestinal dyskinesia, a tendency to constipation, and even with such obvious things as a lag in speech development, disinhibition, and disobedience.

But many of these troubles could have been avoided if parents had treated the problem as it deserved - quite seriously, but without excessive drama. The named diagnoses in the child’s chart are not a signal of panic, but a signal to action! Do you have any doubts about the recommendations of your local pediatric neurologist? Consult your child with another specialist.

Diagnosis of PEP in an infant: what is hidden behind the incomprehensible words?

So, the diagnosis of PEP stands for perinatal encephalopathy. That is, the child during childbirth had factors that could damage the brain. Something happened, and we need to figure out what damage this accident caused in the body.

Words recovery period They quite rightly point out that the nervous system itself, without outside interference, is restored - it’s only a matter of the pace and quality of this restoration. And they are not always satisfactory.

As for the unpronounceable abbreviation SPNRV (syndrome of increased neuro-reflex excitability), then it just means the sad fact that the child is whiny, spits up a lot, is easily excited, and has difficulty calming down. And he needs help to get rid of it.

“Won’t it go away on its own?” - you ask. It will pass. Some children. And the rest will have to carry this burden throughout life. They will be disinhibited, restless, and will not be able to communicate normally with their peers.

Diagnosis of PEP in neurology. Through the eyes of a specialist

What do neurologists pay attention to during examination? Firstly, on muscle tone. Are the reflexes equal on the right and left? Are there any muscle spasms? And vice versa - aren't they contracting too weakly?

Then they check whether the child has signs of increased intracranial pressure. To do this, they do it through an open fontanel - they look to see if the ventricles of the brain are dilated. And in conclusion, the child’s behavior is examined, the correspondence of his so-called psychomotor and physical development to his age.

The child was diagnosed with PEP. What's next?

If the matter is limited to a violation of muscle tone and excitement of the nervous system, the neurologist usually prescribes massage, mild sedatives and drugs that improve cerebral circulation.

If a neurologist discovers that the baby has increased intracranial pressure, which usually depends on excess production of cerebrospinal fluid, he prescribes him a course of so-called dehydration therapy(dehydration - dehydration). For this purpose, various diuretics are given. To compensate for the loss of potassium due to increased urination, drugs containing potassium are prescribed.

One should not hope that these phenomena will go away on their own as the skull grows - this may not happen. By the way, monitoring of intracranial pressure indicators should be carried out later, for several years, which will save your child from headaches and attacks of the so-called vegetative-vascular dystonia in preschool and school age.

Treatment of AEDs in children with movement

But the most important thing for forms of PEP of any complexity are gentle and drug-free methods of restorative treatment: reflexology, special therapeutic massage techniques, elements of therapeutic exercises, hydrotherapy with massage and therapeutic exercises in water of various temperatures and compositions, etc.

They require persistence and great effort from the child’s parents - giving medicine is probably easier than doing a set of exercises every day - but they are very effective. This is explained by the fact that the injured brain, receiving the correct “information” through massage, swimming and gymnastics, recovers more quickly.

Reflexomassage(impact on active points) is first done by the hands of an experienced massage therapist, who then passes the baton of competent handling of the baby to the parents. Don’t forget: babies get tired quickly, all procedures should be carried out briefly, but often, at the height of positive emotions.

Early child swimming with mandatory diving is also a huge help in solving the neurological problems of the baby. What is painful and unpleasant to do on land can be done with a bang in water. When diving into the water column, the body experiences a baroeffect - gentle, soft and, most importantly, uniform pressure on all organs and tissues. Hands clenched into fists, spasmed muscles and ligaments of the body straighten. The thickness of the water restores intracranial pressure in all directions, provides baromassage to the chest, equalizing intrathoracic pressure.

After emerging, the child receives a full, competent breath, which is especially important for babies born by cesarean section, who had hypoxia, etc. Water also helps with problems with intestinal colic - stool improves, spastic painful phenomena go away.

What about your stomach?

Often children with perinatal encephalopathy have serious disorders of the gastrointestinal tract: constipation and diarrhea, bloating, intestinal colic. Usually all this begins with dysbiosis and, unfortunately, often ends with various skin manifestations - exudative diathesis or even eczema.

What's the connection here? The simplest one. When brain hypoxia occurs during childbirth, the center for maturation of immunity, located in the medulla oblongata, almost always suffers. As a result, the intestines are populated by the flora that lives in maternity hospitals, especially with late breastfeeding and early transition to artificial feeding. As a result, the baby develops dysbiosis very early: after all, instead of the necessary bifidobacteria, his intestines are filled with staphylococci, E. coli, etc.

All this is aggravated by the fact that the baby’s intestines, due to a “breakdown” of the nervous system, function poorly, contract incorrectly, and the combination of intestinal dyskinesia with “bad” microbial flora leads to impaired digestion of food. Poorly digested food causes stool disorders, anxiety in the child and, ultimately, skin allergization.

It also happens the other way around: long-term exposure to a damaging factor not related to the central nervous system can cause secondary encephalopathy. For example, if you do not pay attention to the state of the flora of the gastrointestinal tract, especially the presence in the intestines of such “saboteurs” as staphylococci, clear signs of damage to the central nervous system may appear - delayed psychomotor development of the child, weakness of the sphincters, symptoms of increased neuro-reflex excitability and etc.

What should I do? To achieve the best effect, treat not only the intestines, but also the nervous system. Only the joint efforts of a pediatrician and a neurologist with the most active assistance of parents can give the desired effect.

And finally, I would like to remind you that a baby with an unstable nervous system needs maternal warmth, gentle touches, affectionate conversation, peace in the house - in a word, everything that makes him feel protected - needs it even more than a healthy child.

First results

When treating encephalopathy, how can you understand that the efforts of doctors and parents have been successful? The child became calmer, stopped crying for a long time, and his sleep improved. He began to hold his head in time, sat down, then stood up and took the first step. His digestion has improved, he is gaining weight well, and his skin is healthy. This is visible not only to doctors, but also to yourself. This means you have helped your baby overcome damage to the nervous system.

And finally, one example of what a mother's love can do.

In the mid-60s, in one of the maternity hospitals on distant Sakhalin, a daughter was born to a young midwife. As, unfortunately, often happens with doctors, the birth was extremely difficult, the child was born in deep asphyxia, did not breathe for a long time, and then was practically paralyzed for several weeks.

The girl was fed from a pipette and nursed as best she could. To be honest, the doctors thought that this child was dead. And only the mother thought differently. She did not leave the baby, mastered massage perfectly and persistently massaged the barely reviving body.

Eighteen years later, the author of this article met his daughter and mother in Leningrad. They came to enter Leningrad University. It turned out that the girl graduated from school on Sakhalin with a gold medal. It was difficult to take your eyes off her - she was so slender and beautiful. Then she graduated from university, defended her PhD thesis in biology, became a scientist, got married, and gave birth to two beautiful children. None of this might have happened if the mother’s love had been less selfless and reasonable.

Rules for everyone

Study and show an experienced pediatrician the extract from the maternity hospital. If it contains low scores on the Apgar scale (6 and below), or other marks (for example, he did not cry immediately after birth, there was cephalohematoma, hypoxia, asphyxia, convulsive syndrome, etc.), do not delay a consultation with a pediatric neurologist.
If there are no objective indications for consulting a neurologist, but it seems to you that the baby is overly excited, whiny, and capricious beyond all reasonable limits, trust your parental intuition and show the child to the doctor. The baby is unlikely to be healthy if in the first weeks of life he is pathologically passive, lies like a rag, or vice versa, cries 24 hours a day, if he is indifferent to food or vomits like a fountain after each 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.
If you are planning your next child, find out all the causes of perinatal encephalopathy in your firstborn. And if possible, try to correct the situation if it is associated with inattention to your health during pregnancy and childbirth. Attend courses to prepare couples for childbirth. Carefully choose doctors and medical institutions where you plan to give birth to your baby.

Kukulevich Mikhail, pediatrician Nikolaeva Tatyana pediatric neurologist of the highest category
Article from the magazine "Our Baby", November 2001

What is perinatal encephalopathy: a lifelong sentence or a common treatable disease?

Encephalopathy is an organic lesion or damage to human brain tissue by various factors.

The perinatal period is the period from the 28th week of pregnancy to the seventh day after birth. The perinatal period consists of three parts: antenatal (from the 28th week of pregnancy to childbirth), intranatal period (the period of childbirth itself) and postnatal (from childbirth to the seventh day of life).

Perinatal encephalopathy in children is a serious and very dangerous disease with a huge number of consequences, received by a child during the perinatal period and representing a lesion of the most important organ that forms a person’s personality - the brain.

The degree of danger of perinatal encephalopathy in newborns depends on the degree and severity of damage to brain tissue, as well as on the specific type of affected area. First of all, a serious lesion can disrupt the physical-motor and rational functions of the body. Consequences of perinatal encephalopathy: impaired vision, hearing, speech (if the speech center is affected), convulsive activity, disorders of memory and consciousness, paralysis - complete or partial, general weakness, frequent dizziness and loss of consciousness, delayed psychomotor development, and much more, i.e. The concept of encephalopathy is a very generalized term for a huge number of disorders, some of which may not even manifest themselves.

Many modern mothers, having heard such a diagnosis, unfortunately, try to terminate a long-awaited pregnancy or abandon their children in the maternity hospital, fearing that they will end up with a severely disabled or mentally handicapped child. But with such a diagnosis often made, most children are able to lead an active, full-fledged lifestyle, if the diagnosis is made on time and treatment is started.

You shouldn’t write your baby off and take the diagnosis as a death sentence. All human organs have increased regeneration at an early age, which is especially pronounced in infants, and the consequences of perinatal encephalopathy in adulthood may not even appear, only special treatment, care and a correct lifestyle are necessary.

Consequences in adulthood

In adult life, the disease suffered at an early age can have residual severe consequences:

Epilepsy.
Mental retardation.
Violation of any body functions.
psychoneurological diseases.
Autonomic-visceral dysfunctions are disruptions in the functioning of any internal organs due to incorrect signals sent by the brain.
Disorders of memory and consciousness.

But with proper care you can minimize possible risks:

Hyperactivity syndrome and attention disorders.
Headaches and tinnitus, dizziness.
Physical weakness, fatigue and increased morbidity.
Lack of activity and lack of initiative.
Narrowed circle of interests.
Absent-mindedness.
Tendency to depression.

With minimal lesions or lesions of not too vital parts of the brain and a timely diagnosis, complete recovery from perinatal encephalopathy in newborns is also possible. Almost all sick children in adulthood are fully functional citizens who can take care of themselves.

Probable causes

Encephalopathy in newborns can be caused by a huge number of factors, which explains its wide prevalence. The intrauterine development of a child and his nervous system is such a fragile process that it is extremely easy to be disrupted by any negative influence. The placental barrier, of course, is a great protective force of nature, but, unfortunately, it cannot protect from everything, and especially from the stupidity of the mother herself. Here is an incomplete list of causes of perinatal encephalopathy in children:

The most common reason for diagnosis is pathologies of pregnancy - all kinds of birth injuries received as a result of disruption of labor or medical error, blows to the abdominal area, thermal overloads during pregnancy, etc.
In second place is toxic encephalopathy in newborns, caused by the penetration of harmful toxins, most often of alcoholic, narcotic, nicotine or medicinal origin, through the placental barrier.
In third place is encephalopathy in infants, caused by fetal hypoxia for various reasons.
An autoimmune conflict caused by a difference in the Rh factors of the blood of the mother and child carries the risk of this disease.
Unsuccessful independent attempts to terminate an unwanted pregnancy cause not only perinatal encephalopathy in newborns, but also many other serious abnormalities.
Chronic diseases and infectious diseases suffered by the mother during pregnancy can be transmitted to the child and destroy the fragile process of fetal formation. Thus, infection with rubella during pregnancy is a factor in its mandatory medical termination at any stage.
The borderline age of a woman or a man may be the cause of the production of defective germ cells, which as a consequence leads to developmental disorders, including prenatal encephalopathy.
Early age of parents, when the reproductive system of the parents is underdeveloped.
Stress during pregnancy does not seem to be a serious risk factor for young mothers, however, excess hormones easily penetrate the placental barrier and are transmitted to the child’s nervous system. Excessive levels of adrenaline and cortisol burn neurons in adults, and an undeveloped children’s brain can be seriously damaged, because during the period of intensive development, every cell counts, from which this or that organ or part of the brain and peripheral nervous system ultimately turns out.

Prematurity of the fetus causes encephalopathy of the brain in newborns, expressed in the underdevelopment of its parts. This syndrome may easily go away during age-related development, or it may, on the contrary, remain if the development of the brain has been stopped or disrupted by some factors.
Malnutrition of the mother is another cause of various developmental abnormalities, which is rarely taken seriously. The fact is that all the organs and cells of the child are formed from substances received by the mother’s body. If the mother is sharply lacking some substance, vitamin or mineral, then the body’s self-defense mechanism turns on, which does not allow the baby to take the last remnants. The lack of the necessary building material is a violation of the entire process of constructing a new organism, resulting in both deviations in physical development, low quality of the immune system and muscular system, weakness and underdevelopment of internal organs, and deviations in the development of the nervous system, including encephalopathy of the newborn. The periodic desires of the expectant mother for ice cream at three in the morning or potato jam are not a whim caused by hormonal mood swings, but the child’s real need for building materials.
A disturbed ecological situation around a pregnant mother can be affected by a whole range of reasons that cause disturbances in its natural course. There is stress, toxin poisoning, hypoxia due to carbon dioxide, and many other factors.

The huge number of traumatic factors surrounding a pregnant mother in the modern world has led to the spread of the diagnosis of perinatal encephalopathy in the newborn. In most cases, these are minor disorders that go away by adulthood or do not cause significant symptoms. Many newborns, without undergoing a special examination, suffered this syndrome unnoticed by their parents and doctors. But there are also the opposite cases, when a small deviation does not return to normal over time, but, on the contrary, grows and worsens with development, causing irreparable harm to the child. For timely detection, it is necessary to have an idea of the symptoms of encephalopathy in newborns and promptly consult a doctor at their first manifestations.

Symptoms of perinatal encephalopathy

It is very difficult to identify the symptoms of encephalopathy in an infant in the early stages of development. The fact is that small deviations in the erratic movements and incoherent cooing of a newborn are invisible to an untrained eye and become noticeable only by the age of six months, and mental disorders even later - already in the conscious period.

Perinatal encephalopathy, symptoms in newborns:

Absence or weakness of the sucking and or swallowing reflex.
Deviations in the muscle tone of the newborn.
Too violent a reaction or lack thereof to various stimuli.
Sleep disorders. Restless sleep. Sleepless nights with constant crying.
Sharp, rapid raising of arms and legs.
Frequent regurgitation.
Convulsions and epileptic seizures.
High or low blood pressure.

Perinatal encephalopathy in older children can manifest itself as:

Syndrome of increased excitability.
Convulsive syndrome.
Lethargy, inactivity, apathy, absence of any reflexes, depression of vital functions. Collectively, these symptoms are called “comatose syndrome.”
Increased intracranial pressure caused by a consequence of perinatal encephalopathy - excess fluid in the brain (Hypertension-hydrocephalus).
Hyperactivity.
Impaired motor functions, increased awkwardness and carelessness.
Vegetative-vascular dysfunction, causing both constant belching, indigestion and stool disorders, and various skin symptoms.
Retardation in physical and or mental development.
Depression.
Sleep disorders.
Speech disorders.
Lack of clarity in expressing your thoughts.
Migraines and acute headaches.

Varieties

Perinatal encephalopathy is primarily divided into simply encephalopathy with an established cause and unspecified perinatal encephalopathy.

Perinatal encephalopathy unspecified - perinatal encephalopathy in newborns caused by unspecified factors (the cause of its occurrence is not clear).

Encephalopathy unspecified is a more difficult type of encephalopathy to treat, since treatment is based only on minimizing the consequences without eliminating the causes of its occurrence, which can result in residual encephalopathy at an older age.

Residual encephalopathy is the residual manifestations of the disease or its consequences some time after the disease or brain injury.

Unspecified encephalopathy in children is dangerous due to lack of follow-up treatment and confusion of symptoms with other disorders of the child’s nervous system.

Unconfirmed encephalopathy in newborns is a type of disease in which symptoms of encephalopathy appear that are not caused by brain damage.

There are also subtypes of perinatal encephalopathy:

Posthypoxic perinatal encephalopathy caused by lack of oxygen.

Transient or dyscirculatory - caused by impaired blood circulation in the brain.
Hypoxic-ischemic – arising against the background of hypoxia, complicated by circulatory disorders.
Toxic encephalopathy - caused by the action of toxins.
Radiation encephalopathy – developed under the influence of radiation.
Ischemic encephalopathy - caused by destructive processes (destruction processes) in certain areas of brain tissue.
Encephalopathy of mixed origin, most often related to unconfirmed encephalopathy in newborns.

This is not the entire list of encephalopathic subspecies, subdivided according to the causes of occurrence and area of localization of the disease.

Diagnosis of encephalopathy

The presence of symptoms characteristic of the disease is not yet a basis for making a final diagnosis. If encephalopathy is suspected, which is quite easily confused with other diseases of the nervous system, a thorough examination is carried out:

General tests that reveal inflammatory processes, including in the brain, and disruption of the body systems.
Magnetic resonance imaging.
Electroneuromyography is a modern method that tests the sensitivity of peripheral nerve fibers.
An electroencephalogram, which detects epileptic signs by recording the electrical potentials of the brain.
Neurosonography is an ultrasound scan of a child’s brain, which is performed on almost all children as a preventive measure.

Prognosis for children who have had the disease

In most cases, even in the absence of obvious symptoms of encephalopathy, automatic preventive examination is carried out for all risk categories, which now include the majority of the world's population.

With early diagnosis and not too advanced brain lesions, the child most often recovers and has no abnormalities in the future. Such cases are the most common, since the plasticity of a growing child’s body is very high. Even children who have developmental disabilities can become independent, practically healthy people.

Epilepsy.
Decreased activity.
Neurological disorders, minor mental disorders, etc., which do not overly poison the patient’s life and do not interfere with the people around him.

Severe cases consequently entail more dire consequences:

Paralysis.
Mental disability.
Disability.
Early mortality.
Life restrictions (ban on certain products, mandatory procedures, etc.)

Severe consequences occur quite rarely and mainly in the absence of proper treatment and care, which is most often the fault of parents leading an immoral lifestyle (alcoholics, drug addicts) or in low-income or large families where there is not enough money or time to properly care for the baby, or a cruel decision was made to direct them to normal children, and not to bother with a defective child. With the right efforts, severe injuries can have very moderate consequences.

Treatment of a child

Self-medication of perinatal encephalopathy in children is out of the question.

Treatment takes a lot of effort and is carried out exclusively with medication and physiotherapeutic methods. It is very long-term with constant monitoring by the attending physician.

With mild and moderate symptoms, sick children remain on home treatment, which consists of taking medications, physiotherapeutic procedures and periodic observation.

Severe disorders are treated exclusively in a hospital and may even require surgical intervention, for example, in case of hydroencephalic syndrome or damage caused by various tumors, hematomas or death of too large areas.

Treatment is prescribed in a variety of ways, depending on the type and causes of damage, and consists of several interconnected blocks:

Eliminating the cause of the disease.
Treatment of damaged tissue.
Normalization of the nervous system and stabilization of its signals.
Restoring body functions.
General rehabilitation therapy.
Prevention of resistance.

As a restorative therapy and additional assistance in treatment, they often resort to procedures from traditional medicine, which can only be prescribed by a doctor. By independently interfering with the course of treatment, parents can cause irreparable harm to their child.

Prevention of disease in newborns

The diagnosis of perinatal encephalopathy, of course, in most cases is not a death sentence, however, it is much easier to prevent its development in a baby than to deal with the consequences all his life.

There are cases when the mother is powerless to do anything: an accidental blow or disrupted labor, but often the cause of the disease is simply an incorrect lifestyle or genetic predisposition.

Modern medicine has already discovered many ways to deceive nature at the genetic level and give birth to an absolutely healthy baby at almost any age and with any genetic pathologies. It is enough to plan your pregnancy correctly and conduct a thorough examination, based on which you can choose the right method of action.

It is also easy to insure against accidents by preparing for pregnancy in advance and preparing for childbirth for all 9 months. In order to avoid all kinds of birth injuries, you do not need to refuse a cesarean section, which has become a very common and fairly easy procedure, if there is even the slightest indication for it, and also choose in advance a good hospital where the birth will take place.

Pregnancy lasts only 9 months and many women experience it only once or twice in their lives. This is not such a long period of time in which you can be patient and take care of your child, while at the same time saving yourself from big troubles in the future.

Perinatal encephalopathy is a brain lesion that has various causes and manifestations. This is a huge variety of symptoms and syndromes, manifestations and characteristics: 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 are 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 occurring in certain tissue areas. Excessive smoking, stress and alcohol abuse lead to this diagnosis.
Toxic encephalopathy becomes a consequence of brain poisoning by toxic substances during infections, poisoning with 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. The recovery period lasts up to a year or two. What follows is the outcome of the disease.
Each period is characterized by a special course and the presence of 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:

The presence of chronic diseases of the mother;
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.

At a later age, the child experiences frequent bad mood, absent-mindedness, sensitivity to weather changes, and 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.
Hyperexcitability syndrome 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, and 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, makes it possible to determine the presence of epilepsy and delayed age-related 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 hospital treatment. In any case, it is necessary to choose an individual regimen, 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; for increased tone, baclofen or mydocalm are prescribed. 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 disorders of psychomotor development, 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 special gymnastics complexes help improve body tone, develop motor functions of the hands, train and strengthen the baby’s health. If a child has been diagnosed with asymmetry of muscle tone, therapeutic massage is indispensable.

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 a period of intensive growth of the child. Childhood infections may also influence symptoms.

It is mandatory to take vitamin complexes, you should allocate enough time for walks in the fresh air, activities and exercises. You also need a balanced diet and a calm, balanced environment in the home, 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 conducted childbirth, qualified medical 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:

Often, after the first examination by a neurologist in a clinic or maternity hospital, the baby is diagnosed with perinatal encephalopathy. According to various sources, from 30 to 70% of newborns have it. What complaints do mothers have that force the doctor to make such a diagnosis? Prolonged crying and generally tearfulness, frequent sucking, regurgitation, flinching or throwing up of arms and legs, poor nighttime (frequent waking up, restless shallow sleep) and daytime sleep (sleeps little during the day), difficulty falling asleep (long rocking in arms). When examining a child, the doctor may notice disturbances in muscle tone - hypertonicity or hypotonicity, dystonia. Neurosonographic studies sometimes show darkened or altered areas of the brain, sometimes not. The doctor prescribes drugs that improve cerebral circulation (piracetam, nootropil, Cavinton) and sedatives (glycine, citral mixture, valerian, sometimes luminal or phenobarbital), and also recommends massage courses, bathing in soothing herbal mixtures. You probably all know this.

And now it’s worth talking about a different approach to the problem.

Perinatal encephalopathy is a complication of the pathology of pregnancy and childbirth and is diagnosed in newborns in up to 5% of cases (or 1.5-3.6%)! Where does this discrepancy come from? In the book Palchik A.B. and Shabalova N.P. “Hypoxic-ischemic encephalopathy of newborns: a guide for doctors.” (St. Petersburg: "Piter", 2000) the reasons for the widespread incidence of encephalopathy in newborns are explained very well. There is, in general, one reason, and it is called overdiagnosis.

What is the reason for overdiagnosis? What makes doctors give this diagnosis to “everyone”? As part of the research work carried out by St. Petersburg scientists, the following reasons for the “overdiagnosis” of perinatal encephalopathy were identified:

First of all x, this is a violation of the principles of neurological examination:

a) violations of standardization of examination (the most common of them: diagnosis of increased excitability in a trembling and stiff child in a cold room, as well as in an excited state or excessive manipulation by the researcher; diagnosis of depression of the central nervous system in a lethargic child when overheated or in a drowsy state).

For example, in the maternity hospital, the pediatrician prescribed a PEP, since the child often cried loudly, but when the neurologist came to examine the child, the baby was fast asleep, and the doctor said that the tone was normal and he did not see any pathologies. A month later, an examination was carried out at the clinic when the child was sleeping, woke up and was afraid that his strange aunt was pulling his arms and legs. Naturally, he cried and became tense. PEP confirmed.

So, one child may be diagnosed with either hyper or hypotonicity.

b) incorrect assessment of a number of evolutionary phenomena (that is, something that is normal for that age, especially for a 1 month old child, is considered pathological). This is a diagnosis of intracranial hypertension based on a positive Graefe symptom; Graefe’s symptom can be detected in full-term children in the first months of life, in premature children, with intrauterine growth retardation, constitutional features); diagnosis of spasticity based on crossing the legs at the level of the lower third of the legs in newborns when checking the support reaction or step reflex (may be physiological due to the physiological hypertonicity of some muscles of the thighs, but pathological in children older than 3 months); diagnosis of segmental disorders when identifying a “calcaneal foot” (dorsal flexion of the foot - 120° is the norm); hyperkinesis in a 3-4 month old child with restlessness of the tongue (this is a physiological stage of maturation of the child’s motor skills).

This may include regurgitation, as a result of the immaturity of the nervous system and the weakness of the sphincter - a muscular valve located in the upper part of the stomach, which does not hold its contents very well. The norm is considered to be regurgitation after each feeding in a volume of 1-2 tablespoons and once a day vomiting in a “fountain” of more than 3 spoons, if at the same time the baby pees often, feels well and gains weight normally. Diagnosis of the symptom of marbling of the skin - due to the immaturity of the vegetative-vascular system.

But up to 3 years is an absolutely normal phenomenon, because it is just being formed!

Poor night sleep – when the child wakes up frequently. But an infant is characterized by predominantly superficial, shallow sleep and sucking during such sleep. From 3-4 months in children, night sucking may become more active, because During the day, they begin to be easily distracted from the breast and suckle for a relatively short time. Due to active night sucking, they obtain the required amount of milk.

American sleep researcher James McKenna, in his work Breastfeeding & Bedsharing Still Useful (and Important) after All These Years, writes that a study of infant sleep found that the average interval between nightly breastfeedings was about an hour and a half - the approximate length of an adult sleep cycle. You can minimize your mother’s time of “lack of sleep” with the help of rational organization of joint sleep and night feedings. Very often, children sleep better next to their mothers. Rocking motion can also be replaced by breastfeeding before bed (but not everyone succeeds). When I found out that it was “possible” to do this, the time of motion sickness decreased significantly. Often children wake up after sleep in a bad mood, you can also offer the breast, and the world will make the baby happy again!

Secondly x, this is the classification as pathological of a number of adaptive, passing phenomena on the part of the nervous system of the newborn (for example, shuddering or throwing up of arms and legs, trembling of the chin during severe crying or fear, postnatal depression, physiological muscle hypertension, etc.).

Third, poor awareness of the classification of Hypoxic Ischemic Encephalopathy (mainly due to the foreign origin of research on this topic) and insufficient qualifications of the doctor.

For example, a one-month-old child was diagnosed with Minimal Brain Dysfunction, which should be diagnosed after 2 or even 5 years, according to various sources. Another child was prescribed to drink ginseng tincture, which is unacceptable at his age. Often, drug treatments lead to even greater deterioration in children's behavior. Doctors know about the dangers of various medications for children, but either simply do not inform parents, or consciously or unconsciously do not draw their attention to the side effects.

Fourth, these are psychological reasons. They lie in the fact that due to the current situation in domestic healthcare, “overdiagnosis” does not have any administrative, legal, or ethical consequences for the doctor. Making a diagnosis leads to the prescription of treatment, and if the diagnosis is correct or incorrect, the outcome (usually recovery or minimal disorders) is favorable. Thus, it can be argued that a favorable outcome is a consequence of the “correct” diagnosis and the “correct” treatment.

Overdiagnosis of a disease is no better than underdiagnosis. If the diagnosis is insufficient, the negative consequences are clear - due to the lack of timely assistance, the development of a disabling disease is possible. What about overdiagnosis? According to St. Petersburg researchers, with whom it is difficult to disagree, “overdiagnosis” is not a harmless phenomenon, as some doctors sometimes believe. The negative consequences of “overdiagnosis” lie, first of all, in the fact that long-term work within the framework of the doctrine of “overdiagnosis” leads to a “blurring” of the boundaries in doctors’ perceptions between normal and pathological conditions. Diagnosing the “disease” turns out to be a “win-win” option. Diagnosing PEP has become an unaccountable ritual of the pediatric neurologist, which naturally leads to inexplicable statistics on PEP diseases.

The study by St. Petersburg scientists describes in detail the most common errors when performing echoencephalography, neurosonography, Dopplerography, axial computed tomography and magnetic resonance imaging.

The reasons for the errors are different and are associated with the fact that when interpreting the data obtained, parameters and norms developed for older children and adults are used, inadequate assessment of the data obtained and their absoluteization are used, methods are used that have insufficient information content when diagnosing this disease, devices are also used having unsuitable technical characteristics.

Fifthly, this is a lack of understanding by doctors and parents of the natural needs of a newborn child. Most often, a child signals errors in care by crying. The child needs constant contact with his mother immediately after birth.

It is well known that sucking has a kind of sedative effect on the child, which is not comparable in its usefulness to any medicine. The content of the amino acid taurine in human milk, unlike cow's milk, is very high. Taurine is necessary for the absorption of fats, and also serves as a neurotransmitter and neuromodulator during the development of the central nervous system. Since children, unlike adults, are not able to synthesize taurine, it is believed that it should be considered as an amino acid essential for a small child. Among polyunsaturated fatty acids, arachidonic and linolenic acids are especially important, which are necessary components for the formation of the child’s brain and retina. Their content in human milk is almost four times higher than in cow's milk (0.4 g and 0.1 g/100 ml, respectively). Human milk contains nucleotides and numerous growth factors. The latter includes, in particular, nerve growth factor (NGF). That is why it is very important for the child to be breastfed if you had problems during childbirth or during pregnancy, which could lead to fetal hypoxia and injury to its nervous system.

There is still no clear generally accepted tactic for managing children with increased neuro-reflex excitability syndrome; many experts treat this condition as borderline and advise only monitoring such children and refraining from treatment. In domestic practice, some doctors continue to use quite serious drugs (phenobarbital, diazepam, Sonapax, etc.) for children with the syndrome of increased neuro-reflex excitability, the prescription of which in most cases is poorly justified...

If you are still concerned about your child’s condition, it is worth going to or inviting several specialists to your home (at least two, preferably on recommendation (there are doctors who sincerely care about the health of children and are not trying to make money from children’s “problems”), Indeed, sometimes the problems are very serious, such as cerebral palsy and hydrocephalus. About my friend’s child, for example, with the same symptoms as my son, the district neurologist said that you can find fault with every child, and did not make any diagnosis .

Homeopaths have good experience in treating neurological disorders, and official medicine confirms this. But the high plasticity of the child’s brain, its ability to compensate for structural defects, is well known. So you may never know whether the child was helped by therapy or whether he coped with the problems on his own. Massage, both mother's and professional, helps very well (but only if the child responds well to it, does not cry, does not become overexcited, does not lose weight and does not stop gaining weight) Vitamin therapy is indicated, and, given the good absorption of vitamins from mother's milk, pay attention to this is attention.

It is also worth saying about vaccinations for restless children. In one of the Moscow clinics, where babies with severe hypoxic disorders are cared for, the emphasis in treatment is on non-drug methods and maximum avoidance of injections (administration of drugs using electrophoresis, physiotherapy, etc.). My son, after vaccinations (injections), had increased tone in his limbs, general anxiety, however, no one gave us an excuse, since in general perinatal encephalopathy is considered a false contraindication to vaccination, supposedly doctors and patients protect children from vaccinations on the basis of “universal human” and “general scientific” considerations not confirmed by official medicine.

I will also say that in the side effects of vaccines you can find the word “encephalopathy”, that is, the vaccine can cause this condition! The child was born healthy, we gave him several vaccinations in the first days, isolated him from his mother, told her to feed him by the hour, give the child medicines that schizophrenics use, and in a month we are pleased to note that half of the children suffer from perinatal encephalopathy! What else to add?!

The diagnosis of hyperactivity syndrome is very popular in America and is increasingly penetrating to us. On the other hand, in America and Germany they do not know what perinatal encephalopathy is. There is another way to look at the problem - that the whole point is not a neurological pathology or a disease, but simply a special type of people, the individual structure of their nervous system. The book “Indigo Children” by Lee Carroll is proof of this.

You understand, no drug can change the psycho-emotional constitution (personality type). Of great importance is the psychological attitude in the family (understanding the needs of a small child, caring using the Serzov method of “bringing together”) and proper care of the child (breastfeeding, carrying in arms (a sling helps a lot), sleeping together, respecting the child’s personality).

In clinics there is a poster about the benefits of breastfeeding with the words of the ancient Greek philosopher: “Together with the mother’s milk, the soul enters the child.” Mother’s milk is not just food, it is also medicine, a connection with the world, and the transfer of mother’s knowledge about life to the child.

What makes you refer a child to a neurologist? Firstly, information about how the pregnancy and childbirth went. Makes you wary:

severe manifestations of toxicosis (especially late);
suspicion of intrauterine infection;
maternal anemia (hemoglobin below 100 units);
weakness of labor, long anhydrous period, use of drug stimulation or obstetric forceps during labor;
umbilical cord entanglement; the child’s weight is too high or, conversely, signs of immaturity and prematurity;
breech birth, etc.

In a word, everything that can lead to fetal hypoxia during childbirth, that is, to a lack of oxygen, almost inevitably leading to a temporary disruption of the central nervous system (CNS). Viral infections in a woman during the formation of the fetal nervous system, or disturbed ecology of her home or place of work can also damage her work.

Just don't panic!

PEP (perinatal encephalopathy), recovery period, SPNRV (syndrome of increased neuro-reflex excitability).

And, unfortunately, neurologists do not often deign to explain incomprehensible abbreviations. They write for themselves and for the pediatrician, and both parties understand each other perfectly. But not the parents.

What are the dangers of PEP and SPNRV?

How scary is this? Most often, with this question, they run to the pediatrician, who at this moment serves as a translator from an incomprehensible medical language into everyday language.

And everything would be fine if not for one sad fact: some parents do nothing at all. This is facilitated by compassionate people around them, reassuring them with approximately the following words: “Yes, doctors write this to every second person. They wrote to us, but we did nothing and are growing!”

What is hidden behind the incomprehensible words?

So, PEP stands for perinatal encephalopathy. That is, the child during childbirth had factors that could damage the brain. Something happened, and we need to figure out what damage this accident caused in the body.

The words recovery period quite rightly indicate that the nervous system itself, without outside interference, is restored - it’s only a matter of the pace and quality of this recovery. And they are not always satisfactory.

As for the difficult-to-pronounce abbreviation SPNRV (syndrome of increased neuro-reflex excitability), it precisely means the sad fact that the child is whiny, spits up a lot, is easily excited, and difficult to calm down. And he needs help to get rid of it.

What do neurologists pay attention to during examination? Firstly, on reflexes and muscle tone. Are the reflexes equal on the right and left? Are there any muscle spasms? And vice versa - aren't they contracting too weakly?

Then they check whether the child has signs of increased intracranial pressure. To do this, an ultrasound (neurosonogram) is done through an open fontanel - they look to see if the ventricles of the brain are dilated. And in conclusion, the child’s behavior is examined, the correspondence of his so-called psychomotor and physical development to his age.

The diagnosis has been made. What's next?

If the matter is limited to a violation of muscle tone and excitement of the nervous system, the neurologist usually prescribes massage, mild sedatives and drugs that improve cerebral circulation.

If a neurologist discovers that a child has increased intracranial pressure, which usually depends on excess production of cerebrospinal fluid, he prescribes a course of so-called dehydration therapy (dehydration - dehydration). For this purpose, various diuretics are given. To compensate for the loss of potassium due to increased urination, drugs containing potassium are prescribed.

One should not hope that these phenomena will go away on their own as the skull grows - this may not happen. By the way, monitoring of intracranial pressure indicators should be carried out later, for several years, which will relieve your child of headaches and attacks of the so-called vegetative-vascular dystonia in preschool and school age.

Treatment

Reflexomassage (impact on active points) is first done by the hands of an experienced massage therapist, who then passes the baton of competent handling of the baby to the parents. Don’t forget: babies get tired quickly, all procedures should be carried out briefly, but often, at the height of positive emotions.

Early swimming of a child with mandatory diving is also a huge help in solving the neurological problems of the baby. What is painful and unpleasant to do on land can be done with a bang in water. When diving into the water column, the body experiences a baroeffect - gentle, soft and, most importantly, uniform pressure on all organs and tissues. Hands clenched into fists, spasmed muscles and ligaments of the body straighten. The thickness of the water restores intracranial pressure in all directions, provides baromassage to the chest, equalizing intrathoracic pressure.

Tummy and PEP

Results and forecast

And finally, one example of what a mother's love can do.

Rules for everyone

Study and show an experienced pediatrician the extract from the maternity hospital. If it contains low scores on the Apgar scale (6 and below), or other marks (for example, he did not cry immediately after birth, there was cephalohematoma, hypoxia, asphyxia, convulsive syndrome, etc.), do not delay a consultation with a pediatric neurologist.

If there are no objective indications for consulting a neurologist, but it seems to you that the baby is overly excited, whiny, and capricious beyond all reasonable limits, trust your parental intuition and show the child to the doctor. The baby is unlikely to be healthy if in the first weeks of life he is pathologically passive, lies like a rag, or vice versa, cries 24 hours a day, if he is indifferent to food or vomits like a fountain after each 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.

If you are planning your next child, find out all the causes of perinatal encephalopathy in your firstborn. And if possible, try to correct the situation if it is associated with inattention to your health during pregnancy and childbirth. Attend courses to prepare couples for childbirth. Carefully choose doctors and medical institutions where you plan to give birth to your baby.