home Auditorium 8 Pyramidal insufficiency: causes, symptoms, treatment. Pyramidal insufficiency in children Pyramidal delay

Pyramidal insufficiency: causes, symptoms, treatment. Pyramidal insufficiency in children Pyramidal delay

Neurological diseases in children - the phenomenon is quite common. Many are easily treated at the initial stage, so the first symptoms should not be ignored to prevent serious problems in the future.

Some doctors call pyramidal insufficiency syndrome in children an independent disease, while others consider it a syndrome, that is, a set of symptoms that indicate mental and physical health problems.

Find out about the causes of West syndrome in children from ours.

The essence of the disease

Pyramidal insufficiency syndrome occurs due to underdevelopment of areas of the brain, which control a specific muscle group.

It appears in both feet and legs.

The disease may include separate muscle group(feet, neck), also several groups simultaneously. The pathology is called “ballerina syndrome” or equinus foot placement. It can manifest as unilateral or bilateral increased tone.

The syndrome develops due to disorders in the medulla oblongata. The medulla oblongata connects the spinal cord and the brain. The cells that make up the medulla oblongata are called pyramids.

Hence the name of the pathology. When the functions of the pyramids are impaired, the neurons of the spinal cord send a large number of impulses to the muscles, and as a result, hypertonicity and tremor.

Reasons syndrome in children is considered:

ischemic and mechanical cervical spine;
hypoxia during childbirth;
tumors;
infectious diseases affecting the brain;
congenital pathologies.

Severity violations affects the manifestation of the syndrome. With mild brain damage, the child develops increased tone in the arms; more severe damage results in hypertonicity of the feet, incontinence, or tilting of the head.

Typically, pyramidal insufficiency manifests itself in children under 1 year of age. Less commonly diagnosed at older ages.

Symptoms and degrees

Main features, which can be used to suspect pathology in children:

According to doctors, the syndrome in newborns is not a pathology. At this age, hypertonicity of the limbs is an age-related physiological feature.

The child has problems can be identified as follows: put the baby on his stomach and bend his leg, then evaluate the tone of the buttocks and calf muscles. Normally they are equally tense. In pathology, the calves are tense and the buttocks are relaxed.

The severity of symptoms and their number depend on the degree of damage to the pyramids. The following are distinguished: stages:

Subcortical lesions. Causes impairment of fine motor skills.
Lesions of the internal capsule. Possible unilateral paralysis of the face, arms, legs.
Disturbances in the cerebral peduncle. May cause optic nerve palsy.
Lesions in the pyramid itself provoke unilateral paresis of the limbs.
When there are disturbances in the cervical level, multiple sclerosis occurs.
If the thoracic region is affected, then spasticity of the legs is noted.
Disturbances in the last neuron (motor root) cause mild paralysis of the lower limb.

What is the danger of Reye's syndrome in babies? find out right now.

Diagnostics

To make an accurate diagnosis, you need not just a neurological examination, you need to conduct a whole a number of diagnostic studies:

Magnetic resonance imaging. Detects changes in the structure of the brain. Prescribed for seizures and suspected epilepsy.
CT scan. Examines the lining of the brain, the condition of blood vessels, its structure.
Electroencephalography. Allows you to identify hidden (night) cramps.
Electromyography. Measures electrical conductivity of muscles.
Ultrasound of the brain. This method diagnoses tumors and dropsy.

Treatment methods

Treatment of the syndrome involves not just eliminating symptoms, but treating the disease that is the root cause. Choice of therapy determined by the degree of damage.

If muscle tone is slightly increased and no serious diseases have been identified, then it is enough to carry out a course of massage and physiotherapy, exercise therapy, and swimming.
When the nervous system is affected, nootropics, vitamins, and physical therapy are prescribed.
In cases of tumor or hematoma, the issue of surgical intervention is decided.

Medication

Drugs for the treatment of the syndrome are not so harmless.

It is important to choose the right medicine and determine the dosage.

Pantogam, Aminalon, Nootropil, Cerebrolysin improve metabolism in nerve cells.
Dibazol, Proserin improve the nerve impulse and its passage.
Mydocalm, Baclofen, B vitamins relieve muscle tone.

Physiotherapy

Physiotherapy relieves muscle spasms, pain, improves blood flow, and removes nerve pinching. Electrophoresis, ultrasound, amplipulse deliver drugs to muscles using certain waves (electric, ultrasonic).

Balneotherapy is widely used, which includes hydrotherapy and mud therapy. At home, you can arrange warm, relaxing baths.

You need to wait until the baby starts to stand up on his own. Older children are recommended to wear orthopedic shoes, which correctly fixes the foot.

Manual therapy

Includes massage, gymnastics. Her task is restoration of functions of the affected organ.

All procedures must be carried out by a qualified specialist who knows the technique. The doctor uses acupuncture, muscle stretching, and gymnastics.

Infants are prescribed massage and passive gymnastics.

The massage relaxes the muscles, stretches the Achilles tendon so that the child can stand on his full foot. It has been proven that after a massage the child’s condition improves significantly and development accelerates. Some children may outperform their healthy peers in development.

Massage sessions must be completed several times after all symptoms disappear for preventive purposes.

Helps well swimming, walking in water, paraffin therapy. Melted paraffin is applied to the child’s legs in the joint area and held until it cools. This improves blood flow in the joints and relieves pain.

You will find pediatricians specializing in the treatment of hypotension in infants on our website.

Surgery

This method of therapy is resorted to in cases of detection tumors, brain hematomas. Indications for surgery are severe circulatory disorders in the brain that cannot be treated conservatively. For example, arterial thrombosis.

Any treatment is prescribed by a doctor.

It is important to make an accurate diagnosis exclude or confirm serious pathologies brain.

After this, the doctor selects a set of procedures in accordance with the characteristics of each patient.

Prognosis and prevention

Symptoms of pyramidal insufficiency can't be ignored.

Any pathology in the brain does not go away on its own. Subsequently, manifestations of motor disorders are possible.

That is, child starts sitting and walking late. In complex cases, developmental delays and speech impairments are observed. The child gets tired quickly.

If left untreated, the child will walk on tiptoes. This causes improper distribution of the load on the spine, joints and muscles. The baby will begin to have pain in the back and legs. The disease can lead to curvature of the spine, osteochondrosis and vertebral hernia.

In the case of pyramidal insufficiency It is very important to make a diagnosis on time, identify serious pathologies at an early age and begin treatment.

Prevention of the disease in children begins in the womb.

It is important to prevent fetal hypoxia. Huge role plays a role in successful uncomplicated delivery.

In general, with proper and timely treatment, good results can be achieved. The symptoms go away and the child is no different from other children.

About the treatment of pyramidal insufficiency syndrome in infants in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Ballerina's symptom, walking on tiptoes or on tiptoes, equinus planting of the feet - all these are names of one pathology - pyramidal insufficiency syndrome. The disorder can be caused by a huge number of reasons, but is invariably accompanied by moderate/severe muscle dystonia with hypertonicity of the foot and leg. Pyramidal insufficiency with bilateral dystonia, as usual, is monitored in newborns and babies in the first year of life, and is less often diagnosed in children 2-3 years of age.

Why does pyramidal insufficiency occur?

The medulla oblongata is responsible for difficult reflexes. It is part of the brain and connects the terminal to the spinal cord. The organ consists of anatomical cells - pyramids. Hence the name – pyramidal.

When these cells are damaged, movement disorders occur. It is worth noting that in medicine there is no diagnosis of “pyramidal or pyramidal insufficiency.” However, it is given to many children and not always for good reason.

The cause of pathology in a child is perinatal mechanical or ischemic injury to the cervical spinal cord. When the blood circulation of the cervical thickening and the brain stem is disrupted, a daring deviation of the muscle tone of the flexors in the limbs is formed.

The severity depends on the severity of the lesion. The arms become stiff, and with more widespread ischemia, disturbances are also observed in the legs - when the baby is placed on his legs, he unwaveringly rests on his toes (distal parts of the foot).

Symptoms and signs

Key signs of pyramidal insufficiency:

Trembling chin;
Hand tremors;
Throwing the head back;
Poor grasp reflex;
Difficulty holding objects;
Curling your toes in a standing position;
Walking on your toes.

In children under 2-3 months of age, this condition does not cause concern, because they have normal muscle hypertonicity. When the vertical position of the body becomes physiologically intensified, and the baby does not walk normally, it is necessary to determine muscular dystonia - the main symptom of pyramidal insufficiency or spastic paresis of the lower extremities.

The diagnosis is confirmed by the presence of high tendon reflexes, the Babinski reflex persisting for 2-3 months, revival of the tendon reflexes of the hands, delayed reduction of others (mechanical gait, mechanical crawling, Moro, etc.).

Pyramidal insufficiency syndrome can be detected in an infant using an original test: the baby is placed on his stomach, the lower leg is bent halfway at the knee, the calf muscles are palpated, and the tone of the buttocks is examined. In a typical state, muscle tension is identical.

If there is a violation, the calf muscles are tense, the buttocks are in a state of hypotension or typical tone. The pathology often affects the rectus femoris muscles: the legs bend immensely at the hip joints, and when you bring them to the tummy, they find it difficult to straighten in a child lying on his back.

Features of deviation

Pyramidal insufficiency, diagnosed in children, poses a threat because it entails functional disorders called movement disorder syndrome (MDS). In such children, attitudinal reflexes and motor skills are formed late, that is, their development will be delayed (the child will sit up late, crawl, walk, etc.).

Essentially, such a diagnosis indicates a disorder of the motor sphere, but treatment can be prescribed only on the basis of other signs and after clarifying the causes of the disorder.

Almost invariably, the diagnosis of “pyramidal insufficiency” is made when other signs of pathology have not appeared or are absent at all. That is, prescribing any treatment is unsuccessful.

Tumors, inflammatory processes, some congenital pathologies and infections, hemorrhages are the main causes of deficiency, or rather, it is their symptom and a secondary disorder. Considering which part of the body has stopped moving normally, the neurologist correctly determines the affected area of the pyramidal system.

Computed tomography is used as the main diagnostic method. The procedure allows you to correctly identify the lesion in a matter of minutes.

In any case, before prescribing treatment, the doctor must make an accurate, or, one might say, officially present diagnosis. For example, movement disorders can be provoked by minimal brain dysfunction, encephalopathies, and liquor hypertension syndrome.

True neurological pathologies may occur:

birth injuries;
congenital diseases of the nervous system;
brain damage as a result of hypoxia during childbirth (oxygen deficiency);
infectious diseases;
tumors;
abscesses in the spinal cord or brain;
disturbances in the production and outflow of cerebrospinal fluid;
encephalitis and meningitis, causing hydrocephalus.

All of the listed pathologies have characteristic signs and certain methods of treatment; therefore, it is impossible to prescribe any important medical measures on the basis of each only one movement disorder. For example, throwing the head back is one of the signs of meningitis, but no one makes a diagnosis based on this sign alone.

Treatment of children with pyramidal insufficiency

If none of the listed diagnoses are confirmed, then the violation can be eliminated without medication. Basically, various physiotherapy procedures are prescribed. Massage is widely used. We need both the support of a qualified expert and the involvement of parents.

An experienced massage therapist will relieve tone and strengthen muscles. Massage courses traditionally take place every six months. Parents are required to do special preventive exercises with their child every day.

Gymnastics, swimming, and exercises for coordination of movements have a beneficial effect on the body in general and on physical activity in particular.

This applies to both adults and children. Vitamins and medications that improve energy metabolism may be prescribed. It is worth noting that it is necessary to choose special orthopedic shoes when the baby tries to walk. It should have a rough back and a closed front.

If any disease is found that has led to the disorder, treatment is directed both at its elimination and at secondary disorders; it is necessary to stop the signs of pyramidal insufficiency, exclusively in children.

The following drugs may be prescribed:

Improving metabolic processes in nerve cells, say, Nootropil, Encephabol, Cerebrolysin, Aminalon, glutamic acid;
To improve the conduction of a nervous impulse, Dibazol and Proserin are prescribed;
Vasoactive agents for microcirculation;
Substances that normalize muscle tone (eg. Baclofen, Mydocalm, Lioresal);
Vitamin E and group B.

Acupressure and relaxation massage, exercise therapy, reflexology help reduce tone. Orthopedic measures and balneotherapy may also be required. In all cases, treatment methods may differ.

Surgical interventions are resorted to when injuries/tumors of the brain or spinal cord are diagnosed, severe cerebral circulatory disorders that cannot be eliminated by conservative methods (thrombosis, stenosis of extracerebral arteries, malformations of cerebral vessels, intracerebral hematoma, etc.).

If there is the slightest doubt about the disease, parents should immediately seek diagnosis and treatment from an expert. Health to you and your children!

Doctors often perceive pyramidal insufficiency as an independent disease, although in essence it is a syndrome, a number of signs characterizing deviations in mental and physical development. The cause is a violation of the cells of the cerebral cortex.

Causes of pyramidal insufficiency

Pyramidal insufficiency is characterized by a disorder of motor functions. Complex motor reflexes are under the control of the medulla oblongata. It connects the brain to the spinal cord and consists of pyramidal cells.

If damage occurs to this part of the brain, movement is impaired. A state close to paralysis occurs. In medicine it is called central paresis. This diagnosis is closest to the definition of “pyramidal insufficiency”.

With paresis, the function of pyramidal cells is impaired. The neuron in the spinal cord is disinhibited, and a large number of impulses are sent to the muscles. Increased tone and tremor occur.

The syndrome can be unilateral or bilateral depending on the extent of the lesion. Gradually, paresis can cover wider areas and areas of the body.

The reasons for the development of pyramidal insufficiency can be:

organ inflammation;
pathologies acquired at birth;
hemorrhage as a result of heart attacks, strokes;
in infants - damage to the cervical spine as a result of mechanical or ischemic injury;
oncology;
oxygen deficiency during childbirth;
meningitis;
abscesses;
low-grade viral diseases affecting the brain.

Pyramidal insufficiency often occurs in children under one year of age. In adults, it develops as a consequence of previous diseases of the cardiovascular or nervous systems.

How does it manifest?

Symptoms of pyramidal insufficiency are similar to those of other diseases:

encephalopathy;
hypertension;
disorders of brain function.

It is difficult to make a diagnosis: the symptoms are unsystematic. The syndrome is characterized by manifestations:

tremor of the limbs, chin;
walking on toes;
poor finger control;
disturbance of gait, coordination, eye movements;
speech chant;
low intelligence.

To diagnose pyramidal insufficiency, the following types of diagnostics are used:

CT scan;
Magnetic resonance imaging;
electromyography – examines the electrical muscle potential;
Ultrasound of the brain;
EEG (if cerebral palsy is suspected).

Diagnosis of the syndrome is not enough for effective treatment of the patient. The underlying disease causing the symptoms will need to be identified. Therapy should be symptomatic and aimed at eliminating the underlying disease.

There are also methods to determine pyramidal insufficiency:

Prick with a pin. If you prick the tubercle near the thumb with a pin, it will bend towards the index finger.
Jackknife symptom. If the upper limb extends and the lower limb bends (with someone else's help), the patient feels pain.
Venderovich reflex. The patient moves the little finger away from the ring finger if the finger is pulled back with pinch-like movements.
Bare's test. The patient is asked to bring his hands together with his fingers bent and hold. With pyramidal insufficiency, the arms quickly get tired.

If left untreated, pyramidal insufficiency leads to complications:

uneven muscle tension and growth;
problems with the back, joints, and limb function.

How to treat?

The difficulty in treating pyramidal insufficiency lies in the fact that it is not an independent diagnosis, but a group of symptoms caused by the disease. Diagnosis and treatment will consist of identifying and eliminating the cause of pyramidal insufficiency, and then the signs of its manifestation.

For diagnosis, studies are prescribed:

CT and MRI of the brain;
EEG (electroencephalography);
Ultrasound of the brain;
electromyography (study of the muscle area);
general examination by a doctor and additional examinations as necessary.

The doctor identifies the extent of brain damage and the reasons for its development. The type of therapy will depend on these factors:

if there is increased muscle tone, but there is no serious cause of the lesion, massage and physiotherapy are prescribed;
in cases of damage to the nervous system and brain, nootropic medications and vitamin therapy are used in combination with physiotherapy and sessions with a psychologist and speech therapist;
in the presence of tumors, arterial stenosis, hematomas, and injuries, surgical intervention is used to eliminate them.

When the cause is eliminated, treatment of pyramidal insufficiency will be aimed at restoring motor activity, since the syndrome is similar in its symptoms to paresis or central paralysis.

Drug treatment

Parents are concerned about drug treatment for pyramidal insufficiency in children. Medicines are not harmless and have side effects: the doctor chooses them carefully. The medications chosen for treatment act on specific areas and functions of the body.

The following will help improve the metabolism of nerve cells:

Aminalon;
Nootropil;
Glutamic acid;
Encephabol.

The passage of a nerve impulse can be normalized by:

Prozerin;
Dibazol.

Normalization of muscle tone is ensured by:

vitamins B, E;
Lioresal;
Baclofen;
Mydocalm.

Therapy

Treatment of pyramidal insufficiency is aimed at eliminating symptoms and signs. But for their complete disappearance, you need to look for the root cause - the disease - and eliminate it. Sometimes symptomatic therapy is sufficient.

The main treatment measures are designed to return the patient to motor activity. It is necessary to exercise regularly and lead an active lifestyle. Massage gives a good effect. It relaxes the muscles and leads to a decrease in tone. In newborns, massage is often the only way of therapy.

Gymnastics and physiotherapy will not be superfluous. This statement applies to adults and children. Swimming helps a lot.

In severe cases, drugs are prescribed that improve blood circulation and the passage of nerve impulses, vitamins B and E.

Surgical treatment is prescribed if a tumor causing pyramidal insufficiency is diagnosed. The cause of the disease is eliminated.

Pyramidal insufficiency is a syndrome that needs to be treated by eliminating the cause. Timely, qualified assistance will help avoid serious consequences. The main thing is not to perceive illness as a death sentence.

Physiotherapy

Pyramidal insufficiency is a syndrome in which a child walks on his toes due to disturbances in the cerebral cortex and the passage of impulses along the nerves. Increased tone of the limbs does not allow one to lower one's full foot. Treatment is designed to eliminate the disease that provoked the deviation. After eliminating the cause, rehabilitation of the movement function takes place. Physiotherapy is of great importance in this.

Definition and types

Physiotherapy is a set of procedures performed for muscle, joint and spinal diseases. Treatment of pyramidal insufficiency is complemented by it to eliminate excessive muscle tone and accelerate the action of medications.

Physiotherapy helps:

eliminate muscle pain;
remove tone;
normalize blood flow in the pathological area;
eliminate pinched nerve processes;
normalize metabolic processes;
speed up recovery from an infectious process.

Types of physiotherapy:

Electrophoresis. The technique allows for faster delivery of medicinal compounds to the diseased area. Since nootropics and vitamin preparations that relieve spasms are taken in case of pyramidal insufficiency, electrophoresis ensures their rapid delivery to the brain and muscles. Physiotherapy eliminates the inflammatory process in muscle tissue. For treatment, diadynamic currents are carried out, their frequency is 50-100 GHz. Physiotherapy with electrotherapy is carried out for 5 to 10 days. If necessary, the doctor prescribes a repeat course.
Ultrasound. Physiotherapy in this area plays the same role. Ultrasound waves normalize blood flow in the diseased area of the body and relieve muscle spasms. Ultrasound exposure has a number of contraindications: heart problems, jaundice, kidney and liver diseases.
Shock wave therapy. The method involves passing a shock wave of sound through the body. It relieves pain and normalizes blood flow. To improve the condition, 5 procedures are enough.
Balneotherapy. Often used to treat pyramidal insufficiency. This type of physiotherapy consists of water and mud therapy.

How does Physiotherapy work?

Each physical therapy modality affects a specific area or function and improves performance. You cannot replace one technique with another: they have different functions.

Manual therapy

The manual therapy clinic in Germany (Hamburg) offers treatment services for children with paresis and pyramidal insufficiency syndrome. Specialists will find out the reason why the child walks on his toes and will carry out a number of therapeutic measures within the framework of manual therapy, combining it with other techniques.

How does it help?

Manual therapy is a treatment that uses only the hands of a specialist. This is a broad concept that includes massage, gymnastics without active movements, realignment of bones and joints and other techniques. The main goal of this direction in medicine is to return the function of movement to organs and parts of the body.

Manual therapy is a delicate process. Treatment is carried out by a specialist, otherwise complications cannot be avoided. The doctor must behave with caution towards children. The Manual Therapy Clinic in Germany employs high-class doctors: the possibility of error is excluded. Before prescribing a course of treatment, the patient is prescribed a series of diagnostic measures to determine whether there are any deviations in the functioning of other organs and systems. The doctor selects a massage technique.

Pyramidal insufficiency syndrome in children is the result of a pathology of the nervous system, more precisely, of the cells of the cerebral cortex. Treatment should be carried out comprehensively, together with drug therapy and physiotherapy (paraffin therapy, electrophoresis, exercise therapy).

If a child walks on his toes, the task of doctors is to weaken muscle tone, correct gait, sending nerve impulses to the brain through passive exercises, massage and other techniques.

Types of manual therapy

Manual therapy for walking on toes is not limited to massage. This concept includes a set of procedures:

acupuncture;
pharmacopuncture (exposure to areas of the body with medications);
traction and stretching of joints and muscles;
passive gymnastics (movements stimulated by a doctor and aimed at sending an impulse to the brain);
gymnastics with active movements of the baby.

Depending on the type of effect on the body, there are several types of manual therapy:

Arthro-vertebral. This is a hard technique, it involves impact with blows and pushes. Indicated if the child has injuries to the spine or joints.
Cranial. Used for damage to the bones of the brain.
Cutaneous-subcutaneous-myofascial. Used to diagnose disease.

According to the nature of the technique performed, manual therapy can be:

direct or indirect (whether contact is established with the baby’s body);
hard or soft (the activity of movements performed by the massage therapist and the child is taken into account);
passive and active (the child performs the exercises himself or is guided by an osteopath).

The choice of technique depends on the reason for walking on your toes. If this is idiopathic walking (without a reason), treatment will only be aimed at eliminating the tone and bringing the muscles and tendons to the point of walking on a full foot. If the brain or central nervous system is damaged, body massage and a comprehensive approach to recovery will be required.

When walking on toes in small children, doctors try to use a passive, soft technique aimed at direct contact with the baby’s body. The movements of the massage therapist's hands relax the muscles, and passive gymnastics is designed to stretch the Achilles tendon to make it easier for the child to move on a full foot.

Manual therapy is not limited to the lower extremities. In order for the nerve impulse to reach the brain and send a signal to the desired part of the body, the specialist works on the baby’s entire body, relaxing or toning its individual parts. Treatment of pyramidal insufficiency is actively associated with the treatment of osteochondrosis, prevention of spinal curvature and different limb lengths. The procedure ends with a relaxing massage.

Foot massage

Manual therapy is very similar to massage. The main difference from traditional massage is the localization of the effect on the affected areas. With pyramidal insufficiency, the effect is directed to the legs and, in particular, the feet.

Foot massage with increased tone should consist of relaxing movements. Parents acquire basic massage skills on their own, but only a specialist can cope with the problem.

Exercises for baby massage:

Lightly stroke with your hand, starting from the feet to the shins.
Bend the child's leg at the knee and hip joint, flex and extend the foot.
From below to the center of the foot, make movements with your fingers, similar to the number 8.
Apply light pressure on the foot so that the baby bends his toes.
Massage each finger.
You need to complete the procedure with stroking movements from the heel to the toes.

These are elements of massage that are used by manual therapy specialists. At the clinic in Hamburg, a child with pyramidal insufficiency will receive qualified assistance and sessions of manual and physical therapy. When you contact the clinic, you are guaranteed the attention of the staff and a personally developed method of treating your baby.

It should be taken into account that manual therapy is not a panacea for severe neurological diseases. It does not cancel drug therapy. The exception is when the baby is small and cannot take medications on his own. Recovery will require several comprehensive courses of treatment. But pyramidal insufficiency is not always evidence of impairment. Manual therapy for the syndrome is a salvation for the baby.

Additional techniques

If pyramidal insufficiency was detected before one year, and the child is just starting to walk, there is no need to rush to put him on his feet. Wait until the baby wants to stand up and temporarily limit him to an upright position.

When limbs are affected, walking in water is helpful. Training builds skills and prevents muscles from straining excessively, creating the effect of weightlessness. Muscles are strengthened without experiencing tension.

With pyramidal insufficiency, woolen warming helps. To carry them out, the child is wrapped in a woolen blanket, put on insulated clothing and left for a while. Heat relaxes muscles and increases blood flow, nourishing tissues.

Paraffin therapy promotes recovery. Pharmaceutical paraffin is heated to a liquid state and applied to the affected area. There is no risk of a burn for the child, since paraffin does not burn the skin even at high heating temperatures, but it deeply warms the limbs.

Treatment consists of the use of electrophoresis, balneotherapy, mud therapy and other physiotherapy, which can be read about here.

Treatment of pyramidal insufficiency is one of the specialties of the Manual Therapy Clinic in Hamburg. Here specialists will help restore your child’s motor activity. Working with children with limited activity is the profile of a medical institution.

Ballerina's symptom, walking on tiptoes or on tiptoes, equinus planting of the feet - all these are names of one pathology - pyramidal insufficiency syndrome. The disorder can be caused by a large number of reasons, but is always accompanied by moderate/severe muscle dystonia with hypertonicity of the foot and leg. Pyramidal insufficiency with bilateral dystonia is usually observed in newborns and children in the first year of life, and is less commonly diagnosed in children 2-3 years of age.

Why does pyramidal insufficiency occur?

The medulla oblongata is responsible for complex reflexes. It is part of the brain and connects the latter to the spinal cord. The organ consists of anatomical cells - pyramids. Hence the name - pyramidal.

When these cells are damaged, movement disorders occur. It is worth noting that in medicine there is no diagnosis “ pyramidal, or pyramidal, insufficiency" However, it is given to many children and is not always justified.

The cause of the development of pathology in a child is perinatal mechanical or ischemic injury to the cervical spinal cord. When the blood circulation of the cervical thickening and the brain stem is disrupted, a gross deviation of the muscle tone of the flexors in the limbs is formed.

The severity depends on the severity of the lesion. The arms become stiff, and with more widespread ischemia, a disturbance is observed in the legs - when the baby is placed on his legs, he firmly rests on his toes (distal parts of the foot).

Symptoms and signs

Key symptoms of pyramidal insufficiency:

Trembling chin;
Hand tremors;
Throwing the head back;
Poor grasp reflex;
Difficulty holding objects;
Curling your toes in a standing position;
Walking on your toes.

In children under 2-3 months of age, this condition does not cause concern, since they have natural muscle hypertonicity. When the vertical position of the body becomes physiological due to age, and the baby does not walk normally, it is necessary to determine muscular dystonia - the main symptom of pyramidal insufficiency or spastic paresis of the lower extremities.

Pyramidal insufficiency syndrome can be detected in a baby using a kind of test: the baby is placed on his stomach, the shin is bent halfway at the knee, the calf muscles are deeply palpated, and the tone of the buttocks is examined. In a normal state, muscle tension is the same.

If there is a violation, the calf muscles are tense, the buttocks are in a state of hypotension or normal tone. The pathology often affects the rectus femoris muscles: the legs bend excessively at the hip joints, and when brought to the tummy, they are difficult to straighten in a child lying on his back.

Features of deviation

Pyramidal insufficiency diagnosed in children is dangerous because it entails functional disorders called movement disorder syndrome (MDS). In such children, adjustment reflexes and motor skills are formed late, that is, their development will be delayed (the child will sit up late, crawl, walk, etc.).

Essentially, such a diagnosis means a motor disorder, but treatment can only be prescribed on the basis of other symptoms and after determining the cause of the disorder.

Almost always the diagnosis pyramidal insufficiency" is placed in the case when other signs of pathology have not appeared or are absent at all. That is, it is pointless to prescribe any treatment.

Tumors, inflammatory processes, some congenital pathologies and infections, hemorrhages are the main causes of insufficiency, or rather, it is their symptom and secondary disorder. Considering which part of the body has stopped moving normally, the neurologist accurately determines the affected area of the pyramidal system.

Computed tomography is used as the main diagnostic method. The procedure allows you to accurately determine the lesion in a matter of minutes.

In any case, before prescribing treatment, the doctor must make an accurate, or, one might say, officially existing diagnosis. For example, movement disorders can be provoked by minimal brain dysfunction, encephalopathies, and liquor hypertension syndrome.

Real neurological pathologies may occur:

birth injuries;
congenital diseases of the nervous system;
brain damage as a result of hypoxia during childbirth (oxygen deficiency);
infectious diseases;
tumors;
abscesses in the spinal cord or brain;
disturbances in the production and outflow of cerebrospinal fluid;
encephalitis and meningitis, causing hydrocephalus.

All of the listed pathologies have characteristic symptoms and specific treatment methods, so it is impossible to prescribe any serious medical measures based on just one movement disorder. For example, tilting the head back is one of the signs of meningitis, but no one makes a diagnosis based on the symptom alone.

Treatment of children with pyramidal insufficiency

If none of the listed diagnoses are confirmed, then the disorder can be eliminated without medications. Basically, various physiotherapy procedures are prescribed. Massage is widely used. Both the help of a qualified specialist and the involvement of parents are necessary.

An experienced massage therapist will relieve tone and strengthen muscles. Massage courses usually take place every six months. Parents should do special preventive exercises with their child every day.

Gymnastics, swimming, and exercises for coordination of movements have a beneficial effect on the body as a whole and on physical activity in particular.

This applies to both adults and children. Vitamins and medications that improve energy metabolism may be prescribed. It is worth noting that you need to choose special orthopedic shoes when the baby tries to walk. It should have a hard back and a closed front.

If any disease is discovered that has led to a disorder, treatment is directed both at its elimination and at secondary disorders; it is necessary to relieve the symptoms of pyramidal insufficiency, especially in children.

The following drugs may be prescribed:

Improving metabolic processes in nerve cells, for example, “Nootropil”, “Encephabol”, “Cerebrolysin”, “Aminalon”, glutamic acid;
To improve the conduction of nerve impulses, “Dibazol”, “Proserin” are prescribed;
Vasoactive agents for microcirculation;
Substances that normalize muscle tone (eg. “Baclofen”, “Mydocalm”, “Lioresal”);
Vitamin E and group B.

Pyramidal (pyramidal) insufficiency is a collection of symptoms associated with disorders of the nervous system. Basically, pyramidal insufficiency syndrome occurs in children under one year old and adults who have suffered from diseases of the cardiovascular system or have cancer.

Despite the fact that such a disease is not included in the international list of diagnoses, medical workers still make such a diagnosis, also known as ballerina symptom, walking on toes/tiptoes, equinus position of the feet, central paralysis or paresis.

The medulla oblongata is one of five sections of the brain. It connects the brain to the spinal cord and is responsible for performing simple and complex reflexes.

The medulla oblongata consists of a large number of anatomical cells - pyramids, hence the name - pyramidal. And if at least one part of the pyramidal cells fails, then a violation of coordination of movements will appear.

Development of the disorder

Features of the development of pyramidal insufficiency depend on changes in muscle tone and the level of damage to the nervous system (NS).

For example, with central paralysis (incomplete loss of voluntary movements - central paresis), a neuron is disinhibited in the spinal cord. The pyramidal system begins to send a huge number of nerve impulses to the muscles, thereby increasing reflexes and muscle tone. In addition, tremors also appear.

As for flaccid paralysis (paresis) or peripheral, it is formed when a neuron and its process in the spinal cord are damaged. Muscle tone decreases, until the muscle completely immobilizes. Reflexes decline or disappear completely, after which hypotrophy of the innervated area occurs.

Clinical paralysis (paresis) in the lower extremities - tremor and tension appear in the legs, tone increases, gait becomes different. The leg is unbent with difficulty, the foot is placed on the toe, and the impression of steppage (“rooster gait”) is created.

Clinical paralysis (paresis) of the upper limbs - a tremor occurs in the hands; in order to lift something, enormous effort is required due to increased muscle tone. Malnutrition or atrophy begins to develop.

Causes of the disease in adults:

inflammation in the brain (meningitis, encephalitis);
changes in hemodynamics in the brain (heart attack, stroke);
head injuries that cause disturbances in the transmission of nerve impulses;
benign and oncological tumors.

Causes of the disease in children:

hypoxia;
infectious diseases;
inflammatory processes;
birth injuries;
intrauterine developmental anomalies.

Are there neurological problems in children?

When diagnosed with pyramidal insufficiency, the following neurological problems may well occur:

various injuries that occur during childbirth;
congenital diseases of the nervous system (cerebral palsy, spinal dysraphism, infantile hydrocephalus, etc.);
brain hypoxia;
diseases caused by the penetration of pathogenic microorganisms and viruses into the body;
tumors;
purulent inflammation in the spinal cord or brain;
disturbances in the production and outflow of cerebrospinal fluid (cerebrospinal fluid);
encephalitis and meningitis.

Each of the above pathologies has its own characteristic symptoms and methods of treatment.

Features of the clinical picture

Symptoms of pyramidal insufficiency in children:

arms, legs and chin tremble;
throwing the head back;
has difficulty holding objects
in the “standing” position, curl your toes
walk on their toes;
operate their fingers ineptly;
gait, coordination and eye movement are impaired;
speech disorder;
low intelligence.

Symptoms of pyramidal insufficiency syndrome in adults:

muscle hypertonicity of the limbs;
arterial hypertension;
partial or complete immobilization of individual parts of the body;
cramps, spasms;
decreased reflex activity;
overweight;
sexual disorders.

In children up to 2-3 months, pyramidal insufficiency does not cause concern, because they have a natural

muscle hypertonicity

But if the disease is diagnosed in older children, then it already causes serious concern, because it entails movement disorder syndrome (MDS). In such children, not only attitudinal reflexes, but also motor skills develop and form late.

Dr. Komarovsky explains what pyramidal insufficiency is:

Establishing diagnosis

Methods for diagnosing pyramidal insufficiency:

MRI(if there are seizures/spasms or the doctor suspects epilepsy);
CT scan of the brain(used as an additional research method);
electromyography(the neuromuscular system is checked by recording muscle potentials);
Ultrasound of the brain(helps detect tumor processes);
EEG(reveals hidden convulsions that occur during sleep).

In addition to the above methods, tests will be required to confirm the syndrome.

How are children with this diagnosis treated?

Basically, for children diagnosed with pyramidal insufficiency, the doctor prescribes various physiotherapy procedures. You may also need orthopedic means, with the help of which parts of the body are given a physiological position, and balneotherapy (health baths).

To reduce muscle tone and strengthen muscles, doctors recommend acupressure and relaxation massage, a course of which is taken every 6 months.

Every day, parents should do special health-improving and preventive exercises with their child.

If necessary, doctors can prescribe vitamins, vasoactive agents (for microcirculation) and drugs that improve the process of metabolic breakdown.

Surgeries are resorted to only when the doctor has diagnosed:

brain or spinal cord injuries/tumors;
acute cerebrovascular accidents that cannot be cured by chemical, physical and biological methods (for example, thrombosis or intracerebral hematoma).

Is it dangerous?

The diagnosis of “pyramidal insufficiency” in any person suggests serious damage to the nervous system. After all, this can lead to complete or partial immobility.

When the patency of the pyramidal tract is impaired, the following is observed in the body:

state of increased muscle tone;
hypertonicity of the flexor muscles in the upper extremities, and in the lower extensors;
hyperreflexia(segmental reflexes are increased as a result of weakening of the inhibitory influence processes of the cerebral cortex on the segmental reflex apparatus);
synkinesis(involuntary movement of an arm or leg parallel to the voluntary movement of the other arm or leg).

With incomplete damage to pyramidal cells, for example, right-sided pyramidal insufficiency may occur, which manifests itself:

visual impairment;
involuntary oscillatory movements of one or both eyes, mainly in one direction (nystagmus);
decrease in mental abilities.

As for children, not everyone who is diagnosed with this condition has noticeable deviations. Moreover, for most of them, after a while everything goes away by itself.

The thing is that in newborns there are often cases of a slow process of deposition of myelin (a special sheath that improves conductivity) of the nerve fiber. The reason is oxygen starvation during childbirth and cardiopulmonary failure. But still, we should not forget that the diagnosis of “pyramidal insufficiency” hides quite serious problems that cause complete or partial immobilization.

Excellent prevention for the body as a whole is swimming, gymnastics, massage and exercises for coordination of movements.

Pyramidal or pyramidal insufficiency syndrome is a violation of the tone of the muscles of the extremities, especially the lower ones. This pathology is also called “toe walking” or “ballerina symptom.” Often accompanied by equinus or equinovarus foot placement (the feet seem to move apart in different directions, and the ankle “falls” inward).
This condition is often diagnosed in children in the first year of life (before the child learns to walk), less often in two or three year old children. Like the consequences of meningitis, head injury and other lesions of the nervous system, they can develop in adulthood.

Why does pyramidal insufficiency syndrome occur?

The medulla oblongata, whose cells are called “pyramids,” is responsible for complex reflexes in the human body. It is as a result of any disturbances in this part of the brain that the so-called pyramidal insufficiency occurs, i.e., disturbances in the adequacy of reflexes. The most common causes of deficiency are:

congenital pathologies of the NS,
birth injuries,
fetal hypoxia during pregnancy or childbirth,
disruption of the production or outflow of cerebrospinal fluid (cerebrospinal fluid),
infectious diseases,
abscesses,
inflammation of the meninges that cause hydrocephalus (meningitis, encephalitis),
tumors
cerebral hemorrhages.

Pyramidal insufficiency syndrome is by and large not a separate disease. This is a secondary condition caused by an underlying disease of the nervous system.
It is worth noting that in infancy (2-3 months), tightening of the legs and hypertonicity of the lower leg muscles is not a terrible pathology. As the nervous system ages and matures, this condition usually goes away.

Symptoms of pyramidal insufficiency in children

Pyramidal insufficiency in children manifests itself in

weak grasp reflex in infancy and difficulties with holding objects at an older age,
tremors of the arms, legs or chin,
throwing your head back,
walking only on toes without support on the heel,
in a standing position - tuck your toes.

Making such a diagnosis is often unjustified, and it only means hypertonicity of the calf muscles without any other symptoms. We can talk about real insufficiency only when the child can already walk freely, but at the same time steps only on his toes, plus he has other symptoms of dysfunction of the nervous system.
However, if you find any of the listed symptoms in your child, consult a pediatric neurologist, because simple hypertension sometimes hides serious illnesses that can lead to delayed physical (or even mental) development.

Diagnosis of pyramidal insufficiency

First of all, an examination is carried out by a pediatric neurologist, who conducts various tests for age-related reflexes. Very effective and indicative diagnostic tools are tomography and electroencephalography.
In cases where a child not only experiences convulsive muscle twitching, but also a fever, lethargy, etc., a spinal cord puncture may be prescribed to identify the underlying disease that requires urgent treatment (for example, meningitis).

Treatment of pyramidal insufficiency in children

In the case of real pyramidal insufficiency, medical measures are aimed at treating the underlying disease that caused this insufficiency, including surgical intervention. However, in most cases, apart from hypertonicity of the lower leg, no other symptoms are detected. In this case, the main treatment is to relieve hypertonicity and form the correct position of the ankle joint.

Massage and exercise therapy. It is important to combine visits to an experienced specialist who can relax and strengthen muscles with light massages at home. Swimming and light physical exercise also contribute to the proper development of muscles and joints, and the formation of good coordination of movements. To restore energy metabolism and the proper flow of fluids in the body, you can contact an osteopath.
Orthopedic shoes. If pyramidal insufficiency is discovered at an age when the child has already begun to walk, it is important to correctly form the ankle joint, since its incorrect position will lead not only to injuries to the ankle, but also to disruption of the entire musculoskeletal system.
Vitamin therapy.
Sometimes medications are prescribed to improve metabolic processes and nerve conduction.

Childhood lays the foundation for health for the rest of your life. It is very important to respond to any deviations from the norm in a timely manner so as not to miss a serious illness that can significantly reduce a person’s quality of life. If you suspect any pathology or you just want to know that everything is fine with your child, contact our Aximed neurology clinic. Our doctors are qualified specialists with many years of experience; the clinic is equipped with the most modern equipment and has the latest diagnostic tools. With us you will receive a comprehensive diagnosis and comprehensive consultation from the best neurologists in Kyiv.

Pyramid insufficiency is one of the most controversial abnormalities. The disease in question occurs due to underdevelopment of areas of the brain that control the functioning of certain muscle groups. The patient may experience insufficiency in relation to certain muscle groups, for example, arms or legs, or several groups at the same time.

Next, you are invited to familiarize yourself with key information about pyramidal insufficiency in children under 1 year of age. You will learn how the disease manifests itself, what complications it can lead to, and whether there are methods to combat the pathology in question.

Symptoms and manifestations of pyramidal insufficiency

Determining the presence of pyramidal insufficiency in a child is quite simple. The disease manifests itself with the following symptoms:

The doctor can also make this diagnosis if the baby stands on tiptoes or curls his toes while walking.

In babies under 2-3 months of age, pyramidal insufficiency usually does not lead to any complications, because Representatives of this category have natural muscle hypertonicity. As the child develops, when he learns to take a vertical position, pyramidal insufficiency causes a lot of inconvenience, because the child, first of all, cannot fully stand.

In the process of diagnosing the disease, the doctor makes sure of the presence or absence of high tendon reflexes, delayed reduction of other reflexes and other associated pathologies.

To independently determine pyramidal insufficiency in an infant, you can do the following:

Often, pathologies affect the condition of the rectus femoris muscles: they either bend too much at the hip joints when bringing the legs to the stomach, or, when the child is in a supine position, they are difficult to straighten.

Is pyramidal insufficiency a death sentence?

Many doctors do not regard the deviation in question as a disease. The presence of the word “deficiency” in the diagnosis indicates that certain parts of the child’s brain are slightly behind in development.

In the human cerebral cortex there is a region that controls voluntary muscle contractions, i.e. intentionally committed by the “master”. And when a person tries to make any movement, a signal from the brain cells begins to flow through the processes of his nervous system to the corresponding part of the spinal cord. It is the part of the nervous system that occupies the path from cells in the cerebral cortex to the “destination” in the spinal cord that is called the pyramidal tract. In this case, the pyramids themselves refer to the parts of the medulla oblongata through which the nerve impulse moves.

Possible complications of pyramidal insufficiency

Children with this disease often walk on their toes, which causes an incorrect distribution of the center of gravity. The human spine is subject to uneven pressure. The muscles, as well as the joints of the knees and hips, are in constant tension. As a result, if the situation drags on for several years, the child may develop problems with the back, legs, or even joints.

Often, pyramidal insufficiency leads to such a complication as spinal osteochondrosis, which manifests itself as curvature of posture, more severe pain in the back, and sometimes herniated intervertebral discs. Patients often experience headaches and discomfort in the neck area.

Treatment options for pyramidal insufficiency

In most cases, doctors, having examined a child with manifestations of pyramidal insufficiency, claim that no pathologies were found during X-ray examinations, MRI, ultrasound and other diagnostic measures, the baby is completely healthy and there is nothing to worry about. Treatment prescribed by such specialists is usually limited to massage sessions, vitamin complexes and sedatives, which in most cases do not give any significant result.

It is important to understand that any developmental delays, especially if they affect the brain, do not just arise and definitely do not go away without leaving a trace. If there is a late response to adverse symptoms and lack of necessary treatment, the consequences can be much more serious.

In general, pyramidal insufficiency belongs to the category of functional diseases, therefore, the possibility of eliminating its external manifestations is present. The disadvantage of the previously mentioned general massage is the fact that during such procedures the problematic muscles are not fixed, and without this it is impossible to achieve positive results.

A special emendic massage shows a good effect in the treatment of pyramidal insufficiency, during which children's muscles naturally get rid of swelling. As a result of the procedure, an accelerated release of body cells from harmful metabolic products is noted, the function of nerve cells and the brain is normalized, failures in their interaction are eliminated, which allows the patient’s body to fully develop and rapidly catch up.

After a course of massage, little patients become more active and cheerful, and some of them even outperform their peers in development. Regular preventive sessions prevent the occurrence of curvatures and other problems with the spine, the appearance of pain in the neck and back, and the formation of hernias.

For greater effectiveness of therapeutic massage, many experts recommend starting it with the use of paraffin therapy methods. During this preparatory procedure, the patient's skin is covered with paraffin melted to a liquid state. Don’t worry, it’s absolutely safe for the child – there won’t be any burns due to the special physical properties of the substance. Under the influence of molten paraffin, among other things, there is an improvement in blood flow and joint function, which makes massage procedures much more effective and beneficial.

We buy ozokerite or wax at the pharmacy	Ozokerite is black, wax is white. Cosmetic paraffin is not used
Melting	Melt ozokerite, paraffin or their 1:1 mixture in a water bath. Cover the saucepan with paraffin/ozokerite with a lid and wait until it becomes liquid. Stir with a wooden spatula
Pour out the prepared ozokerite or paraffin	We spread the oilcloth, pour the molten substance onto it in a layer of 1.5 cm. Wait until it becomes warm
Applying the composition to the child	We separate the warm ozokerite or paraffin from the oilcloth, cut it with a knife, and place it on the child’s legs or spine. We lay cellophane on top. We put warm knitted socks or stockings on our feet, or cover them with a blanket.
Periodicity	The duration of the procedure is 15-20 minutes, the number of procedures is 5-20, it can be carried out daily or every other day, it is recommended to do this before bedtime, so that after the procedure you can wrap the child up and put him to bed

In general, the treatment option, as well as the need for any additional measures in general, is determined by a specialist individually after assessing the condition of a particular patient.

React in a timely manner to unfavorable changes in your child’s condition, follow the recommendations of specialists and be healthy!

Video - Pyramidal insufficiency in children under 1 year of age

Sometimes neurologists make diagnoses whose names need to be explained in detail due to their pronounced specificity. One of these complex terms is pyramidal syndrome, or pyramidal insufficiency. What it is? Usually the doctor at the appointment does not have the opportunity to explain all the details, so we will talk about this disorder ourselves, about its causes, symptoms and signs, as well as about the treatment of the disease.

But the first thing that needs to be recalled is how such a term as “pyramids” appeared in neurology. Let's talk about this in more detail.

Where did the pyramids come from?

In fact, in the human brain there are not only the pyramids themselves, but also pyramidal pathways and the intersection of these pathways of the same name.

The most important, basic and most important is the pyramidal path system. This is the name of the descending nerve bundles that go from the neurons of the cerebral cortex down to the muscles that perform voluntary, that is, conscious movements.

In addition to voluntary, somatic movements, the influence of these neurons is such that a reflex arises that controls muscle tone. All other tendon reflexes are closed at the level of the corresponding segments of the spinal cord and do not involve the reflex system of the pyramidal tract, that is, they are underlying. However, when this pathway is damaged, they change, since the inhibitory influence of the upper sections disappears (with paralysis) or weakens (with paresis, or partial paralysis).

Some of the fibers in the brain switch to the second neurons of the cranial nerves, and the vast majority of them go down to the bodies of neurons, which are motor and lie in the anterior horns of the spinal cord along its entire length. The real anatomical name for this tract is the corticospinal tract, or corticospinal tract.

This is a thick bundle of white matter (axons - long processes of nerve cells) that originates in the motor cortex, namely in the precentral gyrus.

Since the “hole” in the skull, or foramen occipitale magnum (foramen magnum), is not intended for “slipping dumplings through”, but for connecting the brain and spinal cord in a narrow volume of space, the pyramidal tracts thicken at the level of the cerebral peduncles. When passing to the medulla oblongata, they form true lateral ridges on both sides of the medulla oblongata, very similar to two inverted pyramids. This is where the name of the tract, the intersection, and the diagnosis came from.

In the lower part of the medulla oblongata, a critical event occurs that must be taken into account when diagnosing and treating pyramidal insufficiency in adults and infants, namely: about 80 - 90% of all fibers on each side pass to the opposite side. Therefore, most fibers from the right hemisphere after decussation become left-sided, i.e. go from the left. This phenomenon is called pyramidal decussation. As a result, the cortex “supplies” both fibers from its side and the opposite side to the muscle.

If there is a break or disorder in the activity of the corticospinal bundle at any level - from the cortex to the spinal cord, then pyramidal insufficiency syndrome develops. However, the name “pyramidal insufficiency syndrome” or “pyramidal insufficiency” is incorrect from an anatomical point of view.

Clinical meaning of the syndrome

The practical meaning of all of the above is that the patient develops various disorders in the sphere of voluntary movements: from mild muscle weakness to complete paralysis.

Is this a disease? Of course not. This is simply a syndrome (that is, a set of signs or symptoms), and pyramidal insufficiency can occur in children and adults for a variety of reasons: from trauma and tumor to neuroinfection and simple immaturity of these pathways, which often happens in newborns.

What symptoms and disorders occur in this case?

What is pyramidal deficiency?

There are clear criteria that characterize pyramidal deficiency. This is a description of paralysis or paresis (partial paralysis). Here they are:

decreased strength (for example, with bilateral pyramidal symptoms in the lower extremities) in adults or children;
the ability for subtle movements decreases (embroidery, playing musical instruments);
muscle tone increases (hypertensive type), which is called spasticity. Thus, with pyramidal insufficiency of the legs, a spastic gait occurs, in which there is weakness in the legs and at the same time a limitation in the range of movements;
tendon reflexes increase. When struck with a hammer, the knees and elbows “jump”; when a lying person tries to sharply bend the foot, it makes convulsive twitches - clonus;
at the same time, skin reflexes, for example, abdominal ones, decrease;
pathological reflexes arise, for example, Babinsky, Zhukovsky, Bekhterev, Oppenheim, Rossolimo. For example, Babinski's sign is that when a thin, ticklish object (such as the point of a pencil) is passed along the edge of the sole from bottom to top, the toes will fan out. Normally they should bend.

In children under the age of one and a half to two years, the toes on the leg, on the contrary, should extend, and then extension (extension) is replaced by flexion (flexion). Therefore, treating a child under one year old just because he has a pathological reflex is illiterate. When the pyramid system matures, it will disappear on its own. And a two-year-old baby already has signs of normal foot reflexes, and at the age of 3–5 years the motor system is already mature.

In patients with deep paresis, or central plegia, Babinski's symptom is sharply positive.

there is no muscle atrophy. This serves as an important differential sign between peripheral or flaccid paralysis and central or spastic (pyramidal) paralysis.

Diagnosis of deficiency level

A few words need to be said about the difficulty of accurately diagnosing pyramidal insufficiency. For example, all of the following options are the subject of our topic, from top to bottom:

subcortical lesions (with tumors, cerebral infarctions, hematomas). Fine and professional fine motor skills are impaired or epileptic seizures occur;
when the internal capsule (a place of high density of bundles) is damaged, unilateral hemiparesis occurs, or paralysis of the arms and legs, with possible paralysis of the hypoglossal nerve and paresis of the muscles of half the face;
involvement of the cerebral peduncle adds to hemiparesis paralysis of the oculomotor nerve on the same side (Weber syndrome);
going down below, into the bridge, we get paralysis of one arm or leg or even bilateral hemiplegia, that is, two unilateral paralysis on both sides: as a result, both arms and legs are paralyzed, this can be expressed to varying degrees, from mild paresis to complete tetraplegia;
when the “culprit” of the article itself, the pyramid, is damaged, flaccid paresis of the arm and leg on the opposite side occurs;
The cervical level suffers from multiple sclerosis and amyotrophic lateral sclerosis. The cross was higher, so hemiparesis or hemiplegia occurs on the groan of the lesion;
thoracic level of insufficiency causes spastic paralysis of one leg on the groan of defeat;
finally, damage to the motor root, which can be considered the end of the tract (the last neuron), causes flaccid paresis of one limb.

Now compare how quickly, often without examination, the diagnosis of “pyramidal insufficiency” appears in the outpatient chart. Miracles, and that’s all...

Treatment

With a movement disorder, it all depends on the cause. If a stroke occurs, then prompt activation of the patient is extremely important; massage is needed for pyramidal insufficiency.

Treatment of the most abstract “deficiency” is carried out only in a child, and only if, for some reason, the maturation of his motor bundles is simply delayed. This can be due to perinatal pathology, with a general slowdown in development. In this case, you need gymnastics, swimming, and work with a specialist in physical therapy.

By the way, recently “emendic massage” has appeared, the source of which is the Moscow clinic “Emendo”. In particular, it is indicated for pyramidal insufficiency. In any case, the clinic’s website states that, unlike the author’s, classical methods are ineffective.

As you probably already understood, you can put an equal sign between the terms “central paralysis”, “spastic paresis” and pyramidal insufficiency. Almost any stroke is accompanied by similar symptoms. The main task is to determine the exact level of damage or conduct topical diagnostics. Neurologists, loaded with reports in clinics, simply do not have time to do this, and they present a general formulation of the diagnosis.

In fact, neurologists are acting unprofessionally in this case, since there is simply no such diagnosis in ICD-10. And this means that most often, the doctor has poor command of his subject. After all, neurology is an extremely precise science, akin to electrical engineering, and a neurologist is armed with a hammer with which he “rings” electrical circuits.

Of course, if pyramidal insufficiency occurs in children, which manifests itself in newborns or infants, then this often simply indicates a general and functional, temporary immaturity of the motor system. Here it is truly impossible to show the specific location of the violation: it simply does not exist. This is a variant of the temporary norm, and there is no need to be afraid of it, but only keep it under parental control. You should see a pediatric neurologist in a timely manner so that the baby does not miss the time when he needs to start working with him.

But among adults we can see complete arbitrariness in the interpretation of this term. And the concept of “right-sided pyramidal insufficiency” in a man, which is often heard as a diagnosis, is akin to an electrician’s conclusion that “the wiring has shorted on the right wall of the house somewhere between the switch in the basement and the light bulb in your room.” As they say, draw conclusions and be healthy.