home Folk remedies Signs and causes of cerebral palsy in a child, methods of treating cerebral palsy. What is cerebral palsy, what are the signs of this disease and how is it treated? Can cerebral palsy develop during life?

Signs and causes of cerebral palsy in a child, methods of treating cerebral palsy. What is cerebral palsy, what are the signs of this disease and how is it treated? Can cerebral palsy develop during life?

CEREBRAL PALSY.

The term cerebral palsy combines a number of syndromes that arise in connection with brain damage.

Cerebral palsy occurs as a result of organic damage, underdevelopment or damage to the brain in early ontogenesis (intrauterine development, the moment of childbirth or the early postnatal period). In this case, the phylogenetically “young” parts of the brain and the cerebral cortex are especially affected. Cerebral palsy can manifest itself as a whole complex of motor, mental and speech disorders, combined with disorders of vision, hearing, and various types of sensitivity. The main clinical syndrome of cerebral palsy is movement disorders.

The severity of movement disorders can vary from minimal to very severe and severe.

The first clinical description of cerebral palsy was made by V. LITTLE in 1853. For almost 100 years, cerebral palsy was called LITTLE'S disease. The term “cerebral palsy” was coined by Sigmund Freud in 1893. Since 1958, this term has been officially adopted by WHO (World Health Organization).

WHO has approved the following definition: “Cerebral palsy is a non-progressive disease of the brain that affects parts of the brain that control movement and body position; the disease is acquired in the early stages of brain development.”

Currently, cerebral palsy is considered as a disease resulting from brain damage suffered in the prenatal period or during the incomplete process of formation of the basic structures of the brain, which causes a complex combined structure of neurological and mental disorders.

Etiology and pathogenesis of cerebral palsy.

The causes of cerebral palsy are varied. It is customary to highlight:

prenatal (before the birth of the child, during the mother’s pregnancy)

natal (during childbirth)

postnatal (after the birth of the child).

Most often, the causes are prenatal in 37% to 60% of cases.

Natal from 27% to 40% of cases.

Postnatal – from 3 to 25%.

Prenatal factors.

The state of the mother's health (somatic, endocrine, infectious diseases of the mother), for example, diseases of the cardiovascular system in the mother cause oxygen deficiency in the fetus in 45% of cases.

mother's bad habits;

taking various medications by a pregnant woman.

deviations and complications of pregnancy;

Risk factors include low fetal weight, premature birth, and abnormal fetal position. It was found that a high percentage of children with cerebral palsy had low birth weight. The genetic factor is important, i.e. inheritance of congenital developmental pathology.

Natal factors.

Asphyxia during childbirth, birth trauma. Asphyxia during childbirth leads to dilation of the blood vessels in the fetus's brain and hemorrhages. Birth trauma is associated with mechanical damage or compression of the baby's head during childbirth.

Postnatal factors.

They occur in the early stages of a child’s life, even before the motor system is formed.

Skull injuries, neuroinfections (meningitis, encephalitis), intoxication with drugs (some antibiotics, etc.). Injuries due to strangulation or drowning. Brain tumors, hydrocephalus.

In some cases, the etiology remains unclear and unknown.

Pathogenesis of cerebral palsy.

Cerebral palsy is a consequence of changes in brain cells or disorders of brain development. Pathological changes in the brain in children with cerebral palsy can be determined using computed tomography.

CLINICAL FORMS of cerebral palsy.

Currently, there are more than 20 different classifications of cerebral palsy. In domestic practice, the classification of SEMENOVA K.A. is most often used.

According to this classification, there are five main forms of cerebral palsy:

DOUBLE HEMIPLEGIA;

SPASTIC DIPLEGIA;

HEMIPARETIC FORM

HYPERKINETIC FORM

ATONIC - ASTATIC FORM

In practice, mixed forms of cerebral palsy are distinguished.

DOUBLE HEMIPLEGIA.

The most severe form of cerebral palsy. Occurs as a result of significant brain damage at the stage of intrauterine development. There is pseudobulbar syndrome.

The term hemiparesis or hemiplegia means that one half of the body is affected (face, arm, leg on one side).

Clinical manifestations: Muscle rigidity (Rigidity – inflexibility, inflexibility, numbness caused by muscle tension).

Tonic reflexes that persist for many years. Voluntary motor skills are absent or poorly developed. Children do not sit, do not stand, do not walk. Severe speech disorders, severe dysarthria up to anarthria. Most children have severe mental retardation, which slows down the child’s development and aggravates the condition.

The absence of the inhibitory influence of the higher parts of the nervous system on the reflex mechanisms of the brain stem or spinal cord contributes to the release of primitive reflexes, as a result, muscle tone changes, and pathological postures appear. There is a delay or impossibility of the gradual development of chain righting reflexes, which normally contribute to the child gradually learning to raise and hold his head, sit, stand, and then walk.

SPASTIC DIPLEGIA.

Known as LITTLE disease or syndrome. The most common form of cerebral palsy. Spastic diplegia is characterized by tetraparesis when the arms and legs on both sides of the body are affected. The legs are more affected than the arms. The main clinical symptom is increased muscle tone and spasticity. There is a crossing of the legs when supporting. Limbs may become stiff in an incorrect position. 70–80% of children have severe speech disorders in the form of spastic-paretic (pseudobulbar) dysarthria, sometimes motor alalia, and delayed speech development. Early speech therapy work significantly improves speech. Mental disorders manifest themselves in the form of mental retardation, which can be compensated for by corrective action. Children can study in special schools - boarding schools for children with musculoskeletal disorders or in general education schools. Some children have mental retardation, in which case they are educated in a Type VIII school program. This form of cerebral palsy is prognostically more favorable compared to double hemiplegia. 20–25% of children begin to sit and walk, but with a significant delay (by 2–3 years). The rest learn to move using crutches or in a wheelchair. The child can learn to write and perform some self-care functions.

HEMIPARETIC FORM OF Cerebral Palsy.

This form is characterized by damage to a limb (arm and leg) on one side of the body. The arm is usually more affected than the leg. Right-sided hemiparesis associated with damage to the left hemisphere is observed more often than left-sided hemiparesis. Children acquire motor skills later than healthy children. Already in the first year of life, restriction of movements in the affected limbs is revealed; the child begins to sit on time or with a slight delay, but the posture is asymmetrical, skewed to one side. The child learns to walk by giving his healthy hand. Over time, a persistent pathological posture develops. Shoulder adduction, arm and wrist flexion, spinal scoliosis. The child brings forward the healthy part of the body. The affected limbs are stunted in growth, and shortening of the affected limbs occurs.

Speech disorders in the form of motor alalia, dysgraphia, dyslexia, and counting disorders are noted. In children, spastic-paretic (pseudobulbar) dysarthria is observed.

Intellectual disabilities range from mild mental retardation to mental retardation.

The prognosis for motor development is favorable, children walk independently and master self-care skills.

HYPERKINETIC FORM of cerebral palsy.

Associated with damage to the subcortical parts of the brain. The cause of this form of cerebral palsy may be incompatibility of the blood of the mother and fetus according to the Rh factor or hemorrhage in the area of the caudate body as a result of birth trauma. Movement disorders manifest themselves in the form of involuntary violent movements - hyperkinesis. The first hyperkinesis appears at 4–6 months, most often in the muscles of the tongue, then by 10–18 months in other parts of the body. During the neonatal period, decreased muscle tone, hypotonia and dystonia are noted. Hyperkinesis occurs involuntarily, intensifies with movement and excitement, when attempting to move. At rest, hyperkinesis decreases and disappears during sleep.

In the hyperkinetic form, voluntary motor skills develop with great difficulty. It takes a long time for children to learn to sit, stand, and walk independently. They begin to move independently only at the age of 4–7 years. The gait is jerky and asymmetrical. Balance when walking is easily disturbed, but standing is harder than walking. Automation of motor skills and writing is difficult. Speech disorders in the form of hyperkinetic dysarthria (extrapyramidal, subcortical). Mental and intellectual disorders manifest themselves to a lesser extent than with other forms of cerebral palsy. Most children learn to walk independently, but voluntary movements, especially fine motor skills, are significantly impaired. Children are educated either in a special school for children with special needs or in a mainstream school. They can subsequently study at a technical school or university. A small proportion of children are enrolled in the auxiliary school program.

ATONIC - ASTATIC FORM of cerebral palsy.

With this form of cerebral palsy, there is damage to the cerebellum, sometimes combined with damage to the frontal parts of the brain. There is low muscle tone, imbalance of the body at rest and when walking, imbalance and coordination of movements, tremor, hypermetry (excessive movements).

In the first year of life, hypotension and delayed psychomotor development are detected, i.e. the functions of sitting, standing, and walking do not develop. The child has difficulty grasping and playing with objects and toys. A child learns to sit by the age of 1–2 years, to stand, and to walk by the age of 6–8 years. The child stands and walks with his legs wide apart, his gait is unsteady, his arms are spread to the sides, and he makes many excessive, rocking movements. Hand tremors and poor coordination of fine movements make it difficult to master the skills of writing, drawing, and self-care. Speech disorders in the form of delayed speech development, cerebellar dysarthria, alalia. There may be intellectual impairment of varying severity in 55% of cases. Learning is difficult.

MIXED FORM of cerebral palsy.

With this form, there are combinations of various clinical manifestations characteristic of the above forms: SPASTICO - HYPERKINETIC, HYPERKINETIC - CEREBELLA, etc.

According to the severity of motor disorders, three degrees of severity of cerebral palsy will be distinguished.

Mild - a physical defect allows you to move around and have self-care skills.

Average – children need help from others.

Difficult – children are completely dependent on those around them.

Cerebral palsy is not considered an independent disease.

This term is used to designate a whole complex of movement disorders that arise as a result of brain damage in utero.

The pathology is congenital, its first signs are can be noticed already in children in the first days of life. The most complete and detailed clinical picture appears in infants, that is, before the child reaches 1 year of age. We will talk about what cerebral palsy is in children in this article.

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Concept and characteristics

Cerebral palsy (cerebral palsy) is a pathology that occurs as a result of damage to the areas of the brain responsible for motor activity of the child.

The disease develops in the prenatal period, when the brain is just forming.

During the first years after the birth of a child, in the presence of certain negative reasons, the disease progresses and acquires more and more new manifestations.

However, as the baby grows up, the development of the pathology stops, that is, the brain damage does not worsen. And movement disorders amenable to partial correction.

Brain damage can manifest itself in 2 ways:

nerve cells of an initially healthy brain undergo pathological changes;
the structure of the organ itself is disrupted.

The manifestations of cerebral palsy are very diverse; in some children the motor activity of the legs is impaired (the most common scenario), in others - in the arms, in others the coordination of movements suffers.

Such differences depend on what kind of brain damage occurs and in what period of time it occurred (when exposed to negative factors, the part of the brain that suffers the most is was actively formed at the time of unfavorable conditions).

Causes

Why was the child born with cerebral palsy? Root cause– disruption of the functioning of the brain, in particular, its parts responsible for the ability to move.

Such damage can be caused by a variety of unfavorable factors that arise both in the prenatal period and at the time of birth and in the first months of the baby’s life.

Intrauterine factors	Reasons at the time of birth	Causes in the first months of life
Long-term and intense toxicosis. Premature aging and placental abruption. Threat of miscarriage. Kidney diseases of the expectant mother. Injuries to the fetus during the prenatal period of development. Oxygen deficiency. Fetoplacental insufficiency. Infectious and viral diseases during pregnancy.	Narrow pelvis of a woman. When passing through the birth canal, the child often receives serious injuries. Weakening of labor. The birth of a child ahead of schedule. Large fetal weight. Rapid labor activity. Breech presentation at the time of birth.	Disruption of the respiratory system, leading to hypoxia of the newborn. The entry of amniotic fluid into the child’s oral and nasal cavities, which also contributes to the development of suffocation. - a pathology that occurs as a result of Rh conflict, accompanied by an increased rate of breakdown of red blood cells.

How is it developing?

In children born ahead of schedule, there is immaturity of the brain and its structures.

This can lead to improper development of the organ, and, as a result, the occurrence of cerebral palsy.

Oxygen starvation in the prenatal period it contributes to the occurrence of brain damage, however, if there are no other abnormalities in the development of the child, this phenomenon does not have any visible effect (provided that the oxygen deficiency was insignificant).

If the child has low birth weight, its organs, including the brain, are not fully formed; during hypoxia, some areas of the brain die, and hollow areas appear in their place.

Accordingly, the functionality of the organ is impaired, which leads to disturbances in the motor activity of the body.

Classification of pathology

There are several types of cerebral palsy, which differ from each other in their characteristic features, set of features.

Form	Peculiarities
Spastic diplegia	This form is the most common. It occurs due to damage to areas of the brain that are responsible for the motor activity of the limbs. In children, in the first months after birth, partial or complete paralysis of the legs or arms is observed.
Atonic-astatic	Pathology occurs as a consequence of abnormal development or damage to the cerebellum. The child is unstable, his coordination of movements is impaired, and there is also a decreased tone of muscle tissue.
Hemiparetic	The subcortical and cortical areas of one of the cerebral hemispheres are affected. In this case, motor disturbances are observed only on one side.
Double hemiplegia	Damage occurs in both hemispheres of the brain at once. This form is considered the most dangerous, as it often leads to complete paralysis.
Hyperkinetic	Caused by lesions of the subcortical areas of the brain. Often develops against the background of a spastic form. A child suffering from this type of cerebral palsy is prone to making uncontrolled body movements. Often this manifestation intensifies in those moments when the baby is overexcited, nervous, and worried.

Depending on the child's age it is customary to distinguish the early form(the first signs appear immediately after birth and before 6 months of age), initial residual (6-24 months), late residual (over 2 years).

According to severity they are distinguished:

Light a form in which minor deviations in motor activity are observed. At the same time, the child is able to do without the help of strangers, can dress independently, eat, play, and attend children's educational institutions.
Average form when the baby requires outside help in carrying out complex tasks. However, such a child can attend general education institutions and study successfully.
Heavy a form in which the child cannot do without help, because in this case he is not able to perform even the simplest actions.

Companions of the disease

Cerebral palsy in a child can manifest itself not only in impaired motor function, or its complete absence. It is possible to have other unpleasant moments, such as:

involuntary convulsions;
(formation of pathological fluid in the brain area);
decreased vision and hearing;
(difficulty pronouncing sounds, lack of speech, stuttering);
difficulties in learning to write, count, read;
behavioral disorders, emotional disorders.

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Symptoms and signs

A child suffering from cerebral palsy exhibits the following: symptoms:

Complications and consequences

DPC leads to the development of such serious complications as:

Musculoskeletal disorders(pathological bending of the arms, which in severe cases can provoke dislocation of the joints, deformation of the foot when the baby moves only on his toes, curvature of the spine and persistent violation of posture, as a result of which the child’s body loses its symmetry).
Speech disorders until its complete absence.
Mental retardation, problems with adaptation in a team.

Diagnostics

After the baby is born, the child must be examined by a doctor. This allows you to identify pathology at an early stage of its development and begin treatment as soon as possible. Children who have increased risk of developing cerebral palsy.

These are premature babies who have low birth weight, suffer from congenital anomalies in the development of internal organs, were born as a result of difficult births, and have a low according to Apgar criterion.

The doctor carefully examines the child, checking the severity of innate reflexes and the tone of muscle tissue.

If any deviations are detected, prescribe hardware research:

Ultrasound of the brain;
CT, MRI.

Differential

In the first days of a child’s life, cerebral palsy can manifest itself in the form of signs that are also characteristic of other diseases, the treatment of which is carried out using fundamentally different methods and means.

That is why differential diagnosis is of particular importance. It is important to distinguish cerebral palsy from diseases such as amino acid metabolism disorders, mucopolysaccharidosis, neurofibromatosis, and hypothyroidism.

Objectives of treatment and rehabilitation

Correctly selected therapy is aimed at solving the following problems:

The need to encourage a small patient to develop the skills of movement, self-care, movement of arms and legs;
Prevention of the development of contractures (flexion of limbs), poor posture;
Creating the necessary conditions for the child’s mental development, acquisition of speech, writing and social skills.

Therapy that allows partially restore motor activity, must be comprehensive, including various methods of treatment and correction. The choice of one method or another is made by the doctor.

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Medication

The child is prescribed anticonvulsants drugs (Valparin, Epilim) if convulsions occur, as well as drugs that help eliminate spasms of muscle tissue (Diazepam).

Usage nootropics and other drugs to improve brain activity in cerebral palsy does not produce any results, since brain damage in this case is irreversible.

Self-medication with such means can only harm the child. All medications used for therapeutic purposes should be prescribed only by the attending physician.

Massage and exercise therapy

Massage and special exercises that help strengthening muscle tone, restoring posture, preventing spinal curvature, the child needs to do throughout his life.

At first, a specialist should work with the baby, since a set of massage movements and strengthening exercises is developed individually for each child suffering from cerebral palsy.

Correction of pathological posture

The changes that occur in a child’s body with cerebral palsy lead to disorders of the musculoskeletal system, as a result of which the body is not able to assume a physiological position.

In this case incorrect postures are formed that need correction. Otherwise, persistent poor posture and contractures may develop. For correction, various medical devices are used, such as splints, splints, and bandages.

Correction of contractures surgically

Contracture– persistent flexion of the limbs formed as a result of incorrect position of the body.

This pathology needs correction, otherwise even more serious consequences may develop, such as significant deformation of the joint, its dislocation.

For correction use 2 types of surgical intervention: The Achilles tendon or muscle tissue in the lumbar region may be surgically affected.

Other ways

Depending on what manifestations of cerebral palsy are observed in the child, for more successful treatment it is possible to use other methods, such as:

Physiotherapy, helps relax muscles and eliminate painful spasms.
Classes with speech therapist allow you to eliminate (or reduce) speech disorders.
Socialization child (communication with peers) will help him adapt faster to the team.
Communication with animals(horses, dolphins) allows you to normalize the emotional state of the child and improve his motor activity.

Rehabilitation centers

Name	Address
	Elektrostal, st. Tevosyan, 27
Reatsentr	Samara Novo-Vokzalny dead end 21 "A"
Sail of Hope	Voronezh, st. Plekhanovskaya, 10-a
	St. Petersburg, Pushkin, Parkovaya st. house 64-68
Rehabilitation center	Moscow st. Lodochnaya, 15, building 2
SPC Solntsevo	Moscow Solntsevo, st. Aviatorov, 38
Center for Curative Pedagogy	Moscow Stroiteley, 17b
Speech Pathology Center	Moscow, Solntsevo, st. Aviatorov, 38; Nikoloyamskaya, 20

Cerebral palsy is a disease manifested in very young children. Numerous reasons lead to its development, which can have a negative effect both in the intrauterine period of fetal development and after the baby is born.

Symptoms of the pathology are very diverse; damage affects not only motor function. The disease also negatively affects the emotional, intellectual, and mental development of the child. Therefore, the disease must be identified as early as possible and treatment begun.

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

Sometimes a pregnancy does not end as expected, and the baby is born with a developmental pathology, for example, cerebral palsy (cerebral palsy). It should be noted that the disease is not inherited, but occurs during pregnancy or childbirth. Cerebral palsy is a disease that is a series of syndromes that arise due to damage to the brain; the signs of the disease are associated with a violation of the human motor sphere.

History of disease detection

Cerebral palsy was identified and studied in the early 19th century by the British physician Little, which is why cerebral palsy is also called “Little’s disease.” The British scientist and doctor believed that the main cause of cerebral palsy was pathological labor, during which the child experiences severe oxygen starvation (hypoxia). Sigmund Freud also studied cerebral palsy in his time. He suggested that the cause of the disease was damage to the child’s central nervous system during intrauterine development. This assumption was proven in 1980. But subsequent studies revealed that complicated labor is the most common cause of cerebral palsy.

General characteristics of the condition

Currently, doctors claim that cerebral palsy occurs immediately after birth or during pregnancy. There are many causes of the disease. But mainly it is damage to the central nervous system and associated neurological problems. During the disease, a wide variety of motor dysfunctions are observed. Muscular structures are most affected, which manifests itself in a lack of coordination. Motor activity is impaired due to damage to brain structures. The location and volume of these lesions determine the shape, nature and severity of muscle disorders, which can be single or in combination. Variants of major muscle disorders:

Muscle tension.
Movements of an involuntary chaotic nature.
Various gait disorders.
Limited mobility.
Muscle contractions.

In addition to impaired motor function, cerebral palsy may be accompanied by deterioration in hearing and speech activity. In addition, very often the disease is accompanied by epilepsy and deviations in psychological and mental development. Children have disturbances in the sphere of sensations and perception.

Cerebral palsy does not progress, since the brain damage is localized and does not spread or invade new areas.

Causes

Cerebral palsy is caused by damage to certain areas of the brain that are developing. This damage can occur during pregnancy, when the baby’s brain is just beginning to form, during childbirth, or in the first years of life. In most cases, the exact cause is very difficult to determine. In the scientific literature, the causes of cerebral palsy are divided into several groups:

Genetic causes (damage to the chromosomes of the mother or father, may occur due to aging of the body).
Oxygen starvation of the brain (placental insufficiency both during childbirth and during pregnancy). Factors in the development of oxygen deficiency: placental abruption, long or, conversely, rapid labor, umbilical cord entanglement, incorrect presentation of the fetus.
Infectious diseases, for example, encephalitis, meningitis, cause cerebral palsy. It is especially dangerous if the infection occurs with a high temperature.
Toxic effects on a child (work in hazardous industries, smoking, drugs, alcohol).
Physical impact (if the child was exposed to x-rays or radiation).
Mechanical causes, a consequence of birth injuries.

Also factors that give rise to cerebral palsy are:

Premature birth.
Low weight of the newborn.
Large baby weight or large fetus.
Chronic diseases of women.
Multiple pregnancy.

The risk of developing the disease increases if several factors affect the baby’s brain and nervous system.

Factors in the development of the disease in the first days of life may be:

Hemolytic disease (a congenital disease that develops due to incompatibility of the blood of mother and child).
Asphyxia of the child during labor.
Entry of amniotic fluid into the fetal respiratory tract.
Defects in the development of the respiratory organs.

Childhood cerebral palsy is a consequence of exposure to various factors that lead to disruption of the normal functioning of the child’s brain. The greatest impact has oxygen starvation, which develops due to premature placental abruption, breech position of the fetus, rapid or prolonged labor, and umbilical cord entanglement. Risk factors include Rh conflict between mother and baby and infections.

Sometimes the cause of the development of cerebral palsy is considered to be various pathologies of the vascular system. This is a misconception, since the child’s blood vessels are elastic and soft, they cannot rupture without reason. That is why vascular damage in a child can only occur as a result of severe trauma.

It is important to promptly establish the cause of the development of cerebral palsy, as this determines further tactics of working with the child and his treatment.

Signs

Symptoms of cerebral palsy are divided into late and early. Early scientists include:

The child is lagging behind in physical development (does not hold his head up, does not crawl, does not sit, does not walk on time).
Reflexes that are characteristic of infants persist as the child grows up (the movements of the limbs are chaotic for a long time, the grasping reflex, the stepping reflex).
The child uses only one hand, this is clearly noticeable during play or in everyday life.
The child is not interested in toys.
If you put a child on his feet, he only stands on his toes.

Late signs of cerebral palsy are:

Skeletal deformity, the limb in the affected area is much shorter.
Loss of coordination, low mobility of the child.
Frequent limb cramps.
Gait is difficult, mostly on the toes.
Swallowing problems.
Salivation.
Speech problems.
Myopia, strabismus.
Disease of the gastrointestinal tract.
Involuntary defecation and urination.
Emotional and psychological problems.
Children have difficulty writing, reading, and counting.

The degree of disability depends on the level of development of the child and the efforts of relatives. The higher the level of intelligence, the less motor dysfunction the baby has.

Forms

There are two classifications of the disease - the first is based on the age of the baby, the second on the form of the disorder.

The disease is divided according to age:

Early – symptoms appear before the baby is 6 months old.
Residual initial – the disease is detected from 6 months to 2 years.
Residual later – after 2 years.

Regarding the forms of cerebral palsy, they are classified:

It should be noted that it is difficult to reliably diagnose the form of cerebral palsy in newborns; characteristic signs are revealed by 6 months of the baby’s life.

Diagnosis of the condition

The disease is diagnosed based on the identified characteristic signs. Conditioned reflexes and muscle tone are checked, and an MRI of the brain is also taken. If there is a suspicion of brain damage, an EEG and ultrasound are performed.

A timely diagnosis is very important for a young patient. It is important to recognize the disorder. Children should be examined in the maternity hospital; doctors pay special attention to children:

With light weight.
Those born prematurely.
Having defects and developmental anomalies.
Diagnosed with neonatal jaundice.
Born as a result of difficult and prolonged labor.
With infectious diseases.

Cerebral palsy is diagnosed by a neurologist, but he may additionally prescribe other tests to clarify the diagnosis.

Features of children with cerebral palsy

The main cause of cerebral palsy is a change in the structure of the brain, and the main symptoms are impaired motor activity. Movement disorders occur due to disruptions in the transmission of signals from the brain to the muscles. Cerebral palsy is characterized by the presence of speech, motor, emotional, and mental disorders. They are associated with damage to different muscle groups and brain tissue.

The developmental difficulties of such children are due to enormous difficulties during the performance of complex or coordinated movements. Such children have limited independence, the ability to move freely, and only a partial ability for self-care.

Any movements of children are slow, which is why there is a disproportion between thinking and the idea of the surrounding reality. Logical thinking and abstract knowledge are formed well in such children, and the idea of the world around them is formed only in conditions of constant movement of the child, as a result of which muscle memory is developed.

Children with cerebral palsy are not able to study for a long time; they absorb less information compared to their peers. These children have difficulties with counting and it is very difficult for them to learn mathematical operations.

Emotionally, they are vulnerable, impressionable, and very attached to their parents and guardians.

They usually have a speech disorder, which is why their circle of communication with peers is always limited.

Treatment and rehabilitation of cerebral palsy

The goal and main task of all therapeutic measures is to reduce the manifestations of signs and symptoms of the disease. It is impossible to completely cure the disease, but with the right method, it is possible to ensure that the child acquires the necessary skills and abilities for life.

To choose the nature of treatment, the doctor needs to know the form of cerebral palsy, concomitant diseases and the severity of the disease.

As a rule, anticonvulsants and relaxants are prescribed as medications.

Currently, there are no universal treatments for cerebral palsy. The following methods have proven themselves well:

Massage.
Physiotherapy.
Medical drugs that are aimed at normalizing muscle tone (Dysport, Mydocalm, Baclofen).

The following methods and techniques have a positive effect in treating the disease:

Bobath therapy.
Voight's method.
Load suit "Gravistat" or "Adele".
Pneumatic suit "Atlant".
Speech therapy classes.
Assistive devices (chair, walkers, stand-up machines, exercise equipment, bicycles).

Balneotherapy and hydrotherapy in the pool are successfully used. It is easier for a child to move in water; he first learns to walk in water, after which it is easier for him to perform the same actions on land. Water treatments are completed with hydromassage.

Mud therapy has a good effect, as it has a stimulating effect on nerve cells and relieves muscle tone. In addition, hypertonicity is well normalized with the help of electrophoresis, magnetic therapy, and paraffin therapy.

If changes in muscle structure cannot be corrected, then surgical treatment of cerebral palsy is resorted to. The operations are aimed at performing plastic surgery of muscles and tendons. If it is possible to correct disorders in the tissues of the nervous system, then neurosurgical interventions, stimulation of the spinal cord, and removal of damaged areas are performed.

According to reviews, cerebral palsy must be treated as early as possible, since the condition may worsen due to the gradual development of the orthopedic problem. This may be curvature of the spine, flat feet, club feet, hip dysplasia, and others. If you miss time, you will have to treat not only cerebral palsy, but also correct orthopedic disorders by wearing spacers, splints, and splints.

Principles of working with children

Both doctors and teachers need to deal with children who suffer from cerebral palsy. It is better to start working from an early age for children - from 1 year to 3. It is necessary to take them to classes where they will be taught to speak, perform everyday activities, and teach self-service skills. Such cerebral palsy training centers develop the ability to interact and communicate with peers.

When working with such children, much attention is paid to the development of speech and behavior in society. Each child receives an individual approach that takes into account age and form of pathology. Children are usually taught in groups in the form of a game, led by a competent specialist. The movements of each child are carefully observed, incorrect movements are corrected, and correct ones are encouraged.

To develop correct movement skills, special devices and devices are used to support the head, limbs, and torso in the desired position. The child trains and explores the surrounding space.

Exercise therapy and massage

Massage for cerebral palsy begins at 1.5 months. The course is conducted only by a specialist who can assess muscle tone, frequency of sessions, and degree of impact. It is not recommended to massage yourself.

Physiotherapy exercises include a complex of therapy; exercises must be regular. The complexity of the exercises is set individually for each child, taking into account age, abilities, level of mental and emotional development. The load should increase gradually as the child's condition improves.

As a rule, the following exercises are performed for cerebral palsy:

Complications

Cerebral palsy does not progress over time. But the danger of the disease is that additional pathologies develop against its background. Complications of cerebral palsy:

Prevention of cerebral palsy

During pregnancy, you need to strictly monitor your health. It is important to eliminate bad habits, regularly go to see your doctor, and strictly follow his recommendations. Diagnose conditions dangerous to the fetus, such as hypoxia, in a timely manner. The doctor should correctly assess the mother's condition and choose the correct route of delivery.

Disability

Disability for cerebral palsy is assigned depending on the severity and form of the disease. Children can receive the status of “disabled child with cerebral palsy”, and after 18 years - the first, second or third group.

To obtain disability, it is necessary to undergo a medical and social examination, as a result of which it is established:

Degree and form of the disease.
Nature of damage to the musculoskeletal system.
The nature of speech disorders.
The degree and severity of mental damage.
Degree of mental retardation.
Presence of epilepsy.
Degree of vision and hearing loss.

Parents of a disabled child can receive the necessary rehabilitation means and vouchers to sanatoriums at the expense of the state budget.

Special products that make your child's life easier

Such devices and special equipment can be obtained from the state budget. This is only possible if the doctor has included a list of them in a special rehabilitation card, and the ITU commission, when confirming the disability, has recorded all the means as necessary for the rehabilitation of the child.

Such devices are divided into 3 groups:

For hygienic purposes: toilet chairs, bathing chairs. These devices are equipped with special seats and comfortable belts to secure the child.
Devices intended for movement: wheelchairs for children with cerebral palsy, parapodium, walkers, verticalizers. All these devices allow the child to move in space and explore it. A child who is not able to walk independently will need a stroller (cerebral palsy is a diagnosis for which this item is often extremely necessary), and more than one. For moving around the house - a home version, and for walking on the street, respectively, a street version. A stroller (cerebral palsy), for example, the Stingray, the most lightweight, is equipped with a removable table. There are very convenient and comfortable strollers with electric drive, but their prices are quite high. If your child can walk but has trouble keeping his balance, he will need a walker. They train coordination of movements well.
Devices for child development, medical procedures, training: splints, tables, exercise equipment, bicycles, special toys, soft cushions, balls.

In addition, a child with cerebral palsy will need special furniture, shoes, clothing, and dishes.

Live fully

Many children with cerebral palsy successfully adapt to society, some show themselves in creativity. For example, a seven-year-old boy with cerebral palsy (severe form), who cannot walk at all, but loves to sing, has become a real star. The Internet literally exploded with a video where he covered the track “Minimal” by rapper Eljay. A diagnosis of cerebral palsy does not at all prevent creativity and self-realization. This talented child was visited by the rapper himself; their photo together is very popular among fans of both Eldzhey and the boy Sergei.

Cerebral palsy is a group of diseases in which motor functions and posture are impaired. This is due to a brain injury or a disorder of brain formation. This disease is one of the most common causes of permanent disability in children. Cerebral palsy occurs in approximately 2 cases per thousand people.

Cerebral palsy causes reflex movements that a person cannot control and tightness of the muscle, which can affect part or all of the body. These disorders can range from moderate to severe. There may also be intellectual disability, seizures, visual and hearing impairment. Accepting the diagnosis of cerebral palsy can sometimes be a difficult task for parents.

Cerebral palsy (CP)

Cerebral palsy (CP) is one of the most common diseases in children today. In Russia, according to official statistics alone, more than 120,000 people are diagnosed with cerebral palsy.

Where does this diagnosis come from? Inherited or acquired? A sentence for life or can everything be fixed? Why children's? After all, not only children suffer from it? And what is cerebral palsy anyway?

Cerebral palsy is a disease of the central nervous system in which one (or several) parts of the brain are damaged, resulting in the development of non-progressive disorders of motor and muscle activity, coordination of movements, functions of vision, hearing, as well as speech and psyche. The cause of cerebral palsy is damage to the child's brain. The word “cerebral” (from the Latin word “cerebrum” - “brain”) means “cerebral”, and the word “paralysis” (from the Greek “paralysis” - “relaxation”) defines insufficient (low) physical activity.

There is no clear and complete set of data on the causes of this disease. You cannot catch or get sick with cerebral palsy.

Causes

Cerebral palsy (CP) is the result of injury or abnormal development of the brain. In many cases, the exact cause of cerebral palsy is not known. Damage or disruption of brain development can occur during pregnancy, birth, and even during the first 2 to 3 years after birth.

Symptoms

Even when the condition is present at birth, symptoms of cerebral palsy (CP) may not be noticed until the child is 1 to 3 years old. This happens due to the growth characteristics of the child. Neither doctors nor parents may pay attention to disturbances in the child’s motor sphere until these disturbances become obvious. Children may retain newborn reflex movements without age-appropriate development of movement skills. And sometimes the first to pay attention to a child’s underdevelopment are nannies. If cerebral palsy is severe, then the symptoms of this disease are already detected in the newborn. But the appearance of symptoms depends on the type of cerebral palsy.

The most common symptoms of severe cerebral palsy are

Swallowing and sucking problems
Faint scream
Cramps.
Unusual child poses. The body can be very relaxed or very strong hyperextension with arms and legs spread out. These positions are significantly different from those that occur with colic in newborns.

Some problems associated with cerebral palsy become more obvious over time or develop as the child grows. These may include:

Muscle wasting in injured arms or legs. Problems in the nervous system impair movement in the injured arms and legs, and muscle inactivity affects muscle growth.
Pathological sensations and perceptions. Some patients with cerebral palsy are very sensitive to pain. Even normal everyday activities such as brushing your teeth can be painful. Pathological sensations may also affect the ability to identify objects by touch (for example, distinguish a soft ball from a hard one).
Skin irritation. Drooling, which is common, can lead to irritation of the skin around the mouth, chin and chest.
Dental problems. Children who have difficulty brushing their teeth are at risk for gum disease and tooth decay. Medicines used to prevent seizures may also contribute to the development of gum disease.
Accidents. Falls and other accidents are risks associated with impaired coordination of movements, as well as in the presence of convulsive attacks.
Infections and somatic diseases. Adults with cerebral palsy are at high risk of heart and lung diseases. For example, in severe cases of cerebral palsy, problems arise with swallowing and when choking, some of the food enters the trachea, which contributes to lung diseases (pneumonia).

All patients with cerebral palsy (cerebral palsy) have certain problems with body movement and posture, but many babies do not show signs of cerebral palsy at birth and sometimes only nannies or caregivers are the first to pay attention to deviations in the child’s movements that contradict age criteria. Signs of cerebral palsy may become more obvious as the child grows. Some developing disorders may not become apparent until after the child's first year. The brain injury that causes cerebral palsy does not appear for a long time, but the effects may appear, change, or become more severe as the child gets older.

The specific effects of cerebral palsy depend on its type and severity, level of mental development and the presence of other complications and diseases.

The type of cerebral palsy determines the child's motor impairment.

Most patients with cerebral palsy have spastic cerebral palsy. Its presence can affect both all parts of the body and individual parts. For example, a child with spastic cerebral palsy may have symptoms primarily in one leg or one side of the body. Most children usually try to adapt to impaired motor functions. Some patients can even live independently and work, requiring only occasional assistance from others. In cases where there are impairments in both legs, patients require a wheelchair or other devices that compensate for motor functions.

Complete cerebral palsy causes the most severe problems. Severe spastic cerebral palsy and choreoathetoid cerebral palsy are types of complete paralysis. Many of these patients are unable to care for themselves due to both motor and intellectual impairments and require constant care. Complications such as seizures and other long-term physical consequences of cerebral palsy are difficult to predict until the child is 1 to 3 years old. But sometimes such predictions are not possible until the child reaches school age, and in the process of studying, communicative intellectual and other abilities can be analyzed

The severity of mental impairment, if any, is a strong predictor of daily functioning. Slightly more than half of patients who have cerebral palsy have some degree of intellectual disability. Children with spastic quadriplegia usually have severe cognitive impairment.
Other conditions, such as hearing impairments or problems, often occur with cerebral palsy. Sometimes these disorders are noticed immediately; in other cases they are not discovered until the child gets older.

In addition, just like people with normal physical development, people with cerebral palsy experience social and emotional problems throughout their lives. Since their physical defects exacerbate problems, patients with cerebral palsy need the attention and understanding of other people.

Most patients with cerebral palsy survive to adulthood, but their life expectancy is somewhat shorter. Much depends on how severe the form of cerebral palsy is and the presence of complications. Some patients with cerebral palsy even have the opportunity to work, especially with the development of computer technology, such opportunities have increased significantly.

Cerebral palsy is classified according to the type of body movement and posture problem.

Spastic (pyramidal) cerebral palsy

Spastic cerebral palsy is the most common type. A patient with spastic cerebral palsy develops stiff muscles in some parts of the body that are unable to relax. Contractures occur in damaged joints, and the range of movements in them is sharply limited. In addition, patients with spastic cerebral palsy have problems with coordination of movements, speech disorders and disturbances in swallowing processes.

There are four types of spastic cerebral palsy, grouped according to how many limbs are involved. Hemiplegia - one arm and one leg on one side of the body or both legs (diplegia or paraplegia). They are the most common types of spastic cerebral palsy.

Monoplegia: Only one arm or leg is impaired.
Quadriplegia: Both arms and both legs are involved. Usually in such cases there is damage to the brain stem and, accordingly, this is manifested by swallowing disorders. In newborns with quadriplegia, there may be disturbances in sucking, swallowing, weak crying, and the body may be weak or, on the contrary, tense. Often, upon contact with a child, hypertonicity of the torso appears. The child may sleep a lot and not show interest in his surroundings.
Triplegia: Either both arms and one leg or both legs and one arm are caused.

Non-spastic (extrapyramidal) cerebral palsy

Non-spastic forms of cerebral palsy include dyskinetic cerebral palsy (divided into athetoid and dystonic forms) and ataxic cerebral palsy.

Dyskinetic cerebral palsy is associated with muscle tone that ranges from moderate to severe. In some cases, there are uncontrollable jerks or involuntary slow movements. These movements most often involve the muscles of the face and neck, arms, legs, and sometimes the lower back. The athetoid type (hyperkinetic) type of cerebral palsy is characterized by relaxed muscles during sleep with minor twitching and grimacing. If the muscles of the face and mouth are involved, there may be disturbances in the process of eating, drooling, choking on food (water) and the appearance of inappropriate facial expressions.
Ataxic cerebral palsy is the rarest type of cerebral palsy and affects the entire body. Pathological movements occur in the torso, arms and legs.

Ataxic cerebral palsy is manifested by the following problems:

Body imbalance
Impaired precise movements. For example, the patient cannot reach the desired object with his hand or perform even simple movements (for example, bringing a cup directly to the mouth). Often only one hand is able to reach the object; the other hand may shake as it tries to move the object. The patient is often unable to button clothes, write, or use scissors.
Coordination of movements. A person with ataxic cerebral palsy may walk with too long steps or with their feet spread wide apart.
Mixed cerebral palsy
Some children have symptoms of more than one type of cerebral palsy. For example, spastic legs (symptoms of spastic cerebral palsy related to diplegia) and problems with facial muscle control (symptoms of dyskinetic CP).
Total body cerebral palsy affects the entire body to varying degrees. Complications from cerebral palsy and other health problems are most likely to develop when the entire body is involved rather than isolated parts.

There are several forms of this disease. Spastic diplegia, double hemiplegia, hyperkinetic, atonic-ataxic and hemiplegic forms are mainly diagnosed.

Spastic diplegia or Little's disease

This is the most common (40% of all cases of cerebral palsy) form of the disease, clearly manifesting itself by the end of the first year of life. It occurs mainly in premature babies. They develop spastic tetraparesis (paresis of the arms and legs), and the paresis of the legs is more pronounced. In such children, the legs and arms are in a forced position due to the constant tone of both the flexor and extensor muscles. The arms are pressed to the body and bent at the elbows, and the legs are unnaturally straightened and pressed together or even crossed. Feet often become deformed as they grow.

These children also often have speech and hearing impairments. Their intelligence and memory are reduced, and they find it difficult to concentrate on any activity.

Convulsions occur less frequently than with other types of cerebral palsy.

Double hemiplegia

This is one of the most severe forms of the disease. It is diagnosed in 2% of cases. It occurs due to prolonged prenatal hypoxia, which damages the brain. The disease manifests itself already in the first months of a child’s life. With this form, paresis of the arms and legs is observed with predominant damage to the arms and uneven damage to the sides of the body. At the same time, the arms are bent at the elbows and pressed to the body, the legs are bent at the knees and hip joints, but can also be straightened.

The speech of such children is slurred and difficult to understand. They speak nasally, either too quickly and loudly, or too slowly and quietly. They have a very small vocabulary.

The intelligence and memory of such children are reduced. Children are often euphoric or apathetic.

With this form of cerebral palsy, seizures are also possible, and the more frequent and severe they are, the worse the prognosis of the disease.

Hyperkinetic form

This form of cerebral palsy, occurring in 10% of cases, is characterized by involuntary movements and speech disorders. The disease manifests itself at the end of the first – beginning of the second year of a child’s life. Arms and legs, facial muscles, and neck may move involuntarily, and movements intensify with anxiety.

Such children begin to speak late, their speech is slow, slurred, monotonous, and articulation is impaired.

Intelligence is rarely affected in this form. Often such children successfully graduate not only from school, but also from higher education.

Convulsions in the hyperkinetic form are rare.

Atonic-astatic form

In children suffering from this form of cerebral palsy, the muscles are relaxed, and hypotension is observed from birth. This form is observed in 15% of children with cerebral palsy. They begin to sit up, stand and walk late. Their coordination is impaired, and there is often tremor (trembling of the arms, legs, head).

Intellect in this form suffers slightly.

Hemiplegic form

With this form, which occurs in 32% of cases, the child has unilateral paresis, that is, one arm and one leg on one side of the body are affected, and the arm suffers more. This form is often diagnosed at birth. This form is characterized by speech impairment - the child cannot pronounce words normally. Intelligence, memory and attention are reduced. In 40-50% of cases, seizures are recorded, and the more frequent they are, the worse the prognosis of the disease. There is also a mixed form (1% of cases), in which various forms of the disease are combined.

There are three stages of cerebral palsy:

early;
initial chronic-residual;
final residual.

In the final stage, there are two degrees - I, in which the child masters self-care skills, and II, in which this is impossible due to severe mental and motor impairments.

Diagnostics

Symptoms of cerebral palsy may not be present or detected at birth. Therefore, the attending physician observing the newborn must carefully monitor the child so as not to miss symptoms. However, you should not over-diagnose cerebral palsy, since many motor disorders in children of this age are transient. Often, the diagnosis can only be made several years after the birth of the child, when movement disorders can be noticed. Diagnosis of cerebral palsy is based on monitoring the physical development of the child, the presence of various deviations in physical and intellectual development, test data and instrumental research methods such as MRI.

How to diagnose cerebral palsy in newborns: symptoms

If the baby sharply pulls up his legs or, conversely, stretches them out at the moment when he is taken under the tummy, the lower thoracic and lumbar lordosis (bend) is not observed in his spine, the folds on the buttocks are weakly expressed and at the same time asymmetrical, the heels are pulled up, then parents should suspect the development of cerebral palsy.

The final diagnosis is made by observing how the child develops. As a rule, in children with an alarming obstetric history, the sequence of reactions, the dynamics of general development and the state of muscle tone are monitored. If noticeable deviations or obvious symptoms of cerebral palsy are observed, then additional consultation with a neuropsychiatrist is required.

How does cerebral palsy manifest in children under one year of age?

If the child was born premature or had low body weight, if pregnancy or childbirth had any complications, parents should be extremely attentive to the baby’s condition so as not to miss the alarming signs of developing paralysis.

True, the symptoms of cerebral palsy before one year are little noticeable, they become expressive only at an older age, but still some of them should alert parents:

the newborn has noticeable difficulties with sucking and swallowing food;
at one month of age he does not blink in response to a loud sound;
at 4 months does not turn his head in the direction of the sound, does not reach for the toy;
if the baby freezes in any position or exhibits repetitive movements (for example, nodding his head), this may be a sign of cerebral palsy in newborns;
symptoms of the pathology are also expressed in the fact that the mother can hardly spread the newborn’s legs or turn his head in the other direction;
the child lies in clearly uncomfortable positions;
The baby doesn't like being turned over on his tummy.

True, parents need to remember that the severity of symptoms will greatly depend on how deeply the baby’s brain is affected. And in the future they can manifest themselves as slight clumsiness when walking, or severe paresis and mental retardation.

How does cerebral palsy manifest in children at 6 months?

With cerebral palsy, symptoms at 6 months are more pronounced than in the infant period.

So, if the baby has not lost the unconditioned reflexes characteristic of newborns before the age of six months - palmar-oral (when pressing on the palm, the baby opens his mouth and tilts his head), automatic walking (raised by the armpits, the baby puts his bent legs on a full foot, imitating walking) - this is an alarming sign. But parents should pay attention to the following deviations:

periodically the baby experiences convulsions, which can be disguised as pathological voluntary movements (so-called hyperkinesis);
the child begins to crawl and walk later than his peers;
symptoms of cerebral palsy also manifest themselves in the fact that the baby more often uses one side of the body (pronounced right-handedness or left-handedness may indicate muscle weakness or increased tone on the opposite side), and his movements look awkward (uncoordinated, jerky);
the baby has strabismus, as well as hypertonicity or lack of tone in the muscles;
a baby at 7 months is not able to sit independently;
trying to bring something to his mouth, he turns his head away;
at the age of one, the child does not speak, walks with difficulty, relying on his fingers, or does not walk at all.

Diagnosis of cerebral palsy includes:

Gathering information about the baby's medical history, including details about the pregnancy. Quite often, the presence of developmental delay is reported by parents themselves or it is revealed during professional examinations in children's institutions.
A physical examination is necessary to identify signs of cerebral palsy. During a physical examination, the doctor evaluates how long the baby's newborn reflexes last compared to normal periods. In addition, muscle function, posture, hearing function, and vision are assessed.
Tests to detect a latent form of the disease. Developmental questionnaires and other tests help determine the extent of developmental delays.
Magnetic resonance imaging (MRI) of the head, which may be done to identify abnormalities in the brain.

The complex of these diagnostic approaches makes it possible to make a diagnosis.

If the diagnosis is unclear, additional tests may be ordered to evaluate the condition of the brain and to rule out possible other diseases. Tests may include:

Additional questionnaires.
Computed tomography (CT) of the head.
Ultrasound examination of the brain.

Assessment and management of cerebral palsy
After cerebral palsy is diagnosed, the child must be further examined and other diseases that may be present simultaneously with cerebral palsy be identified.

Other developmental delays in addition to those already identified. Developing abilities need to be assessed periodically to see if new symptoms such as speech delay appear as the child's nervous system is continually developing.
Intellectual delay can be detected using certain tests.
Convulsive episodes. Electroencephalography (EEG) is used to look for abnormal activity in the brain if a child has a history of seizures.
Problems with feeding and swallowing.
Vision or hearing problems.
Behavior problems.

Most often, a doctor can predict many of the long-term physical aspects of cerebral palsy when the child is between 1 and 3 years old. But sometimes such predictions are not possible until the child reaches school age, when deviations can be detected during learning and the development of communication abilities.

Some children need to be retested which may include:

X-rays to detect hip dislocations (subluxations). Children with cerebral palsy usually undergo several x-rays between the ages of 2 and 5 years. In addition, x-rays may be ordered if there is pain in the hips or if there are signs of hip dislocation. It is also possible to order a spinal x-ray to identify deformities in the spine.
Gait analysis, which helps identify disorders and adjust treatment tactics.

Additional examination methods are prescribed if necessary and indicated.

Treatment

Cerebral palsy is an incurable disease. But a variety of treatment methods help patients with cerebral palsy to minimize motor and other disorders and, thus, improve their quality of life. The brain injury or other factors that lead to cerebral palsy do not progress, but new symptoms may appear or progress as the child grows and develops.

Initial (initial) treatment

Exercise therapy is an important part of treatment that begins soon after a child is diagnosed and often continues throughout his or her life. This type of treatment may also be prescribed before diagnosis, depending on the child's symptoms.

Despite the fact that cerebral palsy cannot be completely cured, it needs to be treated to make life easier for the child.

Treatment of this disease comprehensive, includes:

massage to normalize muscle tone;
therapeutic exercises to develop movements and improve coordination (must be carried out constantly);
physiotherapy(electrophoresis, myostimulation) only if there are no seizures;
electroreflexotherapy to restore the activity of motor neurons in the cerebral cortex, resulting in decreased muscle tone, improved coordination, speech, and improved diction;
load suits for correcting body posture and movements, as well as for stimulating the central nervous system;
therapy with animals – hippotherapy , canistherapy ;
working with a speech therapist;
development of the child’s motor skills;
prescription of drugs that improve brain function
classes on special simulators such as loktomat.

If necessary, surgical intervention is performed - tendon-muscle plasty, elimination of contractures, myotomy (incision or separation of the muscle).

It is possible that after some time a method of treatment with stem cells will appear, but so far there are no scientifically proven methods of treating this disease using them.

Complex orthosis for the rehabilitation of patients with cerebral palsy

Characteristic signs of cerebral palsy are impaired motor activity with the subsequent development of vicious attitudes, and subsequently contractures and deformations of large joints of the limbs and spine, therefore timely and adequate orthosis is an important, if not the determining condition for the successful rehabilitation of patients with cerebral palsy.

When prescribing rehabilitation measures, it should be borne in mind that in its development, a sick child must sequentially go through all the stages inherent in a healthy child, namely: sitting (with and without support on the hands), getting up and sitting down, standing with support and only after that walk: first with support, and then without it.

It is unacceptable to skip any of these stages, as well as to carry out rehabilitation measures without orthopedic support. This leads to an increase in orthopedic deformities; the patient develops a stable vicious posture and movement stereotype, which contributes to the development of concomitant orthopedic pathologies.

At the same time, orthotics at all stages of the patient’s development not only protects him from the formation or progression of vicious attitudes and ensures the safety of large joints, but also contributes to a faster and better passage of the current stage.

It should be noted that the upper limbs, which usually receive little attention during rehabilitation, also play an important role in the patient’s life support, since they perform supporting and balancing functions. Therefore, orthotics of the upper extremities is no less important than orthotics of the lower extremities and the spine.

When prescribing orthopedic products, it should be kept in mind that the orthopedic product shown must perform the intended task. In particular, the S.W.A.S.H. hip extension apparatus. cannot be used for walking, because this design does not allow you to do it correctly and without harm to the hip joints. Also, for walking, you should not use lower limb devices with locking joints in the hip and knee joints at the same time. The use of various loading devices without orthotics of large joints is also unacceptable, because in this case, the muscular frame develops with vicious joint alignments, which further aggravates orthopedic pathologies.

Dynamic orthosis

This type of orthosis is used when it is necessary to replace the function of damaged muscles, tendons and nerves of the limbs.

A dynamic orthosis is made for a specific patient, is a removable device and allows you to minimize the consequences of injuries / operations / diseases associated with impaired movement in the limbs, and also, in some cases, has a therapeutic effect.

Medications can help treat some of the symptoms of cerebral palsy and prevent complications. For example, antispasmodics and muscle relaxants help relax tight (spastic) muscles and increase range of motion. Anticholinergics can help improve limb movement or reduce drooling. Other medications may be used as symptomatic treatment (eg, anticonvulsants for seizures)

Permanent treatment

Permanent treatment for cerebral palsy (CP) focuses on continuing and adjusting existing treatment and adding new treatments as needed. Permanent treatment for cerebral palsy may include:

Exercise therapy that can help a child become as mobile as possible. It may also help prevent the need for surgery. If the child has undergone surgical treatment, then intensive exercise therapy may be necessary for 6 months or more. Drug treatment must be constantly monitored in order to avoid possible side effects of drugs.
Orthopedic surgery (for muscles, tendons, and joints) or dorsal rhizotomy (excision of nerves of damaged limbs), in the presence of severe problems with bones and muscles, ligaments, and tendons.
Special orthopedic devices (braces, splints, orthoses).
Behavioral therapy, in which a psychologist helps a child find ways to communicate with peers and this is also part of the treatment.
Massage and manual therapy can also be used in the treatment of both the main symptoms of cerebral palsy and complications associated with impaired biomechanics of movement.
Social adaptation. Modern technologies (computers) have made it possible to employ many patients with consequences of cerebral palsy.

Prevention

The cause of cerebral palsy (CP) is sometimes unknown. But certain risk factors have been identified and their relationship with the incidence of cerebral palsy has been proven. Some of these risk factors can be avoided. Following certain conditions during pregnancy can help reduce the risk of brain damage to the fetus. These recommendations include:

Complete nutrition.
No smoking.
Do not come into contact with toxic substances
Regularly see your doctor.

Minimize injury from accidents
Determine neonatal jaundice
Do not use substances containing heavy metals (lead)
Isolate the child from patients with infectious diseases (especially meningitis)
Immunize the child in a timely manner.

What is important for parents to know

Parents should be very attentive to the condition of their child so as not to miss signs of cerebral palsy in newborns. The symptoms of this pathology should be taken into account especially if there are grounds for alarm in the form of a problematic pregnancy, childbirth, or illnesses suffered by the mother.

If you start treating a child before the age of three, then cerebral palsy is reversible in 75% of cases. But with older children, recovery strongly depends on the state of the child’s mental development.

Cerebral palsy does not have a tendency to progress, therefore, in cases where the pathology affects only the patient’s motor system, and there is no organic damage in the brain, good results can be achieved.

Attention! the information on the site does not constitute a medical diagnosis or a guide to action and is intended for informational purposes only.

What is cerebral palsy - damage to one or more parts of the brain either during intrauterine development or during (or immediately after) childbirth.

Cerebral palsy - cerebral palsy

T The term “cerebral palsy” is used to describe a group of chronic conditions that affect motor and muscle activity with impaired coordination of movements.

Cerebral palsy– damage to one or more parts of the brain either during fetal development, or during (or immediately after) childbirth, or in infancy/infancy. This usually occurs during a complicated pregnancy, which is a harbinger of premature birth.

The word “cerebral” means “cerebral” (from the Latin word “cerebrum” - “brain”), and the word “paralysis” (from the Greek “paralysis” - “relaxation”) defines insufficient (low) physical activity.

Cerebral palsy itself does not progress, because... does not give relapses. However, during the course of treatment, the patient’s condition may improve, worsen, or remain unchanged.

Cerebral paralysis- not a hereditary disease. They can never become infected or get sick. Although cerebral palsy cannot be cured (it is not “curable” in the generally accepted sense), constant training and therapy can lead to improvement of the condition and minimize the consequences of the disease.

How was cerebral palsy diagnosed?

IN In 1860, the English surgeon William Little first published the results of his observations of children who, after suffering a birth injury, developed paralysis of the limbs. The condition of the babies neither improved nor worsened as they grew: problems with the grasping reflex, crawling and walking remained.

Signs of such lesions have long been called “ Little's disease”, and now they are known as “ spastic diplegia" Little hypothesized that these lesions were caused by (hypoxia) during childbirth.

However, in 1897, the famous psychiatrist Sigmund Freud, noticing that children with cerebral palsy often suffered from mental retardation, visual perception disorders and epileptic-type seizures, suggested that the causes of cerebral palsy were rooted in the pathology of the baby’s brain development in the womb.

Despite Freud's assumption, until the 1960s, there was widespread agreement among doctors and scientists that complications during childbirth were the main cause.

However, in 1980, after analyzing data from national studies on more than 35,000 cases of newborns with signs of cerebral palsy, scientists were amazed: complications due to birth trauma amounted to less than 10%...

In most cases, the causes of cerebral palsy have not been identified. Since then, extensive research has begun on the perinatal period, i.e. from the 28th week of intrauterine life of the fetus to the 7th day of life of the newborn.

What types of cerebral palsy are there?

ABOUT The answer to the question of what types of infantile paralysis is identified by modern medicine is of interest to all parents. There are several classifications of types of cerebral palsy, but I will focus on the classification proposed by Professor K. A. Semenova.

Depending on the area of brain damage and the characteristic manifestations of the disease, Semenova identifies the following forms of cerebral palsy:

1. Spastic diplegia. The most common form of cerebral palsy. In general statistics, such babies are 40-80%. There is damage to the parts of the brain responsible for the motor activity of the limbs, which, in turn, leads to complete or partial paralysis of the legs (to a greater extent) and arms.

2. Double hemiplegia. This form of cerebral palsy is expressed by the most severe manifestations. The large hemispheres of the brain or the entire organ are affected. Clinically, rigidity of the muscles of the limbs is observed; children cannot hold their heads, stand, or sit.

3. Hemiparetic form. Unlike other types of cerebral palsy, this form of the disease is characterized by damage to one of the brain hemispheres with cortical and subcortical structures responsible for motor activity. The right or left side of the body suffers (hemiparesis of the limbs), crosswise in relation to the diseased hemisphere.

4. Hyperkinetic form(up to 25% of patients). Subcortical structures are affected. It is expressed in hyperkinesis - involuntary movements, characterized by increased symptoms with fatigue and anxiety. This type of cerebral palsy in its pure form is relatively rare, more often in combination with spastic diplegia.

5. Atonic-astatic form occurs when the cerebellum is damaged. Coordination of movements and a sense of balance suffer most of all, and muscle atony is observed.

Consequences of cerebral palsy

Characteristic features of cerebral palsy are disturbances in motor activity. The muscular sphere is especially affected, causing coordination of movements to deteriorate.

Depending on the extent and location of areas of brain damage, one or more types of muscle pathology may occur - muscle tension or spasticity; muscle pareticity, involuntary movements; disturbance of gait and degree of mobility.

Also, with all types of cerebral palsy in children, the following pathological phenomena may occur:

abnormality of sensation and perception;
decreased vision, hearing;
deterioration of speech;
epilepsy;
impaired mental function.

Other problems are also possible: difficulty eating, weakened urinary and bowel control, breathing problems due to poor body position, bedsores. Training is not easy either.

In order to help a child, you first need to identify and only then develop an action plan.

I hope you have found the answer to the question of what types of cerebral palsy exist. You can also search on the Internet for other common classifications of forms of cerebral palsy, and not just according to Semenova.