How does cerebral palsy manifest itself in different forms and what complications can there be? Infantile cerebral palsy (CP): symptoms, diagnosis and treatment of cerebral palsy.

Cerebral palsy is a group of diseases in which there is a violation of motor functions and posture.

This is due to a brain injury or a violation of the formation of the brain. This disease is one of the most common causes of permanent disability in children. Cerebral palsy occurs in about 2 cases for every thousand people.

Cerebral palsy causes reflex movements that a person cannot control and thickening of a muscle that can affect part or all of the body. These impairments can range from moderate to severe. There may also be intellectual disability, convulsive seizures, impaired vision and hearing. Sometimes it is a difficult task for parents to accept the diagnosis of cerebral palsy.

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 childish? 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 affected, resulting in 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. Cerebral palsy cannot be contracted and become ill.

The reasons

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

Symptoms

Even when the disease is present at birth, the symptoms of cerebral palsy (CP) may not be noticed until the child is 1 to 3 years old. This is due to the growth of the child. Neither doctors nor parents may not pay attention to violations of the child's motor sphere until these violations become apparent. Children may retain the reflex movements of newborns without age-appropriate development of movement skills. And sometimes the first to pay attention to the underdevelopment of the child are nannies. If cerebral palsy has a severe form, then the symptoms of this disease are already found 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 disorders
• Weak cry
• Seizures.
• Unusual postures of the child. The body can be very relaxed or very strong hyperextension with spread of the arms and legs. These postures are significantly different from those that occur with colic in newborns.

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

• Muscle wasting in injured arms or legs. Problems in the nervous system impair movement in the affected arms and legs, and muscle stiffness affects muscle growth.
• Pathological sensations and perception. Some patients with cerebral palsy are very sensitive to pain. Even normal daily activities, such as brushing your teeth, can be painful. Pathological sensations can also affect the ability to identify objects by touch (for example, to distinguish between a soft ball and a hard one).
• Skin irritation. Drooling, which is common, can irritate the skin around the mouth, chin, and chest.
• Problems with teeth. Children who have difficulty brushing their teeth are at risk for gum disease and tooth decay. Anti-seizure medications can also contribute to 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 for heart and lung diseases. For example, in severe cerebral palsy, there are problems with swallowing and when choking, part of the food enters the trachea, which contributes to lung diseases. (pneumonia)

All patients with 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 nurses are the first to pay attention to deviations in the child's movements that contradict age criteria. The signs of cerebral palsy may become more apparent 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 show up for a long time, but the effects may appear, change, or become more severe as the child gets older.

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

1. The type of cerebral palsy determines the movement disorders in a child.

Most patients with cerebral palsy have spastic cerebral palsy. Its presence can affect both in all parts of the body, and in individual parts. For example, a child with spastic cerebral palsy may develop symptoms mainly in one leg or one half of the body. Most children usually try to adjust to motor impairments. Some patients can even live independently and work, needing only occasional assistance. In cases where there are disorders in both legs, patients require a wheelchair or other devices to 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 effects of cerebral palsy are difficult to predict until a 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 learning, communicative intellectual and other abilities can be analyzed.

1. The severity of mental impairment, if any, is a strong indicator 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 mental impairments.
2. Other conditions, such as hearing impairment or problems, often occur with cerebral palsy. Sometimes these disorders are noted immediately; in other cases, they are not detected until the child is older.

In addition, just like people with normal physical development, people with cerebral palsy experience social and emotional problems during 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 postural problems.

Spastic (pyramidal) cerebral palsy

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

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 it happens, and damage to the brain stem and, accordingly, this is manifested by swallowing disorders. Newborns with quadriplegia may have problems with sucking, swallowing, weak crying, the body may be cottony or vice versa tense. Often, when in contact with a child, hypertonicity of the body appears. The child may sleep a lot and not show interest in the environment.
• Triplegia: Either both arms and one leg or both legs and one arm are called.

Non-spastic (extrapyramidal) cerebral palsy

Nonspastic forms of cerebral palsy include dyskinetic cerebral palsy (subdivided 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 jerky twitches 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 slight twitches and grimaces. When the muscles of the face and mouth are involved, there may be disturbances in the process of eating, salivation, choking on food (water) and the appearance of inadequate facial expressions.
• Ataxic cerebral palsy is the rarest type of cerebral palsy and affects the entire body. Pathological movements occur in the torso, arms, legs.

Ataxic cerebral palsy is manifested by the following problems:

• Body imbalance
• Violation of precise movements. For example, the patient is unable to place their hand on the desired object or perform even simple movements (for example, bring the cup exactly to the mouth). Often only one hand is able to reach the object; the other hand may tremble from trying to move that object. The patient is often unable to fasten clothing, write, or use scissors.
• Movement coordination. A person with ataxic cerebral palsy may walk with too large steps or legs 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 (complete) cerebral palsy of the body affects the entire body to one degree or another. Complications of cerebral palsy and other health problems are most likely to develop when the whole body is involved rather than isolated parts.

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

Spastic diplegia or Little's disease

This is the most common (40% of all cases of cerebral palsy) form of the disease, clearly manifested 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 against each other or even crossed. Feet often deform during growth.

Also, these children often have speech and hearing impairments. Their intelligence and memory are reduced, it is difficult for them to concentrate on any activity.

Seizures are less common than in 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, in which the brain is damaged. The disease manifests itself in the first months of a child's life. With this form, paresis of the arms and legs is observed with a predominant lesion of the arms and an uneven lesion of 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 unbent.

The speech of such children is slurred, poorly understood. They speak in a nasal way, 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, convulsions are also possible, and the more often and stronger they are, the worse the prognosis of the disease.

This form of cerebral palsy, which occurs 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, neck can move involuntarily, and movements are intensified during experiences.

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

Intellect rarely suffers in this form. Often such children successfully graduate not only from school, but also from a higher educational institution.

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, stand and walk late. Their coordination is disturbed, and there is often a tremor (trembling of the hands, feet, head).

Intelligence 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 already at birth. Speech impairment is characteristic of this form - the child cannot pronounce words normally. Intelligence, memory and attention are reduced. In 40-50% of cases, convulsions are recorded, and the more often they occur, 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 chronically 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 disorders.

Diagnostics

Symptoms of cerebral palsy may not be present or detected at birth. Therefore, the attending physician observing the newborn needs to carefully monitor the child so as not to miss the symptoms. Nevertheless, it is not worth overdiagnosing cerebral palsy, since many motor disorders in children of this age are transient. Often the diagnosis can be made only a few years after the birth of the child, when it is possible to notice movement disorders. Diagnosis of cerebral palsy is based on monitoring the physical development of the child with the presence of various deviations in physical and intellectual development, analysis data and instrumental research methods such as MRI.

How to diagnose cerebral palsy in newborns: symptoms

If the baby sharply pulls up the legs or, on the contrary, stretches them at the moment when he is taken under the tummy, there is no lower thoracic and lumbar lordosis (bend) 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 established as a result of observing how the child develops. As a rule, in children with a disturbing obstetric history, control over the sequence of formation of reactions, the dynamics of general development and the state of muscle tone is carried out. If there are noticeable deviations or obvious symptoms of cerebral palsy, then an additional consultation with a psychoneurologist is required.

How cerebral palsy manifests itself in children under one year old

If the child was born prematurely or had a 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 warning signs of developing paralysis.

True, the symptoms of cerebral palsy up to a year are not very noticeable, they become expressive only at an older age, but still some of them should alert parents:

• the newborn has difficulty sucking and swallowing food;
• at the age of one month, 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 he has repetitive movements (for example, nodding his head), this may be a sign of cerebral palsy in newborns;
• the symptoms of the pathology are also expressed in the fact that the mother can hardly spread the legs of the newborn or turn his head in the other direction;
• the child lies in obviously uncomfortable positions;
• The baby does not 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 as a slight clumsiness when walking, as well as severe paresis and mental retardation.

How does cerebral palsy manifest itself in children at 6 months?

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

So, if the unconditioned reflexes characteristic of newborns have not disappeared in a baby 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 bent legs on a full foot, imitating walking) is a warning sign. But parents should pay attention to such deviations:

• periodically, the baby has convulsions, which can be disguised as pathological voluntary movements (the so-called hyperkinesis);
• the child later than his peers begins to crawl and walk;
• the symptoms of cerebral palsy are also manifested in the fact that the baby often uses one side of the body (pronounced right-handedness or left-handedness may indicate muscle weakness or their 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 on its own;
• 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, leaning on his fingers, or does not walk at all.

Diagnosis of cerebral palsy includes:

• Gathering information about the child's medical history, including details about the pregnancy. Quite often, the presence of a developmental delay is reported by the parents themselves or it is detected during professional examinations in children's institutions.
• A physical examination is necessary to look for signs of cerebral palsy. During a physical examination, the doctor evaluates how long the reflexes of newborns in a child last compared to normal periods. In addition, an assessment of muscle function, posture, hearing function, vision is performed.
• 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 combination of these diagnostic approaches allows you to make a diagnosis.

If the diagnosis is unclear, additional tests may be ordered to assess the state of the brain and to rule out possible other diseases. Analyzes may include:

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

Evaluation and control of cerebral palsy
After cerebral palsy is diagnosed, the child must be further examined and other diseases that may be simultaneously with cerebral palsy should be identified.

• Other developmental delays in addition to those already identified. Developing abilities should be assessed periodically to see if new symptoms appear, such as speech delay, as the child's nervous system is in continuous development.
• Intellectual lag can be detected through certain tests.
• Convulsive episodes. Electroencephalography (EEG) is used to detect abnormal activity in the brain if the 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 a child is 1 to 3 years old. But sometimes such predictions are not possible until the child reaches school age, when deviations can be detected in the course of learning and development of communication capabilities.

Some children need to be retested which may include:

• X-rays to look for dislocations (subluxations) of the hip. Children with cerebral palsy usually have 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 prescribe an x-ray of the spine to detect deformities in the spine.
• Gait analysis, which helps to identify violations and adjust treatment tactics.

Additional examination methods are prescribed if necessary and if there are indications.

Treatment

Cerebral palsy is an incurable disease. But a variety of treatments help patients with cerebral palsy minimize motor and other impairments and thus improve their quality of life. Brain injury or other factors leading 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 shortly after a child is diagnosed and often continues throughout his or her life. This type of treatment may also be given before a diagnosis is made, depending on the child's symptoms.

Despite the fact that cerebral palsy cannot be completely cured, it must 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 (should be done constantly);
• physiotherapy(electrophoresis, myostimulation) only if there are no seizures;
• electroreflexotherapy to restore the activity of motor neurons of the cerebral cortex, resulting in reduced muscle tone, improved coordination, speech, improved diction;
• load suits for correcting posture and body movements, as well as for stimulating the central nervous system;
• therapy with animals hippotherapy , canistherapy ;
• work with a speech therapist;
• development of motor skills of the child;
• prescribing drugs that improve brain function
• classes on special simulators such as loktomat.

If necessary, surgical intervention is performed - tendon-muscle plastic, elimination of contractures, myotomy (incision or division 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 with their use.

Complex orthotics in the rehabilitation of patients with cerebral palsy

The characteristic signs of cerebral palsy are a violation of motor activity with the subsequent development of vicious attitudes, and later contractures and deformities of large joints of the limbs and spine, so timely and adequate orthotics is an important, if not a 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 consistently go through all the stages inherent in a healthy child, namely: sit (with and without support on hands), get up and sit down, stand 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 activities 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, as a rule, receive little attention during rehabilitation, also play an important role in the life support of the patient, since they perform supporting and balancing functions. Therefore, orthotics of the upper extremities are no less important than orthoses of the lower and spine.

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

Dynamic orthotics

This type of orthotics 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 manage some of the symptoms of cerebral palsy and prevent complications. For example, antispasmodics and muscle relaxants help relax spasmodic (spastic) muscles and increase range of motion. Anticholinergics help improve limb movement or reduce salivation. Other drugs may be used as symptomatic treatment (eg, anticonvulsants, if seizures are present)

Permanent treatment

Permanent treatment for cerebral palsy (CP) focuses on continuing and adjusting existing treatments 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 underwent surgical treatment, then intensive exercise therapy may be necessary for 6 or more months. Drug treatment should be constantly monitored in order to avoid possible side effects of drugs.
• Orthopedic surgery (for muscles, tendons, and joints) or dorsal rhizotomy (excision of the nerves of injured limbs), if there are severe problems with bones and muscles, ligaments, and tendons.
• Special orthopedic devices (braces, splints, orthoses).
• Behavioral therapy, in which the psychologist helps the child find ways to communicate with peers, is also part of the treatment.
• Massage, manual therapy can also be used in the treatment of both the main symptoms of cerebral palsy and complications associated with impaired movement biomechanics.
• Social adaptation. Modern technologies (computers) have made it possible to employ many patients with the consequences of cerebral palsy.

Prevention

The cause of cerebral palsy (CP) is often unknown. But certain risk factors have been identified and proven to be associated with the incidence of cerebral palsy. Some of these risk factors can be avoided. Fulfilling certain conditions during pregnancy helps reduce the risk of brain damage in the fetus. These recommendations include:

• Complete nutrition.
• Do not smoke.
• Do not come into contact with toxic substances
• See your doctor regularly.

• 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)
• Promptly immunize your child.

What parents need to know

Parents should be very attentive to the condition of their child, so as not to miss the 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 diseases suffered by the mother.

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

Cerebral palsy does not tend to progress, therefore, in the case when the pathology has affected only the patient's motor system, and there are no organic damages in the brain, good results can be achieved.

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

Cerebral palsy is one of the most difficult diagnoses that parents of a baby can hear from doctors. If you want to understand what this disease is, what are the symptoms and treatment, check out this article.

Cerebral palsy - what is it?

Cerebral palsy is not a specific disease with specific symptoms. This is a whole group of pathologies of the motor system, which became possible due to serious disorders in the central nervous system. Problems with the musculoskeletal system cannot be considered primary, they always follow brain lesions.

Anomalies in the cerebral cortex, subcortex, capsules and brain stem most often occur even during the period of intrauterine development of the baby. The exact causes that eventually lead to cerebral palsy in newborns are still being investigated by scientists. However, doctors (despite a lot of hypotheses) seriously consider two periods when global changes in the brain can lead to severe pathology - the period of pregnancy and the period immediately before, during and immediately after childbirth.

Cerebral palsy does not progress, the stage of the lesion and limitation of motor functions do not change. As the child grows, some disorders simply become more noticeable, so people mistakenly believe that cerebral palsy can develop and become more complicated.

The group of diseases is quite common - based on statistics, it can be noted that out of a thousand children, two are born with one form or another of cerebral palsy. Boys are almost one and a half times more likely to get sick than girls. In half of the cases, in addition to impaired motor functions, various mental and intellectual disorders are observed.

Pathology was noticed in the 19th century. Then the British surgeon John Little took up the study of birth injuries. It took him exactly 30 years to formulate and present to the public the idea that the oxygen deficiency that the fetus experiences at the time of its birth can result in paresis of the limbs.

At the end of the 19th century, the Canadian doctor Osler came to the conclusion that cerebral disorders are still associated with the hemispheres of the brain, and not with the spinal cord, as the Briton Little had argued before him. However, Osler's arguments were not too convincing to medicine, and Little's theory was officially supported for a very long time, and birth trauma and acute asphyxia were called as starting mechanisms for cerebral palsy.

The term "cerebral palsy" was introduced by the famous doctor Freud, who was a neurologist and studied the problem in his own practice. He formulated intrauterine damage to the child's brain as the main cause of the pathology. He was the first to make a clear classification of different forms of this disease.

Causes

Modern doctors believe that cerebral palsy cannot be considered a hereditary disease. Damage to the motor apparatus and problems with mental development become possible in case of improper development of the baby's brain during the mother's pregnancy, as well as banal underdevelopment of the brain.

If a child was born much earlier than the due date, then the risk of cerebral palsy is several times higher. This is confirmed by practice - many children with disorders of the musculoskeletal system and an established diagnosis of cerebral palsy were born severely premature.

However, prematurity itself is not terrible, it only creates the prerequisites for the development of disorders.

The likelihood of cerebral palsy is usually influenced by other factors that, in combination with premature birth, lead to the disease:

• "mistakes" during the appearance and development of brain structures (first trimester of pregnancy);
• chronic oxygen starvation of the fetus, prolonged hypoxia;
• intrauterine infections that the baby suffered while still in the womb, most often caused by herpes viruses;
• a severe form of Rh-conflict between the mother and fetus (occurs when the mother is negative Rh and the child is positive Rh), as well as severe hemolytic disease of the child immediately after birth;
• brain injury during childbirth and immediately after them;
• infection of the brain immediately after birth;
• toxic effects on the brain of a child with salts of heavy metals, poisons - both during pregnancy and immediately after birth.

However, it is not always possible to establish the true cause of the onset of a child's illness. If only because there is no way to understand at what stage of development of the embryo and fetus that total “mistake” occurred, as well as to prove that brain damage is the result of a conflict of Rh factors. Some children with cerebral palsy have not one, but several reasons for the development of the disease.

Forms and their characteristics

Since cerebral palsy is a group of disorders, there is a fairly detailed classification of the forms of each type of lesion. Each form of cerebral palsy has certain signs and manifestations:

Hyperkinetic (dyskinetic)

This form is most often diagnosed in children who suffer an attack of antibodies associated with Rh conflict in utero. When they are born, the development of hemolytic disease of the newborn (HDN) plays a role, its nuclear icteric form is especially dangerous. This affects the subcortex of the brain, as well as auditory analyzers.

The child suffers from a hearing impairment, he has uncontrollable twitching of the eyes. He makes involuntary movements. Increased muscle tone. Paralysis and paresis are able to develop, but are not considered mandatory. Children with this type of cerebral palsy are quite poorly oriented in the surrounding space, they have difficulties with intentional actions of the limbs - for example, it is difficult for a child to pick up one or another object.

With all this, the intellect suffers to a lesser extent than with some other types of cerebral palsy. Such children (with due efforts on the part of parents and teachers) are perfectly socialized, they are able to study at school, many then manage to enter a university, get a profession and find a job.

Ataxic (atonic-astatic)

This type of cerebral palsy is associated with damage to the cerebellum, the frontal lobes of the brain, and the pathway between the cerebellum and the frontal lobe. Such damage is most often the result of chronic severe fetal hypoxia, an anomaly in the development of these brain structures. Birth trauma to the frontal lobes is often cited as a likely cause.

With this form, the child's muscle tone is reduced. When moving, the muscles do not coordinate with each other, so the child is not able to make purposeful movements. It is practically impossible to maintain balance due to reduced muscle tone. There may be trembling (tremor) of the limbs.

Such children are most prone to epileptic seizures. At an early age there are problems with the development of vision and speech. With proper care, systematic studies, adequate therapy, children with an athanic-astatic form of cerebral palsy can demonstrate certain low intellectual abilities that allow them to only slightly master the basics of speech and realize what is happening. In more than half of the cases, speech remains undeveloped, and the children themselves do not show any interest in this world.

Spastic tetraplegia (spastic tetraparesis)

This is the most severe form of cerebral palsy. It occurs due to damage to the brain stem, both hemispheres or the cervical spine. The most likely causes are intrauterine hypoxia of the fetus, mechanical asphyxia when the neck is wrapped around the umbilical cord, hemorrhage in the brain (when affected by toxins, for example, or when the brain is infected). Often, a birth injury is considered as the cause, in which the cervical spine was affected.

With this form of cerebral palsy, the motor activity of all four limbs (both arms and legs) is disturbed - approximately to the same extent. Since the arms and legs cannot move, their inevitable and irreversible deformation begins.

The child experiences muscle and joint pain, he may have difficulty breathing. More than half of children with such cerebral palsy have impaired activity of the cranial nerves, resulting in strabismus, blindness, and hearing impairment. In 30% of cases, microcephaly is noted - a significant decrease in the volume of the brain and cranium. More than half of patients with this form suffer from epilepsy.

Unfortunately, such children cannot serve themselves. There are also big problems with learning, since the intellect and psyche suffer to a large extent, and the child not only does not have the opportunity to take something with his hands, he does not have a banal motivation to take something or do something.

Spastic diplegia (Little's disease)

This is the most common form of cerebral palsy, it is diagnosed in three out of four sick children. With an illness, some parts of the white matter of the brain are usually affected.

Spastic lesions are bilateral, but the legs are more affected than the arms and face. The spine is deformed very quickly, the mobility of the joints is limited. Muscles contract uncontrollably.

The intellect, mental development and development of speech suffer quite pronouncedly. However, this form of the disease is subject to correction, and a child with Little's disease can be socialized - however, the treatment will be long and almost permanent.

Hemiplegic

This is a unilateral spastic lesion that most commonly affects the arm rather than the leg. This condition becomes possible as a result of hemorrhage in one hemisphere of the brain.

The socialization of such children is possible if their intellectual capabilities are sufficiently large. Such babies develop with a large lag behind their peers. They are characterized by a delay in mental and mental development, problems with speech. Sometimes epileptic seizures occur.

mixed

With this form of pathology, brain dysfunction can be observed in a variety of structures and areas, so the likelihood of a combination of disorders of the motor apparatus is quite real. Most often, a combination of a spastic form and a dyskinetic form is detected.

unspecified

This form of the disease is spoken of if the lesions are so extensive that it is not possible to establish the specific parts of the brain in which the anomaly occurred (malformation or traumatic impact).

Symptoms and signs

It is not always possible to see the first signs of cerebral palsy in an infant even in the maternity hospital, although serious brain disorders are noticeable from the first hours of a child's life. Less severe conditions are sometimes diagnosed somewhat later. This is due to the fact that as the nervous system grows, the connections in it become more complicated, violations of the motor and muscular apparatus become apparent.

There are alarming symptoms that should make parents wary and see a doctor. These symptoms are not always signs of cerebral palsy, quite often they indicate neurological disorders that are not related to cerebral palsy in any way.

However, they cannot be ignored.

Parents should be suspicious if:

• the child does not fix his head well, cannot hold it even at 3 months;
• the muscles of the crumbs are weak, which is why the limbs look like "noodles";
• the child does not roll over on his side, does not crawl, cannot fix his eyes on the toy and does not take toys in his hands, even if he is already 6-7 months old;
• unconditioned reflexes, with which every child is born (and which should normally disappear by six months), continue to persist after 6 months;
• the limbs are spastically tense and do not relax, sometimes spasms occur in “attacks”;
• the child has convulsions;
• visual impairment, hearing impairment;
• chaotic movements of the limbs, uncontrolled and random (this symptom cannot be assessed in newborns and children in the first month of life, since for them such movements are a variant of the norm).

The most difficult to determine the signs of cerebral palsy in children under the age of 5 months. This task is difficult even for an experienced doctor. He may suspect a pathology, but he has no right to confirm it until the child is 1 year old. For one or more symptoms from the above list, it is impossible to suspect cerebral palsy, as well as mistakenly take the symptoms of some similar diseases for cerebral palsy.

Parents should be very careful, because if the treatment of some forms of pathology is started early, before the age of 3, then the results will be excellent, and the child will be able to lead a completely fulfilling life.

Stages of the disease

In medicine, there are three stages of the disease. The first (early) begins at about the age of 3-5 months, the initial stage is called a disease detected at the age of six months to 3 years, the late stage is said if the child is already 3 years old.

The smaller the stage, the more favorable the prognosis for a cure. Even if the child cannot be completely cured, it is quite possible to minimize the negative manifestations. The child's brain (even those affected by trauma or malformations) has a high ability to compensate, and this can and should be used to correct disorders.

Diagnostics

Quite often, genetic diseases are mistaken for cerebral palsy, which are completely independent diseases, as a result of which children are given a diagnosis that does not correspond to reality. Modern medicine is very developed, but the symptoms associated with brain pathology are still not well understood.

It is usually possible to determine the disease closer to 1 year. If a child at this age does not sit, does not crawl, shows other progressive signs of disorders of the nervous system, then the doctor prescribes an MRI.

Magnetic resonance imaging is the only more or less reliable study that allows you to judge the presence of cerebral palsy - and even establish its presumptive form.

For small children, the procedure is carried out under general anesthesia, since in the capsule for taking pictures you have to lie still and for a long time. Children can't do that.

With genuine cerebral palsy, layered MRI images show atrophy of the cortical and subcortical zones of the brain, a decrease in the density of white matter. To distinguish cerebral palsy from a huge list of genetic syndromes and conditions similar in manifestation, a child may be assigned an MRI of the spinal cord.

If the child has convulsions, the doctor prescribes electroencephalography. Ultrasound of the brain is relevant only for newborns, this technique is sometimes used in maternity hospitals if there is a suspicion of cerebral palsy.

The reason for an ultrasound examination may be factors such as prematurity and low birth weight of the child, the established fact of intrauterine infection, the use of special forceps by obstetricians during childbirth, hemolytic disease, a low Apgar score of the newborn (if the child "scored" at birth no more than 5 points) .

At a very early stage after birth, symptoms of very severe forms of cerebral palsy can be visually visible. At the same time, it is also important to distinguish them and separate them from other similar pathologies. The alarming symptoms of a newborn include a sluggish sucking reflex, the absence of spontaneous limb movements, and hydrocephalus.

Treatment

Medicine cannot always find an explanation for recovery with various diagnoses. Below we will talk about traditional treatment in medicine, but now we want to show you an unusual story with a happy ending.

There is an amazing person Arkady Zucker, who was diagnosed with a severe form of cerebral palsy at birth. Doctors confidently told the parents that their child would never walk and speak normally, the life of a healthy person is impossible for him. However, his dad did not agree with the opinion of the doctors, saying that he simply could not have a sick child. Since Arkady is his son, he is definitely healthy. We ask that you take the time to watch the 14-minute video of what happened next.

Treatment does not aim to restore the functioning of the affected parts of the brain, since this is almost impossible. Therapy is aimed at enabling the child to acquire skills and abilities that will help him become a member of society, get an education, serve himself independently.

Not every form of cerebral palsy is subject to such correction, since the severity of brain damage in them is different. But in most cases, doctors and parents, through joint efforts, still manage to help the child, especially if the treatment began in a timely manner, until the baby is 3 years old. The following options can be distinguished:

Massage and Bobath Therapy

Motor functions are restored sequentially, for this, therapeutic massage and Bobath therapy are used. This method was founded by a British couple, therapists Berta and Carl Bobath. They proposed to influence not only the damaged limbs, but also the child's psyche. In a complex psychophysical impact gives excellent results.

Such therapy allows the child to develop over time not only the ability to move, but also to do it completely consciously. Bobath therapy is contraindicated only for children with epilepsy and convulsive syndrome. For everyone else, this method is recommended.

The exercise therapy specialist selects an individual program for each baby, since Bobath therapy, in principle, does not provide for a single approach and a specific scheme. Depending on how and how the limbs are affected, at the first stage, the doctor does everything to ensure that the body “forgets” the wrong position. For this, relaxing technologies and exercises, massaging are used.

At the second stage, the specialist makes the correct physiological movements with the child’s limbs so that the body “remembers” them. At the third stage, the child begins to be motivated (in a playful or other form) to independently perform those very “correct” movements.

Bobath therapy allows the child to go through all the natural stages of development, albeit later, - standing on all fours, crawling, sitting, grasping with hands, resting on legs. With due diligence in classes, parents and doctors achieve excellent results - the “correct” positions are perceived by the child’s body as familiar and become an unconditioned reflex.

Food

Proper nutrition is very important for a child with cerebral palsy, since many babies with this diagnosis have concomitant pathologies of internal organs and the oral cavity. The digestive system is the most commonly affected.

There is no special diet for children with cerebral palsy. When prescribing nutrition, the doctor takes into account the development of sucking and swallowing reflexes, as well as the amount of food that the child “loses” in the process of eating - sheds, cannot swallow, burps.

From the diet of children with this diagnosis, coffee and carbonated drinks, smoked fish and sausage, canned food and pickled foods, as well as spicy and salty dishes are completely eliminated.

Formulas are encouraged (regardless of age) as they provide a more balanced diet. If the child refuses to eat or cannot do so due to the lack of a swallowing reflex, a special probe can be installed for him.

Vojta therapy

The method, which bears the name of its creator - the Czech doctor Vojt. It is based on the formation in children of motor skills characteristic of their age. For this, the exercises are based on two starting skills - crawling and turning. Both in a healthy child are formed at the level of reflexes.

In a child with lesions of motor skills and the central nervous system, they have to be formed "manually" so that later they become a habit and give rise to new movements - sitting, standing and walking.

The Vojta therapist can teach the technique to parents. All exercises are carried out independently, at home. The clinical effectiveness of this type of impact (as well as Bobot therapy) has not been proven to date, but this does not prevent medical statistics from being regularly updated with positive numbers of improved conditions for children with cerebral palsy.

Medicines

There is no special bet on pills and injections, since there is no such medication that would help cure cerebral palsy completely. However, some drugs significantly alleviate the condition of the child and help him to actively rehabilitate. Not every baby with such a pathology needs their use, the expediency of using drugs is determined by the attending physician.

Often prescribed to reduce muscle tone Baclofen, "Tolperison". Reduce muscle spasticity and botulinum toxin preparations - "Botox", "Xeomin". After the introduction of "Botox" into a spasmodic muscle, visible muscle relaxation appears already on the 5-6th day.

This action sometimes lasts from several months to a year, after which the tone usually returns. But the motor skills acquired during this time are preserved, so botulinum toxins are included in the Russian standard for the treatment of cerebral palsy - as a means of complex therapy.

With epileptic seizures, the child is prescribed anticonvulsant drugs, to improve cerebral circulation, nootropic drugs are sometimes prescribed.

Some disorders in cerebral palsy are quite successfully corrected surgically. Tense ligaments and tendons are operated on, muscle-tendon plasty is performed, surgeons are excellent at eliminating ossification and limited movement of the joints, which accompany some forms of the disease.

Other Methods

Very good results are shown by the treatment of children with cerebral palsy with the help of pets. Animal therapy (this is the international name of the method, not always used in Russia) allows the child to socialize faster, stimulates intellectual and mental functions. Most often, parents of a child with such a diagnosis are advised to get a dog or cat. At the same time, the child should communicate and be close to his pet as often as possible.

Hippotherapy - treatment with the help of horses - has also become very widespread. In many Russian cities there are clubs and centers where kids with cerebral disorders go in for horseback riding under the supervision of experienced hippotherapists.

While riding in the saddle, all muscle groups are involved in a person, and attempts to maintain balance are reflexive, that is, a signal from the brain to set the muscles in motion is not at all necessary. During classes, children develop useful motor skills.

The beneficial impulses that a horse sends to its rider while walking are a natural massage. During the procedure, the child is placed in the saddle, pulled along the horse's spine, seated, trying to load all the "problem" parts of the body and limbs.

Emotionally, children perceive a live horse much better, emotional contact is exactly the factor that allows you to form motivation in a child with cerebral palsy.

If parents and children do not have the opportunity to communicate live with such animals, then a hippo simulator will come to the rescue, on which all movements are monotonous, the same.

Methods with unproven effectiveness

Quite often, children are prescribed vascular drugs "Cerebrolysin", "Actovegin" and others, classed as nootropics. Although their use is widespread, it raises great doubts, since clinical trials have not shown a significant change in the condition of children with cerebral palsy after a course of treatment with nootropic drugs.

Quite often on the Internet, parents who are constantly looking for new methods and ways to defeat a terrible disease stumble upon modern homeopathic remedies, which promise "improvement of brain activity". None of these funds currently have official approval from the Ministry of Health, their effectiveness has not been proven.

Treatment of cerebral palsy stem cells- another commercial and very profitable step for manufacturers of drugs with unproven action. Clinical trials have shown that stem cells cannot restore movement disorders, since they do not have any effect on the connection between the psyche and motor skills.

Experts believe there is little benefit in cerebral palsy and from manual therapy. No one detracts from its significance, with a number of other pathologies during the recovery period after injuries, the technique gives positive results. However, it is in children with cerebral palsy that its use is inappropriate.

Forecasts

With the modern level of medicine, the diagnosis of cerebral palsy is not a sentence. Certain forms of the disease lend themselves to complex therapy, which includes the use of medications, massage, rehabilitation techniques, and work with a psychologist and a correctional teacher. Even some 50-60 years ago, children with cerebral palsy rarely lived to adulthood. Now life expectancy has changed in a big way.

On average, with treatment and good care, a child with cerebral palsy today lives to be 40-50 years old, and some have managed to overcome the retirement age. It is rather difficult to answer the question of how long they live with such a diagnosis, because much depends on the degree and severity of the disease, its form and the characteristics of the course in a particular child.

A person with cerebral palsy is prone to premature aging, his actual age is always lower than his biological age, because deformed joints and muscles wear out faster, creating the preconditions for early aging.

Disability

Disability in children with cerebral palsy is issued based on the form and severity of the course of the disease. Children can count on the status of a “child with a disability”, and after they come of age, they can receive the first, second or third group of disability.

To obtain a disability, the child will have to undergo a medical and social examination, which should establish:

• form and degree of cerebral palsy;
• the nature of the lesion of the motor function (on one or both sides, whether there are skills in holding objects, leaning on the legs);
• the severity and nature of speech disorders;
• the severity and degree of mental damage and mental retardation;
• the presence of epileptic seizures;
• the presence, as well as the degree of hearing loss, vision.

Children with severe disabilities are usually given the category of "disabled child", which, before the age of 18, needs to be re-confirmed. The parents of such a child will be able to count on receiving the rehabilitation means necessary for the child and visiting a sanatorium at the expense of the federal budget.

Development Features

In infants, cerebral palsy has almost no clear manifestations (in any case, up to 3-4 months). After that, the baby begins to rapidly lag behind in development from his healthy peers.

Children with cerebral palsy have difficulty with coordinated movements. As they get older, the child will try to avoid them. If at the same time intellectual abilities are preserved, then the kids grow “slow”, they do everything very slowly, leisurely.

Children with a light children with cerebral palsy are rarely aggressive and angry. On the contrary, they have an incredible attachment to their parents or guardians. She can reach panic if the baby is afraid to be alone.

Some forms of cerebral palsy “deform” the personality so much that the child can become withdrawn, embittered, aggressive (for no apparent reason). However, it would be wrong to attribute everything only to the form of the disease. Parents play a very important role in shaping the character of a child. If they are positive, good-natured, encourage the achievements of the child, then the likelihood of getting an aggressive child is minimized.

At the physical level, in children with cerebral palsy, the lack of understanding of what the correct position of the body in space should be comes first. Since an erroneous signal comes from the affected brain, the muscles receive it incorrectly, hence the inability to do something consciously and spontaneous movements.

Reflexes (Moro, grasping and others), which are characteristic of all newborns, disappear in order to give way to new skills. In children with cerebral palsy, these innate reflexes often persist, and this makes it difficult to learn new movements.

Many children with cerebral palsy are characterized by insufficient body weight, minimal subcutaneous fat, and weak (often blackened and crooked) teeth. Individual features of development are determined by a single factor - the preservation of intellectual potential. If it is, then a lot can be adjusted and corrected.

Means of rehabilitation

Special funds that make life easier for a child with cerebral palsy can be obtained from the federal budget. True, this is only possible if the doctor has entered their exact list in the rehabilitation card, and the ITU commission, when confirming disability, has recorded a list of necessary funds for rehabilitation.

All devices are divided into three large groups:

• hygienic devices;
• devices that make it possible to move;
• devices for the development of the child, training and medical procedures.

In addition, the child may need special furniture adapted for babies with cerebral palsy, as well as shoes and dishes.

Hygiene

These facilities include toilet chairs and bathing chairs. In order not to carry the child to the toilet (especially if he is already large and heavy), a toilet chair is used, which consists of a chair equipped with a removable sanitary tank. The chair also has wide, comfortable straps for secure fixation of the child.

The bath chair has an aluminum frame and a waterproof seat. On it, parents will be able to place the child comfortably and calmly bathe him. The tilt adjustment allows you to change the angle to change the position of the body, and the seat belts securely hold the child in the bath.

Mobility

A child who cannot move independently needs a wheelchair, and more than one. Wheelchairs are used to move around the house, and strollers are used for walking. Walking option (for example, "Stingray") is lighter, sometimes equipped with a removable table. Manufacturers of electric wheelchairs offer very good options, but their price is quite high.

If a child has learned to walk, but cannot (or cannot always) keep his balance, he needs a walker. A well-fitted walker can also help in the process of learning to walk. In addition, they train coordination of movements. Usually walkers look like a frame with four wheels and a safety device. The wheels cannot roll back, this completely eliminates tipping.

A more complex version of the walker is the parapodium. This is a dynamic stander that will allow the child not only to stand, but also to exercise on the simulator at the same time. In such an orthosis, the child will be able to move independently. However, the parapodium is suitable only for children who have retained their intellectual functions, for everyone else it is better to use a regular static stand.

The verticalizers fix the child in the region of the popliteal space, as well as the feet, on the hips and on the belt. It can lean slightly forward. If the model is equipped with a table, then the child will even be able to play there.

Devices for the development of the child

Such devices include special furniture, tables and chairs, some verticalizers, langets, a bicycle, exercise equipment and complex orthopedic shoes. All furniture is equipped with body position regulators, seat belts. It can be one item (chair or table) or a whole set, where each element is combined and combined with another.

A special bicycle for children with cerebral palsy is not only a toy, but also a means of active rehabilitation. It has a special (unusual for most people) design. It is always three-wheeled, and its steering wheel is not connected to the pedals. Therefore, turning the steering wheel in the wrong direction does not lead to turning the wheels in a given direction.

Such a bike is equipped with mounts for the hands, legs and feet, as well as a cane that allows parents to push the device with the child forward if the child cannot pedal on his own.

Using a bicycle allows you to prepare your child well for learning to walk, trains leg muscles, alternating movements.

simulators

The modern medical industry has taken a step forward, and children with cerebral palsy today have access not only to the most familiar exercise bikes, but also to real exoskeletons that will take over all the “work” of the muscles. In this case, the child will make movements together with the exoskeleton, due to which the reflex correct movement will begin to form.

The most popular in Russia is the so-called Adele costume. This is a whole system of support and load flexible elements. Classes in such a suit allow the child to correct the posture, the position of the limbs, which ultimately has a good effect on other body functions. The kid begins to speak better, draw, it is easier for him to coordinate his own movements.

Adele's costume is very reminiscent of the outfit of a volunteer cosmonaut from a science fiction film, but this should not be scary. The average course of treatment in such an outfit is about a month. In this case, the child (from 3 years old) will have to walk, bend and unbend, squat (if possible) in this suit for 3-4 hours a day.

After such courses, which can be taken on the basis of a rehabilitation center, children feel more confident, they control their own hands and feet more easily, their arches are strengthened, a wider step appears, they master new skills. Doctors say that the risk of developing "fossil" joints is reduced several times.

For home use, the most common treadmill, ellipsoid, as well as expensive (but very useful and effective) Motomed and Lokomat exoskeletons are well suited.

And at home, in a rehabilitation center, you can use the Gross simulator. It is very easy to fix it in the country, and in the apartment, and on the street, and even in the pool, so that the child can practice in the water. The simulator is a movable block with a stretched cable, elastic rods, hand rings, for which the child will hold on. Insurance and a special lever-carbine mechanism are provided.

Classes on such a simple simulator (according to the Ministry of Health) give amazing results - every fifth baby with cerebral palsy develops the skills of independent movement with legs, about a third of children with such a diagnosis, after systematic classes, were able to attend specialized schools and study.

In half of the cases, speech development improves. More than half of the children have significantly improved coordination of movements, 70% of the children have the prerequisites for acquiring new skills - they were able to learn to sit, get up, and take their first steps.

To fix the joints in the correct position, orthoses, splints and splints are often used. The most popular manufacturing companies - Swash and Gait Corrector.

Children from 1 year old can play with special toys for "special" babies, they include sets for fine motor skills with small movable and securely fastened parts. The production of special toys for the medical rehabilitation of such children is carried out in St. Petersburg, they are produced under the brand name "Tana-SPb". Unfortunately, the cost of the sets is quite high. A complete set costs about 40 thousand rubles, but it is possible to buy one or two toys from the set (1500-2000 rubles each).

These motor toys are also great for children with severe mental retardation, they stimulate not only motor skills, but also many other functions of the child's body.

Charitable foundations

Parents should not be left alone with a serious illness of the child. Many rehabilitation means cannot be purchased at the expense of the budget, and incomes do not allow them to be bought on their own. In this case, charitable foundations created to help children with cerebral palsy will help. No one will ask parents for any “entry fees”, it is enough to send letters to the foundations describing the problem, confirming the diagnosis, and wait for the necessary support.

If you do not know where to turn, here are just a few organizations operating throughout Russia and well-established in helping children with cerebral palsy:

• Charitable Foundation "Children of cerebral palsy" (Tatarstan, Naberezhnye Chelny, Syuyumbike st., 28). The fund has been operating since 2004.
• "Rusfond" (Moscow, PO box 110 "Rusfond"). The fund has been operating throughout the country since 1998.
• Charitable Foundation "Creation" (Moscow, Magnitogorskaya st., 9, office 620). Since 2001, the Foundation has been working with children who are undergoing treatment and rehabilitation with cerebral palsy in clinics across the country.
• Spread Your Wings Charitable Foundation (Moscow, Bolshoy Kharitonevsky lane, 24, building 11, office 22). The Foundation has been operating since 2000 and provides support to disabled children.
• Kindness Foundation (Moscow, Skatertny lane, 8/1, building 1, office 3). She has been working only with children with cerebral palsy since 2008.
• Charitable Foundation "Children of Russia" (Ekaterinburg, 8 March st., 37, office 406). Helping children with cerebral and other disorders of the central nervous system since 1999.
• Fund for helping children with cerebral palsy "Kovcheg" (Novosibirsk, Karl Marx str., 35). Helping families with children with cerebral palsy since 2013.

If you are going to write to the funds, you should definitely open a bank account with the target indication “for treatment”. You can send applications to all funds, the age of the children does not matter. Applications are accepted from mothers of infants and from parents of children under 18 years old.

What are the special devices for children with cerebral palsy to facilitate their independent movement, you will learn from the video below.

Cerebral palsy (ICP) is a general medical term that is used to refer to a group of motor disorders that progress in infants due to trauma to various areas of the brain in the perinatal period. The first symptoms of cerebral palsy can sometimes be detected after the birth of a child. But usually the signs of the disease appear in infants in infancy (up to 1 year).

Etiology

Cerebral palsy in a child progresses due to the fact that certain parts of his central nervous system were damaged directly in the prenatal period of development, during the birth process, or in the first months of his life (usually up to 1 year). In fact, the causes of cerebral palsy are quite diverse. But they all lead to one thing - some areas of the brain begin to function incompletely or completely die.

Causes of cerebral palsy in a child in the prenatal period:

• toxicosis;
• untimely detachment of the "children's place" (placenta);
• risk of miscarriage;
• nephropathy of pregnant women;
• trauma during childbearing;
• fetal hypoxia;
• fetoplacental insufficiency;
• the presence of somatic ailments in the mother of the child;
• rhesus conflict. This pathological condition develops due to the fact that the mother and child have different Rh factors, so her body rejects the fetus;
• ailments of an infectious nature that the expectant mother suffered during the gestation of the fetus. The most potentially dangerous pathologies include,;
• fetal hypoxia.

Causes that provoke cerebral palsy during labor:

• narrow pelvis (injury to the child's head during its passage through the mother's birth canal);
• birth injury;
• violation of labor activity;
• childbirth before the due date;
• large weight of the newborn;
• rapid childbirth - pose the greatest danger to the baby;
• breech presentation of the child.

The reasons for the progression of the disease in the first months of a newborn's life:

• defects in the development of elements of the respiratory system;
• asphyxia of newborns;
• aspiration of amniotic fluid;
• hemolytic disease.

Varieties

There are 5 forms of cerebral palsy, which differ from each other by the zone of brain damage:

• spastic diplegia. This form of cerebral palsy is diagnosed in newborns more often than others. The main reason for its progression is the traumatization of brain areas that are “responsible” for the motor activity of the limbs. A characteristic sign of the development of the disease in a child under one year old is partial or complete paralysis of the legs and arms;
• atonic-astatic form of cerebral palsy. In this case, there is damage to the cerebellum. Signs of cerebral palsy of this type - the patient cannot keep balance, coordination is impaired, muscle atony. All these symptoms appear in a baby under the age of one year;
• hemiparetic form. The “target” areas of the brain are the subcortical and cortical structures of one of the hemispheres responsible for motor activity;
• double hemiplegia. In this case, two hemispheres are affected at once. This form of cerebral palsy is the most severe;
• hyperkinetic form of cerebral palsy. In most clinical situations, it is combined with spastic diplegia. It develops due to damage to the subcortical centers. A characteristic symptom of the hyperkinetic form of cerebral palsy is the commission of involuntary and uncontrolled movements. It is noteworthy that such pathological activity can increase if a child less than a year old or older is worried or tired.

Classification based on the age of the child:

• early form. In this case, the symptoms of cerebral palsy are observed in a newborn in the period from birth to six months;
• initial residual form. The period of its manifestation is from 6 months to 2 years;
• late residual- from 24 months.

Symptoms

Cerebral palsy has many manifestations. The symptoms of the disease directly depend on the degree of damage to the structures of the brain, as well as on the location of the focus in this organ. You can notice the progression of cerebral palsy after birth, but more often it is detected after a couple of months, when it becomes clearly visible that the newborn is lagging behind in development.

Signs of cerebral palsy in a newborn:

• the baby is not at all interested in toys;
• the newborn does not roll over on its own for a long time and does not hold its head;
• if you try to put the baby, then he will not stand on the foot, but only on the toes;
• limb movements are chaotic.

Symptoms of cerebral palsy:

• paresis. Usually only half of the body, but sometimes they spread to the legs and arms. The affected limbs change - they shorten and become thinner. Characteristic deformations of the skeleton in children with cerebral palsy - deformity of the sternum;
• violation of the tone of muscle structures. A sick child has either spastic tension or complete hypotension. If there is hypertonicity, then the limbs take an unnatural position for them. With hypotension, the child is weak, there is a tremor, he can often fall, since the muscle structures of the legs do not support his body;
• pronounced pain syndrome. In children with cerebral palsy, it develops due to various bone deformities. The pain has a clear localization. It most commonly occurs in the shoulders, back, and neck;
• violation of the physiological process of swallowing food. This sign of cerebral palsy can be detected immediately after birth. Babies cannot fully suckle their mother's breasts, and babies do not drink from a bottle. This symptom occurs due to paresis of the muscular structures of the pharynx. It also causes salivation;
• violation of speech function. It occurs due to paresis of the vocal cords, throat, lips. Sometimes these elements are affected simultaneously;
• convulsive syndrome. Seizures occur at any time and at any age;
• chaotic pathological movements. The child makes sudden movements, can grimace, take certain poses, and so on;
• articular contractures;
• significant or moderate decrease in hearing function;
• developmental delay. This symptom of cerebral palsy does not occur in all sick children;
• decreased visual function. Often there is also strabismus;
• malfunction of the digestive tract;
• the patient involuntarily excretes excrement and urine;
• progression of endocrine diseases. Children with such a diagnosis are often diagnosed with dystrophy, growth retardation,.

Complications

Cerebral palsy is a chronic disease, but over time it does not progress. The patient's condition may worsen if secondary pathologies occur, such as hemorrhages, somatic ailments.

Complications of cerebral palsy:

• disability;
• violation of adaptation in society;
• the occurrence of muscle contractures;
• violation of food intake, as the paresis affected the muscles of the pharynx.

Diagnostic measures

The diagnosis of the disease is carried out by a neurologist. The standard diagnostic plan includes the following examination methods:

• careful inspection. A medical specialist evaluates reflexes, visual and hearing acuity, muscle function;
• electroencephalography;
• electroneurography;
• electromyography;

Additionally, the patient can be referred for consultations to narrow specialists:

• speech therapist;
• ophthalmologist;
• psychiatrist;
• epileptologist.

Therapeutic measures

It should be said right away that such a pathology cannot be completely cured. Therefore, the treatment of cerebral palsy is primarily aimed at reducing the manifestation of symptoms. Special rehabilitation complexes provide an opportunity to gradually develop speech, intellectual and motor skills.

Rehabilitation therapy consists of the following activities:

• sessions with a speech therapist. It is necessary for a sick child to normalize speech function;
• exercise therapy. A set of exercises is developed only by a specialist strictly individually for each patient. They must be performed daily in order for them to have the desired effect;
• massage for cerebral palsy is a very effective method of rehabilitation. Doctors resort to segmental, point and classical types. Massage with cerebral palsy should be carried out only by a highly qualified specialist;
• use of technical means. These include crutches, special inserts placed in shoes, walkers, and more.

Physiotherapeutic methods and animal therapy are also actively used in the treatment of cerebral palsy:

• hydrotherapy;
• oxygen barotherapy;
• mud treatment;
• electrical stimulation;
• warming up the body;
• electrophoresis with pharmaceuticals;
• dolphin therapy;
• hippotherapy. This is a modern method of treatment based on the patient's communication with horses.

Medical therapy:

• if a child has epileptic seizures of varying degrees of intensity, then he must be prescribed anticonvulsant drugs to stop the seizures;
• nootropic pharmaceuticals. The main purpose of their appointment is the normalization of blood circulation in the brain;
• muscle relaxants. These pharmaceuticals are prescribed to patients if they have hypertonicity of muscle structures;
• metabolic agents;
• antiparkinsonian drugs;
• antidepressants;
• neuroleptics;
• antispasmodics. These drugs are prescribed to the patient with a strong pain syndrome;
• analgesics;
• tranquilizers.

Medical specialists resort to surgical treatment of cerebral palsy only in severe clinical situations, when conservative therapy does not have the desired effect. They resort to the following types of interventions:

• brain surgery. Doctors carry out the destruction of structures that are the cause of the progression of neurological disorders;
• spinal rhizotomy. Doctors resort to this operable intervention in case of severe muscle hypertonicity and severe pain syndrome. Its essence lies in the interruption of pathological impulses that come from the spinal cord;
• tenotomy. The essence of the operation is to create a support position for the affected limb. It is prescribed if the patient develops contractures;
• sometimes specialists perform tendon or bone grafts to stabilize the skeleton a little.

About 30,000 patients with cerebral palsy (ICP) live in Ukraine. The capabilities of these people differ significantly: some are able to walk independently when others need constant support for this; some people manage without outside help in their daily lives, while others need a special, adapted environment for people with special needs.

Since the manifestations of the same disease vary so much, parents of children with cerebral palsy are looking for answers to fairly common and quite natural questions:

Why was I not offered a diagnosis of cerebral palsy during pregnancy?
Why are children born with cerebral palsy?
Why does my baby look and behave differently than his peer with the same diagnosis?

Actually, to answer them, we have prepared this article.

1. Causes of occurrence: the history of the study of cerebral palsy
2. Causes of cerebral palsy during pregnancy
3. Risk factors for cerebral palsy during pregnancy
4. Is it possible to diagnose cerebral palsy during pregnancy?
5. Causes of cerebral palsy during childbirth
6. Risk factors for cerebral palsy during childbirth
7. Causes of cerebral palsy after the birth of a child
8. Risk factors for cerebral palsy after childbirth
9. Is it possible to determine cerebral palsy in the first year of a child's life?
10. Myths about the causes of cerebral palsy

Causes of occurrence: the history of the study of cerebral palsy

For the first time, both cerebral palsy itself and its probable causes were described in 1843 by the British orthopedic surgeon John Little in a series of lectures "On the nature and treatment of deformities of the human skeleton." In one of the lectures, he describes the manifestations of spastic diplegia (one of the forms of cerebral palsy) in an infant, the causes of which he saw in a sharp lack of oxygen and mechanical trauma to the child's brain immediately before or during childbirth. Later, spastic diplegia was called Little's disease for a long time.

The term "cerebral palsy" appeared much later, namely in 1889. It was introduced into medical use by the Canadian physician-scientist William Osler. He was convinced that the main reason for the development of cerebral palsy is damage to the child's brain. Also, the founder of psychoanalysis, the most quoted psychiatrist in the world, Sigmund Freud, was interested in the problem of cerebral palsy. It was he who formed the theory regarding the period of occurrence of cerebral palsy. Freud was the first to suggest that the disease develops during pregnancy, and, as you know, over time, his hypothesis was fully confirmed.

Over time, the problem of cerebral palsy began to attract the attention of an increasing number of scientists. Gradually, new theories emerged. However, instead of joining forces to solve a common problem, medical professionals spent more time discussing and forming new theories. In order not only to generalize the already developed theoretical base, but also to systematize it, at the end of the 50s of the XX century, the Little Club appeared in London. Members of this club developed the Memorandum of Terminology and Classification of Cerebral Palsy, thanks to which researchers from different countries were able to use the same concepts in matters of cerebral palsy. It was a real breakthrough in the scientific world.

It is reliably known that all forms of cerebral palsy arise as a result of damage to the brain that develops. Thus, a logical question arises: if the premise is the same, why then are the manifestations of this disease so dissimilar? The fact is that cerebral palsy is a consequence of damage to different parts of the child's brain for various reasons.

Causes - what most likely causes the development of the disease.

Risk factors are a property, feature of a child, or any exposure to him, which increases the likelihood of developing a disease (according to the official definition of WHO).

It is worth noting that children who have risk factors do not necessarily have cerebral palsy. But still, they necessarily require special attention and regular examinations by qualified specialists who, if necessary, can help with diagnosis and the choice of the most effective treatment method.

Causes of cerebral palsy during pregnancy

The established causes of the threat of cerebral palsy include:

1. Infectious diseases of the mother during pregnancy.
Studies show that maternal infections during pregnancy increase the risk of brain damage to the fetus. The most important danger lies in the fact that an infectious disease of a pregnant woman can either be accompanied by any symptoms (for example, fever) or proceed without visible manifestations. Infectious pathogens that can cause cerebral palsy during pregnancy are the so-called TORCH infections (toxoplasma, rubella virus, cytomegalovirus, herpes simplex virus), as well as other bacteria and viruses.

2. 2. Genetic mutations.
Until recently, it was believed that only 1-2% of cases of the disease occur as a result of genetic mutations. However, in 2016, Australian scientists proved that the number of various mutations that can be called the cause of cerebral palsy reaches at least 14%.

3. 3. Fetal hypoxia.
Hypoxia is an insufficient amount of oxygen in the blood and tissues. It can be observed in the fetus throughout pregnancy due to various factors. A particular risk of developing hypoxia occurs with fetoplacental insufficiency. The fact is that the complex of symptoms that occurs in this condition develops as a result of the pathology of the placenta. This organ is especially important for a child, because it receives oxygen in the womb through the placenta. Hypoxia is dangerous because of the significant damage done to internal organs, primarily to the brain.

4. Congenital malformations of the brain
Even the slightest movement arises as a result of the complex work of the pathways of the nervous system. Therefore, an anomaly in the structure of the center of the pathways, the brain, can be manifested by motor disorders. The study also confirms this: in people with cerebral palsy, congenital malformations of the brain are more common.

Risk factors for cerebral palsy during pregnancy

1. Different Rh factor or blood type in mother and child
There are cases when mother and child have different Rh factor or blood type. As a result of this condition, the child's blood cells are destroyed and there is a threat of severe jaundice (why it is dangerous for the child, read here). Therefore, if this condition is likely to develop, special control is necessary even during pregnancy and constant monitoring of the baby after birth.

2. Multiple pregnancy
When pregnant with more than one child, children with the threat of cerebral palsy are born 12 times more often. If one of the twins dies, this risk increases by 108 times.

3. Maternal comorbidities
The risk of having children with the threat of developing cerebral palsy is increased by certain diseases of the mother. These include epilepsy, thyroid disease, obesity, blood clotting disorders, hypertension, heart disease, diabetes mellitus, anemia, and occupational diseases (for example, when working with heavy metals or vibration).

4. Bad habits of the mother
The interdependence between smoking, alcohol or drug use by expectant mothers and the birth of children with cerebral palsy has already been proven. The fact is that these substances are extremely toxic. They can not only cause hypoxia, but also be risk factors for congenital malformations of internal organs.

5. 5. Environmental factors
Although indirectly, everything that surrounds the expectant mother during pregnancy can also affect the health of the baby. Factors that affect the risk of cerebral palsy during pregnancy are socio-economic conditions, the quality of medical services, and even the environmental features of the place of residence of a pregnant woman.

Is it possible to diagnose cerebral palsy during pregnancy?

One of the most common questions from parents is: “Was it possible to detect cerebral palsy during pregnancy?” Unfortunately, this is not always possible. However, routine medical examinations, as well as the results of tests and ultrasound diagnostics, may indicate the likelihood of developing a pathology in the fetus. Therefore, it is very important that specialized specialists constantly monitor the condition of the expectant mother to assess the existing risk factors.

Causes of cerebral palsy during childbirth

About 20 years ago, there was a popular theory that the most common cause of the birth of children with cerebral palsy is a difficult birth. But today it is known that in fact the risk of this disease during childbirth is only 10-20% (according to a report by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics).

The main reason for the development of cerebral palsy during childbirth is asphyxia - an acute lack of oxygen in the blood and tissues of the child. It is especially dangerous for the brain, which is sensitive to even a slight lack of oxygen. Asphyxia occurs due to complications that occur during childbirth - for example, with placental abruption, abnormal labor, head trauma to a newborn baby.

Risk factors for developing cerebral palsy during childbirth
1. Complicated childbirth
There are cases when, even with the normal course of pregnancy, childbirth takes place with various complications. This creates the basis for the development of hypoxia and asphyxia. The most dangerous complications can be preterm labor (before 37 weeks of pregnancy), eclampsia, uterine rupture, umbilical cord pathology (knots of the umbilical cord, entanglement around the neck of the fetus, prolapse of the umbilical cord) and placenta (for example, its detachment).

2. Low or overweight baby at birth
Newborns with low (less than 2500 grams) and overweight (more than 4000 grams) have a higher risk of cerebral palsy. A large difference in weight compared to the norm only increases this risk.

3. Breech presentation of the fetus
The physiological intrauterine position for the fetus is head presentation. Other types of presentation, especially breech presentation, can complicate the course of labor and make it much longer. This creates dangerous prerequisites for the possible development of asphyxia.

4. Birth trauma
Unfortunately, it happens that during childbirth there is an injury to the brain of the child, which can be a risk factor for the onset of the disease. For example, this can happen if a vacuum extractor or obstetrical forceps is used incorrectly.

Causes of cerebral palsy after the birth of a child

Already after birth, in the first years of a child's life, some circumstances can create a threat of cerebral palsy. According to statistics, this is 5-10% of all cases. Why is this happening?

1. Severe jaundice.
The reason for the specific color of the skin in jaundice is an increase in bilirubin. In the case when this increase is several times higher than normal and jaundice is not treated properly, bilirubin can cause irreparable damage to the developing brain. Most often, a severe course of jaundice leads to a dyskinetic form of cerebral palsy.

2. Acute cerebrovascular accident
Usually this situation occurs due to concomitant diseases that are not always possible to detect in time. These diseases include abnormal development of cerebral vessels, heart defects, and blood diseases. In this case, there is a risk of developing cerebral palsy due to cerebral hemorrhage, which can even happen spontaneously.

3. Brain injury
Injury to the child's brain (for example, in a fall or car accident) can lead to symptoms that are characteristic of cerebral palsy.

4. Infectious disease of the brain of a child
Bacterial meningitis and viral encephalitis are infectious diseases that affect the brain. They can cause a delay in motor and mental development and even the loss of already acquired skills.

Risk factors for cerebral palsy after childbirth:
1. Different Rh factor or blood type in mother and child (see here).
2.2. Lack of vaccination of the child.. Many infectious diseases that can lead to inflammation of the brain and its membranes (meningococcal infection, tuberculosis, poliomyelitis, measles) can be prevented by creating active immunity through vaccination.

3. Diseases of the child's blood.
Some rare blood disorders, such as thrombophilia or sickle cell anemia, can cause acute cerebrovascular accident. This dangerous condition is the first signal of a disease, which, unfortunately, is not always possible to suspect.

4. Insufficient prevention of childhood injuries
Even an ordinary everyday situation can cause a traumatic head injury, which is so dangerous for the developing brain. Therefore, it must be remembered that failure to use car seats when transporting a child, high changing tables and the lack of barriers in the crib can lead to serious injury.

It should be noted that it is difficult, and sometimes even impossible, to determine the exact cause of the birth of a child with cerebral palsy, as well as the time of the onset of the disease. The causes and risk factors listed above do not necessarily act separately - their combination is possible, which causes each individual clinical picture.

Is it possible to determine cerebral palsy in the first year of a child's life?

Basically, doctors diagnose children from 12 to 24 months. However, even if it is impossible to determine cerebral palsy before this date, with the help of a detailed neurological examination and the latest diagnostic methods, it is possible to determine the risk of developing the disease in the first months of life and begin treatment of the child.

There is no need to despair because your child has suspected cerebral palsy. The earlier it is known about the possibility of the occurrence of pathology, the faster measures can be taken to improve the health, motor and psychoverbal development of the baby.

Myths about the causes of cerebral palsy

Finally, let's look at a few myths about the causes of cerebral palsy.

Myth #1: Cerebral palsy is a rare disease.
Sometimes parents who have children with cerebral palsy may think that this is a rare disease. However, cerebral palsy is the most common cause of movement disorder causing disability in children. Sometimes it is not at all obvious that a person is diagnosed with cerebral palsy, because its manifestations can be minimal.

Myth No. 2. If a baby was born with cerebral palsy, there is a high probability of a disease for the unborn child in this family.
Cerebral palsy is not a hereditary disease. There is only a 1% chance that children with cerebral palsy will have brothers or sisters with the same disease in the future.

Myth #3: Vaccination causes cerebral palsy.
There is no clinical or experimental evidence of a relationship between vaccination and cerebral palsy. At the same time, an infection, the development of which can be prevented by the introduction of a vaccine, is one of the causes of cerebral palsy.

Myth number 4. Cerebral palsy is "contagious."
Due to the important role of viruses and bacteria in the development of cerebral palsy, there may be an erroneous opinion that this disease can be "infected". But, of course, this is not at all the case, because cerebral palsy is a non-communicable disease.

We hope that the information was useful and helped at least a little to answer such important questions about cerebral palsy. We look forward to your feedback and suggestions about the next topic of our blog. Thank you for your attention and we wish health to your children.

Cerebral palsy (CP) is not one disease, but a group of movement disorders. Deviations occur during the perinatal period (from 22 weeks of pregnancy to the seventh day after birth). In sick children, there are delays in physical development, speech disorders, dysfunction of the motor system.

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General characteristics of cerebral palsy

Cerebral palsy may include different types of deviations: paralysis and paresis, changes in the musculoskeletal system, speech disorders, unsteady walking, etc.

Children with cerebral palsy may develop mental disorders, epilepsy. Vision and hearing deteriorate. These problems arise as a result of brain damage.

The more extensive and serious the lesion, the more dangerous the disturbances in the body. Cerebral palsy cannot develop because damage to brain structures is always limited.

Note! As he grows older, it may seem that his condition has only worsened. In fact, impairments become more pronounced against the backdrop of learning and communication difficulties. These problems are invisible until the baby can walk and eat on his own.

Diagnosis of deviation is made using clinical and anamnestic data. People who have been diagnosed with a pathology must continuously undergo rehabilitation. They need permanent treatment.

World statistics registers 1 case of pathology per 1000. In Russia, this figure is 2-6 cases per 1000. Premature babies suffer from this deviation 10 times more often. Recent studies have shown that half of all children with cerebral palsy were born prematurely.

Cerebral palsy is one of the leading problems in modern pediatrics. Scientists argue that sick children appear more often not only because of the deterioration of the environment, but also because of the medical methods of neonatology, which allow nursing babies with various serious pathologies.

Forms of cerebral palsy

This form is characterized by damage to the lower extremities, hands and face are not so badly damaged. Spastic diplegia treatable. Rehabilitation is the faster, the better the hands are developed.

Quite common and atactic form of cerebral palsy. In patients, muscle tone is very low, but tendon reflexes are quite pronounced. In children, speech is poorly developed due to damage to the vocal cords. The reason for this condition is insufficient oxygen supply to the fetus during pregnancy, trauma to the frontal lobe of the brain.

Causes of cerebral palsy in newborns

Sick children usually appear due to prematurity. Immediate causes of cerebral palsy during pregnancy:

1. Violations in the structure of the brain.
2. Oxygen starvation of the fetus during pregnancy.
3. Venereal diseases in the mother (the most dangerous infection is genital herpes).
4. Incompatibility of maternal and fetal blood groups.
5. Brain injuries received during gestation or during childbirth.
6. Toxic poisoning brain in infancy.
7. Incorrect birth.

It is believed that the presence of chronic serious diseases in the mother and the use of harmful substances are the main causes of cerebral palsy in newborns. Diseases such as anemia, hypertensive crisis, rubella, etc. cause lesions brain in the fetus.

Each case of cerebral palsy is individual. The exact cause of the appearance of deviations is usually not exactly known, since, as a rule, several adverse factors act on the body of the mother and fetus.

There is a misconception that pathology occurs due to problems with blood vessels. But this is not true, since all the vessels in young children are very pliable and extensible, they cannot be damaged on their own. Violations in the vascular system of an infant can appear only as a result of traumatic exposure.

To successfully treat cerebral palsy, specialists need to establish root cause occurrence of deviations.

Symptoms of cerebral palsy

It is very important to identify the main symptoms as early as possible and make a diagnosis. Doctors recommend having a special baby diary where it is necessary to record all the achievements of the child.

Parents should carefully monitor the manifestation of absolute reflexes that occur immediately after birth. Attention should also be paid to fading reflexes.

For example, the palmar-mouth reflex should disappear in the second month. If it remains until the sixth month, then the baby most likely has a dysfunction of the nervous system. It is important to monitor the development of the baby's speech, his mobility and the emergence of various skills. The diary should include any suspicious behavior:

• head nodding;
• uncontrolled movements;
• staying in one position for a long time;
• lack of contact between mother and baby.

Children's doctors are not always in a hurry to diagnose cerebral palsy. Most often, when specific signs are found, the pediatrician puts encephalopathy to a child under the age of one year. The baby's brain has great compensatory abilities, it can completely get rid of the consequences of damage.

If there are no changes in development (the child does not speak, does not walk, does not sit, etc.), then cerebral palsy is diagnosed.

Treatment

Most often, the diagnosis of "Infantile cerebral palsy" is not a sentence. If you approach the treatment of deviations in a comprehensive and correct way, conduct active rehabilitation. Adult with cerebral palsy can be a perfect person able to start a family and achieve career success. Paralysis remains with a person forever, but its negative impact can be minimized by timely treatment. To achieve a good result, it is necessary to diagnose the pathology in time and start therapy as soon as possible.

Adults with cerebral palsy who have completed the main intensive course of treatment in childhood, they can become full members of society.

The sick pass a course of treatment special preparations, they are given massages that normalize muscle tone.

Regular exercise therapy is needed, as well as exercises that help adjust motor skills. Classes with a speech therapist and a psychologist are required. In some cases, the intervention of a surgeon is required.

Intensive rehabilitation measures should be carried out up to up to eight years when the brain is in the stage of active development. At this time, healthy parts of the brain take over the functions of the damaged ones.

The treatment course is almost always aimed at improvement of motor skills for every patient. Restorative measures need to be carried out throughout life, but in childhood they should be given the most attention. Only in this way will rehabilitation be as effective as possible.

Recently, therapeutic methods are often practiced, which are built in contact with animals. Such communication positively affects the mood, his psyche. Such methods can be switched only with the permission of a doctor.

Doctors often prescribe voit and bobat therapy. These are healing practices aimed at stimulating movements associated with unconditioned reflexes. The purpose of these techniques is to bring the patient's motor activity to a normal state, to form habits.

There are special tracksuits, designed for children with disorders in the musculoskeletal system. For example, Adele or Gravistat. They help to correct incorrect positions of the limbs, bring muscle tone back to normal due to their stretching. The correct position of the torso, legs, arms is established with the help of special clamps, springs. The patient is in a medical suit for some time and tries to move. Treatment with this method is carried out in courses, staying in a suit becomes longer with each subsequent session.

Operations of this kind are very complex, their essence lies in the destruction of certain brain structures that are responsible for the production of pathological signals. Implants that suppress impulses are sometimes implanted.

Surgical intervention an orthopedist is needed in cases where it is necessary to eliminate deformities of the arms, legs and joints. They are made in order to facilitate walking and any other movement. For example, surgery on the Achilles tendon helps to restore the correct position of the foot.

Most of the therapeutic measures are applied in special medical institutions for children with cerebral palsy. Treatment methods should be practiced at home.

Note! The most favorable is sanatorium treatment. Sanatoriums specializing in children with paralysis have special equipment and the best conditions for effective treatment.

Cerebral palsy needs to be treated as soon as the diagnosis is made. If nothing is done, then condition may worsen due to developmental disorders. Such a baby will need to be treated not only for paralysis, but also for acquired orthopedic problems.

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