What forms of cerebral palsy exist and what is their difference. Classification of various forms and types of cerebral palsy and their characteristics What is cerebral palsy disease in children

First signs of cerebral palsy can be detected in newborns in the first days of life and up to one year. Professionals and even parents can determine the presence of the disease in the early stages of development, which is necessary to prevent exacerbations. Cerebral palsy in children often manifests itself as a complex of symptoms that need to be recognized in a short time.

Doctors do not always examine the child properly in order to promptly identify symptoms of cerebral palsy. Parents spend a lot of time with their baby, which gives them a chance to independently detect the disease. Most characteristic appearances cerebral palsy in young years:

1. Inability to detect folds between buttocks.
2. Lack of lumbar curve.
3. Asymmetry of two areas of the body.

In the first days of life with severe cerebral palsy, the following signs can be diagnosed:

1. Excessive muscle tone or being too relaxed.
2. In the first days of life, optimal muscle tone is visible, but disappears after some time.
3. If hypertonicity occurs, the child’s movements look unnatural and are often carried out too slowly.
4. Unconditioned reflexes do not disappear, and the child does not begin to sit or hold his head up on his own for too long.
5. Asymmetry of various parts of the body. On the one hand, symptoms of hypertonicity occur, on the other, muscle weakening may follow.
6. Muscle twitching, in some cases complete or partial paralysis is possible.
7. Unreasonably increased anxiety, frequent loss of appetite.

On a note! If a child actively uses only one side of the body, gradual muscle atrophy occurs on the other part, the limbs do not develop fully, and often do not grow to the required parameters. There is a curvature of the spine, disturbances in the function and structure of the hip joints.

Most often, cerebral palsy in children is detected quickly, since they make active movements with the limbs located on one side. Often patients hardly use the arm with weakened tone, which is rarely separated from the body. The child does not turn his head without great effort, even several months after birth. Often parents need to turn their baby over on their own from time to time.

Even if you don't notice danger signs or if you doubt their presence, you need to regularly check diagnostic examinations. Be attentive to the health of the child if he was born premature, develops too slowly, or you notice problems during childbirth.

On a note! If you discover serious deviations in the development or behavioral characteristics of the baby, you should consult a doctor for advice.

Methods self-diagnosis cerebral palsy:

How to identify cerebral palsy in a three-month-old child?

In the period from 3 months to six months, the child exhibits congenital reflexes, including hand-to-mouth and heel reflexes. The presence of the first can be checked by pressing your fingers on inner part brushes, while the child opens his mouth. To check for the presence of a heel reflex, you need to lift the child by placing him on his feet. Usually babies try to move around. IN healthy condition the child stands on his full foot. If cerebral palsy manifests itself, he rests only on his fingertips or cannot use his legs for support at all.

At 3 months, cerebral palsy can be quickly diagnosed if the child actively uses only one side of the body. In many cases, this symptom can be detected within a few days after the baby is born. Insufficient muscle tone on the one hand and hypertonicity on the other are caused by pathologies of the relationship between the two hemispheres of the brain.

If the innervation is carried out incorrectly, the child's movements become clumsy, he uses opposite parts of the body in different ways, and an inhibited reaction appears. Manifestations of cerebral palsy can be seen even on the face. Maybe complete absence chewing muscles, which causes asymmetry of the facial muscles. Strabismus often develops.

On a note! Sick children often cannot sit independently, and this deviation can persist for up to six months or longer.

How to recognize cerebral palsy in an infant?

If brain damage is minimal, typical symptoms it is difficult to identify not only parents, but even professional specialists. Clumsy movements, overexertion muscle tissue are observed only with severe damage to brain cells.

You can suspect the presence of brain disorders if you have the following symptoms:

1. Sleep pathologies.
2. Inability to roll over independently.
3. The child cannot hold his head up.
4. Conditioned reflexes apply to only one side of the body.
5. The baby often remains in one position without moving for a long time.
6. Periodically there are cramps in the limbs.
7. Facial asymmetry varying degrees expressiveness.
8. The limbs vary in length.

Common signs of cerebral palsy

The clinical picture may vary depending on the form of the disease. Each of them is characterized specific symptoms, affecting the child’s life in different ways.

Diplegic form

Occurs when brain damage occurs during intrauterine development. These disorders can be noticed by muscle hypertonicity. Sick children are in a characteristic position, as their legs are extended and often crossed.

Until one year of age, you may notice that the child practically does not use lower limbs when moving. Often children do not try to sit up or even roll over. As the course of the disease worsens, serious deviations in physical development may develop.

It is quite easy to detect the presence of this form of the disease. To do this, it is enough to try to put the child on his feet. In this case it appears sharp increase muscle tone. The child moves, while leaning only on tiptoes. The gait is unsteady; with each new step, the child touches one foot with the other, moving the limbs straight in front of him.

On a note! In the diplegic form of the disease, deviations in mental development often appear.

Hemiplegic form

The disease often occurs when one of the cerebral hemispheres is damaged. High risk development of the hemiplegic form of cerebral palsy persists in children suffering from intrauterine infection. This disease can occur even with minor hemorrhage during childbirth.

The hemiplegic form of cerebral palsy is manifested by limited movements in the limbs, while persistently increased muscle tone remains. The child moves actively, but at the same time he is diagnosed with too frequent muscle contractions in the part of the body, the innervation of which is responsible for the affected area of ​​the brain.

Video - How to recognize cerebral palsy

Hyperkinetic form

Occurs when there are structural disorders of the subcortical ganglia responsible for innervation. Often the disease manifests itself as a result of negative immune activity in the mother’s body in relation to the child. In this case, the symptoms of cerebral palsy are also pronounced. The child’s muscle tone often stabilizes, but after a while it increases. In some cases, muscle tone does not increase, but decreases. The child's movements become awkward, he takes uncomfortable and unnatural poses. In many cases, with this form of the disease, intelligence is preserved, which is why the prognosis when carrying out timely treatment considered conditionally favorable.

When should you be wary?

There are several types of symptoms that can be used to determine the severity and form of the disease. Often negative signs appear very clearly, making them almost impossible not to notice even before the age of one year. In most cases, cerebral palsy manifests itself with severe symptoms; disorders often lead to impairment of motor and coordination functions.

Motor signs of cerebral palsy:

1. Hyperkinetic form of this disease.
2. Dystonia and related disorders.
3. Development of motor skills in only one limb.
4. Muscle spasticity.
5. Periodic appearance of paresis, paralysis.

Dystonia with cerebral palsy steadily progresses, after some time additional negative symptoms arise, which can lead to a number of complications. Often it is not cerebral palsy that progresses, but the disorders and diseases associated with it. During the active growth of the child, the intensity of negative symptoms can either increase or decrease.

Often cerebral palsy becomes more complicated after some time structural pathology joints, muscle disorders. These deviations are almost impossible to stop if you refuse to use surgical intervention.

On a note! Often, pathologies arise as a result of disruptions in the functioning of certain parts of the brain. As a result, patients suffer from malfunction muscles, deviations in the functioning of internal organs are also possible.

If disturbances in the functioning of the brain occur, the following disorders may form:

1. Non-standard, illogical behavior.
2. Inability to learn something new, speak simple words.
3. Intellectual failure.
4. Hearing impairment, speech pathology.
5. Regular occurrence of problems with swallowing.
6. Lack of appetite.

If cerebral palsy causes muscle and neurological disorders, the quality of life of children is greatly reduced. In some cases accompanying illnesses affect the human body more strongly than primary pathologies. Often cerebral palsy is accompanied by a decrease in intelligence, damage various structures brain.

Cerebral palsy in children is often characterized by standard features, but can occur in a unique pattern. To determine the presence of cerebral palsy, especially in mild forms, special tests are used. Based on a group of symptoms, a disease is identified. Doctors take into account a combination of signs from muscle tissue and nervous system.

To put accurate diagnosis to determine the dynamics of the development of the disease, doctors use various diagnostic measures. Negative signs often appear from the first days or weeks of a baby’s life. It is possible to make a diagnosis and characterize the course of the disease up to a year, but the information obtained is clarified at an older age.

Diagnosis of cerebral palsy is carried out using an assessment general condition brain. Modern instrumental technologies are used, including MRI, CT, ultrasound. Using data diagnostic studies Pathological foci, disturbances in the structure of the brain, as well as areas of hemorrhage can be identified.

Worsening clinical picture can be traced using neurophysiological research methods. Electromyography and similar measures are performed. Laboratory and genetic diagnostic methods are used to determine symptoms characteristic of cerebral palsy.

Ekaterina Morozova

Reading time: 8 minutes

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The term known in medicine as cerebral palsy does not mean one disease, as some might think, but a whole complex of diseases with disorders in various body systems.

The very first signs of cerebral palsy (note - not to be confused with infantile paralysis) can appear immediately after the baby is born. But, in most cases, the disease is detected a little later (but still in infancy).

What is the cause of the disease, and what is it?

What is cerebral palsy in a child - the main risks and consequences of cerebral palsy

The disease, which in science was given the name cerebral palsy (note: cerebral palsy), is primarily characterized by early development: during development in the mother’s belly, at the time of birth or during the first months of life.

Regardless of the reasons for the development of the disease, there is a malfunction in certain areas of the brain or their complete destruction.

The disease is characterized...

• Early development.
• Damage to brain structures (approx. - spinal or brain).
• Impaired motor/muscular activity.
• Possible disturbances of the psyche, hearing and vision, as well as speech and coordination of movements.

It should be noted that cerebral palsy is not a genetic or contagious disease.

At the same time, despite the severity of the disease, it is amenable to rehabilitation, which allows one to correct symptoms and improve the child’s quality of life for his socialization to the possible extent.

It is noted that the highest percentage of cases is observed among boys.

What are the possible consequences of cerebral palsy?

First of all, the orthopedic consequences of the disease are noted. They are regarding violations motor activity become primary complications, and if promptly eliminated, it is quite possible to put the child in short time on your feet.

Dystrophic processes in skeletal muscles: this complication has highest value. In the absence of proper treatment, it leads to deformation of joints and bones - which, in turn, lead to impaired movement in general and provoke pain.

Other possible complications of the disease include:

1. Pathological muscle tone.
2. The appearance of seizures.
3. Having difficulty swallowing.
4. The appearance of uncontrolled movements.
5. Disorders of urination/defecation processes.
6. Developmental delay.
7. The appearance of problems with vision, speech and hearing.
8. Having problems of an emotional nature.

It is worth noting that the symptoms of cerebral palsy will not necessarily be severe - it all depends on the case. Signs of the disease can be barely noticeable - or be expressed in absolute disability, in accordance with the degree of damage to the central nervous system.

It is important to say that with cerebral palsy, despite the fact that it is chronic, there is no progression.

A worsening of the sick child’s condition can only be observed when secondary pathologies appear. For example, with hemorrhages, with epilepsy or somatic manifestations.

Main causes of cerebral palsy – who is at risk?

The key reason for the development of the disease is considered to be a developmental disorder - or complete death - of a specific part of the brain, acquired before - or immediately after - birth.

There are more than 100 factors that can influence the development of cerebral palsy. All these factors, potentially harmful to the baby’s nervous system, are combined in medicine into 3 groups.

Namely, factors that relate to...

• The course of pregnancy.
• The birth itself.
• The adaptation period of a newborn outside the womb during the 1st month of life (sometimes up to 2 years).

The reasons for the 1st group of factors include:

1. Late toxicosis.
2. Threat of miscarriage.
3. Rhesus conflict between mother and fetus (approx. – with negative rhesus mothers).
4. Fetal hypoxia.
5. Infectious diseases acquired during pregnancy. The most dangerous are rubella (if the mother did not have it in childhood), syphilis, and toxoplasmosis.
6. Injuries received by the mother during pregnancy.
7. Somatic diseases.
8. Early placental abruption.
9. Fetoplacental insufficiency.

The reasons of the 2nd group include:

1. Injuries to the baby's head that he received while passing through the mother's narrow pelvis.
2. Other birth injuries.
3. Breech presentation of the fetus.
4. Violation of labor activity.
5. The baby's weight is too high.
6. Premature birth.
7. And most dangerous factor- rapid birth.

The causes of the 3rd group were identified as:

1. Asphyxia of newborns.
2. Hemolytic disease (note – occurs against the background of Rh conflict).
3. Aspiration of amniotic fluid.
4. Developmental disorders respiratory system.
5. Drug stimulation of labor and acceleration of labor through puncture of the amniotic sac.
6. Serious illnesses suffered by the child (approx. - herpetic infection, meningitis or even encephalitis).
7. Baby's head injuries.
8. Previous poisoning (in a child) with lead.
9. Cases that could lead to brain hypoxia (note: blockage respiratory tract crumbs of something, drowning, etc.).

According to statistics, almost half of babies with cerebral palsy were born prematurely. Unfortunately, vulnerability is greatest due to incomplete development of systems and organs, which, alas, significantly increases the risk of oxygen starvation.

As for asphyxia during childbirth, it accounts for less than 10 percent of all cases of cerebral palsy.

Most common cause development of the disease are considered hidden infections in the mother (note - the degree of their toxic effect on the fetal brain is extremely high).

It is important to note that most of the listed risk factors cannot be called absolute.

In addition, the consequences of these factors can be, if not prevented, then at least minimized.

Forms of cerebral palsy

Experts identify several forms course of cerebral palsy, differing primarily in the area of ​​brain damage, as well as manifestations of the disease and other factors:

• Hyperkinetic. The causes of this form include Rh conflict, hypoxia, fetal poisoning with toxins, trauma at birth, fetal nutritional deficiency, etc. This form of the disease has 3 stages of development. At an early stage (approx. lasts 3-4 months), convulsions, disruptions in the respiratory system and arrhythmia are noted. initial stage(note - lasts 5-48 months) is characterized by pronounced muscle hypertonicity, and late - atrophy of individual muscles and consolidation of motor activity disorders. This form of the disease is considered the most susceptible to treatment.
• Atonic-static. With this form of the disease, low intelligence, a complete lack of interest in the outside world, and even aggressiveness are noted. Signs of the form are underdevelopment of speech and optic nerves, tremors of the limbs, high muscle tone, inability to walk or even sit, etc.
• Spastic diplegia. This form is the most common. It is characterized by damage to both sides of the body with emphasis on the legs, extremely rapid deformation of the joints, paresis vocal cords, impaired development of the psyche and body systems, mental retardation, etc. Treatment in this case is practically useless, but there are techniques that help the child adapt to the world.
• Spastic tetraparesis. The main signs are a decrease in the activity of all limbs with their subsequent deformation, pain and spasms, mental retardation, etc. The form of the disease requires continuous treatment to avoid serious deterioration in health.
• Atactic. This form also has several stages of development. And if at an early stage only poor posture and partial disturbances in normal movements may be observed, then at a severe stage the child is no longer able to care for himself or move at all. Unfortunately, symptoms do not appear immediately.
• Spastic-hyperkinetic. In this case they talk about mixed form disease, manifested in the manifestation spastic symptoms with hyperkinetic disease. Signs of the disease appear at an older age after a disruption in the development of any body system.
• Right-sided hemiparesis. A type of disease in which there is paralysis of the entire right side bodies. The causes are usually serious infections, trauma, stroke, tumor, diabetes or meningitis. Usually the disease manifests itself in adulthood.

Each form of cerebral palsy has its own characteristics, causes of development, symptoms and methods of treatment.

The development of the disease can occur in completely different ways, but it is important to recognize the signs in time and begin treatment immediately to avoid irreversible consequences.

Persistent treatment and regular classes can give tangible results in almost any form of cerebral palsy.

All information in the article is given exclusively in educational purposes, it may not be appropriate for your specific health circumstances and is not medical advice. The website сolady.ru reminds you that you should never delay or ignore visiting a doctor!

Cerebral palsy is one of the most common neurological disorders that prevent a child from fully developing and living. Cerebral palsy, or cerebral palsy for short, is a disorder of physical and mental functions in a child due to brain damage. Brain damage can occur during pregnancy and childbirth, as well as during the first year of life. According to statistics, up to 70% of all cases occur in the prenatal period, i.e. the lesion occurs during pregnancy (and in the first 3 months). Unfortunately, morbidity statistics are steadily increasing all over the world, but in Russia they do not yet exceed 2 patients per 1000 healthy people.

Cerebral palsy symptoms

It is impossible to recognize cerebral palsy during pregnancy; moreover, the first symptoms are noticed only in newborns, whose development is clearly behind the norm. Symptoms are usually divided into early and late.

Early symptoms:

• pathology of body position, pathological, the child cannot hold his head up, cannot roll over, does not crawl, does not sit, etc.);
• lack of hearing, hearing impairment;
• delayed psychomotor development;
• difficulties with feeding.

Late symptoms:

• skeletal deformity (curvature pelvic bones, shortening of one of the limbs, scoliosis, etc.);
• limitation of joint mobility;
• sensory organ disorders;
• convulsions;
• mental retardation;
• problems with bowel movements and urination.

Cerebral palsy causes

One of the most common causes is brain damage through infection. The greatest danger here is rubella, which the mother suffered during pregnancy. A pregnant woman herself can cope with the disease quickly and easily, but the disease can damage the brain of an unborn child. Very often, children who have had rubella in utero experience various disorders of organs and systems - hearing loss, heart disease, etc. The herpes virus can also damage a child’s brain in utero.

Another reason for the development of cerebral palsy is oxygen starvation () during passage through birth canal. This also includes head injuries during birth.

Development of cerebral palsy in postpartum period possibly due to meningitis and head injuries to the baby.

Other less common causes:

• Rhesus conflict;
• Hypoglycemia, hyperbilirubinemia;
• Radiation damage, x-rays, other effects of electromagnetic radiation;
• Poisoning during pregnancy;
• Genetic (damage to maternal or paternal chromosomes).

Must be installed immediately exact reason cerebral palsy, since the subsequent course of treatment and rehabilitation depends on the cause.

Types of cerebral palsy

There are three main types of cerebral palsy.

Athetoid (dyskinetic)

This is the most light form Cerebral palsy - disorders affect only the basal ganglia (a complex of subcortical neurons). Symptoms include muscle cramps, slight twitching of facial muscles, and slight hearing and speech disturbances. The intelligence and mental development of such children are no different from healthy ones. They can live a full life.

Ataxic (hypotonic)

This type of cerebral palsy is characterized by damage to the cerebellum and manifests itself as a violation of motor functions. First, it all starts with pathological muscle tone, then coordination of movements is disrupted. Moderate mental retardation is observed.

Spastic

The spastic type of cerebral palsy is characterized by decreased muscle tone and lethargy. This type, in turn, is divided into three types:

Quadriparesis– occurs as a result of problematic childbirth (hypoxia, damage) and is characterized by decreased muscle tone, the child cannot hold his head, his arms are bent at the elbows, his hands are clenched into a fist, and his legs are crossed due to constant spasms.

Hemiparesis- paralysis of one of the limbs. It is diagnosed only some time after the birth of the child, when an unnatural position of one of the limbs is observed.

Diplegia- paralysis of the lower and upper limbs, while the lower extremities are most affected. The child cannot walk and the mobility of his arms is limited.

In addition to the main types of cerebral palsy, there are also mixed forms, when a child is diagnosed with several types at once.

Treatment and care for children with cerebral palsy

Regardless of what form of cerebral palsy a child has, in 60% of cases he has
problems with mental development, even despite preserved intelligence. Such children should study in specialized schools, where specialists in this field find the right approach to the development of everyone individual child. Physiotherapists, teachers, psychologists and occupational therapists are responsible for the education and development of children with cerebral palsy in specialized schools.

Against the background of cerebral palsy, other pathologies arise that complicate the life of the child and parents. Constipation often occurs. In 40% of cases, epilepsy attacks occur, in 20% there are hearing impairments and strabismus. Speech may also be absent or delayed in development.

Treatment of cerebral palsy is based mainly on maintaining muscle elasticity and the development of normal physical and psychological health child.

After a full examination, doctors draw up an individual rehabilitation and treatment program and recommend specialized schools.

Of the medications, only antiepileptic drugs are needed if the child has epileptic seizures. It is also possible to prescribe muscle relaxants if the child has severe muscle cramps.

At long term diseases due to muscle paralysis or muscle weakness, muscle contractures occur, which are removed surgically. Regular physical therapy is necessary to prevent the formation of contractures.

Physiotherapy for cerebral palsy also prevents joint deformation and muscle atrophy. Used in physiotherapy various techniques, among which:

• Bobath technique (a special set of exercises and poses to improve muscle tone and motor skills);
• Peto's technique (dividing each movement into several motor acts and elaborating them);
• proprioceptive technique (pressure, touching, stretching, stimulation, allowing to reduce the degree of spasm or, conversely, lethargy).

Massage, electrophoresis, magnetic therapy, paraffin therapy, etc. are also used in the treatment of cerebral palsy.

Let's sum it up

Cerebral palsy is now successfully supported and treated. Modern techniques allow the child to fully develop and live. The most important thing is to detect pathology in time - the earlier the disease is detected, the better the prognosis for treatment. As practice shows, despite restrictions in movement, children diagnosed with cerebral palsy are very active, cheerful and cheerful. All they need is the love and support of their parents!

Cerebral palsy, or cerebral palsy, is a pathology of the central nervous system associated with underdevelopment of the brain, which is not progressive, but manifests itself as a lag in the physical and mental development of the baby.

Movement disorders may have varying degrees severity: from muscle twitching to paralysis and pronounced violation balance. Mental retardation and speech disorders also depend on the extent of brain damage.

In any case, cerebral palsy interferes normal development child and acquiring vital skills. According to statistics, the prevalence of cerebral palsy in Russia is 2 cases per 1000 children.

Causes

Brain damage can occur during fetal development (about 70% of all cases), or after birth. The first trimester of pregnancy is considered the most dangerous.

The most common cause is brain damage due to infection. The body of the pregnant woman herself can cope with the disease, but this does not protect the fetal brain from the damaging effects of the infection.

The following infections in pregnant women are important for the development of cerebral palsy:

• herpetic infection;
• toxoplasmosis.

Increase the risk of disease:

• late toxicosis;
• Rh conflict between mother and fetus;
• embryo development disorders;
• malposition;
• rapid or, conversely, protracted labor;
• severe jaundice of the newborn;
• birth injuries.

All listed states lead to oxygen starvation(hypoxia), which contributes to disruption of the anlage and subsequent development of the brain.

Factors increased risk are also:

• endocrine pathology of the mother (especially hypothyroidism);
• dementia and epilepsy;
• bad habits (drug addiction and alcoholism);
• long-term infertility;
• stressful situations;
• The age of the pregnant woman is under 18 years and over 40 years.

During the birth process, the occurrence of cerebral palsy may be associated with birth trauma or fetal hypoxia during protracted labor. In many cases, the cause of damage is a combination of several factors.

In rare cases, the pathology can be caused by radiation and x-ray exposure or other electromagnetic radiation; women during pregnancy; .

After the birth of a child, the cause of brain damage can be meningoencephalitis (inflammation of the membranes and substance of the brain) and traumatic brain injury.

Symptoms

It is impossible to determine cerebral palsy before the birth of a child. As a rule, the first manifestations of the disease are noticed only when the baby lags behind in physical and psychomotor development.

Signs of cerebral palsy are divided into early and late. The timing of the onset of symptoms and their nature depend on the severity and location of the underdeveloped areas of the brain. The severity of manifestations can also vary: from mild to very severe.

TO early symptoms relate:

• violation of muscle tone in a newborn: the child does not hold his head up as expected, cannot roll over on his own, and subsequently cannot crawl or sit;
• hearing impairment up to complete loss;
• delayed psychomotor development, including speech, lack of interest in toys;
• difficulties in developing feeding skills.

TO late signs can be attributed:

• the appearance of skeletal deformities: scoliosis, shortening of limbs, etc.;
• impaired mobility in joints;
• convulsions and epileptic attacks (in 40% of cases);
• delayed intellectual development;
• impairment of hearing, vision and other sense organs (in 20% of cases);
• increased salivation;
• and defecation.

Most of all, impaired functions of the musculoskeletal system become noticeable: in addition to increased tone muscles, involuntary twitching may occur, and limbs may move poorly or not move at all. The child cannot stand on his feet or rests only on his toes, and cannot hold a toy in his hand.

Stiffness in the joints further limits movement. Developed paralysis of the limbs makes them thin and shortened. It is possible that epileptic seizures. Strabismus, decreased visual acuity, twitching may develop eyeballs and etc.

The child’s psyche is disturbed, his education becomes inaccessible due to restlessness and lack of concentration, and memory loss. He doesn’t like to draw or paint pictures and doesn’t know how.

With mild symptoms, the child is perceived as awkward and clumsy. He cannot catch the ball, kick it, and does not know how to hold a spoon in his hand correctly. The baby shows no interest in playing or communicating with other children.

Impaired coordination of movements leads to the fact that the child cannot fasten a button or tie a shoelace, cannot jump (over a jump rope or obstacle), and often bumps into objects.

Types of cerebral palsy

According to the classification, the following types of cerebral palsy are distinguished:

• Dyskinetic or athetoid: the mildest form of the disease, manifests itself in the form of convulsive muscle contractions, including twitching of facial muscles, mild speech and hearing impairments. The mental development of children does not suffer.
• Ataxic paralysis: caused by damage to the cerebellum, which leads to impaired coordination of movement. Mental retardation is moderate.
• The spastic type is characterized by lethargy and decreased muscle tone. Mental retardation is noted in 60% of cases. This type of cerebral palsy has 3 varieties:

Quadriparesis, or tetraparalysis: develops due to damage during childbirth; the child does not hold his head up, his arms are bent at the elbows, his fingers are clenched into fists, his legs are crossed;

Hemiparesis, or hemiplegia: it is noticed by the unnatural position of the limbs on one side;

Diplegia: damage to the upper or lower (more often) extremities, which is why the child does not walk.

May be marked mixed form and unspecified cerebral palsy.

The diagnosis is established on the basis of neurological disorders identified during examination by a neurologist, data additional examination(determination of the electrical potential of muscles, electroencephalography), results of examination by other specialists (orthopedist, ophthalmologist, ENT doctor, psychiatrist).

Treatment

To select individual treatment, the child’s identified disorders and physical abilities are assessed using special tests.

Since the vast majority of children with cerebral palsy have mental retardation and delayed speech development, their education is usually carried out in a specialized school or boarding school, where, in addition to teachers, psychologists, physiotherapists, speech therapists and other specialists work with them.

It is extremely important to begin treatment for cerebral palsy in early dates and carry out continuously, only in this case can you count on a favorable result. Complex treatment Each child is treated according to an individual plan.

It may include the following components:

• drug treatment;
• physiotherapy;
• orthopedic and surgery;
• physiotherapy;
• psychological help;
• classes with a speech therapist on speech development;
• Spa treatment.

The goal of treating a child with cerebral palsy is to improve muscle elasticity, increase the functionality of the musculoskeletal system and develop psychological health.

Drug treatment is symptomatic in cerebral palsy. It includes the use of brain metabolic drugs, neuroprotectors (Cerebrolysin, Ceraxon, Cortexin, Somazin, Piracetam, etc.), vascular agents(Actovegin).

In case of severe muscle spasm, muscle relaxants are used (Mydocalm, Baclofen, etc.), vitamin preparations(Neurovitan, B vitamins). In severe cases, small doses of botulinum toxin (Botox) can be administered to several points in the tense muscle.

For epileptic seizures, the doctor selects anticonvulsants(Lamotrigine, Toparamate, etc.). If necessary, painkillers, antidepressants or tranquilizers are prescribed.

Widely applied physiotherapeutic treatment , aimed at preventing deformation and contractures of joints and muscles. Used big number treatment methods:

• electrophoresis;
• paraffin therapy;
• applications with ozokerite;
• magnetic therapy;
• electrical stimulation of muscles;
• mud treatment and balneotherapy;
• massage.

In case of muscle contractures (limitation of movement in the joints), if joint dislocations occur, surgical treatment is possible: lengthening of tendons and muscles, bones (arthroplasty, achilloplasty), nerve surgery. In some cases, orthopedists use in treatment plaster casts and hardware development of joints.

Since 2006, a method of treating cerebral palsy with stem cell implantation began to be used. This technique is a method of biological “cleaning” of the central nervous system. In Russia, this treatment is carried out at the General Hospital of the Armed Police. About 3,000 children with different types Cerebral palsy, the effectiveness of treatment reaches 85% (according to the results for 2013).

The method is based on the ability of stem cells to independently differentiate and replace damaged nerve cells. In addition, these cells can repair damaged myelin sheath nerve cell and thereby ensure normal impulse conduction.

As a result of stem cell treatment, children's motor function(stability of posture in sitting and standing, walking improved, etc.), speech developed better and intellectual abilities, memory and concentration, squint decreased, salivation normalized.

Daily exercise is essential for treatment physical therapy, special sets of exercises of which are selected for each child. Wherein wide application finds the use of exercise equipment.

Psychological assistance is necessary at any age of the child. In case of speech impairment, the speech therapist also selects special exercises for daily speech development exercises.

The sanatorium-resort stage of treatment for children with cerebral palsy is carried out in sanatoriums in Odessa, Evpatoria, Truskavets, Saki, etc.

Often in early childhood the symptoms of cerebral palsy are almost invisible, but they become more pronounced as the child grows older. Children suffering from this disease begin to hold their head up, roll over, sit, crawl and walk later than others. But “baby” reflexes, which normally disappear at 6-8 months, persist longer. Often, by the age of one and a half years, such children control one hand much better than the other, since the other half of their body is too weak.

However, the muscles of a child suffering from cerebral palsy may not only be too relaxed. They may also be too tense. Both are called pathological muscle tone. Because of it, the child's arms and legs can take unnatural positions.

The movements of a person suffering from cerebral palsy are too sharp or, conversely, too slow. Quite often the child cannot control them.

Often those suffering from this disease experience skeletal deformities. Typically, the arm and leg on the affected side are somewhat shorter than on the healthy side. If this difference is not corrected, scoliosis may develop.

Many children suffering from cerebral palsy have mental development delays. However, if a child does not respond to his name, he may have problems not with mental development, but with hearing. It is too common pathology with cerebral palsy.

Some children are unable to speak normally due to an inability to move their lips and tongue correctly. They may also have problems initially with sucking and later with swallowing. These children often drool because they cannot swallow saliva. In this case, parents need to closely monitor the child while eating - there is a danger of suffocation due to the fact that food can get into the respiratory tract.

Approximately 30% of these children experience seizures. They can begin immediately after birth, or maybe after a few years. Often, cramps are not noticed, considering that they are simply involuntary movements of the arms or legs.

Approximately 75% of people with cerebral palsy have vision problems. Most often this is strabismus, which occurs due to weakness of the muscles that control eye movements. They often also have myopia.

Many people with cerebral palsy have dental caries. This occurs due to the inability to brush your teeth properly. Congenital deficiency of tooth enamel also plays a role in the occurrence of this disease.

Some children may have problems with urination and bowel movements because they cannot control the related muscles.

Description

For every 1000 children, approximately 2-3 children suffer from cerebral palsy. However, more of them are born - approximately 1.7-5.9 per 1000 births. It was previously thought that cerebral palsy developed due to problems during childbirth. Now it is known that improper childbirth, of course, plays a role in the development of this disease, but not the first one - in almost 80% of cases the disease begins in the prenatal period (before the birth of the child). There are many risk factors for this disease:

• premature birth;
• complications during childbirth;
• tight umbilical cord entanglement;
• the fruit is too large;
• narrow pelvis;
• low birth weight, especially if body weight is less than 1 kg;
• multiple fetuses (twins, triplets and more);
• congenital pathologies of the structure of the brain and spinal cord;
• cerebral circulatory disorders in the fetus;
• infectious diseases suffered by the mother during pregnancy;
• diseases thyroid gland and diabetes mellitus in the mother;
• hypertension, coronary heart disease, heart defects in the mother;
• smoking and drinking alcohol during pregnancy;
• Rh conflict between mother and fetus;
• hypo- and vitamin deficiencies in the mother;
• hemolytic disease of the newborn;
• poor environmental situation.

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

Spastic diplegia or Little's disease

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

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

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

Double hemiplegia

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

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

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

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

Hyperkinetic form

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

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

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

Convulsions in the hyperkinetic form are rare.

Atonic-astatic form

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

Intellect in this form suffers slightly.

Hemiplegic form

With this form, which occurs in 32% of cases, the child has unilateral paresis, that is, one arm and one leg on one side of the body are affected, and the arm suffers more. This form is often diagnosed at birth.

This form is characterized by speech impairment - the child cannot pronounce words normally.

Intelligence, memory and attention are reduced.

In 40-50% of cases, seizures are recorded, and the more frequent they are, the worse the prognosis of the disease.

There is also a mixed form (1% of cases), in which various forms of the disease are combined.

There are three stages of cerebral palsy:

• early;
• initial chronic-residual;
• final residual.

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

Diagnostics

You should contact a neurologist with suspected cerebral palsy if:

• at the age of 1 month, the child does not blink his eyes in response to a loud sound;
• at the age of 4 months the child does not turn his head towards the sound;
• at the age of 4 months the child does not reach for a toy;
• at the age of 7 months the child does not sit without support;
• at the age of 12 months the child does not speak words;
• at the age of 12 months the child does everything mainly with one hand;
• the child has seizures;
• the child has strabismus;
• the child’s movements are too sudden or too smooth;
• the child does not walk or walks incorrectly, for example, on tiptoes.

The doctor makes a diagnosis based on a thorough examination of the child, parental complaints, family history, as well as the course of pregnancy and childbirth. (electrophoresis, myostimulation) only if there are no seizures;

If necessary, carry out surgery- tendon-muscle plasty, elimination of contractures, myotomy (incision or separation of the muscle).

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