The main signs of cerebral palsy. Signs of cerebral palsy in a child depending on age

Doctors call cerebral palsy one of the most terrible diagnoses that can be made to a newborn - the causes of this disease in various forms continue to be discussed by doctors, as well as treatment methods. The only thing experts say with certainty is that cerebral palsy is not a hereditary disease. Who is at risk and is it possible to reduce the likelihood of this disorder in the fetus?

What is Cerebral Palsy

The abbreviation of cerebral palsy was assigned by experts to a group of symptom complexes that occur with motor disorders, devoid of a tendency to progress. However, this does not diminish the need for treatment of cerebral palsy, since a child who has been diagnosed with this diagnosis will show delays or other symptoms of mental and physical development as they grow older. The term "infantile paralysis" associated with poliomyelitis has nothing to do with this disease. It will show up as follows:

  • intelligence develops behind the norm;
  • problems with muscle tone, causing childhood disability;
  • violations of the emotional-volitional sphere;
  • epileptic seizures.

According to ICD-10, cerebral palsy has the code G-80 (neurological disease) and is divided into several forms. Focusing on them, it is convenient for specialists to group all the causes of cerebral palsy and select methods for treating cerebral palsy. According to the international classification, the following forms are distinguished:

  • 80.0 - tetraplegia (in clinical manifestations, there is an increase in muscle tone in the hands).
  • 80.1 - diplegia (among the main symptoms is hypertonicity of the muscles of the legs).
  • 80.2 - hemiplegic (spastic syndrome).
  • 80.3 - dyskinetic (hyperkinetic).
  • 80.4 - ataxic (atonic-astatic).
  • 80.8 - mixed.
  • 80.9 - unspecified.

Why does cerebral palsy occur in children

In cerebral palsy, there are brain disorders affecting the cortex, subcortical zones, capsules and trunk separately or together (determined by the form of the disease). Due to brain damage, there are also lesions of the nervous system, in which neuronal pathology appears (up to diffuse necrosis). What complications follow this depends on the form of cerebral palsy.

Causes of cerebral palsy in newborns

At the end of the 19th century, fetal asphyxia during childbirth was considered the main prerequisite for cerebral palsy, and doctors adhered to this theory for almost a century. The only one who spoke about risk factors during the prenatal period was Sigmund Freud. However, even in modern medicine there are difficulties with understanding cerebral palsy - the causes of this disease continue to be discussed by doctors. Doctors divide them into 3 categories:

  • Pathologies of fetal development during pregnancy (influence of intrauterine infections, chronic diseases of the mother, etc.)
  • Damage to the cerebral hemispheres during difficult childbirth (birth trauma, asphyxia, early birth).
  • External factors in the postpartum period (toxic damage or physical trauma to the brain).

Is it possible to detect cerebral palsy during pregnancy

Most parents want to know before the baby is born that he will be completely healthy, but with cerebral palsy this is difficult. The main part of the causes of this disease is prenatal in nature, so special care should be taken during childbirth and in preparation for them. When carrying a fetus, a woman can only try to prevent pathologies as much as possible with timely treatment, but even in the absence of therapy, these are not the key reasons for the birth of children with cerebral palsy.

Diagnosis of cerebral palsy in newborns

Children with paralysis at the age of 3-4 years can be recognized even by a photo, but at the time of birth only through a series of checks. The first is whether the baby has enough oxygen: if there is a deficiency, this can be considered a consequence of brain anomalies and a symptom of cerebral palsy. The key symptom of cerebral palsy is a disorder of muscle coordination, which manifests itself in the first days after birth. However, to diagnose the disease, you need to pay attention to a few more points:

  • muscle tone problem
  • thrown back head, flaccid or strongly bent limbs;
  • impaired reflexes of the newborn.

Causes of cerebral palsy during pregnancy

According to statistics, 60% of children born with cerebral palsy received it during the formation of the body in the womb. However, this is not enough for the appearance of cerebral palsy in a child - the causes of the prenatal onset of the disease must be combined with factors that occur during childbirth, or with postnatal ones. If we consider situations of cerebral palsy associated with pathologies of intrauterine development, they may occur due to:

  • chronic diseases of the mother;
  • infections transferred during pregnancy;
  • genetic factors;
  • complications during pregnancy.

The mother has a chronic disease

Doctors advise women planning a pregnancy to treat everything that can be treated in advance, not without reason: chronic diseases of the mother can negatively affect the formation and development of the fetus. The danger is not only diabetes mellitus and diseases of the endocrine system - doctors also include chronic hypertension, heart disease (especially congenital malformation), anemia, and overweight as risk factors for cerebral palsy of this type. However, this reason alone does not provoke the birth of a child with cerebral palsy.

Violation of the course of pregnancy

Toxicosis, preeclampsia and other problems that a woman may encounter are not only health problems - each of them is accompanied by a violation in the oxygen metabolism of tissues, as a result of which fetal hypoxia develops, or may be a prerequisite for placental insufficiency or placental abruption. These factors increase the risk of cerebral palsy - the causes of occurrence will lie in encephalopathy: a hypoxic-ischemic disorder that occurs in the fetal brain.

Lifestyle of the expectant mother

Taking medications, alcoholism, frequent stress, nicotine abuse, difficult working conditions and even physical injuries are things that a pregnant woman should be protected from. These factors are included among the causes of cerebral palsy, although they increase the risk of this pathology by only 10%. They are directly related to the complication of the course of pregnancy mentioned above, the consequence of which is a violation of the placental blood flow of the fetus and the risk of perinatal hypoxia.

hereditary predisposition

It is impossible to get cerebral palsy from the next of kin - the causes of its occurrence are not hereditary, but doctors do not exclude genetic factors. According to medical theory, the presence of defects in the chromosomes of the parents can affect the activation of pathological proteins, resulting in morphological changes in the body. However, doctors consider this cause of cerebral palsy to be the most controversial.

Breech presentation of the fetus

Normally, the baby should come out of the uterus head first, but this is not the only variant of his posture in the mother's womb. According to statistics, every 20th woman is faced with a breech presentation of the fetus: this can be diagnosed after the 36th week. The increased risk of a child with cerebral palsy with this diagnosis is due to 2 points:

  • During childbirth, going forward with the buttocks does not expand the woman's bone ring, therefore, with a narrow pelvis, this creates a prerequisite for birth trauma due to deformation of the skull and cervical region.
  • If the cause of the breech presentation is hydrocephalus and other developmental abnormalities, they increase the risk of brain disorders.

Prenatal factors of cerebral palsy

According to medical assumptions, the majority of patients with cerebral palsy - the causes of which are unclear due to the absence of problems with intrauterine development - owe the disease to birth injuries: they occupy a leading position among the prerequisites for acquired cerebral palsy. Brain damage in such a situation occurs due to:

  • violations of labor activity (including early childbirth);
  • child asphyxia;
  • spinal/cranial deformities.

preterm birth

In premature babies, according to statistics, the frequency of the diagnosis of cerebral palsy is significantly higher than in those born on time, which is explained by the imperfection of the vessels in the fetal brain. Their increased fragility leads to an increase in the likelihood of damage, and if birth trauma is added to this, brain pathology is almost inevitable. However, not every premature baby will have even a mild form of cerebral palsy - the causes of its occurrence in the prenatal period are more serious and are mainly associated with injuries.

Asphyxia of the newborn

Predominantly suffocation in a child during childbirth is preceded by early diagnosis of chronic oxygen deficiency in the fetus, however, in addition, problems with the placenta, cardiovascular and endocrine diseases of the mother can also be included here. Often, fetal asphyxia has causes in the prenatal period and is one of the main answers to the question of what causes cerebral palsy in newborns. However, its occurrence is not excluded even after the normal course of pregnancy during childbirth, which is facilitated by:

  • entanglement of the umbilical neck of the fetus;
  • breech presentation;
  • dysfunction of labor activity;
  • age of the pregnant woman - women over 30 years old are at risk.

birth trauma

If the doctor excludes congenital cerebral palsy by noting the normal course of pregnancy and fetal development, the problem may lie in birth injuries, which give both a mild form of the disease and a more serious condition. In a situation where the child steps forward with his feet, the doctor, even with careful actions, can provoke a sprain of the cervical region and deformation of the skull, which will lead to brain damage and acquired diseases of the nervous system. A similar scheme is possible with:

  • violation of labor activity;
  • fast / prolonged labor;
  • anhydrous childbirth.

Causes of cerebral palsy in children in the postpartum period

If the question of why children with cerebral palsy are born can be dealt with relatively quickly - intrauterine development disorders and the negative impact of birth trauma on the brain speak for themselves, then acquired cerebral palsy is absolutely unclear for most parents. Here, doctors identify some of the most obvious reasons:

  • inflammation of the subarachnoid zone of the brain;
  • physical / mechanical impact (injuries);
  • intoxication.

Toxic brain injury in hemolytic pregnancy

Rhesus conflict can make itself felt in the first days of a baby's life. Against its background, there is the development of jaundice in newborns and the accumulation of bilirubin, the danger of which is in the toxic damage to the nuclei of the brain. If the disease is recognized at an early stage, it is reversible, but later the affected areas die, which causes cerebral palsy.

Mechanical trauma to the head

Among the acquired causes of cerebral palsy, any injuries of newborns (even a slight blow) that affect the head in the first days of life are necessarily included. Against their background, due to the deterioration of blood circulation (in severe situations - hemorrhages), oxygen deficiency occurs, the functioning of the affected area of ​​the brain decreases, and motor and mental disorders appear.

Poisoning by drugs and toxic substances

In the first 4 weeks, the newborn is especially vulnerable, so taking medications (especially tranquilizers) by a breastfeeding mother is prohibited due to the risk of brain damage, especially if the pregnancy was difficult. No less dangerous for the baby are sepsis, alcohol and nicotine addictions of the mother, lead poisoning.

Video

Cerebral palsy (CP) is a neurological disease that has a group of permanent disorders, mostly associated with movement problems.

Signs of cerebral palsy appear at an early age and vary among different children, although in general they have a similar pattern of pathological abnormalities.

Disorders associated with cerebral palsy include poor coordination, neck stiffness, muscle weakness, and tremors. There may be problems with physical sensations, vision, hearing, swallowing, and speech.

Delays in the development of the child are among the first signs of cerebral palsy in an infant.

Signs of cerebral palsy in children under 1 year old and after a year will be considered further.

Every baby develops at a different rate. Some early developmental delays usually go away as the child matures, but missing important milestones may indicate underlying neurological disorders.

Lack of progress in physical development is one of the first signs that a child may develop cerebral palsy.

If parents are concerned that their child is not crawling, walking or talking during the period appropriate for his age, this is an occasion to contact specialists who will help monitor the development of the child and formulate the correct diagnosis.

Stages of child development

Child development is divided into 4 main stages:

  • physical growth;
  • cognitive (mental) development;
  • training in the skill of social interaction;
  • emotional growth.

Some children experience delays associated with physical growth, while others take longer to learn social or emotional interactions.

Every child's development is unique in its own way. However, knowing what is considered normal can help you recognize problems faster and take action.

The normal stages of a child's development refer to the general pattern of physical, emotional, intellectual, and social achievement that most children follow.

These stages are formulated on the basis of the average progress of the total number of children.

Signs of cerebral palsy in a newborn

It is rather difficult to determine the signs of cerebral palsy in a newborn baby before the first month of life, because. they appear only during the development of his nervous system in the form of the first deviations.

Determining the signs of cerebral palsy in newborns and older children is optimally carried out by the method of differential diagnosis. The presence of developmental abnormalities may indicate possible health problems.

The normal development of a newborn is considered if he:

  • has a normal tone in all muscles;
  • has no dysfunction of the pelvic area;
  • has no difficulty with vision and hearing;
  • makes smooth, controlled, not abrupt movements;
  • does not have involuntary muscle contractions or their increased tone.

Diagnosis of the health of older children is carried out in the same way.

2 months and older

  • requires head support
  • reacts to light
  • automatically folds hands without releasing them;
  • sharply pushes with legs, lying on his back;
  • screams when hungry and when uncomfortable;
  • starts smiling.

Signs of cerebral palsy in a child at 6 months

The normal development of a child at this age is considered if he:

  • sits with support;
  • holds the head independently;
  • communicates through "body language";
  • shows happiness and pleasure;
  • starts eating soft foods;
  • likes to play with people;
  • starts to "babble".

10 months and older

  • recognizes people's faces;
  • responds to own name;
  • sits down without assistance;
  • can roll over;
  • shifts objects from one hand to another;
  • begins to connect vowels when communicating.

12 months and older

The normal development of a child at this age is considered if he:

  • stands with support;
  • starts to crawl;
  • can use fingers independently;
  • understands some gestures;
  • knows his own name;
  • imitates parents;
  • displays emotions;
  • chooses toys;
  • plays peek-a-boo!;
  • visually alert.

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Up to 18 months

The normal development of a child at this age is considered if he:

  • begins to walk independently;
  • can pick up small items;
  • can use colored pencils and markers;
  • enjoys reading books to him;
  • has a vocabulary of up to 20 words;
  • can use cutlery;
  • imitates the sounds and actions of others;
  • responds to basic questions to him.

Children aged 18 months and over

The normal development of a baby at this age is considered if he:

  • plays with other people;
  • can "throw tantrums";
  • shows love;
  • starts working;
  • can climb stairs;
  • throws a ball;
  • vocabulary is replenished, speaks short phrases;
  • begins to create a kind of game;
  • can jump with both feet.

It should be noted that these stages of development are not comprehensive. Some children achieve the required milestones earlier or later than expected, but are still within the normal range of development.

Recognition of clear signs of cerebral palsy

As a rule, parents and caregivers can detect developmental delays in a child by comparing his development at certain stages with other children.

If the child seems to be lagging behind in some areas, especially in the motor area, this may be a symptom of cerebral palsy.

Recognizing the signs of cerebral palsy through careful observation of the child can lead to early diagnosis of the disease. The diagnosis of cerebral palsy in most children is recognized around the age of 18 months.

Common hallmarks of cerebral palsy include:

  • the child does not kick;
  • movements are excessively "rigid";
  • movements are lazy or weak-willed;
  • eye movement problems;
  • preference for movements on one side of the body;
  • no smile for three months;
  • the child cannot hold his head for three to six months;
  • does not bring his hand to his mouth at three months of age;
  • does not reach out to pick up an object;
  • not sensitive to sound or light;
  • delayed signs of communication;
  • unable to walk after 18 months;
  • does not have friendly relations with people;
  • he has no preferences for objects;
  • the child has “uncomfortable” or unusual muscle tone.

Cases of mild cerebral palsy take longer to diagnose because the signs and symptoms don't become sufficiently apparent until the baby is a little older. As a rule, these signs are reliably determined at preschool age.

Ages from birth to three years require careful observation. Parents should be vigilant if they notice that other children are ahead of their baby in development.

Early diagnosis of cerebral palsy increases the likelihood of improving a child's long-term quality of life.

What to do if the baby develops slowly?

Parents should find a pediatrician who:
  • experienced in diagnosing cerebral palsy and other movement disorders;
  • has a desire to build relationships with the family;
  • sensitive and compassionate to the child;
  • knows experts in other useful fields.

Finding a good doctor is one of the first steps in getting a proper diagnosis and treatment for your child.

Conclusion

Even though there is no cure for cerebral palsy, helping your baby early can help him learn to do some things that will help him manage some of the symptoms of the disease. This will help prevent possible problems and reveal the maximum possibilities of the child in the situation of his illness.

Physical therapy is one of the most important treatments. Medicinal methods, surgery, the use of special equipment and technical means can also help the child improve his quality of life in the long term.

Related video

CEREBRAL PALSY.

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

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

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

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

The WHO approved the following definition: “Cerebral palsy is a non-progressive disease of the brain that affects its departments that control movements and body position, the disease is acquired in the early stages of brain development”

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

Etiology and pathogenesis of cerebral palsy.

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

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

natal (during childbirth)

postnatal (after the birth of a child).

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

Natal from 27% to 40% of cases.

Postnatal - from 3 to 25%.

prenatal factors.

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

mother's bad habits;

taking various medications by a pregnant woman.

deviations and complications of the course of pregnancy;

The risk factor is the small weight of the fetus, early delivery, incorrect position of the fetus. It was found that a high percentage of children with cerebral palsy had low birth weight. The genetic factor is important, i.e. inheritance of congenital pathology of development.

natal factors.

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

postnatal factors.

Occur in the early stages of a child's life, even before the motor system is formed.

Skull injuries, neuroinfections (meningitis, encephalitis), drug intoxication (some antibiotics, etc.). Injury due to suffocation or drowning. Brain tumors, hydrocephalus.

In some cases, the etiology remains unclear, unknown.

The pathogenesis of cerebral palsy.

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

CLINICAL FORMS of cerebral palsy.

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

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

DOUBLE HEMIPLEGIA;

SPASTIC DIPLEGIA;

HEMIPARETIC FORM

HYPERKINETIC FORM

ATONIC - ASTATIC FORM

In practice, mixed forms of cerebral palsy are distinguished.

DOUBLE HEMIPLEGIA.

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

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

Clinical manifestations: Rigidity of the muscles (Rigidity - inflexibility, inflexibility, numbness due to muscle tension).

Tonic reflexes that have persisted for many years. Voluntary motor skills are absent or poorly developed. Children do not sit, do not stand, do not walk. Gross speech disorders, severe dysarthria up to anartria. Most children have severe mental retardation, which hinders the development of the child and aggravates the condition.

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

SPASTIC DIPLEGIA.

Known as LITTLE's disease or syndrome. The most common form of cerebral palsy. Spastic diplegia is characterized by tetraparesis when the arms and legs of both sides of the body are affected. The legs are more affected than the arms. The main clinical symptom is increased muscle tone, spasticity. There is a crossing of the legs during support. Limbs can freeze in the wrong position. In 70 - 80% of children, pronounced speech disorders in the form of spastic - paretic (pseudobulbar) dysarthria, sometimes motor alalia, delayed speech development. Early speech therapy significantly improves the state of speech. Mental disorders are manifested in the form of a delay in mental development, which can be compensated with corrective action. Children can study in special boarding schools for children with disorders of the musculoskeletal system or in general education schools. Some of the children have mental retardation, in which case they study according to the program of the VIII type school. This form of cerebral palsy is prognostically more favorable than double hemiplegia. 20 - 25% of children begin to sit, walk, but with a significant delay (by 2 - 3 years). The rest learn to move around using crutches or in a wheelchair. The child can learn to write, perform some self-service functions.

HEMIPARETIC FORM of cerebral palsy.

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

There are speech disorders in the form of motor alalia, dysgraphia, dyslexia, and counting disorders. Children have spastic-paretic (pseudobulbar) dysarthria.

Intellectual disabilities range from mild mental retardation to mental retardation.

The prognosis of motor development is favorable, children walk independently, master self-service skills.

HYPERKINETIC FORM of cerebral palsy.

Associated with damage to the subcortical regions of the brain. The cause of this form of cerebral palsy may be the incompatibility of the blood of the mother and fetus according to the Rh factor or hemorrhage in the region of the caudate body as a result of a birth injury. Motor disorders are manifested in the form of involuntary violent movements - hyperkinesis. The first hyperkinesias appear at 4-6 months more often in the muscles of the tongue, then by 10-18 months in other parts of the body. During the neonatal period, there is a reduced muscle tone, hypotension and dystonia. Hyperkinesis occurs involuntarily, intensifies with movement and excitement, with an attempt to move. At rest, hyperkinesis decreases and disappears during sleep.

In the hyperkinetic form, voluntary motor skills develop with great difficulty. Children can not learn to sit, stand, walk on their own for a long time. They begin to move independently only by 4-7 years. The gait is jerky, asymmetrical. Walking balance is easily disturbed, but standing is harder than walking. Difficulty automating motor skills, writing. Speech disorders in the form of hyperkinetic dysarthria (extrapyramidal, subcortical). Mental and intellectual disorders are manifested to a lesser extent than in other forms of cerebral palsy. Most children learn to walk independently, but voluntary movements, especially fine motor skills, are largely impaired. Children are educated either in a special school for children with NOD or in a public school. They can later study at a technical school or university. An insignificant part of the children study according to the program of the auxiliary school.

ATONIC - ASTATIC FORM of cerebral palsy.

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

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

MIXED FORM of cerebral palsy.

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

According to the severity of motor disorders, there are three degrees of severity of cerebral palsy.

Easy - a physical defect allows you to move around, have self-service skills.

Medium - children need the help of others.

Severe - children are entirely dependent on others.

The diagnosis that scares everyone and everyone is cerebral palsy. Causes, forms of cerebral palsy - these questions concern any modern parent if, during the bearing of a child, the doctor speaks of a high probability of such a deviation, or if he had to face it after birth.

What is this about?

Cerebral palsy is a collective term, it is applied to several types and types of conditions in which the human support system and the ability to move suffer. The cause of congenital cerebral palsy is damage to the brain centers responsible for the possibility of performing various voluntary movements. The patient's condition inexorably regresses, sooner or later the pathology becomes the cause of brain degeneration. Primary disorders occur even during the development of the fetus in the mother's body, somewhat less often cerebral palsy is explained by the characteristics of childbirth. There is a risk that the cause of cerebral palsy will be some events that happened to the child shortly after birth and negatively affected the health of the brain. External factors can have such an impact only in the early period after birth.

Even today, doctors know a huge number of factors that can provoke cerebral palsy. The reasons are varied, and protecting your child from them is not always easy. However, from medical statistics it is clear that most often the diagnosis is made to premature babies. Up to half of all cases with cerebral palsy are babies born prematurely. This reason is considered the most significant.

Factors and risks

Previously, of the reasons why children are born with cerebral palsy, the first and most important was the trauma received at the time of birth. It can be provoked by:

  • too fast birth;
  • technologies, methods used by obstetricians;
  • narrowed maternal pelvis;
  • abnormal pelvic anatomy of the mother.

Currently, doctors know for certain that birth injuries lead to cerebral palsy only in a very small percentage of cases. The predominant share is the specificity of the development of the child while in the mother's womb. Previously considered the main cause of cerebral palsy, the problem of childbirth (for example, prolonged, very difficult) is now classified as a consequence of violations that occurred during childbearing.

Let's consider this in more detail. Modern doctors, finding out with cerebral palsy, analyzed the statistics of the influence of autoimmune mechanisms. As it was found, some factors have a significant impact on the formation of tissues at the stage of the appearance of the embryo. Modern medicine believes that this is one of the reasons explaining a considerable percentage of cases of health deviations. Autoimmune disorders affect not only while in the mother's body, but also affect the child after childbirth.

Shortly after birth, a previously healthy child may become a victim of cerebral palsy due to infection, against which encephalitis has developed. Trouble can be caused by:

  • measles;
  • chicken pox;
  • flu.

It is known that the main causes of cerebral palsy include hemolytic disease, which manifests itself as jaundice due to insufficient functioning of the liver. Sometimes a child has an Rhesus conflict, which can also provoke cerebral palsy.

It is far from always possible to determine the reason why children are born with cerebral palsy. Doctors' comments are disappointing: even MRI and CT (the most effective and accurate research methods) cannot always provide enough data to form a complete picture.

The complexity of the question

If a person is different from those around him, he attracts attention to himself - this fact no one doubts. Children with cerebral palsy are always an object of interest to those around them, from laymen to professionals. The particular complexity of the disease lies in its effect on the whole organism. With cerebral palsy, the ability to control one's own body suffers, as the functionality of the central nervous system is impaired. Limbs, facial muscles do not obey the patient, and this is immediately evident. With cerebral palsy, half of all patients also have developmental delays:

  • speech;
  • intellect;
  • emotional background.

Often, cerebral palsy is accompanied by epilepsy, convulsions, tremors, an incorrectly formed body, disproportionate organs - the affected areas grow and develop much more slowly than healthy elements of the body. In some patients, the visual system is disturbed, in others cerebral palsy is the cause of mental, auditory, and swallowing disorders. Possible inadequate muscle tone or problems with urination, defecation. The strength of manifestations is determined by the magnitude of the violation of brain functionality.

Important nuances

There are cases when patients successfully adapted to society. They have access to a normal human life, full, filled with events, joys. Another scenario is also possible: if quite large areas of the brain were affected during cerebral palsy, this will be the reason for assigning the status of a disabled person. Such children are completely dependent on others, as they grow older, the dependence does not become weaker.

To some extent, the future of the child depends on his parents. There are some approaches, methods, technologies that allow to stabilize and improve the patient's condition. At the same time, one should not count on a miracle: the cause of cerebral palsy is a lesion of the central nervous system, that is, the disease cannot be cured.

Over time, in some children, the symptoms of cerebral palsy become more widespread. Doctors disagree on whether this can be considered the progress of the disease. On the one hand, the root cause does not change, but the child tries to learn new skills over time, often encountering failure along the way. Having met a child with cerebral palsy, you should not be afraid of him: the disease is not transmitted from person to person, it is not inherited, therefore, in fact, its only victim is the patient himself.

How to notice? The main symptoms of cerebral palsy

The cause of the violation is a malfunction of the central nervous system, leading to dysfunction of the motor brain centers. For the first time, symptoms can be seen in a baby at the age of three months. Such a child:

  • develops with a delay;
  • noticeably lagging behind peers;
  • suffers from convulsions;
  • makes strange, unusual movements for babies.

A distinctive feature of such an early age is increased cerebral compensatory capabilities, so the therapeutic course will be more effective if it is possible to make an early diagnosis. The later the disease is detected, the worse the prognosis.

Reasons and discussions

The cause of the main symptoms of cerebral palsy is a violation in the work of the brain centers. This can be provoked by a variety of injuries formed under the influence of a wide range of factors. Some appear during development in the mother's body, others at birth and shortly after. As a rule, cerebral palsy develops only in the first year of life, but no later. In most cases, dysfunction of the following brain regions is detected:

  • bark;
  • area under the bark;
  • brain stem;
  • capsules.

There is an opinion that the functionality of the spinal cord suffers with cerebral palsy, but there is no confirmation at the moment. Spinal cord injuries were found in only 1% of patients, so there is no way to conduct reliable studies.

Defects and pathologies

One of the most common reasons for the diagnosis of cerebral palsy is defects obtained during fetal development. Modern doctors know the following situations in which there is a high probability of deviations:

  • myelination is slower than normal;
  • abnormal cell division of the nervous system;
  • disruption of connections between neurons;
  • errors in the formation of blood vessels;
  • the toxic effect of indirect bilirubin, which led to tissue damage (observed with a conflict of Rh factors);
  • infection;
  • scarring;
  • neoplasms.

On average, in eight children out of ten patients, the cause of cerebral palsy is one of the indicated.

Especially dangerous infections are toxoplasmosis, influenza, rubella.

It is known that a child with cerebral palsy can be born to a woman suffering from the following diseases:

  • diabetes;
  • syphilis;
  • heart pathology;
  • vascular diseases.

Both infectious and chronic pathological processes in the mother's body are possible causes of cerebral palsy in a child.

The mother's body and the fetus may have conflicting antigens, Rh factors: this leads to severe health problems for the child, including cerebral palsy.

The risks are increased if during pregnancy a woman takes medications that can adversely affect the fetus. Similar dangers are associated with drinking and smoking. Finding out what causes cerebral palsy, doctors found that more often such children are born to women if the birth was postponed before the age of majority or over forty. At the same time, it cannot be said that the listed reasons are guaranteed to provoke cerebral palsy. All of them only increase the risk of deviations, they are recognized patterns that must be taken into account when planning a child and bearing a fetus.

I can not breathe!

Hypoxia is a common cause of cerebral palsy in children. The treatment of pathology, if it is provoked precisely by a lack of oxygen, is no different from other causes. As such, there will be no recovery over time, but with early detection of signs, an adequate course of patient rehabilitation can begin.

Hypoxia is possible both during gestation and during childbirth. If the child's weight is less than normal, there is every reason to assume that hypoxia accompanied a certain stage of pregnancy. Diseases of the heart, blood vessels, endocrine organs, virus infection, and kidney disorders can provoke the condition. Sometimes hypoxia is provoked by toxicosis in severe form or in the later stages. One of the causes of cerebral palsy in children is a violation of blood flow in the mother's small pelvis during childbearing.

These factors negatively affect the supply of blood to the placenta, from which the cells of the embryo receive nutrients and oxygen, which are vital for proper development. If the blood flow is disturbed, the metabolism weakens, the embryo develops slowly, there is a possibility of low weight or growth, impaired functionality of various systems and organs, including the central nervous system. They talk about underweight if the newborn weighs 2.5 kg or less. There is a classification:

  • children born before 37 weeks of gestation with adequate weight for their age;
  • premature babies with a small mass;
  • low birth weight babies born on time or late.

Hypoxia and developmental delay are discussed only in relation to the last two groups. The first is considered normal. For premature, born on time and later than the term of underweight children, the risk of developing cerebral palsy is estimated to be quite high.

The health of the child depends on the mother

Mostly the causes of cerebral palsy in children are due to the period of development in the mother's body. Anomalies in the fetus are possible under the influence of various factors, but most often the cause is:

  • the development of diabetes (violations on average - in three children out of a hundred born to mothers who suffered from gestational diabetes);
  • disturbances in the work of the heart and blood vessels (heart attack, sudden changes in the level of pressure);
  • infectious agent;
  • physical injury;
  • acute poisoning;
  • stress.

One of the risk factors is multiple pregnancy. This cause of cerebral palsy in newborns has the following explanation: when carrying several embryos at once, the mother's body is faced with increased load indicators, which means that the probability of having children prematurely, with low weight, is significantly higher.

Birth: not everything is so simple

A common cause of cerebral palsy in newborns is birth trauma. Despite the stereotypes that this is possible only in the event of an obstetrician's mistake, in practice, injuries are much more often explained by the characteristics of the mother's or child's body. For example, a woman in labor may have a very narrow pelvis. Another reason is also possible: the child is very large. During the birth, the body of a child may suffer, the harm done to it becomes the cause of various diseases. Often there are clinical manifestations of cerebral palsy in newborns for reasons:

  • incorrect position of the embryo in the uterus;
  • placing the head in the pelvis along the wrong axis;
  • too fast or very long labor;
  • use of unsuitable accessories;
  • obstetrician's mistakes;
  • asphyxia for various reasons.

Currently, caesarean section is considered one of the safest birth options, but even this approach cannot guarantee the absence of birth trauma. In particular, there is a possibility of damage to the vertebrae of the neck or chest. If at birth a caesarean section was resorted to, it is necessary to show the baby to an osteopath soon after birth to check the adequacy of the condition of the spine.

On average, cerebral palsy occurs in two girls out of a thousand, and for boys the frequency is slightly higher - three cases per thousand babies. There is an opinion that this difference is due to the large body size of boys, which means that the risk of injury is higher.

At present, it is impossible to insure against cerebral palsy, as there is no one hundred percent guarantee to foresee and prevent it. In an impressive percentage of cases, the causes of acquired cerebral palsy, congenital, can be established after the fact, when anomalies manifest themselves in the development of the child. In some cases, already during pregnancy there are signs indicating the likelihood of cerebral palsy, but in their bulk they cannot be corrected or are eliminated only with great difficulty. And yet, you should not despair: you can live with cerebral palsy, you can develop, be happy. In modern society, a rehabilitation program for such children is being actively promoted, equipment is being improved, which means that the negative impact of the disease is mitigated.

Relevance of the issue

Statistical studies show that, on average, under the age of one year, cerebral palsy is diagnosed with a frequency of up to 7 out of a thousand children. In our country, the average statistical indicators are up to 6 per thousand. Among preterm infants, the incidence is approximately ten times higher than the global average. Doctors believe that cerebral palsy is the first trouble among chronic diseases that affect children. To some extent, the disease is associated with environmental degradation; neonatology is recognized as a factor, since even children whose weight is only 500 g can survive in hospital conditions. Of course, this is a real progress in science and technology, but the frequency of cerebral palsy among such children, unfortunately, is significantly higher than average, so it is important not only to learn how to nurse children weighing so little, but also to develop ways to provide them with a full, healthy life.

Features of the disease

There are five types of cerebral palsy. The most common is spastic diplegia. Various experts estimate the frequency of such cases at 40-80% of the total number of diagnoses. This type of cerebral palsy is established if lesions of the brain centers cause paresis, from which the lower limbs primarily suffer.

One form of cerebral palsy is damage to the motor centers in one half of the brain. This allows you to set the hemiparetic type. Paresis is characteristic of only one half of the body, opposite to that cerebral hemisphere, which has suffered from aggressive factors.

Up to a quarter of all cases are hyperkinetic cerebral palsy, caused by a violation of the activity of the subcortex of the brain. Symptoms of the disease are involuntary movements that are activated if the patient is tired or excited.

If the disorders are concentrated in the cerebellum, the diagnosis sounds like "atonic-astatic cerebral palsy." The disease is expressed by static disorders, muscle atony, inability to coordinate movements. On average, this type of cerebral palsy is detected in one patient out of ten patients.

The most difficult case is double hemiplegia. Cerebral palsy is caused by an absolute violation of the functionality of the cerebral hemispheres, due to which the muscles are rigid. Such children cannot sit, stand, hold their heads.

In some cases, cerebral palsy develops according to a combined scenario, when symptoms of different forms appear simultaneously. Most often, the hyperkinetic type and spastic diplegia are combined.

Everything is individual

The degree of severity of deviations in cerebral palsy is different, and clinical manifestations depend not only on the localization of diseased brain areas, but also on the depth of disorders. There are cases when already in the first hours of life the health problems of the baby are visible, but in most cases it is possible to make a diagnosis only a few months after birth, when a developmental lag is noticeable.

It is possible to suspect cerebral palsy if the child does not have time in motor development for peers. For quite a long time, the baby cannot learn to hold the head (in some cases this does not happen). He is not interested in toys, he does not try to roll over, consciously move his limbs. When you try to give him a toy, the child does not try to keep it. If you put the child on his feet, he will not be able to stand on his foot completely, but will try to rise on his tiptoes.

Paresis of a separate limb or one side is possible, all limbs may be affected at once. The organs responsible for speech are not sufficiently innervated, which means that pronunciation is difficult. Sometimes cerebral palsy is diagnosed with dysphagia, that is, the inability to swallow food. This is possible if the paresis is localized in the pharynx, larynx.

With significant muscle spasticity, the affected limbs can be completely immobile. Such parts of the body lag behind in development. This leads to a modification of the skeleton - the chest is deformed, the spine is bent. With cerebral palsy, contractures of the joints are detected in the affected limbs, which means that the violations associated with attempts to move become even more significant. Most children with cerebral palsy suffer from fairly severe pain due to skeletal disorders. The most pronounced syndrome in the neck, shoulders, feet, back.

Manifestations and symptoms

The hyperkinetic form is indicated by sudden movements that the patient cannot control. Some turn their heads, nod, grimace or twitch, assume ostentatious postures, and make strange movements.

With the atonic astatic form, the patient cannot coordinate movements, is unstable when trying to walk, often falls, and cannot maintain standing balance. Such people are more likely to suffer from tremors, and the muscles are very weak.

Cerebral palsy is often accompanied by strabismus, gastrointestinal disturbances, respiratory dysfunction, and urinary incontinence. Up to 40% of patients suffer from epilepsy, and 60% have impaired vision. Some can't hear well, others can't hear sounds at all. Up to half of all patients have disorders in the endocrine system, expressed by hormonal imbalance, excess weight, growth retardation. Often, with cerebral palsy, oligophrenia, retarded mental development, and a decrease in the ability to learn are revealed. Many patients present with behavioral and perceptual disturbances. Up to 35% of patients have a normal level of intelligence, and every third mental impairment is assessed as mild.

The disease is chronic, regardless of the form. When the patient becomes older, previously hidden pathological disorders gradually appear, which is perceived as false progress. Often, the deterioration of the condition is explained by secondary health difficulties, since with cerebral palsy the following are often:

  • strokes;
  • somatic diseases;
  • epilepsy.

Hemorrhages are often diagnosed.

How to discover?

So far, it has not been possible to develop such tests and programs that would make it possible to establish cerebral palsy for certain. Some typical manifestations of the disease attract the attention of doctors, so that the disease can be detected at an early stage in life. It is possible to suggest cerebral palsy by a low score on the Apgar scale, by violations of muscle tone and motor activity, lagging behind, lack of contact with the next of kin - patients do not respond to their mother. All these manifestations are a reason for a detailed examination.

Cerebral palsy or cerebral palsy is a congenital disease of the brain during fetal development. Acquired cerebral palsy is extremely rare, due to traumatic brain injury or infection.

Cerebral palsy is the most common cause of childhood disability, affecting nine out of a thousand children.

In many respects, such statistics are explained by insufficient knowledge, complexity and unpredictability of this disease.

Causes of cerebral palsy

Cerebral hypoxia is considered to be the main cause of cerebral palsy. Hypoxia can occur due to rapid or prolonged labor, when oxygen enters the baby's brain in very small quantities.

Contact with radiation and chemicals literally “poisons” the fetus, so it is not surprising that a woman working in a hazardous industry will give birth to a child diagnosed with cerebral palsy. No less than chemicals, the disease is provoked by X-rays and exposure to electromagnetic fields. Not a small influence on the formation of cerebral palsy in a child is also exerted by the bad habits of the mother, the pathology of the thyroid gland function.

Injury received during or before childbirth is another factor influencing the development of cerebral palsy. An injury sustained during childbirth can seriously damage the full-fledged brain of an unborn child. Most often in such cases, hemorrhage occurs, followed by the death of parts of the brain. It is worth noting that children born by caesarean section practically do not have a diagnosis of cerebral palsy.

Infectious diseases such as meningitis or encephalitis can also trigger cerebral palsy.

The brain of a newborn can also be paralyzed, intellectually disabled without any birth trauma. It is smaller than the healthy brain of children of this age and is afflicted with deep genetic disorders. These children, as a rule, rarely survive: only 10% of them. In this case, the main cause of the disease is a hereditary factor.

Symptoms of cerebral palsy

At an early age, when the central nervous system of the child is not fully formed, children with cerebral palsy are almost no different from others.

Over time, it becomes more noticeable that the baby is significantly behind his peers in development. He begins to hold his head and roll over late, cannot sit without support for a long time, does not crawl. The symptoms of cerebral palsy become even more obvious when the child is already a year old, and there are no hints of the first steps. An unhealthy child also has problems with hearing and speech: he does not react to sharp sounds by blinking, and begins to talk at the age of 2-3 years. At about the same age, you can notice that the child uses mainly one hand (right-handedness or left-handedness).

The movements of a child diagnosed with cerebral palsy are abrupt and uncontrollable, or, conversely, sluggish, most often aimless. Cramps of the arms and legs, as well as the lower jaw, may begin when crying.

A child aged 5-6 years may have a number of uncontrollable habits, such as lip biting, nail biting. He is hyperactive, disobedient. He doesn't speak well because he can't control his lips and tongue. The child begins to salivate, caused by the inability to control the work of many muscle groups responsible for swallowing. A patient with cerebral palsy develops strabismus caused by weakness of the muscles responsible for the movement of the eyeball. The gait is most often tense, the child literally walks “on his toes”, while the legs are somewhat crossed and pressed one to the other.

Treatment of cerebral palsy

The best way for the health of a child diagnosed with cerebral palsy is physical activity, of course, if it is allowed by a doctor. Remedial gymnastics with specialists, massage, warm baths - this is exactly what is needed for the rehabilitation of the patient.

Treatment of cerebral palsy involves the use of drugs aimed at improving the functioning of the brain. The Voight method can also be applied, the essence of which is to restore the natural patterns of human movement, as well as to form motor skills. The child must learn to control balance, make grasping and stepping movements of the limbs.

It is advisable to wear orthopedic shoes to avoid foot deformity.

A patient with cerebral palsy should be taught normal walking, regularly and methodically develop each muscle group through training and exercises. Exercises for muscle stretching, endurance and stress relief will very soon give positive results, and with a long course of treatment, a child diagnosed with cerebral palsy will practically not differ from a healthy peer.

Remember that for a child diagnosed with cerebral palsy, the best treatment is a friendly atmosphere in the family, love and sincere hope of relatives for recovery.

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