Causes of cerebral palsy, types and forms. Cerebral palsy The most common cause of cerebral palsy

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

History of disease detection

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

General characteristics of the state

Currently, doctors say that cerebral palsy occurs immediately after birth or during pregnancy. The causes of illness are many. But mainly it is damage to the central nervous system and related neurological problems. With the disease, a wide variety of disorders of motor functions are observed. Muscle structures are most affected, this manifests itself in impaired coordination. Motor activity is impaired due to damage to brain structures. The localization and volume of these lesions determine the form, nature and severity of muscle disorders, which may be single or in combination. Options for major muscle disorders:

• Muscle tension.
• Movements of involuntary chaotic character.
• Various gait disorders.
• Limited mobility.
• Muscle contractions.

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

Cerebral palsy does not progress, since brain damage is point, it does not spread and does not capture new areas.

Causes

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

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

Also, the factors that give rise to cerebral palsy are:

• premature birth.
• Small birth weight.
• Large baby weight or large fetus.
• Chronic diseases of women.
• Multiple pregnancy.

The risk of developing the disease increases if several factors that affect the baby's brain and nervous system act at once.

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

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

Children's cerebral palsy is a consequence of the influence of various factors that lead to disruption of the normal functioning of the child's brain. The greatest influence is oxygen starvation, which develops due to premature detachment of the placenta, the gluteal position of the fetus, rapid or prolonged labor, entanglement of the umbilical cord. Risk factors are Rh-conflict of mother and baby, infections.

Sometimes the cause of the development of cerebral palsy is considered various pathologies of the vascular system. This is an erroneous opinion, since the vessels of the child are elastic and soft, they cannot burst without a reason. That is why vascular damage in a child can occur only as a result of a severe injury.

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

signs

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

• Lagging behind the child in physical development (does not hold his head, does not crawl, does not sit, does not walk by the due date).
• The reflexes that are characteristic of infants are preserved with the growing up of the child (limb movements are chaotic for a long time, grasping reflex, stepping reflex).
• The child uses only one hand, this is clearly noticeable during the game or at home.
• The child is not interested in toys.
• If you put the child on his feet, he gets up only on his toes.

Late signs of cerebral palsy are:

• Deformation of the skeleton, in the affected area the limb is much shorter.
• Impaired coordination, low mobility of the child.
• Frequent spasms of the limbs.
• Gait is difficult, mostly on toes.
• Swallowing problems.
• Salivation.
• Problems with speech.
• Myopia, strabismus.
• Disease of the gastrointestinal tract.
• Involuntary defecation and urination.
• Emotional and psychological problems.
• It is difficult for children to write, read, count.

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

Forms

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

By age, the disease is divided into:

• Early - symptoms appear before 6 months of a baby's life.
• Residual initial - the disease is detected from 6 months to 2 years.
• Residual later - after 2 years.

Regarding the forms of cerebral palsy classify:

• Spastic tetraplegia - areas of the brain that are responsible for motor function are affected. This happens, as a rule, in the prenatal period of a child's development due to oxygen deficiency. This type of cerebral palsy is one of the most severe and serious forms of the disease. The disease manifests itself in the form of problems with swallowing, impaired formation of sounds and their reproduction, paresis of the muscles of the limbs, problems with attention, visual impairment, strabismus, mental retardation.
• Spastic diplegia is the most common form of the disease, accounting for about 75% of all cases. As a rule, it is detected in children who were born as a result of premature birth. The disease manifests itself in the form of damage to the lower extremities, delayed mental and mental development, problems with speech. But, despite all the manifestations of the disease, patients with cerebral palsy of this type successfully study at school, are adapted in society. They do certain types of work.
• Hemiplegic form is more often seen violations in the movement of the upper limbs. The cause of this form of cerebral palsy is cerebral hemorrhage or heart attacks in the brain. Such children have good learning abilities, they can learn a number of actions, but their speed will not be great. Children who suffer from this form of the disease often have mental retardation, lag in speech development, mental problems, and frequent epileptic seizures.
• The dyskinetic form is the cause of hemolytic disease (a congenital disease that develops during the Rhesus conflict of the blood of the mother and baby). Such children have involuntary body movements, paresis and paralysis appear in all parts of the body. The positions of the limbs are not normal. At the same time, this type of cerebral palsy is considered the mildest form. Children can study at school, not be inferior in intellectual abilities to their peers, they can graduate from a higher educational institution, live a normal life in society.
• Ataxic form - the main causes of the disease are fetal hypoxia or trauma to the frontal lobes of the brain. A sign of this form is paresis of the vocal cords and muscles of the larynx, trembling of the limbs, and involuntary movements. As a rule, children suffer from mental retardation. With proper work with the child, he can learn to stand and even walk.
• Mixed form - when the patient has symptoms of several forms of the disease.

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

Condition Diagnostics

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

Timely diagnosis is very important for a small patient. It is important to recognize the disorder. Children should be examined even in the maternity hospital, doctors pay special attention to children:

• With little weight.
• Born prematurely.
• Having defects and anomalies of development.
• Diagnosed with neonatal jaundice.
• Born as a result of difficult and prolonged childbirth.
• with infectious diseases.

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

Features of children with cerebral palsy

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

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

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

Children with cerebral palsy are not able to study for a long time, they learn a smaller amount of information compared to their peers. These children have difficulty with counting, it is very difficult for them to learn mathematical operations.

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

They, as a rule, have a speech disorder, which is why the circle of communication with peers is always limited.

Treatment and rehabilitation of cerebral palsy

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

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

As medicines, as a rule, anticonvulsants are prescribed, relaxing.

Currently, there are no universal methods for the treatment of cerebral palsy. The following methods have worked well:

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

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

• Bobath-tarapiya.
• Voight method.
• Load suit "Gravistat" or "Adeli".
• Pneumosuit "Atlant".
• Logopedic classes.
• Auxiliary devices (chair, walker, standers, exercise machines, bicycles).

Successfully used balneotherapy, hydrotherapy in the pool. It is easier for a child to move in the water, he first learns to walk in the water, after that it is easier for him to perform the same actions on the ground. Water procedures are completed with hydromassage.

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

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

According to reviews, cerebral palsy should be treated as early as possible, as the condition may worsen due to the gradual development of an orthopedic problem. It can be curvature of the spine, flat feet, clubfoot, hip dysplasia, and others. If you miss the time, you will have to treat not only cerebral palsy, but also correct orthopedic disorders by putting on spacers, splints, splints.

Principles of working with children

With children who suffer from cerebral palsy, it is necessary to deal with both doctors and teachers. It is better to start working from an early age of children - from 1 to 3 years old. It is necessary to take them to classes where they will be taught to speak, perform daily activities, and teach self-care skills. Such training centers for cerebral palsy develop the ability to interact and communicate with peers.

In working with such children, much attention is paid to the development of speech and behavior in society. Each child has an individual approach that takes into account the age, form of pathology. Education of children, as a rule, is carried out in groups in the form of a game, which is led by a competent specialist. The movements of each child are carefully observed, incorrect movements are corrected, and correct ones are encouraged.

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

Exercise therapy and massage

Massage with cerebral palsy begins to be carried out from 1.5 months. The course is conducted only by a specialist who can assess muscle tone, the frequency of sessions, the degree of impact. It is not recommended to massage yourself.

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

As a rule, with cerebral palsy perform the following exercises:

• Stretching.
• Decreased muscle tone.
• Strengthening individual muscle groups.
• Endurance exercises.
• For balance.
• To increase muscle strength.

Complications

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

• Disability.
• Eating problems.
• Epilepsy.
• Delayed growth and development.
• Scoliosis.
• Incontinence.
• Salivation.
• Psychological and mental disorders.

Prevention of cerebral palsy

During pregnancy, you must strictly monitor your health. It is important to eliminate bad habits, regularly go to appointments with your doctor, strictly follow his recommendations. Timely diagnose conditions dangerous to the fetus, for example, hypoxia. The doctor should correctly assess the condition of the mother and choose the right way of delivery.

Disability

Disability in cerebral palsy is assigned depending on the severity and forms of the disease. Children can receive the status of "child with cerebral palsy", and after 18 years - the first, second or third group.

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

• The degree and form of the disease.
• The nature of the lesion of the musculoskeletal system.
• The nature of speech disorders.
• Degree and expressiveness of mental defeats.
• degree of mental retardation.
• The presence of epilepsy.
• The degree of loss of vision, hearing.

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

Special tools that make life easier for a child

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

Such devices are divided into 3 groups:

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

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

live fully

Many children with cerebral palsy successfully adapt in society, some manifest themselves in creativity. So, for example, a seven-year-old boy with cerebral palsy (severe form), who cannot walk at all, but loves to sing very much, has become a real star. The Internet literally blew up the video where he made a cover of the track "Minimal" by rapper LJ. Cerebral palsy-diagnosis does not interfere with creativity and self-realization at all. The rapper himself visited this talented child, their joint picture is very popular among fans of both LJ and the boy Sergei.

The term cerebral palsy is used to designate a group of symptom complexes, manifested by disorders in the motor sphere. These disorders result from damage to the central nervous system. Cerebral palsy can occur in a mild, subtle form or have a severe course that requires ongoing treatment.

Cerebral palsy refers to diseases of the nervous system and according to ICD 10, the disease is assigned the code G80, there are also subparagraphs indicating the form of paralysis. Cerebral palsy refers to non-progressive diseases of the nervous system, but if left untreated, the child will lag far behind in development, both mentally and physically, from their peers.

Rehabilitation measures started in early childhood can achieve excellent results, of course, everything depends on the form of the disease. Children with cerebral palsy generally live to old age and can have children of their own.

Causes of cerebral palsy

According to statistics, from 6 to 12 children for every thousand newborns are born with a diagnosis of cerebral palsy and many people think that this disease is inherited, however, the direct cause of the development of cerebral palsy in the fetus is a pathological disorder of the brain structures, which leads to this condition is insufficient oxygen supply. The risk of developing cerebral palsy increases under the influence of the following provoking factors:

• Infectious diseases of the mother throughout pregnancy, these primarily include the herpes virus, cytomegalovirus, toxoplasmosis.
• Incorrect development of brain regions during fetal development.
• Blood incompatibility between mother and child- Rhesus - a conflict leading to hemolytic disease of the newborn.
• Chronic fetal hypoxia during pregnancy and childbirth.
• Endocrinological and acute somatic diseases of the mother.
• Difficult delivery, protracted labor, trauma to the child received during the passage through the birth canal.
• In the early perinatal period, cerebral palsy can be caused by toxic damage to the body with heavy poisons, infectious diseases that affect the brain regions and cortex.

A large role in the development of cerebral palsy is given to oxygen starvation of the brain, which occurs when the uterus is improperly located in the body of the fetus, protracted labor, entanglement of the neck with the umbilical cord. In most children, the influence of several factors at once is revealed, one of which is considered the leading one, while others increase its negative influence.

Forms of cerebral palsy and their characteristics

The severity of motor disorders in children with cerebral palsy can be completely different and therefore the disease is usually divided into forms.

• Hyperkinetic form exhibited in the event that the baby has an unstable muscle tone, on different days it can be increased, normal or reduced. Ordinary movements are awkward, sweeping, involuntary movements of the limbs, hyperkinesis of the muscles of the face are observed. Disturbances in the motor sphere are often accompanied by pathologies of speech and hearing, while the mental activity of such children is at an average level.
• Atonic-astatic form develops mainly with damage to the cerebellum and frontal lobes. It is characterized by extremely low muscle tone, which prevents the child from holding a vertical position. Mental development proceeds with a slight delay, but in some cases oligophrenia is determined in children.
• Spastic diplegia is the most common form. Muscle functions are impaired on both sides, with the lower limbs being more affected. In children from an early age, the formation of contractures is formed, deformation of many joints and the spine is detected. Mental and speech development is delayed, strabismus, speech pathologies are often detected, a child with this form, with appropriate rehabilitation measures, becomes socially adapted.
• Spastic tetraparesis(tetraplegia) is one of the most severe forms of cerebral palsy, the disease is caused by significant anomalies in the lesions of most parts of the brain. Paresis is observed in all limbs, the muscles of the neck can be constantly relaxed, in such children mental development is often below average. In almost half of the cases, tetraparesis is accompanied by seizures of epilepsy. Children with this form can rarely move independently, understanding the world around them is difficult due to problems with speech and hearing.
• Atactic form- rare, with its development, there are violations in the coordination of all movements and maintaining balance. The child often has a tremor of the hands, because of which he cannot perform normal activities. The delay in the development of mental activity in most cases is moderate.
• Spastic-hyperkinetic form(dyskinetic form) a combination of involuntary movements, increased muscle tone and paresis with paralysis is revealed. Mental development at the age-appropriate level, such children successfully graduate not only from school, but also from institutes.
• Right-sided hemiparesis refers to the hemiplegic form, in which one of the sides of the hemisphere is affected. The muscle tone of the limbs is increased on the one hand, paresis and contractures develop. The muscles of the hand suffer the most, involuntary movements of the upper limb are noted. With this form, there may be symptomatic epilepsy, disturbances in mental development.

Signs and symptoms

Symptoms of muscle pathologies in cerebral palsy depend on the area and degree of brain damage.

The main signs are represented by the following violations:

• Tension of different muscle groups.
• Spasmodic involuntary muscle contractions in the limbs and throughout the body.
• Pathological disorders when walking.
• Limitation of general mobility.

In addition to these signs, pathologies of visual, auditory and speech functions, disorders of mental and mental activity are detected in children. Symptoms of the disease also depend on the age of the baby. Cerebral palsy does not progress, since the lesion is point-like and, as the child grows older, does not capture new areas of the nervous tissue.

The appearance of a deterioration in the course of the disease is explained by the fact that the symptoms are less noticeable at a time when the baby is not yet walking and does not attend preschool institutions.

Consider the signs of cerebral palsy in an infant:

• In newborns with cerebral palsy you can pay attention to the fact that the baby moves only the limbs of one side of the body, the opposite ones are usually pressed to the body. A newborn child with cerebral palsy, when trying to get a clenched fist into his mouth, turns his head in the opposite direction. Difficulties also arise when the mother tries to push the legs apart or turn the baby's head.
• One month. In one month, you can pay attention to the fact that the baby still does not smile, cannot hold his head even for a few seconds, there is no focus on a specific object. The baby is restless, the sucking and swallowing reflex is often difficult, there are often convulsions and involuntary shudders.
• 3 months. In children with cerebral palsy at three months, the preservation of absolute reflexes can be observed, that is, those that are present at birth, but should normally disappear by three months. These are stepping movements, when the baby, leaning on the legs, is able to take several steps. Also palmar reflex - when you press your fingers on the palm of your hand, the child involuntarily opens his mouth. At three months, the baby, also with normal development, is already trying to roll over, and in the prone position he confidently holds his head.
• 4 months. A baby at 4 months old should already consciously respond to his mother, make sounds, smile, actively move his arms and legs, take a toy and examine nearby objects. A child with cerebral palsy will be lethargic, when crying, he can arch his body in an arc, he takes objects with only one hand.
• 6 months. At six months of their lives, most babies pronounce individual syllables, can roll over on their own, hold their heads well, swallow from a spoon or mug, and try to crawl. The child reacts differently to mother and relatives. The presence of any violations is indicated not only by muscle hypertonicity, but also by their weakness, constant anxiety of the baby, and poor sleep.
• 9 months. At 9 months, a child with cerebral palsy does not show interest in walking, does not sit well, falls on his side, and is not able to hold objects for a long time. With normal development at this age, the baby should already rise, move around the crib or with the support of adults around the room. The child already recognizes his favorite toys, tries to name them, pronouncing individual sounds or syllables.

Of course, not all signs of developmental delay are symptoms of cerebral palsy. But parents should remember that it depends only on them how the child will live in later life - according to statistics, more than half of the identified and treated children with cerebral palsy in the first year of life in the future differ from their peers in only a few violations.

Diagnostics

When diagnosing, the doctor needs not only to examine the child and carry out a number of diagnostic procedures, but also to find out how the pregnancy and childbirth proceeded. Cerebral palsy must be differentiated from other diseases, often if there is a deterioration in already mastered skills, then this indicates completely different pathologies. The examination is based on the data of MRI, computed tomography.

During pregnancy, anomalies in the development of the brain can be detected using ultrasound, but doctors will not claim that the child will have cerebral palsy. According to the identified violations, one can only assume the appearance of a developmental delay in the baby after birth and, on the basis of this, conduct an appropriate examination. The presence of herpes and cytomegalovirus infection should also alert.

Treatment

It is necessary to be treated immediately after the diagnosis is established, and it is best if the entire complex of therapeutic measures is carried out in the first year of life. The nerve cells of a child in the first year of life are able to fully recover, at an older age only rehabilitation and adaptation of the child to social life is possible.

Exercise therapy for cerebral palsy

A special group of physical exercises is necessary for the child every day. Under the influence of classes, muscle contractures decrease, the stability of the psycho-emotional sphere is formed, and the muscle corset is strengthened.

The child from a prone position should be stimulated to lean on a solid support with his feet.

From a position lying on your stomach, you need to pull the baby by the handles up, making springy movements in all directions.

The child is on her knees, the mother should stand behind and, fixing the baby's legs, try to ensure that he moves forward.

Complexes of exercises should be selected in conscience with the doctor, their effectiveness depends largely on the perseverance of the parents.

The video shows a set of exercise therapy exercises for children with cerebral palsy:

Massage

Massage with cerebral palsy is not recommended to start earlier than one and a half months and only a specialist should perform it. The wrong choice of massage technique can lead to increased muscle tone. Correctly carried out by the course of massages can facilitate the restoration of functions, have a general strengthening and healing effect.

Medical treatment

Of the drugs, neuroprotectors are prescribed - Cortesin, Actovegin, muscle relaxants. Vitamin complexes and preparations that improve metabolic processes in the body are widely used. In some cases, sedative therapy is prescribed.

Botulinum toxin preparations are injected locally into the muscles with increased tone in children with spastic disorders. The toxins relax the muscles and increase their range of motion. The drugs act for three months and then they need to be re-injected. The use of botulinum toxins is recommended for the treatment of those children who have a limited group of disorders. Botulinum toxins include Botox, Dysport

Logopedic work with cerebral palsy

Classes with a speech therapist for children with cerebral palsy are very important. Proper staging of speech is the key to his further successful learning and communication with peers. Classes are selected based on the form of speech impairment in cerebral palsy.

Operations for cerebral palsy

Surgical intervention for cerebral palsy is performed in older children in the absence of the effect of the therapy. Surgical interventions are most often aimed at treating contractures, which helps the child become more active with movements.

Taping

Taping is fixing a special plaster on a certain area of ​​the body for several days. Its purpose is to reduce pain and increase the mobility of the affected area of ​​the body. With the help of kinesio tapes, the directions of movements are corrected, blood circulation improves, and muscle endurance increases.

New and non-standard methods of treatment

Every year, new methods of treating cerebral palsy appear, some of them really turn out to be effective, others help only a limited number of patients.

Osteopathy

This is a manual impact on various parts of the body in order to restore movement disorders. Osteopathy improves blood circulation in the brain, restores the natural connections between the nerve endings and the muscles regulated with their help.

Only a qualified specialist knows the technique of osteopathy, so you need to consider all the options for clinics before deciding on the treatment of cerebral palsy osteopathy in your child.

Stem cell treatment.

Transplantation of stem cells into a child's body allows stimulating the restoration of nervous tissue and thus the damaged areas of the brain begin to function normally. The introduction of stem cells is effective, even if such treatment is started only in adolescence.

hippotherapy

Therapeutic riding. LVE helps to increase the child's physical activity, helps to restore motor functions, and forms new skills. Communication with horses is also useful for the psycho-emotional state of the child - babies with cerebral palsy who have completed a course of hypothermia become much calmer, worry less about their condition, learn to adapt in society.

Achilloplasty

Designed to reduce muscle contractures. After the operation, the range of motion expands, surgical intervention is carried out no earlier than 4-5 years.

Equipment for children with cerebral palsy

Depending on the degree of impairment of motor functions, children with cerebral palsy need special devices that help them move around and restore impaired functions.

• strollers necessary for children who cannot move independently. Special strollers have been developed for home and walks, modern models have an electric drive, which ensures the convenience of their use. The PLIKO stroller belongs to the walking stroller, it is light in weight and also easy to fold. The stroller is designed taking into account the normal physiological position of a child with cerebral palsy. The stroller "Lisa" due to its design features can also be used for children - teenagers.
• Walkers are required if the child walks, but cannot maintain balance. With the help of walkers, children not only learn to walk, but also learn to coordinate their movements.
• simulators- this group includes any device that helps the baby develop his activity and learn certain skills.
• Bicycles with cerebral palsy of a three-wheeled design and with a steering wheel not connected to the pedals. The bike must have a mount for the body, shins and hands, a push handle is required. Fastening on the foot pedals allows you to develop movements in the legs, strengthens the muscles.
• Exercise bikes strengthen the muscles of the legs, contribute to the consolidation of motor skills, form endurance. Exercise bike helps and strengthen the immune system
• hippotrainers- devices that imitate all the movements of a horse during its walking or running. That is, on the hippo simulator, the child's body sways back, forward and to the sides. Hippo-simulators allow you to strengthen your back muscles, form a beautiful posture, and improve flexibility in the joints.
• Suits for the treatment of cerebral palsy are designed as space suits, that is, the body in them is in weightlessness. The material used for the costumes promotes a tight fixation of the body and simultaneous relaxation of the muscles, which allows the child to take the first steps. The pneumatic chambers in the suit inflate and stimulate the work of different muscle groups, transmitting impulses from them to the cerebral cortex.

• Orthopedic shoes and orthoses are necessary to suppress hyperkinesis and the development of contractures. Fixed in the right position, the limbs learn to function correctly and at the same time the risk of developing skeletal deformities is reduced. Shoes and orthoses for each child are selected individually.
• Verticalizers and platforms. The stander is a special device that allows the child to hold the body in an upright position without assistance. The stander has fixators for the back, feet, knee joints. Verticalizers allow you to establish the correct functioning of internal organs, contribute to mental development and adaptation.

Rehabilitation

Rehabilitation for cerebral palsy is necessary for better physical activity of the child, his adaptation in the social sphere, to master all the necessary skills. Activities that promote rehabilitation are selected based on the age of the baby, the degree of impairment of his motor activity, hypotonia or hypertonicity of the muscles.

• The Loskutova method is based on the restoration of respiratory breathing and on carrying out a variety of movements, which relieves internal tension, increases the elasticity of muscles and joints.
• Voigt's method is based on activating the work of the brain by making reflex movements. Classes are held jointly with parents, their task is to perform the proposed exercises with the child up to 4 times a day. The purpose of the technique is to consolidate each movement, from simple to complex.

Rehabilitation centers and specialized sanatoriums

Infantile cerebral palsy (CP)

The collective name "infantile cerebral palsy" (abbreviated as cerebral palsy) means not one pathology, but many disorders of the nervous system (NS), malformations that form during pregnancy, in the natal and postnatal periods, united by a single set of symptoms.

Movement disorders in cerebral palsy, often combined with mental, speech, cognitive impairments, epilepsy, visual and hearing disorders, etc., are secondary symptoms arising from developmental anomalies, injuries, and inflammatory pathologies of the brain. Although they are considered non-progressive, as a child with cerebral palsy grows and develops, the objective clinical picture may improve or worsen, depending on:

• forms of cerebral palsy, the degree of damage to the central nervous system;
• adequately selected therapy for concomitant disorders;
• success of the rehabilitation program for cerebral palsy;
• psycho-emotional state of a particular patient diagnosed with cerebral palsy;
• his social environment;
• joint efforts of parents, doctors, teachers and other caring people who, by the will of fate, are nearby, take part in habilitation, the fate of children with cerebral palsy in the first year of life and older.

Manifesting at an early age, a childhood disease (ICP) will gradually develop over the years into an adult. Congenital or acquired in the natal and postnatal periods, pathologies of the central nervous system accompany a person throughout his life. If the brain damage is insignificant, it was possible to diagnose cerebral palsy in time, start symptomatic treatment and rehabilitation up to a year, continue them if necessary throughout life, there is a chance that motor, cognitive and other impairments will be minimal in adulthood. Modern habilitation and rehabilitation programs for cerebral palsy allow leveling pathological symptoms in mild degrees of damage.

Some adults who were once diagnosed with cerebral palsy receive education, various professions, move up the career ladder, run at the Paralympic Games. Among them are artists and lawyers, musicians and teachers, journalists and programmers. The whole world knows the names of prominent people who cannot be called "patients with cerebral palsy". Special people who, by the will of fate or nature, found themselves in a less advantageous position, in comparison with the rest, ordinary people, were able to rise above the disease, defeat it, and achieve much more than others in life.

Let's talk about some of them.

cerebral palsy in women

Known not only in her native continent, but throughout the world, the Australian prose writer, public figure, Anna MacDonald. She spent from 3 to 14 years in a closed institution, where they did not live in isolation from society, but there were disabled people with cerebral palsy and other serious illnesses. This dramatic segment of fate became the subject of the sensational book "Anna's Exit", and later the script of the feature film.

Similar, but not so dramatic, is the fate of the Russian screenwriter Maria Batalova. She has also been struggling with the symptoms of cerebral palsy for many years, but her relatives and people who love her have always been by her side. The bright lines of her works for adults, wonderful stories for children are permeated with philanthropy. In 2008, her screenplay for The House on the English Embankment was awarded the highest award at the Moscow Film Premiere Film Festival.

Six gold medals of the Russian championships in horse dressage among Paralympic athletes are on the account of a beautiful young mother and at the same time a successful model, Anastasia Abroskina. Her illness, which had long outgrown childhood (cerebral palsy, hyperkinetic form), could not break the will to win, destroy the thirst for life of an elegant, seemingly very fragile, but in fact, incredibly persistent, purposeful woman.

In the middle of the 15th century, the illegitimate son of the notary Piero da Vinci, Leonardo, was born in Italy. From birth, the boy's right arm and right leg did not obey, he had a hemiplegic form of cerebral palsy. Therefore, when he grew up, he limped slightly when walking, and he learned to write, draw, etc., with his left hand. Thanks to his divine gift, numerous talents, the world cultural heritage was enriched with great canvases (“Annunciation”, “Madonna with a Flower”, etc.), sculptural works (unfortunately lost), and he was also an architect, scientist, inventor.

Among our contemporaries who are diagnosed with cerebral palsy and world famous are actors Sylvester Stallone, RJ Mitt, Chris Foncheska.

In 2008, one of the sensations of the Paralympic Games in Beijing was the triumph of the Russian athlete Dmitry Kokarev. The young swimmer brought one silver and three gold medals to our team.

The pride of all Crimeans is their fellow countryman, a legendary man, Niyas Izmailov, a special child, a disabled person with cerebral palsy, who grew up and became the world champion among ordinary bodybuilders.

Children and cerebral palsy: from birth for many years

World medical statistics state that today children with cerebral palsy (up to a year and older) are found in the population with a frequency of 0.1 to 0.7%. Moreover, boys are victims of pathology almost one and a half times more often than girls. For every 1000 citizens in different countries, on average, there are 2 to 3 people with a lesion of the nervous system, which is called "children's" (CP), as it occurred during intrauterine development, in the natal or postnatal period. However, in some countries, children with cerebral palsy are much more common among the population.

So, in the US, the numbers are much higher, and they differ even for neighboring states. For example, in 2002, statistics showed that children with cerebral palsy (1 year of age and older) per 1000 people occur with a frequency of:

• 3.3 in Wisconsin;
• 3.7 - in the state of Alabama;
• 3.8 in the state of Georgia.

On average, American scientists said that children with cerebral palsy (1 year and older) occur at a frequency of 3.3 patients per 1000 population.

• In Russia, according to Rosstat in 2014, per 100,000 children, there were, on average, 32.1 small patients with cerebral palsy (from 1 year of age to 14 years of age).
• According to the estimates of the Ministry of Health in the Russian Federation in 2010, there were more than 71 thousand children with cerebral palsy (1 year - 14 years).

The forecast of experts of the World Health Organization is not very comforting. Children with cerebral palsy are being born more and more often. And in the coming years, the number of babies who have signs of cerebral palsy from birth will increase.

Despite the fact that the disease is childhood, cerebral palsy accompanies the patient from birth, relentlessly following him all his life. Therefore, the fight against the disease is always going on.

If the baby has perinatal brain damage, cerebral palsy, the year (first from birth) can determine the entire future fate. After all, the objective clinical picture in the future will depend on how:

• signs of cerebral palsy were quickly identified;
• the form and extent of damage to the nervous system are precisely determined;
• the chosen symptomatic therapy is adequate;
• correctly compiled rehabilitation and habilitation programs for cerebral palsy.

Parents of children with various forms of cerebral palsy often regret the time, energy and money spent in vain on psychics, traditional healers, etc., in the first years after the birth of a baby. It is important that fathers and mothers who are confused and sometimes morally crushed by the changes that have taken place in their lives, with the birth of a special child, be guided on the right path by specialists, doctors, and psychologists. The road of habilitation, socialization is always very difficult, thorny for every family that has children with special needs.

Therefore, it is better not to stray by the roundabout paths, making your way to the touch, testing alternative methods on your own son or daughter, expecting miraculous healing and losing precious time during which deformities, contractures have time to form, and other related complications appear. And rely on the existing world experience in habilitation and treatment of cerebral palsy, enlist the support of specialists.

And the sooner the parents stop looking into the past, looking for an answer to the question “why” cerebral palsy was sent, seeing the causes of the disease in the “evil eye” of ill-wishers or stirring up their own actions, they will understand that it is necessary to live in the present, the sooner they will understand how to live in future.

Helping the baby to fight for life, rejoicing in every, albeit tiny, completely invisible to others, but such a huge victory for the family, giving, without a trace, all his love and tenderness to the most defenseless, helpless of all people, mom and dad, grandparents, other relatives and strangers by blood, but the most humane people on this Earth, who become foster parents, guardians, educators for abandoned children with cerebral palsy, acquire the meaning of existence. They improve spiritually, gaining invaluable experience of compassion and mercy.

Special people or patients with cerebral palsy?

Parents, doctors, teachers and other people are products and part of society. The worldview and attitude of each individual towards the disabled are formed by virtue of public opinion, the position of the state.

The moral norms of the modern human population, which distinguish people from animals, differ significantly from those that existed at the dawn of human civilization. They have changed significantly in the process of evolution of society.

Weaker children have always come into the world, including those with cerebral palsy. However, in addition to natural selection, in the old days people tried on the role of gods, deciding who has the right to life and who is not worthy. Infanticide, the killing of infants with signs of inferiority, has existed for thousands of years. Only in 374, for the first time in world history, a law was issued prohibiting the physical destruction of newborns with various pathologies. But only in the 9th century did the Christian world begin to equate infanticide with the usual murder of one's own kind.

The spiritual life of Western European society and the entire world civilization has experienced great positive changes, thanks to the great figures of the Renaissance and the humanists-educators who fought for the rights of the disabled during the French Revolution. Thanks to them, society for the first time realized its responsibility for the disadvantaged, outcasts, patients with cerebral palsy, etc.

Humanity has gone through a huge evolution of spiritual growth over the past hundred years. And this process continues today, before the eyes of each of us.

Thus, in 2008, an event occurred that in the future should change the lives of people with disabilities with cerebral palsy and other pathologies in Russia. Our country has signed the Convention on the Rights of Persons with Disabilities. The new international law was ratified by deputies in 2012. It is designed to help socialize people with disabilities, reduce manifestations of discrimination against them by the state, officials, and society.

The state turned its gaze towards special people. The media talked about an accessible environment for people with disabilities, inclusion, equal opportunities. Many positive changes are happening before our eyes. The mere fact that large and small people in wheelchairs, with various orthopedic devices appeared on the streets of Russian cities, already indicates that the process has begun.

However, much remains to be changed. First of all, in the mind of each individual person. So that adults and children are not afraid of people with disabilities, including those with cerebral palsy, do not shy away from them in public places, do not humiliate and offend, voluntarily or involuntarily, do not ignore their difficulties. Society must understand that patients with cerebral palsy are ordinary people, only they have their own characteristics, like every person.

Special people have the same desires and dreams as ordinary people. Only in order to fulfill even the smallest of them, it is sometimes necessary to make incredible efforts. For example, to take a walk in the park on a fine day, learn to draw or find a true friend.

Therefore, they need help, not only material, but physical, psychological. Not alms, but the sincere participation of others. And yet - partnerships, on an equal footing.

They are the same people, just caught in a quandary.

Several diseases at once, which are based on an anomaly of development or damage to the brain during the intrauterine development of a child, at the time of childbirth or in the postnatal period, are called cerebral palsy.

In 1861, William Little, an orthopedic surgeon from England, first described the clinical picture of one of the varieties of cerebral palsy, he saw the causes of spastic diplegia in oxygen starvation at the time of childbirth. But he believed that it was not the brain that was affected, but the spinal cord. In honor of him, this form of cerebral palsy is sometimes called "Little's disease" today.

The term "cerebral palsy" was introduced into medical practice in 1893 by Sigmund Freud, at that time already a well-known psychoanalyst. In 1897, he first compiled a classification of children, listing the signs of cerebral palsy. Freud first described the development of cerebral palsy. Unlike Little, he saw differently the etiology and pathogenesis of cerebral palsy, the causes of pathology. According to Freud, not only the spinal cord suffered, but first of all, the brain with cerebral palsy, he looked for the causes of violations not only in birth injuries and asphyxia. Freud believed that the development of cerebral palsy begins much earlier. He was the first to call the cause of cerebral palsy an abnormal intrauterine development of the child.

Signs and manifestations of cerebral palsy

Since 1980, according to the definition of experts from the World Health Organization, signs of cerebral palsy, as a group of pathological syndromes of the nervous system, are considered non-progressive motor and psychoverbal disorders. They are a consequence of brain damage in cerebral palsy, the causes of which lie in the postnatal, intranatal and intrauterine periods of a child's development.

Throughout history, since the identification of signs of cerebral palsy by William Little, there have been many attempts to classify and streamline the symptom complexes of a group of syndromes. However, according to some scientists, it was not possible to draw up a single, clear concept of a multifaceted pathology, forms of cerebral palsy.

In general, the severity of the condition of patients with cerebral palsy is assessed according to three degrees of damage:

• mild - complete socialization is possible with a given degree of impairment in cerebral palsy, training, mastering not only self-service skills, but also professions, engaging in socially useful work, a full life;
• medium - partial socialization, self-service with the help of other people are possible;
• severe - a person remains completely dependent on others, cannot serve himself without outside help.

To date, several classifications are used in medical practice, including various forms of cerebral palsy.

In Russia, they often use the classification compiled in 1972 by Professor Xenia Alexandrovna Semenova, who in our country was affectionately nicknamed "grandmother of cerebral palsy." This classification combines the following forms:

• atonic-astatic;
• hyperkinetic;
• hemiparetic;
• spastic diplegia;
• double hemipletic;
• mixed.

In Europe, the following clinical classification scheme for signs of cerebral palsy is usually used:

• ataxic paralysis;
• dyskinetic paralysis;
• spastic paralysis.

At the same time, the dyskinetic form has two types of cerebral palsy, the symptoms of which differ from each other:

• choreoathetous;
• dystonic.

The spastic form also has two options for the development of cerebral palsy:

• bilateral paralysis;
• unilateral paralysis.

Bilateral damage is divided into:

• quadriplegia;
• diplegia.

In international medical practice, the ICD-10 statistical classification has been adopted. According to her, all cerebral palsy (ICP) is divided into:

• spastic - G80.0;
• spastic diplegia - G80.1;
• children's hemiplegia - G80.2;
• dyskinetic - G80.3;
• ataxic - G80.4;
• other types of cerebral palsy - G80.8;
• unspecified cerebral palsy - G80.9.

The development of a child with cerebral palsy goes through several stages.

The first of them is called "initial", it lasts from birth to six months.

If during it, as early as possible, the correct diagnosis of cerebral palsy is established, adequate therapy is prescribed, rehabilitation begins, there are much more chances to avoid unwanted complications and an extreme degree of disability.

The next stage, the initial residual, lasts from six months to 3 years.

At this time, the diagnosis of cerebral palsy has already been made, the degree of brain damage is clear and predictions have been made. But no modern classifications and predictions are able to accurately predict the compensatory capabilities of the brain of a particular child. Especially if they are multiplied by the persistence of the patient himself, the efforts of his relatives, doctors, everyone who participates in the rehabilitation program for cerebral palsy. It is during this period that the rehabilitation of cerebral palsy gives its first fruits. In addition, the correct strategy for dealing with the disease at the initial residual stage lays the foundation for the development of a child with cerebral palsy in the future.

The residual stage starts at 3 years of age.

Although organic brain lesions are irreversible, and the symptom complex in this period is finally formed and is considered non-progressive, classes with children with cerebral palsy cannot be stopped. Persistent and consistent habilitation, rehabilitation, education in cerebral palsy are of great importance at any age, for children and adults. If you conduct regular training and classes, cerebral palsy can be corrected. A clear proof of this are many adults and grown-up children who, thanks to training, habilitation and rehabilitation, were able to defeat cerebral palsy and live a full life.

At the end of the last millennium, Ukrainian scientists, Vladimir Ilyich Kozyavkin and Vladimir Oleksandrovich Padko, proposed a new rehabilitation classification of cerebral palsy, the symptoms of motor and psychoverbal disorders were systematized for a unified assessment of the condition of patients at different stages of rehabilitation with cerebral palsy. It is based on an assessment of three main syndromes, which, in combination with an additional one, make it possible to diagnose cerebral palsy. These are the syndromes:

• speech disorders;
• intellectual disorders;
• movement disorders.

Syndrome of speech disorders can be characterized by:

• delayed speech development;
• sensory, motor or mixed alalia;
• dyslalia;
• ataxic, spastic, hyperkinetic or mixed dysarthria.

The syndrome of intellectual disorders is defined as mental retardation of two degrees:

• light;
• expressed.

The syndrome of movement disorders, at various stages of development of cerebral palsy, is assessed based on:

• severity - plegia (complete absence) or paresis (limitation, weakness);
• prevalence - by the number of limbs involved;
• the nature of the violations - according to the type of changes in muscle tone.

Based on the assessment of the syndrome of motor disorders, the following stages are distinguished, which the development of cerebral palsy goes through:

• stages of locomotion;
• vertical phase.

The stage of locomotion is divided into several segments, each of which is characterized by a certain way of movement in space:

• impossibility of movement in space;
• movement with the help of body turns;
• simple crawling (plastunsky);
• spasmodic, non-alternating crawl;
• alternating, reciprocal or alternating crawling;
• kneeling;
• walking in an upright position, with the help of special devices and devices;
• independent walking (pathological).

The verticalization phase also has several stages:

• lack of head control in the prone position;
• the presence of head control in the prone position;
• ability to sit independently;
• getting up with support;
• ability to stand up without support.

Assessment of the state at different stages of rehabilitation, taking into account the development of a child with cerebral palsy, allows us to trace the dynamics of neurological syndromes, outline immediate goals and perspectives.

Each form of cerebral palsy has symptoms that distinguish it from others. The differences are due to the specific causes of cerebral palsy, the nature and extent of lesions of the nervous system. Therefore, even within the framework of the general form, children of the same age may have significant differences in development, even against the background of a single rehabilitation program.

Let us stop optionally on the main forms and their features.

The hyperkinetic, athetotic form (3.3% of patients) goes through two phases of the formation of neurological syndromes - the hyperkinetic one replaces the dystonic one. Muscle tone differs significantly - from severe spasticity to hypotension-dystonia. As a rule, dyskinesias, ataxia, psychoverbal retardation are diagnosed. Despite rehabilitation, training and classes with children with cerebral palsy of this form, deformities of the extremities, scoliosis are formed over time.

The atactic form (9.2% of patients) manifests with the "sluggish baby" syndrome in the first weeks after birth. With this form of cerebral palsy, the causes of pathological syndromes are hidden in lesions of the frontal lobes of the brain. The delay in motor development is combined with a decrease in muscle tone. With brisk tendon reflexes, the following are noted:

• intentional tremor of the upper extremities;
• torso ataxia;
• dysmetria;
• discoordination.

Despite the efforts of rehabilitation, regular classes, with cerebral palsy of this form:

• there are great difficulties, often the impossibility of verticalization of the body, since the mechanism of postural control is disturbed;
• astasia-abasia syndrome often develops (inability to sit and stand);
• gross mental retardation is recorded.

Spastic forms (up to 75% of patients) are characterized by:

• increased muscle tone;
• an increase in tendon reflexes;
• clonuses;
• pathological reflexes of Rossolimo, Babinsky;
• inhibition of surface reflexes;
• lack of muscle control
• oppression of normal synkinesis;
• formation of pathological friendly movements.

The clinical picture is different for different spastic forms of cerebral palsy.

Quadriplegia (tetraplegia) is characterized by a violation of the muscle tone of the whole body, more often the hands are affected to a greater extent. If significant differences are recorded in the lesion, with a predominance in the upper limbs, we are talking about bilateral hemiplegia.

Signs of this spastic form are:

• lack of head control;
• impossibility of visual-spatial coordination;
• due to violations of the mechanisms of formation of postural reflexes, there are big problems with the verticalization of the body;
• have difficulty swallowing;
• articulation is difficult;
• speech problems;
• despite classes with children with cerebral palsy of this spastic form, as a rule, deformations of the limbs and spine, contractures develop;
• delays in psychoverbal development of various degrees.

Paraplegia is a predominant lesion of the lower extremities, combined with preserved motor function of the hands, minor or moderate impairment of the functionality of the upper extremities. With safe speech and perfect head control, despite training and classes, with cerebral palsy of this spastic form, a “ballerina pose” is formed and there are:

• flexion contractures in the knee joints;
• equino-varus or equino-valgus foot deformities;
• dislocations of the hip joints:
• hyperlordosis of the lumbar spine;
• kyphosis of the thoracic spine, etc.

Patients with paraplegia have difficulty learning skills:

• seats;
• standing;
• walk.

Hemiplegia is a spastic lesion of one side of the body, in which the arm is more affected. Are noted:

• violation of the function of grasping;
• extension with external rotation of the leg on the side of the lesion;
• in addition to increased tone, there is an increase in tendon reflexes;
• even under the condition of systematic training, cerebral palsy of this form is complicated by the shortening of the affected limbs as the child grows;
• contractures of the shoulder, elbow joints, hand, thumb can form;
• contractures develop in the lower limb, horse foot;
• high risk of scoliosis.

The prognosis for consistent habilitation, regular classes with children with cerebral palsy of this spastic form is more favorable in comparison with others. The success of social adaptation correlates with the syndromes of psychoverbal disorders and intellectual disorders.

Diagnosis of cerebral palsy: the importance of timely diagnosis

Rehabilitation of cerebral palsy is more successful, the earlier the correct diagnosis is made. An experienced pediatrician or neurologist may notice even minor neurological disorders in a newborn based on:

• careful examination;
• assessment of reflexes;
• measurements of visual acuity, hearing;
• determination of muscle functionality.

High-tech modern methods of examination help to confirm or refute the fears of doctors:

• Magnetic resonance imaging;
• CT scan;
• electromyography;
• electroneurography;
• electroencephalography, etc.

Since the neurological symptom complex in cerebral palsy is accompanied by a variety of disorders and pathologies, in addition to observation by a neuropathologist, patients need consultations:

• psychotherapists;
• epileptologists;
• speech therapists;
• otolaryngologists;
• optometrists, etc.

As well as forms of cerebral palsy, the causes of chronic symptom complexes of motor disorders are very diverse. Among the most frequent are:

• premature birth of a small person, prematurity (according to world statistics, about half of all episodes of cerebral palsy are associated with it);
• malformations of the central nervous system;
• brain damage as a result of hypoxia and ischemia;
• transferred intrauterine viral infections, including herpes;
• postnatal infectious diseases;
• toxic lesions;
• Rh-conflict of the blood of the mother and fetus;
• CNS injuries during childbirth and in the postnatal period, etc.

Curious statistics are collected on the popular forum "Children-Angels". Parents of children with cerebral palsy among the common causes of damage to the nervous system are called today:

• improper delivery - 27.1%;
• premature pregnancy - 20.2%;
• errors in resuscitation, treatment - 11%;
• vaccination - 8%;
• mother's illness during pregnancy and taking medications - 6.6%;
• psycho-emotional stress of future mothers - 5.7%, etc.

Complex treatment of cerebral palsy

When talking about the treatment of cerebral palsy, it means a complex of therapeutic and rehabilitation measures that can improve the clinical picture, reduce the severity of pathological symptoms.

Complex treatment of cerebral palsy may include:

• drug therapy;
• physiotherapy methods;
• rehabilitation measures;
• in some cases, surgical treatment is indicated.

Cerebral palsy, as a rule, is complicated by many other pathologies:

• epilepsy;
• scoliosis, arthritis and other diseases of the musculoskeletal system;
• hydrocephalus;
• atrophy of the optic nerve and other visual disorders;
• disorders of coordination of movements;
• hearing impairments;
• psychoemotional disorders;
• behavioral disorders;
• speech disorders, etc.

The goal of symptomatic therapy is not the causes, but the complications of cerebral palsy

Drug treatment of cerebral palsy and non-drug therapy, as a rule, are designed to deal with common complications. An integrated approach allows avoiding undesirable scenarios for the development of pathology, reducing the pathological symptoms of concomitant diseases.

So drug treatment allows:

• stop epileptic seizures;
• minimize, as far as possible, metabolic disturbances;
• relieve muscle tone;
• reduce pain symptoms;
• stop panic attacks, etc.

Habilitation and rehabilitation of cerebral palsy are based on three main principles:

• early start;
• A complex approach;
• duration.

The initial residual stage is the most promising for compensating for neurological deficits. It is at the age of 6 months to 3 years that the most active response to rehabilitation programs is observed.

Individual rehabilitation programs for cerebral palsy

Comprehensive rehabilitation programs for young and mature patients with CNS lesions are made taking into account:

• forms of the disease;
• the extent of perinatal lesions;
• individual features;
• concomitant diseases, etc.

Comprehensive rehabilitation for cerebral palsy may include:

• medical methods;
• methods of social and environmental adaptation;
• speech therapy classes;
• psychotherapy sessions;
• educational programs for patients with cerebral palsy, training, occupational therapy, etc.

Most patients with cerebral palsy need special devices, devices, orthopedic products that make life easier, make it possible for special people to move in space. If disability is established, for a person with cerebral palsy, during the examination by specialists of medical and social expertise, an individual rehabilitation program is drawn up, which may include various technical means or assistive devices.

They are conditionally divided into three groups:

• providing the possibility of movement in space (wheelchairs, walkers, standers, seats);
• designed for the development of motor abilities (verticalizers, bicycles, chairs, orthoses, tables, orthopedic shoes, etc.);
• facilitating patient hygiene (toilet chairs, bath seats, etc.).

Exercise therapy for cerebral palsy

Physical therapy or kinesitherapy for various forms of cerebral palsy can mitigate the negative effects of physical inactivity, forced lack of movement, and correct motor disorders.

Classes should be regular, systematic, throughout the life of a person with cerebral palsy. Types of fitness, alternation of exercises, loads are selected by kinesiotherapists, exercise therapy instructors, together with neuropathologists, pediatricians, psychotherapists and other specialists.

Special fitness workouts for different forms and degrees may include:

• medical gymnastics;
• gymnastic exercises;
• sports-applied training;
• training on simulators, etc.

Massage for cerebral palsy helps:

• optimize blood circulation;
• improve lymph flow;
• normalize metabolic processes in muscle tissue;
• improve the functionality of various systems and organs.

In clinical practice, the following massage techniques are widely used in rehabilitation programs for children and adults with cerebral palsy:

• classical;
• segmental;
• point;
• sedative;
• tonic;
• Monakov's system.

Speech development

Many patients with cerebral palsy have speech disorders of varying degrees. Regular and consistent sessions with speech therapists help:

• normalize the tone of the muscles that provide articulation;
• improve the motor skills of the speech apparatus;
• form the correct speech breathing and synchronize it with articulation and voice;
• develop optimal sound, voice power;
• smooth out phonetic defects, improve pronunciation;
• to achieve intelligibility of speech;
• facilitate verbal communication, etc.

In order for a patient with cerebral palsy to adequately perceive the world around him, objects, people, to form an idea of ​​their shapes, sizes, position in space, smells, tastes, etc., it is necessary to form a complete perception of information by his senses. The importance of sensory education (correction) is that it allows:

• develop tactile-motor, auditory, visual and other types of sensory perception;
• form sensory samples of shapes, colors, sizes, etc.;
• improve cognitive abilities;
• correct speech disorders, enrich vocabulary.

Animal Therapy

For the rehabilitation of children with cerebral palsy, classes with animals are successfully used:

• dolphin therapy;
• canistherapy;
• hippotherapy, etc.

In the process of communicating with younger brothers, the child receives not only positive emotions, vivid impressions, which in themselves are an excellent medicine. During training with horses, dogs, dolphins in children with various forms of cerebral palsy:

• expanding motor capabilities;
• new skills and abilities appear;
• muscle tone is normalized;
• the volume of movements increases;
• hyperkinesis is reduced;
• improves coordination;
• improve speech skills;
• fears and the effects of stress go away;
• psychological and behavioral disorders are reduced, etc.

Art classes with cerebral palsy, teaching drawing, modeling, applied arts:

• enrich the spiritual world of kids and adults;
• are an excellent training of sensory perception;
• develop fine motor skills;
• contribute to the correction of psycho-emotional disorders;
• form imaginative thinking;
• improve the ability to concentrate;
• help to get rid of behavioral disorders.

Little artists, sculptors, masters see the fruits of their labor, get satisfaction from creativity, joy from communicating with beauty, gain confidence in their own abilities. Many children find their favorite hobby, and for some, the passion for needlework and drawing develops into the main business of their lives.

Habilitation for cerebral palsy and socialization of disabled people

Today, in relation to children with cerebral palsy, the term "habilitation" is more often used. It is more accurate, as it reflects the fact that, unlike, the complex of therapeutic and pedagogical measures is aimed not at restoring lost skills and abilities (motor, speech, cognitive), but at their acquisition, for the first time. Habilitation serves the socialization of children with various forms of cerebral palsy. In the process of training and education, the child masters:

• movement;
• self-care skills;
• labor activity;
• speech;
• sensory perception, etc.

The ultimate goal of habilitation, which, unfortunately, is not always achievable due to the degree and extent of damage to the nervous system, is the integration of patients with cerebral palsy into society.

Perseverance in achieving the goal, daily work can change a lot in the life of a child with cerebral palsy. Unlike ordinary children, labyrinthine and cervical tonic reflexes interfere with their development. Pathologies of vision, hearing, psycho-speech disorders, difficulties with spatial analysis and synthesis that accompany motor disorders make learning difficult. But thanks to the joint efforts of the patient himself, relatives, doctors, teachers, speech therapists, today it is possible to change the lives of many people with cerebral palsy. Those who, remaining in social isolation, without the opportunity to receive habilitation and education, used to become helpless people with severe disabilities, today they often gain independence, master professions, and create their own families.

Special child and ordinary school

Until recently, the education of children with cerebral palsy in our country, with the exception of isolated cases, was carried out in specialized boarding schools. Correctional educational institutions continue to educate children with special needs who cannot attend a regular school.

But today the right to inclusive education is enshrined in the strategic National Doctrine of the Russian Federation. Therefore, a child with motor and psycho-speech disorders, with limited ideas about the world around him, can receive an inclusive education, study in a regular, general education school.

The element of competition, the desire to be equal among equals is a great incentive for learning. Daily classes, homework, allow you to broaden your horizons, improve thinking, memory and other cognitive abilities. In addition, getting the first experience of independent living outside the home, communicating with peers, teachers, the child expands the boundaries of the spiritual world, learns to exist in society, interact with other members of the team.

And this is a great experience not only for a special boy or girl, but also for quite ordinary children. Along with mathematics, languages, biology and other sciences, they have the opportunity to receive a free lesson in kindness, mercy, compassion, and mutual assistance. Provided that adults, teachers, psychologists, who must provide support for a child with cerebral palsy in a regular school, help them figure out what is “good” and what is “bad”, they will show an example of philanthropy.

If, for some objective reason, a child with cerebral palsy cannot attend general education or correctional institutions, today there is the possibility of home schooling.

During individual homework, the teacher can devote attention and time entirely to one student. The child feels protected, and therefore more relaxed at home, so it is easier for him to concentrate on the learning process.

However, being homeschooled, he will be deprived of the opportunity to communicate with peers, life in a team, independence in decision-making, etc.

Therefore, if the condition of the child, the form of the disease and the degree of impairment allow him to receive an inclusive education, parents and other adults should do everything possible for his successful integration into the children's team.

Cerebral palsy - this abbreviation scares all parents and often sounds like a sentence. However, when receiving such a diagnosis, the parents of the child should not give up, but are simply obliged to sound the alarm. This terrible diagnosis should be questioned and the true causes leading to a violation of the child's motor functions should be identified. The fact is that pediatric neuropathologists tend to make this diagnosis, which is familiar to them, from the first year of a child's life - when the first signs of paralysis and paresis appear. However, with deep scientific and practical research, it turned out that the diagnosis of cerebral palsy is a very conditional, inaccurate diagnosis. As Anatoly Petrovich Efimov, traumatologist-orthopedist-neurorehabilitologist, doctor of medical sciences, professor, general director of the Interregional Center for Restorative Medicine and Rehabilitation in Nizhny Novgorod, notes, “cerebral palsy is not a sentence yet, since 80% of cases can be cured until full recovery child. If this is done in a timely manner, as my medical practice shows, children under 5 years old are cured in 90% of cases and go to school along with ordinary children.

Cerebral palsy does not happen without a cause. When any conversation appears on the part of doctors about the threat of cerebral palsy or cerebral palsy, parents should do the following.
Firstly, parents need to find out the causes of cerebral palsy together with the doctor, if the doctor insists on this diagnosis. And these reasons are few, and in any hospital they can be established in one or two weeks. There are only six causes leading to cerebral palsy.

First reason are inherited genetic factors. All the disorders that are in the genetic apparatus of the parents can really manifest themselves in the form of cerebral palsy in a child.

The second reason- this is ischemia (impaired blood supply) or hypoxia (lack of oxygen) of the fetal brain. This is the oxygen factor, the lack of oxygen to the child's brain. Both can occur during pregnancy or during childbirth as a result of various vascular disorders and hemorrhages.

Third reason- This is an infectious factor, that is, a microbial one. The presence in the child in the first days and the first weeks or months of life of diseases such as meningitis, encephalitis, meningoencephalitis, arachnoiditis, occurring with high fever, severe general condition of the child, with poor blood or cerebrospinal fluid tests, with the detection of specific microbes that are the causative agents of an infectious disease .

Fourth reason- these are the actions of toxic (poisonous) factors, poisonous drugs on the body of a future person. This is most often the intake by a woman of potent drugs during pregnancy, the work of a pregnant woman in hazardous working conditions, in chemical industries, in contact with radiation or chemicals.

Fifth reason is a physical factor. Impact on the fetus of high-frequency electromagnetic fields. Irradiation, including X-ray, radiation and other physical adverse factors.

Sixth reason- this is a mechanical factor - birth trauma, trauma before childbirth or shortly after them.

In each polyclinic, in one to two weeks, one can fully assess the root causes of paralysis of brain functions. Practice shows that pediatric neuropathologists are fond of diagnosing and searching for only infectious or ischemic causes of brain damage in a child. A viral or infectious brain lesion is often diagnosed. Doctors also pay attention to the lack of oxygen due to vascular disorders, although most vascular disorders and hemorrhages are precisely traumatic, because young blood vessels in newborns cannot burst on their own, like in old people 80-90 years old, so there is no typical stroke in children. Vessels in newborns and children are soft, elastic, supple, adaptive, therefore, it is deeply wrong to explain the causes of cerebral palsy with vascular disorders. Most often, they are caused by traumatic causes. The importance of identifying the root cause of the disease is that the entire program of further treatment and the life prognosis for the child depend on it.

Cerebral palsy is of three groups.

First group- True cerebral palsy, not acquired. The disease is hereditary, congenital, primary, when at the time of the birth of a child, his brain is really deeply affected by genetic disorders or disorders of embryonic development. It is underdeveloped, smaller in size and volume, the convolutions of the brain are less pronounced, the cerebral cortex is underdeveloped, there is no clear differentiation of gray and white matter, there are a number of other anatomical and functional disorders of the brain. This is the primary one, i.e. true infantile cerebral palsy. The brain at the time of birth is biologically and intellectually defective, paralyzed.

Primary cerebral palsy is formed due to:
1) hereditary causes;
2) the action of various adverse factors during the embryonic (intrauterine) development of the child;
3) severe birth trauma, often incompatible with life.
But if such a child was miraculously revived and saved, the state of the brain or spinal cord remains incompatible with normal development.
There are about 10% of such children.

Second group- True cerebral palsy, but acquired. Children with such a diagnosis are also about 10%. These are children with acquired disabilities. Among the causes are severe birth trauma, for example, deep hemorrhage during childbirth with the death of parts of the brain, or the traumatic effect of toxic substances, especially anesthesia, as well as severe infectious brain damage with purulent meningoencephalitis, etc. such serious causes, affecting the brain and nervous system of the child, form a severe picture of cerebral palsy, but they are no longer hereditary and embryonic in nature, in contrast to the first group of patients with cerebral palsy, but acquired. Despite the severity of the lesion, children can be adapted to independent movement and walking so that they can later serve themselves. Their everyday rehabilitation is possible so that their movement is independent, so that they do not need to be carried on their hands, since aging parents cannot do this, and the body of a child grows to a significant weight of a man or woman.

Third group- ICP is not true acquired. This is a false, pseudo-cerebral palsy, or secondary, acquired cerebral palsy syndrome, a much larger group. At the time of birth, in this case, the children's brain was biologically and intellectually complete, but as a result of the action, first of all, birth injuries, disturbances appeared in various parts of the brain, leading to subsequent paralysis of individual functions. 80% of children suffer from acquired cerebral palsy. Outwardly, such children differ little from children with true cerebral palsy, except for one thing - their intellect is preserved. Therefore, it can be argued that all children with a smart head, with a intact intellect, are never children with true cerebral palsy. That is why all these children are very promising for recovery, since the cause of cerebral palsy-like syndrome in them was mainly a birth injury - severe or moderate.
In addition to birth injuries, the cause of secondary (acquired) cerebral palsy is oxygen starvation of the brain during pregnancy, mild hemorrhages in the brain, exposure to toxic substances, and physical adverse factors.

In addition to the diagnosis of cerebral palsy, it is worth dwelling on the diagnosis of “threat of cerebral palsy”. It is placed mainly in the first year of a child's life. At the same time, it is necessary to take into account: until the main causes of paralysis of the nervous system, the musculoskeletal system have not been identified, until a modern comprehensive examination of the child has been carried out, and until normal, natural terms for the appearance of walking have come, it is impossible to prematurely diagnose "the threat of cerebral palsy". For such children under one year old, it is necessary to bother a lot, first of all, to parents, to advise them in the best centers, with the best doctors in order to finally understand the prospects for the development of such a disease in a child.

An important and numerous group of patients diagnosed with cerebral palsy are children with the so-called secondary cerebral palsy, that is, initially at the time of birth, these children had no reason to diagnose cerebral palsy. The nature of such diseases does not create. Where do they come from? It turns out that all these children only have cerebral palsy-like diseases, with the consequences of birth injuries or other pathological factors. But due to improper treatment, by the age of 7-10 they become children with secondary cerebral palsy - absolutely unpromising, with irreversible functional disorders, with medical and biological consequences, that is, severely disabled. This group of children lies entirely on the conscience of doctors. For various reasons, they were treated for years with a treatment regimen for cerebral palsy, without finding out the true causes of the development of movement disorders and other disorders. As for the treatment of cerebral palsy, they used potent drugs that affect the brain, prescribed inadequate physiotherapy, primarily electrical procedures, used manual therapy without justification, prescribed active massage of those parts of the body where it is undesirable, used chipping methods, as in the treatment of true cerebral palsy, methods electrical stimulation, prescribed hormonal drugs, etc. Thus, incorrect treatment carried out for years (5, 7, 10 years) forms a large group of disabled people with secondary infantile paralysis. This group of children is a great sin of modern medicine. First of all, child neurology. Parents need to know about this in order to prevent the further formation of such a group of patients in our society as children with cerebral palsy of an untrue, acquired, secondary nature. With the right modern diagnostics, with the right rehabilitation treatment, all these children can recover to a normal state, i.e. they can master a certain working specialty, depending on the age and the timing of the start of adequate rehabilitation.

How should the parents of a child behave when diagnosed with "threat of cerebral palsy" or "cerebral palsy"?

First of all, don't give up. They should know that in addition to the traditional neurological treatment regimens for cerebral palsy, in Russia there is an opportunity to accurately diagnose the true causes of cerebral palsy. And also to distinguish true cerebral palsy from acquired, true causes leading to paralysis of the brain, from causes paralyzing temporarily, i.e. so that the paralyzing disturbances are reversible. Particularly effective is the group of children who have developed cerebral palsy as a result of birth trauma, since many of the consequences of trauma are reversible. And reversibility means curability. Therefore, cerebral palsy caused by birth trauma is treated in such a way that further the child has prospects for recovery at any age. Although it should be noted that the earlier treatment is started, the more effective it is. The best curability is observed in children under 5 years old - in 90% of cases, up to 10 years old - about 60%. After 10 years, due to the fact that children are neglected, that is, many physiological disorders appear in their bodies by this time, and not only in the brain, but also in bones, joints, muscles and other organs, they are already recovering worse. But they are sure to be restored to the level of independent movement and self-service. These patients should apply and actively engage in all methods of family rehabilitation at home until a positive end result appears. Of course, the older the child, the more time it takes to recover. But in any case, you can not stop and to achieve the desired results, you need to practice at home. Rehabilitation is for all ages.

Ekaterina SERGEEVA

Cerebral palsy (ICP) is a pathology of the motor activity of the child, which appeared due to brain damage during pregnancy, childbirth or in infancy. The perception of the outside world, the ability to communicate, in most cases - the psyche are disturbed. The disease is difficult to treat, but does not progress. There are different types of cerebral palsy, in which the disease proceeds with characteristic features.

Most often, the symptoms of the disease make themselves felt during the first months of life.

How common is cerebral palsy?

According to world statistics, almost a quarter of cases of pathology of the nervous system in children (24%) are due to cerebral palsy. Despite the development of medicine, pregnant women and newborns continue to be the most vulnerable group of the population, subject to increased exposure to any stress factors.

Reasons for the development of cerebral palsy

The cause of cerebral palsy is a violation of the transmission of brain impulses to the muscles. It develops when brain cells are damaged in the early stages of development. This can happen both in utero and during childbirth or after birth.

During pregnancy

The body of a woman during pregnancy requires a sparing regimen, a more attentive attitude. Adverse factors can be detrimental to the development of the child:

• exposure to radiation, toxic substances, drugs, alcohol, certain medications;
• severe illness of the expectant mother;
• infections transferred during pregnancy;
• oxygen starvation;
• the course of pregnancy with complications;
• incompatibility of the Rh factor in the blood of mother and baby.

During childbirth

Childbirth does not always go smoothly - doctors sometimes have to respond quickly to unforeseen situations. The development of cerebral palsy can be affected by:

• fetal asphyxia (entanglement of the umbilical cord, prolonged labor, etc.);
• birth injury.

After the birth of a child

After the birth of a child, the living conditions of the mother and baby have a decisive influence on his body. The following situations are dangerous for brain damage:

• the child's brain does not receive enough oxygen;
• carcinogens enter the baby's body;
• head injury;
• transferred infections.

How to recognize cerebral palsy in a child after 1 year

By the age of 12 months, a normally developing child already knows a lot. He rolls over, sits down, stands up, tries to walk, utters separate words. The kid responds to his name, emotionally reacts to the world around him, communicates.

Of course, each baby has an individual pace of development. One child can walk with his feet or start talking earlier, the other later. However, CNS pathologies usually appear in combination.

Parents should be wary if at the age of 1 year and older:

• does not crawl and at the same time does not try to walk (some children do one thing: either crawl for a long time, or walk right away);
• cannot stand independently without support;
• does not speak separate short words (“mom”, “dad”, “woof”, etc.);
• does not try to find a toy hidden in front of his eyes, does not reach for catchy things that interest him;
• the baby's limbs on one side of the body are more active than on the other;
• the child has seizures.

Types of cerebral palsy

In world practice, several types (forms) of this disease are distinguished. The differences between them are in the symptoms, degree and localization of the CNS lesion.

Spastic tetraplegia

This is a severe form of cerebral palsy that develops due to a critical lack of oxygen. Because of this, there is a partial death of brain neurons, liquefaction of the structure of the nervous tissue. In half of the cases, epilepsy is observed. Other possible symptoms are disturbances in attention, speech, swallowing, intellect, paresis of the muscles of the arms and legs. Visual impairment: optic nerve atrophy up to blindness, strabismus. Possible microcephaly (decrease in the size of the skull). With this form of the disease, a person can become disabled, incapable of basic self-care.

Spastic diplegia (Little's disease)

It is diagnosed most often - in 75% of cases of cerebral palsy. Predominant in children born prematurely. Causes - hemorrhages in the ventricles of the brain, changes in the structure of brain tissue.

The muscles of the legs are mainly affected, with bilateral paresis developing. Already at an early age, joint contractures can form, resulting in a change in the shape of the spine, joints, with a violation of their mobility.

This form of cerebral palsy is accompanied by mental retardation, speech and mental retardation. If the cranial nerves are affected, the child may develop a mild degree of mental retardation. However, children with Little's disease are able to learn. If the muscles of the hands can function normally, a person is able to adapt to life, partially serve himself in everyday life, even perform feasible work.

With this type of disease, the muscles of the limbs (usually the arms) are affected only on one side. The causes of cerebral palsy of the hemiplegic form are usually hemorrhages, cerebral infarctions. A child with this form of the disease can learn to perform movements as well as a healthy one, but it will take him much longer to acquire such skills. The disease can affect the intellect to varying degrees. It depends on how the child will be able to learn and live among other people. Moreover, mental development is often not associated with motor disorders, despite the fact that the illness of such a person betrays his gait. This is the so-called Wernicke-Mann position, about which they say: “The leg mows, the hand asks.” The person walks on tiptoe, carrying the straight leg forward, and the arm on the affected side is extended into the characteristic pose of a begging person.

With the hemiplegic form of cerebral palsy, mental development, the psyche, and speech can be disturbed. Some patients suffer from epileptic seizures.

Dyskinetic (hyperkinetic) form

The cause of this type of cerebral palsy is hemolytic disease of the newborn. The name comes from hyperkinesis (dyskinesis) - involuntary muscle movements in different parts of the body, characteristic of sick people. They are slow, stringy movements that may be accompanied by convulsions with muscle contraction. In the hyperkinetic form of cerebral palsy, paralysis and paresis are observed, including those of the vocal cords, a violation of the normal posture of the trunk, limbs, and difficulty in pronouncing sounds. At the same time, the intelligence of sick children is normal, they are able to learn and develop normally. People with this form of cerebral palsy successfully graduate from school, even universities, find work, fully adapting to life in society. Their feature against the background of other people is only gait and oral speech.

It occurs due to severe fetal hypoxia during childbirth, as well as trauma to the frontal lobes of the brain. A characteristic feature of the manifestations is associated with reduced muscle tone and strong tendon reflexes. Speech disorders are often observed. Patients often have trembling of the hands and feet. All this is associated with paresis of the muscles of various parts of the body. A small or medium degree of mental retardation is characteristic.

Mixed or combined forms

Mixed forms of cerebral palsy are a combination of different forms of the disease. This happens because the child, for some reason, is affected by various structures of the brain.

Most often there is a combination of spastic and dyskinetic forms of cerebral palsy, as well as hemiplegic and spastic diplegia.

In addition, depending on the age at which the disease was detected in a child, cerebral palsy is divided into stages:

• from birth to 6 months - early form;
• from 6 to 2 years - the initial residual form;
• after 2 years - late residual form.

Diagnosis of cerebral palsy after a year

By the year with cerebral palsy, the baby usually has all the signs of the disease: non-progressive motor disorders, uncoordinated movements, developmental delay. Diagnostic methods, as a rule, are used to confirm the diagnosis, exclude diseases with a similar clinical picture, and clarify the form of the disease. However, it is not easy to make an accurate diagnosis for a baby.

The child is examined by a neurologist, who will prescribe an MRI - magnetic resonance imaging of the brain. The purpose of this procedure is to identify the affected areas of the brain. In addition, MRI helps to establish the presence of changes in the substance of the cortex and subcortex of the brain, as well as determine their type. This may be, for example, a decrease in the density of white matter.

Treatment of cerebral palsy

There is no universal treatment for cerebral palsy. Therapy for cerebral palsy is aimed at improving motor activity, speech development and correction of the child's psyche.

The earlier cerebral palsy is detected, the better results can be achieved in the treatment of a child. An important role is played by the emotional and mental state of the mother of the baby.

Medical treatment

Treatment of cerebral palsy is strictly individual. Medications are recommended according to the symptoms of the disease. To support the nervous system, glutamic acid, drugs Nootropil, Aminalon can be prescribed. If the child is hyperexcitable, sedatives are indicated. Children with cerebral palsy are often recommended B vitamins, which improve brain metabolism.

In some cases, it is required to reduce intracranial pressure, for which magnesium is prescribed intravenously. For this purpose, there are also mixtures with diacarb and citral in the composition.

In the presence of a convulsive syndrome, the doctor will prescribe the baby such drugs as Luminal, Chlorocan, Benzonal. Normalization of muscle tone occurs due to the intake of Mydocalm, Biclofen and other drugs.

But cerebral palsy cannot be cured by drugs alone. Treatment of the disease must be comprehensive. Be sure to treat not only the symptoms, but also the disease that has become the root cause of paralysis.

Massage and physiotherapy exercises

Therapeutic gymnastics and physiotherapy are an obligatory component of the treatment of cerebral palsy. For the development of muscles, electrophoresis, mud and thermal baths, magneto-, balneo-, acupuncture are used.

With young children, exercise therapy, massage, any other procedure can be done as a game. It is important to praise the baby for the slightest achievements. This will help to create a friendly, relaxing atmosphere, which only contributes to successful treatment.

Correction of incorrect postures

If you allow a child with cerebral palsy to stay in an uncharacteristic position, then over time it will be perceived by him as normal. In this case, there may be a violation of the mobility of the joints and muscles, in which it will never be possible to take the pose of a healthy person. A child with cerebral palsy is gradually established the correct muscle stereotype, fixing normal postures in his memory. To do this, use special corrective overalls (for example, a “spiral” suit). Correct postures are fixed with the help of tires, rollers, verticalizers and other devices.

In extreme cases, they resort to surgical treatment: tendon plasty, removal of joint contractures, neurosurgical operations.

Other corrective treatments

In a child with cerebral palsy, speech is most often impaired. To correct it, classes are held with a speech therapist. It is important to follow all the recommendations of the doctor.

Animal therapy has become widespread - treatment with the help of animals. For the treatment of children with cerebral palsy, horseback riding, swimming with dolphins, and positive communication with animals are used.

A difficult but important issue is the social adaptation of a child with cerebral palsy. Among other things, communication is required with both healthy and similar children. For parents and relatives of the baby, it is also useful to work with a psychologist: after all, a life-long sick child in a family is a strong stress. Parents should prepare themselves for the fact that when the child grows up, it will be important for him to learn to accept himself and the world around him.

Complications

If the child is not treated and rehabilitated, orthopedic complications of cerebral palsy may appear: scoliosis, kyphosis, stiffness of the joints and spine, pathological flexion of the limbs up to dislocations, foot deformity. This is due to the body being in the wrong postures.

As for the speech and psyche of the child, their condition may worsen due to life isolated from society. If there is no communication with peers, there is no one to talk to, then speech becomes “not needed”. And rejection by society can cause depressive states and a feeling of rejection, which will only strengthen the picture of the disease.