Cerebral Palsy (infantile Cerebral Palsy) - Causes, Forms, Symptoms, Signs, Diagnosis, Treatment Of Infantile Cerebral Palsy

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Cerebral palsy

Causes, symptoms, signs and diagnosis of cerebral palsy

Causes of infantile cerebral palsy

Cerebral palsy is a whole group of childhood diseases with pathologies of the central nervous system, impaired coordination of speech, movement, delayed intellectual development, dysfunction of the muscular and motor systems. As the analysis has shown, in most cases it is impossible to single out only one cause that entails the onset of cerebral palsy. Very often, a combination of several negative factors at once, manifested both during childbirth and during pregnancy, leads to such a disease.

Many researchers have data that brain damage begins during intrauterine development of the fetus in about eighty percent of cases of cerebral palsy. Intrauterine pathology can be further aggravated by intrapartum. The cause of this disease cannot be established in about every third case. Modern medicine knows more than four hundred factors that can affect the course of intrauterine development.

Exposure to the brain of a combination of harmful factors causes the appearance of cerebral pathology in about 70-80% of cases. In many children, the cause of the disease is the pathology of the mother's pregnancy (various infections, impaired placental circulation, toxicosis), which can lead to insufficient development of the structures of the brain, especially those parts of it that are responsible for maintaining body balance and the formation of reflex mechanisms.

As a result, the distribution of muscle tone in the skeleton is incorrect, and pathological motor reactions begin. Birth injuries caused by types of obstetric pathology (abnormal structure of the pelvis and a narrow pelvis of the mother, rapid or prolonged labor, weakness of labor) only in a small number of cases are the only cause that leads to brain damage in the fetus.

The severity of childbirth, in most cases, is determined by the pathology already existing in the child, formed as a result of his intrauterine damage. Hemolytic disease of the newborn, also called "kernicterus", can also cause cerebral palsy. This jaundice can be caused by various mechanisms - liver failure of the newborn, incompatibility of the blood of the fetus and the mother according to the Rh factor or group.

In addition, chronic or acute diseases in the mother are an extremely unfavorable factor - first of all, rubella, diabetes mellitus, obesity, anemia, heart defects, and hypertension can be attributed to them. Also, perinatal risk factors include taking certain medications during pregnancy, for example, tranquilizers, and some activities related to professional activities - physical trauma, psychological discomfort, stress, alcoholism.

The influence of various infectious agents on the fetus, especially of viral origin, has recently been given considerable importance in the etiology of infantile cerebral palsy. Violation of the normal course of pregnancy - immunological incompatibility between the fetus and the mother, threats of termination, toxicosis - are also negative factors. Complication of childbirth. In this case, it should be borne in mind that if the child has a pathology of intrauterine development, then childbirth often has a protracted and difficult course.

At the same time, conditions are created for the appearance of asphyxia and mechanical trauma to the head, which can be attributed to secondary factors that cause additional disorder in the initially damaged brain. But many researchers attribute preterm birth to the factors that most contribute to the development of cerebral palsy. It is worth noting that with cerebral palsy, males are predominantly affected. On average, in boys, cerebral palsy occurs 1.3 times more often and is more severe than in girls.

Forms of infantile cerebral palsy

The classification of infantile cerebral palsy is based on the nature and prevalence of movement disorders. There are five types of such violations:

1. Spasticity - increased muscle tone (its severity decreases with repeated movements).

2. Athetosis is a constant involuntary movement.

3. Rigidity - tense, dense muscles constantly resisting passive movements.

4. Ataxia - imbalance, accompanied by frequent falls.

5. Tremors or tremors of the limbs.

In about 85% of cases, there is an athetoid or spastic type of disorder. By localization, four forms are distinguished:

1. Monoplegic (one limb is involved).

2. Hemiplegic (full or partial involvement of both limbs on only one side of the body).

3. Dialogue (involving either both lower or both upper limbs).

4. Quadriplegic (full or partial involvement of all four limbs).

Cerebral palsy symptoms

Symptoms of this ailment can be detected immediately after the birth of a child, or they can gradually manifest themselves in infancy. In the latter case, it is very important to identify and diagnose them as soon as possible. Doctors advise all parents to keep a special diary of the child's development, where the main achievements of the baby will be indicated. It is very important for parents to monitor the manifestation of absolute reflexes that arise in a child after birth, and then gradually fade away.

For example, the automatic walking reflex and the palmar-oral reflex should disappear in 1-2 months, but if they persist up to 4-6 months, then dysfunction of the nervous system can be suspected. In addition, it is very important to monitor: the sequence and timing of speech development and the development of motor skills, the development of playing skills (for example, lack of interest in toys). The following situations should also be noted: lack of contact with the mother, nodding of the head, performing involuntary movements, freezing in one position.

Pediatricians are not always in a hurry to diagnose infantile cerebral palsy. In many cases, on the basis of the detected specific symptoms (suppression of reflexes, increased excitability, and so on), a child under one year old is diagnosed with encephalopathy. The children's brain has great compensatory capabilities that can completely reverse the consequences of brain damage.

If a child older than a year does not speak, does not walk, does not sit, has mental abnormalities, and doctors confirm the stability of neurological symptoms, then cerebral palsy is diagnosed. Movement disorders (tremor of the extremities, ataxia, rigidity, athetosis, spasticity) are the main symptoms of cerebral palsy.

In addition, there may be violations of the organs of hearing and vision, changes in orientation in space, perception, epilepsy, speech development disorders, learning problems, delayed emotional and mental development, functional disorders of the urinary system and gastrointestinal tract. If you find the above symptoms, you should immediately contact a specialist.

Signs of cerebral palsy

In a newborn, the signs of cerebral palsy are influenced by the location of pathological foci and the measure of brain damage. These signs can be both quite obvious and noticeable only for specialists. External manifestations can be designated as clumsiness, or as strong muscle tension, which made it impossible for the child to move independently.

In an infant or an older child, early signs of cerebral palsy can be identified using the skill table for certain ages - walking and crawling, sitting, rolling over, grabbing, tracking movements. Below are some of the external symptoms that make it possible to suspect the disease of infantile cerebral palsy (the final diagnosis can only be made by a qualified specialist):

· Anxiety and poor sleep in the child;

· Child's lagging behind in physical development (he started to crawl late, raise his head, roll over);

· There are gaze stops, convulsions, flinching;

· Disorders of muscle tone: by 1.5 months the hypertonicity of the arms does not decrease, and by the age of four months - of the legs. The child's muscles are excessively sluggish or, conversely, tight, movements are slow or sharp;

· There is a slowdown in emotional development (at one month the child does not smile);

· Body asymmetry. For example, one arm is relaxed and the other is tense. Or a visual difference in limbs, for example, in the thickness of the arms or legs.

If such signs are detected, you should seek qualified medical advice.

Diagnostics of the infantile cerebral palsy

It is possible that the symptoms of cerebral palsy are not found or are not present at birth. Therefore, the attending physician observing the newborn should carefully examine the child so as not to miss these symptoms. Nevertheless, overdiagnosis of cerebral palsy is not worth it, since in children of this age many motor disorders are transient. In many cases, the final diagnosis can be made a couple of years after birth, when it is possible to notice movement disorders.

Diagnosis of this disease is based on monitoring the presence of deviations in the child's intellectual and physical development, test data, as well as instrumental research methods (in this case, magnetic resonance imaging - MRI is performed). It includes:

· Collection of all information about the medical history of the baby, not excluding the details of the pregnancy. The presence of various delays in the development of the child is often reported by the parents themselves, or it is found during examination in child care facilities.

· Physical examination is essential to detect signs of cerebral palsy. During it, a qualified specialist assesses how long the reflexes of newborns persist in the child in comparison with normal periods. In addition, the assessment of muscle function, hearing function, posture, vision is carried out.

· Samples for detecting the latent form of the disease. Various analyzes and developmental questionnaires can help determine the degree of developmental delays.

· An MRI may also be done to identify a disorder in the brain.

The complex of such diagnostic methods allows you to make a final diagnosis. If the diagnosis is unclear, additional tests may be prescribed to exclude possible other diseases and to assess the state of the brain. They include: ultrasound examination of the brain, computed tomography of the head, additional questioning. After the diagnosis of cerebral palsy, to identify other diseases that may be at the same time with cerebral palsy, the child undergoes additional examination.

Cerebral Palsy Treatment

First of all, the treatment of cerebral palsy is carried out with the help of training of mental and physical functions, allowing to reduce the severity of the neurological defect. Occupational therapy and physical therapy improve muscle function. Hearing correction and speech therapy help the patient's speech development. Various orthopedic devices and braces make it easier to maintain balance and walk.

Long-term therapy should include special education programs, development of communication skills, psychological counseling. Treatment of infantile cerebral palsy also includes courses of special massage and a complex of physiotherapy exercises. On the recommendation of doctors, drugs are used to lower muscle tone and drugs that improve the nutrition of the nervous tissue and microcirculation. The earlier a course of treatment and rehabilitation programs for cerebral palsy is started, the better.

Thanks to this, large deviations in the development of the child can be avoided. All treatments and medications should only be prescribed by qualified professionals.

Teaching parents to restore muscle movement:

A deeply premature baby. Full restoration of Bogdan:

Author of the article: Sokov Andrey Vladimirovich | Neurologist

Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".