Module on cerebral palsy. Mild cerebral palsy - symptoms and methods of treating the disease

Cerebral palsy is not considered an independent disease.

This term is used to designate a whole complex of movement disorders that arise as a result of brain damage in utero.

The pathology is congenital, its first signs are can be noticed already in children in the first days of life. The most complete and detailed clinical picture manifests itself in infants, that is, before the child reaches 1 year. We will talk about what cerebral palsy is in children in this article.

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Concept and characteristics

Cerebral palsy (cerebral palsy) is a pathology that occurs as a result of damage to the areas of the brain responsible for motor activity of the child.

The disease develops in the prenatal period, when the brain is just forming.

During the first years after the birth of a child, in the presence of certain negative reasons, the disease progresses, acquiring more and more new manifestations.

However, as the baby grows up, the development of the pathology stops, that is, the brain damage does not worsen. A movement disorders amenable to partial correction.

Brain damage can manifest itself in 2 ways:

• nerve cells of an initially healthy brain undergo pathological changes;
• the structure of the organ itself is disrupted.

The manifestations of cerebral palsy are very diverse; in some children the motor activity of the legs is impaired (the most common scenario), in others - in the arms, in others the coordination of movements is impaired.

Such differences depend on what kind of brain damage occurs and in what period of time it occurred (when exposed to negative factors The part of the brain that suffers the most is the one that was actively formed at the time of unfavorable conditions).

Causes

Why was the child born with cerebral palsy? Root cause– disruption of the functioning of the brain, in particular, its parts responsible for the ability to move.

Such damage can be caused by a variety of unfavorable factors that arise both in the prenatal period and at the time of birth and in the first months of the baby’s life.

Intrauterine factors	Reasons at the time of birth	Causes in the first months of life
Long-term and intense toxicosis. Premature aging and placental abruption. Threat of miscarriage. Kidney diseases of the expectant mother. Injuries to the fetus during the prenatal period of development. Oxygen deficiency. Fetoplacental insufficiency. Infectious and viral diseases during pregnancy.	Narrow pelvis of a woman. When passing through the birth canal, the child often receives serious injuries. Weakening of labor. Having a baby earlier due date. Large fetal weight. Rapid labor activity. Breech presentation at the time of birth.	Disruption of the respiratory system, leading to hypoxia of the newborn. Hit amniotic fluid in the mouth and nasal cavity child, which also contributes to the development of suffocation. - pathology arising as a result of Rh conflict, accompanied by increased speed breakdown of red blood cells.

How is it developing?

In children born ahead of schedule, there is immaturity of the brain and its structures.

This can lead to improper development of the organ, and, as a result, the occurrence of cerebral palsy.

Oxygen starvation in the prenatal period it contributes to the occurrence of brain damage, however, if there are no other abnormalities in the development of the child, this phenomenon does not have any visible effect (provided that the oxygen deficiency was insignificant).

If the child has low birth weight, its organs, including the brain, are not fully formed; during hypoxia, some areas of the brain die, and hollow areas appear in their place.

Accordingly, the functionality of the organ is impaired, which leads to disturbances in the motor activity of the body.

Classification of pathology

There are several types of cerebral palsy, which differ from each other in their characteristic features, set of features.

Form	Peculiarities
Spastic diplegia	This form is the most common. It occurs due to damage to areas of the brain that are responsible for the motor activity of the limbs. In children, in the first months after birth, partial or complete paralysis of the legs or arms is observed.
Atonic-astatic	Pathology arises as a consequence of not proper development or cerebellar lesions. The child is unstable, his coordination of movements is impaired, and there is also decreased tone muscle tissue.
Hemiparetic	The subcortical and cortical areas of one of the cerebral hemispheres are affected. In this case, motor disturbances are observed only on one side.
Double hemiplegia	Damage occurs in both hemispheres of the brain at once. This form is considered the most dangerous, as it often leads to complete paralysis.
Hyperkinetic	Caused by lesions of the subcortical areas of the brain. Often develops against the background of a spastic form. A child suffering from this type of cerebral palsy is prone to making uncontrolled body movements. Often this manifestation intensifies in those moments when the baby is overexcited, nervous, and worried.

Depending on the child's age it is customary to distinguish the early form(the first signs appear immediately after birth and before 6 months of age), initial residual (6-24 months), late residual (over 2 years).

According to severity they are distinguished:

1. Light form in which they are observed minor deviations in motor activity. At the same time, the child is able to do without the help of strangers, can dress independently, eat, play, and attend children's educational institutions.
2. Average form when the baby needs outside help in carrying out complex tasks. However, such a child can attend general education institutions and study successfully.
3. Heavy a form in which the child cannot do without help, because in this case he is not able to perform even the simplest actions.

Companions of the disease

Cerebral palsy in a child can manifest itself not only in impaired motor function, or its complete absence. It is possible to have other unpleasant moments, such as:

• involuntary convulsions;
• (formation of pathological fluid in the brain area);
• decreased vision and hearing;
• (difficulty pronouncing sounds, lack of speech, stuttering);
• difficulties in learning to write, count, read;
• behavioral disorders, emotional disorders.

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Symptoms and signs

A child suffering from cerebral palsy exhibits the following: symptoms:

Complications and consequences

DPC leads to the development of such serious complications as:

1. Musculoskeletal disorders(pathological bending of the arms, which in severe cases can provoke dislocation of the joints, deformation of the foot when the baby moves only on his toes, curvature of the spine and persistent violation of posture, as a result of which the child’s body loses its symmetry).
2. Speech disorders until its complete absence.
3. Mental retardation, problems with adaptation in a team.

Diagnostics

After the baby is born in mandatory examined by a doctor. This makes it possible to identify pathology early stage its development and begin treatment as soon as possible. Children who have increased risk development of cerebral palsy.

These are premature babies who have low birth weight, suffer from congenital anomalies in the development of internal organs, were born as a result of difficult births, and have a low according to Apgar criterion.

The doctor carefully examines the child, checking the severity of innate reflexes and muscle tone.

If any deviations are detected, prescribe hardware research:

• Ultrasound of the brain;
• CT, MRI.

Differential

In the first days of a child’s life, cerebral palsy can manifest itself in the form of signs that are also characteristic of other diseases, the treatment of which is carried out using fundamentally different methods and means.

That is why differential diagnosis is of particular importance. It is important to distinguish cerebral palsy from diseases such as amino acid metabolism disorders, mucopolysaccharidosis, neurofibromatosis, and hypothyroidism.

Objectives of treatment and rehabilitation

Correctly selected therapy is aimed at solving the following problems:

1. The need to encourage a small patient to develop the skills of movement, self-care, movement of arms and legs;
2. Prevention of the development of contractures (flexion of limbs), poor posture;
3. Creating the necessary conditions for the child’s mental development, acquisition of speech, writing and social skills.

Therapy that allows partially restore motor activity, must be comprehensive, including various methods of treatment and correction. The choice of one method or another is made by the doctor.

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Medication

The child is prescribed anticonvulsants drugs (Valparin, Epilim) if convulsions occur, as well as drugs that help eliminate spasms of muscle tissue (Diazepam).

Usage nootropics and other drugs to improve brain activity in cerebral palsy does not produce any results, since brain damage in this case is irreversible.

Self-medication with such means can only harm the child. All medications used for therapeutic purposes should be prescribed only by the attending physician.

Massage and exercise therapy

Massage and special exercises that help strengthening muscle tone, restoring posture, preventing spinal curvature, the child needs to do throughout his life.

At first, a specialist should work with the baby, since the complex massage movements and strengthening exercises are developed individually for each child suffering from cerebral palsy.

Correction of pathological posture

The changes that occur in a child’s body with cerebral palsy lead to disorders of the musculoskeletal system, as a result of which the body is not able to assume a physiological position.

In this case are being formed incorrect postures that need correction. Otherwise, development may occur persistent violation posture, formation of contractures. For correction, various medical devices are used, such as splints, splints, and bandages.

Correction of contractures surgically

Contracture– formed as a result of not correct position body persistent flexion of the limbs.

This pathology needs correction, otherwise even more serious consequences may develop, such as significant deformation of the joint, its dislocation.

For correction use 2 types of surgical intervention: may be subject to surgery Achilles tendon, or muscle tissue in the lumbar region.

Other ways

Depending on what manifestations of cerebral palsy observed in a child, for more successful treatment It is possible to use other methods, such as:

1. Physiotherapy, helps relax muscles and eliminate painful spasms.
2. Classes with speech therapist allow you to eliminate (or reduce) speech disorders.
3. Socialization child (communication with peers) will help him adapt faster to the team.
4. Communication with animals(horses, dolphins) allows you to normalize emotional state child, improve his motor activity.

Rehabilitation centers

Name	Address
	Elektrostal, st. Tevosyan, 27
Reatsentr	Samara Novo-Vokzalny dead end 21 "A"
Sail of Hope	Voronezh, st. Plekhanovskaya, 10-a
	St. Petersburg, Pushkin, Parkovaya st. house 64-68
Rehabilitation center	Moscow st. Lodochnaya, 15, building 2
SPC Solntsevo	Moscow Solntsevo, st. Aviatorov, 38
Center for Curative Pedagogy	Moscow Stroiteley, 17b
Speech Pathology Center	Moscow, Solntsevo, st. Aviatorov, 38; Nikoloyamskaya, 20

Cerebral palsy is a disease manifested in very young children. Numerous reasons lead to its development, which can have a negative effect both in the intrauterine period of fetal development and after the baby is born.

Symptoms of the pathology are very diverse; damage affects not only motor function. The disease also negatively affects the emotional, intellectual, mental development child. Therefore, the disease must be identified as early as possible and treatment started.

About how to recognize cerebral palsy in a child, you can find out from the video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Cerebral palsy () is a disease disruptive at work motor system which arise as a result of damage to areas of the brain or their incomplete development.

Back in 1860, Dr. William Little began to describe of this disease, which was called Little's disease. Even then it was revealed that the cause was oxygen starvation of the fetus at the time of birth.

Later, in 1897, psychiatrist Sigmund Freud suggested that the source of the problem could be disturbances in the development of the child's brain while still in the womb. Freud's idea was not supported.

And only in 1980 it was found that only 10% of cases of cerebral palsy occur as a result of birth injuries. Since then, specialists have more than close attention began to focus on the causes of brain damage and, as a consequence, the appearance of cerebral palsy.

Provoking intrauterine factors

Currently, more than 400 reasons are known occurrence of cerebral palsy. The causes of the disease are correlated with the period of gestation, childbirth and the first four weeks after (in in some cases the period of possibility of manifestation of the disease is extended until the child is three years old).

It is very important how the pregnancy progresses. According to research, it is during intrauterine development in most cases, disturbances in fetal brain activity are observed.

Key reasons that can cause dysfunction in the developing child’s brain, and the occurrence of cerebral palsy during pregnancy:

Postnatal factors

In the postpartum period, the risk of occurrence decreases. But he also exists. If the fetus was born with a very low body weight, then this may pose a danger to the child’s health - especially if the weight is up to 1 kg.

Twins and triplets are more at risk. In situations where a child receives it at an early age, this is fraught with unpleasant consequences.

These factors are not the only ones. Experts do not hide the fact that in every third case it is not possible to identify the cause of cerebral palsy. Therefore, the main points that are worth paying attention to first have been listed.

An interesting observation is the fact that boys are 1.3 times more likely to be affected by this disease. And in males, the course of the disease manifests itself in a more severe form than in girls.

Scientific research

There is evidence that particular importance in considering the risk of occurrence should be given to the genetic issue.

Norwegian doctors from the field of pediatrics and neurology conducted a large study, which revealed a close relationship between the development of cerebral palsy and genetics.

According to the observations of qualified specialists, if parents already have a child suffering from this disease, then the possibility of another child in this family with cerebral palsy increases 9 times.

A research team led by Professor Peter Rosenbaum came to these conclusions after studying data on more than two million Norwegian babies born between 1967 and 2002. 3649 children were diagnosed with cerebral palsy.

Cases with twins were considered, situations with relatives of the first, second and third degrees were analyzed. Based on these criteria, the incidence of cerebral palsy in infants belonging to different categories of relationship was identified.

As a result, the following data was provided:

• if a twin has cerebral palsy, then the probability of the other twin getting it is 15.6 times higher;
• if you're sick brother or sister, then the risk of having another child suffering from cerebral palsy increases 9 times; if uterine - 3 times.
• if available cousins and sisters diagnosed with cerebral palsy, the risk of their baby developing the same problem increases 1.5 times.
• parents with this disease increase the likelihood of having a child with a similar diagnosis by 6.5 times.

It is important to know the causes and risk factors for cerebral palsy, since its development can be prevented. if you take care of the health of the mother and fetus prematurely.

To do this, you should not only visit a doctor regularly, but also maintain a healthy lifestyle, avoid injuries, viral diseases, use of toxic substances, carry out treatment in advance and do not forget to consult about the safety of the medications used.

Understanding the importance of precautions is the best prevention cerebral palsy.

Cerebral palsy (CP) - Today it is one of the most common diseases in children. In Russia only by official statistics More than 120,000 people are diagnosed with cerebral palsy.

Where does this diagnosis come from? Inherited or acquired? A sentence for life or can everything be fixed? Why children's? After all, not only children suffer from it? And in general, what is cerebral palsy?

cerebral palsy - this is a disease of the central nervous system, in which one (or several) parts of the brain are damaged, resulting in the development of non-progressive disorders of motor and muscle activity, coordination of movements, functions of vision, hearing, as well as speech and psyche.

The cause of cerebral palsy is damage to the child's brain. The word "cerebral" (from Latin word“cerebrum” - “brain”) means “cerebral”, and the word “paralysis” (from the Greek “paralysis” - “relaxation”) defines insufficient (low) physical activity.

Clear and full complex There is no information about the causes of this disease. You cannot catch or get sick with cerebral palsy. Doctors agree that the main possible reasons The development of cerebral palsy is as follows:

• acute hypoxia - insufficient oxygen supply to the child’s brain, which leads to the death of brain cells and hemorrhages;
• birth trauma;
• infections;
• injuries during the first year of life.

Main risk factors for cerebral palsy:

• premature babies, low birth weight;
• premature placental abruption;
• birth of a large fetus;
• incorrect presentation of the fetus;
• anatomically and clinically narrow pelvis;
• rapid labor;
• labor induction and labor stimulation;
• Rh factor or group incompatibility of the fetus and mother.

So, the main causes of cerebral palsy are associated with the development of pregnancy and childbirth, and these conditions are not inherited, therefore such paralysis is often called congenital cerebral palsy. A less common type is acquired cerebral palsy (traumatic brain injuries due to accidents or brain infections). As a result, having received such a condition immediately after birth, a person is forced to live and fight with it, sometimes all his life.

The form of cerebral palsy and the severity of the disease are determined by a neurologist. With a mild degree, the child is teachable, able to move independently, and has self-care skills. The average degree requires additional assistance from adults. Children with severe cerebral palsy are completely dependent on others; intellectual development fluctuates between moderate and severe mental retardation.

Due to the fact that cerebral palsy - disorder or malformation of the brain, other symptoms that are associated with brain dysfunction, may appear in children with cerebral palsy. For example, learning disabilities, squinting, hearing impairment, poor speech, difficulty swallowing, drooling and poor motor coordination. About a third of all patients with cerebral palsy have seizures. Children with cerebral palsy often have difficulty gaining weight and growing. Often, a whole range of other problematic conditions appear that are not directly related to the brain, but which greatly complicate a person’s life: breathing problems, osteoporosis, and others.

Of course, it will be very difficult for a family to cope with the ordeal that has befallen them alone, and the success of rehabilitation largely depends on the coherence and coordination of the work of different specialists. However, they occupy the position of consultants and assistants, and the leading role in this labor-intensive and lengthy process is still given to the people closest to the baby. It is possible to overcome the consequences of cerebral palsy, and the earlier treatment is started, the greater the chances of achieving success. It must be remembered that with proper rehabilitation, a child can forget about disability, become an independent person and a full-fledged member of society.

I have been diagnosed with cerebral palsy (cerebral palsy) since birth. More precisely, from the age of one (about then the doctors finally determined the name of what was happening to me). I graduated from a special school for children with cerebral palsy, and 11 years later I came to work there. 20 years have passed since then... According to the most conservative estimates, I know, more or less close, more than half a thousand people with cerebral palsy. I think this is enough to dispel the myths that those who are faced with this diagnosis for the first time tend to believe.

Myth one: Cerebral palsy is a serious illness

It is no secret that many parents, upon hearing this diagnosis from a doctor, experience shock. Especially in recent years, when the media more and more often talk about people with severe cerebral palsy - about wheelchair users with damage to their arms and legs, slurred speech and constant violent movements (hyperkinesis). They don’t even know that many people with cerebral palsy speak normally and walk confidently, and with mild forms they do not stand out among healthy people at all. Where does this myth come from?

Like many other diseases, cerebral palsy ranges from mild to severe. In fact, it’s not even a disease, but common cause a range of disorders. Its essence is that during pregnancy or childbirth, certain areas of the cerebral cortex are affected in the baby, mainly those responsible for motor functions and coordination of movements. This is what causes cerebral palsy - a disorder proper operation individual muscles to the point of complete inability to control them. Doctors count more than 1000 factors that can trigger this process. It's obvious that various factors cause different consequences.

Traditionally, there are 5 main forms of cerebral palsy, plus mixed forms:

Spastic tetraplegia– the most severe form when the patient is sick due to excessive stress muscles are unable to control either arms or legs and often experiences severe pain. Only 2% of people with cerebral palsy suffer from it (hereinafter statistics are taken from the Internet), but they are the ones most often talked about in the media.

Spastic diplegia- a form in which either the upper or lower limbs. The legs are more often affected - a person walks with bent knees. Little's disease, on the contrary, is characterized by severe damage to the hands and speech with relatively healthy legs. Consequences of spastic diplegia occur in 40% of cerebral palsy patients.

At hemiplegic form motor functions of the arms and legs on one side of the body are affected. 32% have signs of it.

In 10% of people with cerebral palsy, the main form is dyskinetic or hyperkinetic. She is characterized by strong involuntary movements– hyperkinesis – in all extremities, as well as in the muscles of the face and neck. Hyperkinesis often occurs in other forms of cerebral palsy.

For ataxic form characterized by decreased muscle tone, sluggish slow movements, severe imbalance. It is observed in 15% of patients.

So, the baby was born with one of the forms of cerebral palsy. And then other factors are included - factors of life, which, as you know, is different for everyone. Therefore, what happens to him after a year is more correctly called the consequences of cerebral palsy. They can be completely different even within the same form. I know a man with spastic diplegia of the legs and quite strong hyperkinesis, who graduated from the Faculty of Mechanics and Mathematics of Moscow State University, teaches at the institute and goes on hikes with healthy people.

According to various sources, 3-8 babies out of 1000 are born with cerebral palsy. The majority (up to 85%) have mild and moderate severity diseases. This means that many people simply do not associate the peculiarities of their gait or speech with the “terrible” diagnosis and believe that there are no cerebral palsy in their environment. Therefore, the only source of information for them is publications in the media, which do not at all strive for objectivity...

Myth two: Cerebral palsy is curable

For most parents of children with cerebral palsy, this myth is extremely attractive. Without thinking about the fact that disorders in the functioning of the brain today cannot be corrected by any means, they neglect the “ineffective” advice of ordinary doctors, spending all their savings and collecting huge sums with the help of charitable foundations to pay for an expensive course at the next popular center. Meanwhile, the secret to alleviating the consequences of cerebral palsy is not so much in fashionable procedures, but in constant work with the baby, starting from the first weeks of life. Baths, regular massages, games with straightening the legs and arms, turning the head and developing precision of movements, communication - this is the basis that in most cases helps the child’s body partially compensate for the disturbances. After all main task early treatment consequences of cerebral palsy - not correcting the defect itself, but preventing improper development of muscles and joints. And this can only be achieved through daily work.

Myth three: Cerebral palsy does not progress

This is how those who are faced with mild consequences of the disease console themselves. Formally, this is true - the state of the brain does not really change. However, even light form hemiplegia, practically unnoticeable to others, by the age of 18 inevitably causes curvature of the spine, which, if not addressed, is a direct path to early osteochondrosis or intervertebral hernias. And this means severe pain and limited mobility, up to the inability to walk. Each form of cerebral palsy has similar typical consequences. The only trouble is that in Russia this data is practically not generalized, and therefore no one warns growing children with cerebral palsy and their relatives about the dangers that await them in the future.

It is much better known to parents that the affected areas of the brain become sensitive to general condition body. A temporary increase in spasticity or hyperkinesis can be caused even by a common flu or a surge in blood pressure. IN in rare cases nervous shock or serious illness cause a sharp long-term increase in all the consequences of cerebral palsy and even the appearance of new ones.

Of course, this does not mean that people with cerebral palsy should be kept in greenhouse conditions. On the contrary: than stronger body a person, the more easily he adapts to unfavorable factors. However, if the procedure or physical exercise regularly cause, for example, increased spasticity, they should be abandoned. Under no circumstances should you do anything through “I can’t”!

Parents should pay special attention to the condition of the child from 12 to 18 years of age. At this time, even healthy children experience serious overload due to the peculiarities of the body's restructuring. (One of the problems of this age is skeletal growth, which outstrips the development of muscle tissue.) I know several cases when walking children, due to problems with the knees and hip joints at this age they sat in a wheelchair, and forever. This is why Western doctors do not recommend putting cerebral palsy children aged 12-18 years on their feet if they have not walked before.

Myth four: everything comes from cerebral palsy

The consequences of cerebral palsy are very different, and yet their list is limited. However, relatives of people with this diagnosis sometimes consider cerebral palsy to be the cause of not only a disorder motor functions, as well as vision and hearing, but also such phenomena as autism or hyperactivity syndrome. And most importantly, they believe that if cerebral palsy is cured, all other problems will be solved on their own. Meanwhile, even if the cause of the disease is indeed cerebral palsy, it is necessary to treat not only it, but also the specific disease.

During the birth process, Sylvester Stallone's facial nerve endings were partially damaged - part of the actor's cheeks, lips and tongue remained paralyzed, however, slurred speech, a grin and large sad eyes later became his calling card.

The phrase “You have cerebral palsy, what do you want!” is especially funny! sounds in the mouths of doctors. I heard it more than once or twice from doctors of different specialties. In this case, I have to patiently and persistently explain that I want the same thing as any other person - relief from my own condition. As a rule, the doctor gives in and prescribes the procedures that I need. As a last resort, going to the manager helps. But in any case, when faced with a particular disease, a person with cerebral palsy has to be especially attentive to himself and sometimes tell doctors necessary treatment to minimize the negative impact of procedures.

Myth five: people with cerebral palsy don’t get hired anywhere

It is extremely difficult to say anything based on statistics here, because there is simply no reliable data. However, judging by the graduates of the mass classes of special boarding school No. 17 in Moscow, where I work, only a few remain at home after school. About half go to specialized colleges or departments of universities, a third go to regular universities and colleges, and some go straight to work. At least half of the graduates are subsequently employed. Sometimes girls quickly get married after finishing school and begin to “work” as a mother. The situation is more complicated with graduates of classes for children with mental retardation, however, even there, about half of the graduates continue their studies in specialized colleges.

This myth is spread mainly by those who are unable to soberly assess their abilities and want to study or work where they are unlikely to meet the requirements. Having received a refusal, such people and their parents often turn to the media, trying to force their way. If a person knows how to balance desires with possibilities, he finds his way without showdowns and scandals.

A good example is our graduate Ekaterina K., a girl with a severe form of Little’s disease. Katya walks, but can work on a computer with just one finger of her left hand, and her speech is understood only by very close people. The first attempt to enter a university as a psychologist failed - after looking at the unusual applicant, several teachers declared that they refused to teach her. A year later, the girl entered the Academy of Printing in the editorial department, where there was a distance learning option. Her studies went so well that Katya began earning extra money by taking tests for her classmates. Get a job after graduation permanent job she failed (one of the reasons was the lack of an ITU labor recommendation). However, from time to time she works as a moderator of educational websites in a number of universities in the capital ( employment contract is registered to another person). And in his free time he writes poetry and prose, posting his works on his own website.

Dry residue

What can I advise parents who find out that their baby has cerebral palsy?

First of all, calm down and try to pay him as much attention as possible, surrounding him (especially at an early age!) only positive emotions. At the same time, try to live as if your family is growing ordinary child– walk with him in the yard, dig in the sandbox, helping your baby establish contact with peers. There is no need to remind him about the disease once again - the child himself must come to an understanding of his characteristics.

Secondly, do not rely on the fact that sooner or later your child will be healthy. Accept him for who he is. One should not think that in the first years of life all efforts should be devoted to treatment, leaving the development of intelligence “for later.” The development of mind, soul and body are interconnected. Much in overcoming the consequences of cerebral palsy depends on the child’s desire to overcome them, and without the development of intelligence it simply will not arise. If the baby does not understand why he needs to endure the discomfort and difficulties associated with treatment, there will be little benefit from such procedures.

Third, be lenient with those who ask tactless questions and give “stupid” advice. Remember: recently you yourself knew no more about cerebral palsy than they did. Try to calmly conduct such conversations, because their attitude towards your child depends on how you communicate with others.

And most importantly, believe: your child will be fine if he grows up to be an open and friendly person.

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Anastasia

I read the article. My topic :)
32 years old, right-sided hemiparesis (mild form of cerebral palsy). Ordinary kindergarten, regular school, university, independent search for a job (in fact, that’s where I am now), travel, friends, ordinary life….
And I went through the “lame-footed” one, and through the “club-footed” one, and through God knows what. And there will be much more, I'm sure!
BUT! The main thing is positive attitude and strength of character, optimism!!

Nana

Should we really expect things to get worse with age? I have mild degree, spasticity in the legs

Angela

And people's attitude doesn't favorable conditions lives were ruined. At 36 years old, I have no education, no job, no family, although it is a mild form (right-sided hemiparesis).

Natasha

After vaccinations, a lot of “cerebral palsy” appeared. Although the children do not have cerebral palsy at all. There is nothing congenital or intrauterine there. But they attribute it to cerebral palsy and, accordingly, they “heal” it incorrectly. As a result, they actually get a type of paralysis.
Often the cause of “congenital” cerebral palsy is not trauma at all, but an intrauterine infection.

Elena

A wonderful article that raises a huge problem - how to live “with it”. It has been well shown that it is equally bad not to take into account the presence of limitations associated with the disease and to attach excessive importance to them. You shouldn't focus on what you can't do, but rather focus on what you can.
And it is indeed very important to pay attention to intellectual development. We even injected Cerebrocurin, it gave us a huge boost in development, after all, embryonic neuropeptides really help to use the existing capabilities of the brain. My opinion is that you shouldn’t wait for a miracle, but you shouldn’t give up either. The author is right: “this can only be achieved through the daily work” of the parents themselves, and the sooner they do this, the more productive it will be. It’s too late to start “preventing improper development of muscles and joints” after one and a half years of age - “the locomotive has left.” I know on personal experience and from the experiences of other parents.
Ekaterina, all the best to you.

* Kinesthesia (ancient Greek κινέω - “move, touch” + αἴσθησις - “feeling, sensation”) - the so-called “muscular feeling”, a sense of position and movement of both individual members and the whole human body. (Wikipedia)

Olga

I completely disagree with the author. firstly, why didn’t they say anything about double hemiplegia when considering the forms of cerebral palsy? it differs from ordinary hemiplegia and from spastic tetraparesis. secondly, cerebral palsy is truly curable. if we mean the development of compensatory capabilities of the brain and improvement of the patient’s condition. thirdly, the author has seen heavy children in the eyes??? those that are out of the question to bear playing in the sandbox. when you look at a child almost in the wrong way and he shakes with convulsions. and the screaming doesn't stop. and he arches in such a way that there are bruises on mom’s arms when she tries to hold him. when the child cannot only sit or lie down. fourthly. the form of cerebral palsy is nothing at all. the main thing is the severity of the disease. I saw spastic diplegia in two children - one is almost no different from his peers, the other is all crooked and with convulsions, of course, he cannot even sit upright in a stroller. but there is only one diagnosis.

Elena

I don’t quite agree with the article as a mother of a child with Cerebral palsy-spastic diplegia, medium degree gravity. As a mother, it’s easier for me to live and fight thinking that if this is incurable, then it’s fixable—it’s possible to bring the child as close as possible to “norms.” social life. For 5 years we have heard enough that it is better to send our son to a boarding school and give birth to a healthy one ourselves... and this is from two different orthopedic doctors! It was said in front of a child whose intellect was preserved and he heard everything... of course he closed himself off, began to avoid strangers... but we have a huge leap - our son walks on his own, although he has poor balance and his knees are bent... but we are fighting. We started quite late - from 10 months , before this they treated other consequences of premature birth and doctors’ indifference...

According to statistics, the diagnosis of cerebral palsy (cerebral palsy) is made in 2-2.5% of cases per 1000 children. When studying cerebral palsy, the causes of the disease are of paramount importance for the timely adoption of measures to prevent them. In our country, perinatal anomaly among newborns is 24%. Most large percentage early childhood disabilities are congenital pathologies development of the nervous system.

General characteristics of cerebral palsy

For many centuries, this disease was not called anything, despite the fact that it has accompanied humanity throughout its history. The first official name "Little's disease" was given in the mid-nineteenth century. William John Little is a British orthopedic surgeon. By publishing his article for the Obstetric Society of Great Britain, he did not claim primacy in the discovery of this disease. Not finding a description of the disease in medical literature at that time, he compiled a detailed description. Based on own experience Little wrote about the causes of cerebral palsy in children caused by difficult births, asphyxia and prematurity.

Almost 40 years later, Canadian William Osler proposed the name “cerebral palsy.” He also studied the influence of obstructed labor on the occurrence of the disease. The famous psychiatrist of that time, Sigmund Freud, did not ignore this problem. He published his research and coined many terms to describe cerebral palsy that are still used today.

The term cerebral palsy implies a whole series neurological disorders caused by damage to the central nervous system (hereinafter referred to as the CNS). The disease occurs during intrauterine development and in the first days of life. For the first time, cerebral palsy may appear after childbirth and further in infancy. Children with central nervous system disorders are developmentally delayed, have problems with motor skills and lack, or vice versa, increased muscle tone. Cerebral palsy is characterized by such manifestations as impaired speech development, problems with motor activity, problems with vision and hearing. Very often, cerebral palsy leads to complications associated with the disorder mental activity and its development.

Cerebral palsy cannot progress because the damage to brain tissue is limited to certain areas. As the child develops and matures, these lesions do not increase or invade new brain structures. Sometimes, as such a child grows, it seems to those close to him that the disease is progressing, but this is not the case. It’s just that when growing up and learning, the symptoms on an older baby are more clearly visible than on a baby who cannot walk and eat on his own.

There are the most various complications Cerebral palsy, the causes of which lie in the physical consequences of neurological pathology. Many of them are associated with weakening of the muscles of the larynx, tongue, and oral cavity. This causes difficulty eating, disturbance chewing process, problems with swallowing. Problems with swallowing control may cause drooling, which can irritate the skin around the mouth. Weakness of the bladder muscles often leads to urinary incontinence. Such children need increased hygiene measures. Due to incorrect body position, deformation often occurs spinal column. The consequences may be difficulty standing, walking, compression of internal organs, difficulty breathing and constant pain.

Children suffering from cerebral palsy have their own characteristics that are worth mentioning. Due to changes affecting the structure of the brain, one of the main external manifestations- These are problems with movement. This is due to a violation of the signals sent by the brain to the muscles, while the muscles themselves may be in hypo- or hyperdynamia. It is also typical to display disorders associated with volitional and emotional sphere, retardation in mental development and spoken language.

The development of children with cerebral palsy depends on the physical capabilities of each individual child. It is often associated with difficulties that arise when the child tries to make coordinated movements. Development is extremely complicated by the presence of psycho-emotional disorders. The child’s inability to perceive external signals normally environment, leads to slower skill formation. Developmental activities should be aimed at maximizing the development of the area in which a child with cerebral palsy has problems.

Causes of cerebral palsy

Considering cerebral palsy and its causes, we can identify ten main factors influencing its occurrence.

1. Intrauterine disorder of child brain development.
2. Physical incompatibility of the fetus and its mother.
3. Fetal hypoxia during intrauterine development.
4. Intrauterine infection (most often transmitted from the mother).
5. Violations of the integrity of the brain associated with toxic poisoning.
6. Hereditary factor.
7. Infectious diseases suffered during the formation of the brain.
8. Injury to the fetal brain in utero or during childbirth.
9. Problems in accompanying and assisting childbirth.
10. Mechanical traumatic effects on the fetus.

The causes of developmental disorders resulting in problems of the central nervous system and their consequences of cerebral palsy are strictly individual. Sometimes it is not possible to identify the exact cause; it may depend on a combination of traumatic factors. In general, the formulation is such that the causes of cerebral palsy in children are several unfavorable factors that violate the integrity of the brain structure and lead to irreversible changes.

Approximately 50% of the occurrence of cerebral palsy in children is due to pathologies caused by prematurity. Modern medical advances make it possible to deliver a premature baby from 28 weeks. But statistics inexorably prove that it is very difficult to raise a child born so early completely healthy. Therefore, such children have a significantly increased risk of developing a pathology such as cerebral palsy. Besides the fact that such a birth is in itself a trauma for the child. This depends on three more risk factors. The first is complications during nursing: cerebral hemorrhages, respiratory problems and, as a result, hypoxia. The second is infections, since the child is still too small and has not developed immunity. And third, early birth itself can be triggered by severe complications of pregnancy. These complications could already be the cause of a central nervous system disorder.

A large percentage of the causes of this disease are due to intrauterine fetal hypoxia. The mother's blood, which enters through the umbilical cord, carries oxygen, necessary for the child for proper development. In case of placental abruption, the amount of oxygen decreases, which pathologically affects the development of the baby’s brain and cardiovascular system. To avoid hypoxia, treatment must begin no later than 5-7 days from the start of oxygen starvation. Hypoxia can also be caused by the child’s improper diligence. Lightning or prolonged labor. Umbilical cord entwined around the neck, short umbilical cord, Rh conflict between the mother and the fetus. Infections and diseases suffered by a woman during pregnancy.

For a more convenient understanding of why children are born with cerebral palsy, the causes of its occurrence can be divided into several large subgroups:

• Physically caused reasons. The effect of an electromagnetic field on the fetus during pregnancy. Radiation exposure, x-rays.
• Genetic factor - parental pathologies at the chromosomal level can contribute to the development of diseases of the central nervous system in the child.
• Oxygen starvation of the brain. It can appear both during intrauterine development and during childbirth.
• Poisoning with toxic substances or medications that affect the body of the expectant mother. Very often this is caused by insufficiently effective labor protection at an enterprise with hazardous production where a pregnant woman works. The mother is taking strong medications or narcotic substances is highly likely to cause cerebral palsy.
• Mechanically caused reasons. Exposure to birth trauma, forceps assisted delivery and fetal malposition. Mechanical injuries received by the mother during pregnancy, which affected the state of the child’s brain.

It is believed that cerebral palsy is caused by vascular diseases. This is an incorrect statement. The fact is that the elasticity and softness of the fetal vessels does not allow them to collapse. If the vessels were damaged, this was due to a traumatic factor of sufficient force. And not as a result of violations of internal development.

Taking as a basis the factors influencing the appearance of cerebral palsy, the factors causing this disease can be divided into two more groups: genetic factors and non-genetic, with many patients affected by both factors. In this regard, the previous classification is still more convenient, since it was created based on the time frame of pathological changes.

There are several reasons that can affect the occurrence of cerebral palsy and each deserves special attention. At the moment when maturation occurs during intrauterine development, the child’s brain and central nervous system are especially sensitive to the manifestation of various anomalies. Some of them act crudely - taking over the fetal brain, and some, which are not outwardly diagnosed - disrupt the conduction of brain impulses that send signals.

Perinatal causes. CNS disorders can be hereditary or acquired. If the mother suffered an infectious disease during pregnancy, this greatly increases the risk of cerebral palsy in the fetus. Diseases such as herpes virus, toxoplasmosis, rubella, cytomegalovirus at certain stages of development can provoke irreversible destructive processes. All these infections can be dangerous for the child only if the mother encounters them for the first time. Fortunately to childbearing age Most mothers have already had these viruses and are immune to them. There is a test to determine immune status expectant mother, it should be used before pregnancy and during pregnancy.

A child may have a stroke during perinatal development. It can happen due to damage to blood vessels - hemorrhagic. And due to blockage of the vessel with air - ischemic. Both mother and child may have coagulopathies (immune, acquired and genetic problems with blood clotting), which is also a risk factor for cerebral palsy.

Almost any pathogenic hereditary cause can become the trigger that provokes a disorder of the central nervous system. Also, all the factors that contribute to a decrease in fetal weight, early birth makes the child vulnerable and increases the risk of subsequent disorders. Such factors may include maternal drinking of alcohol, tobacco and drug use. Considering that the child absorbs all the necessary substances through the placenta from the mother’s blood, through it he also receives toxic substances. Detachment or other placental disorders caused by this factor, in addition to affecting the baby, also lead to premature birth.

Some diseases of the expectant mother or injury to the pregnant woman often cause abnormal development of the fetus. Mothers who carry antithyroid, autoimmune and other antibodies in their blood put the fetus at risk of central nervous system disorders. When a pattern is observed in the blood of a pregnant woman higher level cytokines (proteins), the presence of which is caused by inflammation, fetal neurons are at maximum risk.

Mechanical damage and trauma during pregnancy can greatly affect the fetus, injuring it as well. In addition, blows and injuries can cause disruption of the integrity of the placenta, disruption of oxygen supply to the fetus and premature birth.

Intrapartum reasons. Problematic childbirth causing asphyxia of the child can lead to the development of severe disorders of the motor system and psyche. This may be a short umbilical cord or, on the contrary, a tight entanglement around the neck, prolapse of the umbilical cord. Such reasons are called mechanical. Complications during childbirth such as premature placental abruption or bleeding are called hemodynamic.

In some cases, the baby may become infected during childbirth; this factor is called infectious. In approximately 15% of cases cerebral palsy causes occurrences appear after birth - these are postnatal causes. Rhesus and blood group incompatibility between mother and fetus is very common. A child may develop bilirubin encephalopathy, one of the consequences of which is dyskinetic and hyperkinetic syndromes. Dangerous infections affecting the brain, cause irreversible damage in the cortex, the consequences of which are disruption of the integrity of the structure of brain tissue and the occurrence of cerebral palsy.

During the early postpartum period The child may experience convulsions, causing disturbances in the nervous system. Also, seizures can already be the consequences of diseases that can destroy brain tissue, such as stroke, encephalitis and others. Before a child reaches the age of 3 years, the causes of cerebral palsy can affect his fragile nervous system. This can be the consequences of injury, suffocation, poisoning with toxins, or drowning.

Forms of cerebral palsy and their characteristics

Considering that in the diagnosis of cerebral palsy, the causes and symptoms have many forms, making a classification of this disease is very problematic. One existing classification lists four forms of the disorder.

Spastic paralysis (tetraplegia) is one of the most severe forms Cerebral palsy. It is caused by hypoxia suffered during pregnancy or complicated childbirth. Some neurons in the brain died and completely lost their function. It is often complicated by other pathologies. This may be epilepsy, swallowing disorder, loss of speaking function. Forced laughter or crying syndrome may occur; they appear at the moment of any action towards the child, be it touching or changing body position.

There are often cases when this form of cerebral palsy is accompanied by paresis of muscles in the arms and legs, problems with vision and hearing arise, attention and mental and emotional development are weakened. From paralysis of the limbs, ties are formed, which lead to the curvature of the correct position of the body. If the damage involves the nerves of the head, this can lead to strabismus and hearing loss, up to complete atrophy of the optic and auditory nerves. The associated developmental delay leads to a disease such as microcephaly (inappropriate growth, small size heads). Considering that all these violations are extremely severe, the child cannot master even the simplest self-care techniques.

Spastic paralysis (diplegia). Diplegia is the most common form of cerebral palsy. If we take statistics, then almost 75% of other types of this disease are susceptible to it. It was this form that was described in his time by the Briton W.D. Little. She typically has problems with the leg muscles more than other limbs, and two legs are affected at once. However, in the early childhood contractures develop poorly, which entails improper development of the shape of the joints and spine.

The so-called Little's disease very often manifested itself in premature babies. Here, cerebral hemorrhages are often the cause. The main manifestation is paralysis of the legs, often complicated by delayed mental and speech development. IN pathological process The nerves of the head may become involved, leading to mental retardation. A child who has Little's disease may be quite learnable. Upper limbs the most mobile and developed, which contributes to better adaptation in society and among peers.

Hemiplegic paralysis. This form is represented by partial paresis of one side of the body, either right or left. Here hand mobility suffers more. The main cause of this form of cerebral palsy is cerebral hemorrhages and cerebral infarctions. The child can do different movements, while the speed of development of skills is reduced in contrast to ordinary children. Mental development depends only on the abilities of the child; he is not affected in any way by impaired muscle activity.

The hemiplegic form is characterized by a specific gait of the child. The leg on the injured side does not bend at the knee and hip, but is bent at ankle joint. The child steps on his toes, throwing his straight leg forward. The arm on this side is bent in elbow joint, the palm is turned up and curved “boat”. At the same time, speech delay or slower speech may occur.

Ataxic paralysis. This form is characterized by low muscle activity (hypotonia) and incoordination of limb movements. Tendon reflexes are increased. There may be paralysis or weakness of the larynx and vocal cords, leading to speech problems. The ataxic form is caused by hypoxia and birth injuries frontal lobe of the fetal brain. Children often have mild mental retardation.

Mixed paralysis. With this form of cerebral palsy, symptoms are usually mixed, which complicates diagnosis. It is characterized by damage to several areas of the brain, and the combination of such forms of cerebral palsy as dyskinetic, spastic and hemiplegic, in various combinations.

The symptoms of cerebral palsy can be divided into two types.

Main symptoms. The main symptoms are those lesions of the central nervous system that actually led to its disorder and are characterized by impaired coordination and motor skills of the child, spasticity of muscle tissue, and hyperkinesis. Symptoms may worsen over time, this is not due to the fact that cerebral palsy does not progress. Strengthening may occur due to complications caused by the underlying disease, such as deformation of joints, limbs and muscle tissue. Sometimes such complications require surgery.

Associated symptoms. This is a set of symptoms caused by a central nervous system disorder that do not relate to the motor and motor function of the child:

• Mental, motivational, emotional disorders.
• Paroxysmal mental disorders and epilepsy.
• Impaired perception, vision, hearing.
• Problems with speech function and eating disorders.

All accompanying symptoms of cerebral palsy worsen the child’s comfort level of life more than the main symptoms do.

Diagnosis and treatment for cerebral palsy

When diagnosing cerebral palsy, the causes and the most effective treatment of the disease are determined by early diagnosis. In order to identify the disease, a series of observations and studies will be required. Unfortunately, there is no analysis capable of immediately identifying cerebral palsy. In most cases, the diagnosis of cerebral palsy is made in the first year of a child's life. For diagnosis, modern means such as tomography and electroencephalography are used. In laboratory tests, this is a biochemistry analysis, a genetic test for hereditary diseases.

Characteristic external symptoms disorders of the nervous system can be noticed in different age categories: early period - up to 5 months of the child, initial residual period - from 6 months to 3 years, late residual period - from 3 years and older. During these periods, the child’s slow development is revealed: he cannot raise his head, does not roll over on his own, cannot grab a rattle with his hands, cannot sit independently, and does not stand on his legs when he is held. Uses only one hand for playing and grasping, the second remains motionless. Doesn't walk on his own, and when held, he only relies on one leg.

All these signs of cerebral palsy They are not necessarily very pronounced; sometimes they are almost invisible. The severity of symptoms and its intensity depend on the depth of damage to the central nervous system. Hyper or physical inactivity may appear as limbs that are too tense or too relaxed. When muscle tone is tense, the child may take uncomfortable forced postures; when weakened, this may result in weakness and inability to raise an arm or leg.

Symptoms of cerebral palsy that appear after 3 years are considered late. For ease of diagnosis, they can be divided into groups of signs:

1. Skeletal deformation - the affected limbs are underdeveloped, there are curvatures of the bones, and deformation of the spine.
2. Joint contractures - limited joint movement, compression of the joint due to improper distribution and deformation of muscle tissue at the site of the lesion.
3. Convulsive syndrome- can manifest itself both immediately after birth and during the development of cerebral palsy; sometimes they can be confused with spastic movements of the limbs, which complicates diagnosis.
4. Problems with swallowing - appear from the first days of life, are expressed in the fact that the child sucks sluggishly, swallows poorly, and cannot cope with salivation.
5. Hearing problems - the child does not respond to voices and sounds, which makes timely development difficult.
6. Speech disorders - due to weak tone of the muscles of the larynx, tongue, lips, the child cannot pronounce clear sounds, this causes problems with communication.
7. Visual problems - defeat optic nerves causes decreased vision, strabismus, and in severe cases blindness.
8. Impaired jaw formation is the incorrect positioning of teeth and the associated difficulties in cleaning them, which can lead to caries and tooth loss.
9. Retarded mental and emotional development is not immediately detected, but is of paramount importance in disability; the lower the level of intelligence, the higher the degree of disability of the child.
10. Problems with holding urine and feces - the functioning of the sphincters and muscles responsible for controlling bowel movements and urination is impaired.
11. Problems with motor skills and muscle tone - the child moves awkwardly, movements are sharp and chaotic, or, on the contrary, slow.

There are the following phenomena by which one can determine muscle disorders. Convulsive syndrome, tension or weakened muscle tone. Inability to respond to loud, sharp sounds. Absence of a grasping reflex, developmental lag compared to peers of the same age. Starting from the age of one year, the child has no attempts to pronounce even the simplest words. Strabismus, poor vision. The child uses only one limb for play and manipulation. Problems with the ability to stand on their feet and walk, reluctance to stand on their feet, the child only walks on his toes.

There is no universal medicine that cures cerebral palsy completely. All measures for the treatment of cerebral palsy are focused on improving those body functions that are most affected by damage to the central nervous system. The child is taught correct motor reflexes, which are reinforced through daily exercises with a physical therapy instructor. There are many systems for the rehabilitation of such children that help develop the child’s physical abilities starting from the first days of diagnosis. There are programs that also allow you to develop mental and psychological abilities, and promote maximum adaptation of a child with cerebral palsy in society.

Massage is included in the package mandatory procedures for a child with a central nervous system disorder. It is worth noting that massage should be performed by a specialist who can give an accurate assessment of the state of muscle tone. And carry out exactly the massage course that is needed at this stage. In case of severe tissue deformations that cannot be corrected, doctors may resort to surgical intervention. This is done to alleviate the patient’s condition and correct disorders that worsen the quality of life.

Drug therapy aimed at improving muscle function and stimulating brain and vascular activity can also be carried out. Symptomatic treatment prescribed by the patient's attending physician. Sanatorium treatment for children with cerebral palsy gives very good results. Good results gives timely early start treatment and stimulation of immobile limbs.