Movement disorder syndrome in infants. Movement disorder syndrome: causes, symptoms, diagnosis, treatment, prognosis

Syndrome motor disorders in infants is a disease in which the baby experiences abnormalities motor activity(decrease or increase), weakening of muscle strength and muscle dystonia.

Most often, this disease affects infants aged two to four months. The risk of getting this disease increases if the child has suffered hypoxia (oxygen starvation) or brain injury. Like many other diseases, movement disorder syndrome (MDS) is divided into several types.

Types of DSN

Muscle hypertonicity – increased muscle tone. The child is unable to maintain balance for a long time.
Muscle hypotonia is decreased muscle tone. This type of SDN also applies to older children.
Cerebral palsy – .
Cerebellar syndrome is a disorder of the work and functions of the cerebellum. (Drunken gait).
TLR - tonic labyrinthine reflex. Children cannot move to a sitting position and cannot roll over from one side to the other.

Causes

Complications during childbirth. Quite often, an impatient obstetrician-gynecologist, in order to speed up the process of the birth of a child, begins to push the baby out, using force, which has an adverse effect on the fetus, injures it, as a result of which the baby receives SDN.
If the mother suffered from oxygen starvation (hypoxia) during pregnancy or the child during childbirth, then you can be sure that the baby will receive SDN.
Nervous system infection. The source of this infection is a sick mother, who infects the fetus through the placenta.
Improperly formed apparatus of the musculoskeletal system.

It is very important to diagnose SDN as early as possible. Therefore, a young mother must take full responsibility to monitor the health and behavior of her child, especially in the first months of his life.

Symptoms

Weak muscle strength is the main symptom of the disease. All the baby’s movements occur “in slow motion.” The child cannot hold his head, neck, or raise his arms and legs without assistance.
The baby is not able to take pathological positions. Difficulty, almost impossible, in flexion and extension of the upper and lower and upper limbs. The child cannot bend his fingers.
The monotony of crying and screaming is also characteristic feature movement disorder syndrome.
The facial expressions of a sick child are significantly different from the facial expressions of a healthy child. She is quite poor, the baby starts smiling late. For example, if a healthy baby begins to please his parents with his smile in the first month of life, then a baby suffering from motor impairment syndrome shows a smile in best case scenario- at three months of age.
Visual and auditory reactions are significantly delayed.

Treatment

Osteopathy, massage, physiotherapy, and reflexology rank first in terms of effectiveness in treating movement disorder syndrome in children. In any case, the child mandatory must be observed by a neurologist and undergo the treatment prescribed by him.

Osteopathy is an alternative official medicine. Is over in a gentle way treatment of SDN in children rather than drug and invasive treatment. Therapeutic effect done through massage internal organs, in particular, the impact on the desired points of the body.

Massage and physical therapy. Children under the age of one year must undergo at least 4 courses of physical therapy and massage. One course consists of at least 20 sessions, the session consists of a certain set of therapeutic exercises. In the intervals between courses, parents should massage their child themselves.

To perform massage procedures, it is necessary to use ointments. A specialist should tell you which ointment you should buy for your baby.

To obtain the desired result, special attention must be paid lower limbs. Before starting the exercises, wrap your baby’s feet in wool clothes. After finishing gymnastic exercises, you can make boots from paraffin or baths with boiled oats.

Your child’s attending physician must carry out special diagnostics that help specifically determine the types of disorders. (Sitting, walking, crawling, etc.)

Having made the results based on this, the neurologist can prescribe a series of homeopathic medicines and shape the child’s diet. In particular, with SDN, the baby should eat foods containing vitamin B. Or prescribe injections.

Reflexology. This type of treatment is most effective if the child has delays in the development and maturation of the nervous system.

Prevention

Provide your child with complete freedom of action (Do not overdo it. Safety rules have not been canceled.) Do not limit him to a narrow cradle. If possible, it would be nice to provide the baby separate room. The child must develop, have an interest in life, in learning about the world around him. Provide him with more objects to explore: bright toys, colorful pictures, etc.

Another important and useful for the development of the nervous system of children is barefoot walking, gymnastics, massotherapy without fail. Exercises on a large ball () also have a positive effect in the prevention of SDN.

Play finger games with your child as often as possible, touch him, and walk on textured surfaces.

Modern mothers perceive the diagnosis of “motor disorder syndrome” as a death sentence, despair and give up. This is the wrong reaction! This disease is curable and must be fought. And if you really love your child, you will never give up, but will fight for your child’s health to the end.

Movement Disorder Syndrome (MDS) – a disorder motor sphere human, caused by brain damage and disruption of the central nervous system. It usually affects one or more parts of the brain: the cerebral cortex, subcortical nuclei, brainstem. Form muscle pathology determined by the volume and area of brain damage. The disease is manifested by pathological changes in muscle tone and various motor disorders.

The disease develops in infants 2-4 months old who have suffered trauma or brain hypoxia. The causes of movement disorder syndrome in children may be negative factors that have an intrauterine effect on the fetus and cause perinatal lesion central nervous system. Convulsive muscle activity, hypotension and weakness require urgent treatment.

SDN clinically manifests itself already in the first days and weeks of a child’s life. In sick children, hypo- or hypertonicity of muscles occurs, spontaneous motor activity decreases or increases, motor function of the limbs is weakened, and reflex activity is disrupted. They are behind in physical development from their peers, cannot cope with purposeful movements and their coordination, and have difficulties with hearing, vision and speech. The development of muscle tissue in different limbs occurs at different rates.

These problems gradually provoke a violation mental development and inferiority of intelligence. Speech and psycho-emotional development slows down. Children with SDN begin to sit, crawl and walk somewhat later than their peers. Some of them cannot hold their heads up even at one year old. Complete absence voluntary movements of the laryngeal muscles in children leads to a violation of the swallowing reflex. This sign indicates a serious stage of the pathology, which requires urgent therapeutic measures that can eliminate such dangerous symptoms.

Since the syndrome does not progress, its timely and correct treatment gives impressive results. According to ICD-10, it is coded G25 and belongs to “Other extrapyramidal and movement disorders.”

Etiology

Etiopathogenetic factors causing perinatal damage to the central nervous system - PPCNS and provoking the syndrome:

The exact reason in each specific case is not always clear. Typically, the syndrome develops with simultaneous exposure to several negative factors, and one of them is the leader, and the rest only enhance the effect.

Symptoms

Changes in the normal structure of the brain are manifested by various motor disorders. This is due to a violation of the transmission of nerve impulses from brain structures to skeletal muscles and the development pathological condition in these muscle groups.

Clinical signs of movement disorder syndrome in infants:

Decreased muscle strength, slow baby movements.
Muscle hypotonia leads to dystrophic processes and thinning of the limbs.
Weakening or strengthening of tendon reflexes.
Paralysis and paresis.
Muscle overstrain, spasms, cramps.
Involuntary movements.
Violation of basic reflexes - grasping and sucking.
Inability to independently hold the head, lift and bend limbs, roll over, bend fingers.
Monotonous screaming and crying.
Articulation impairment.
Poor facial expressions of the patient, lack of smiles.
Delayed visual and auditory reactions.
Difficulty breastfeeding.
Convulsive syndrome, bluish skin.

Infants with SDN sleep poorly, stare at one point for a long time, and periodically shudder convulsively. They can turn their head and spread their legs only with outside help. Patients press one arm tightly to the body. With their other hand they move and pick up the rattle. Complete relaxation is often replaced by body tension. If there are visual dysfunctions, the baby does not reach the right thing on the first try.

Symptoms of hypertension:

the baby's body bends in an arched manner,
the baby begins to hold his head up early, pick up toys,
a sick child presses his clenched fists to his body,
head turned to one side
The baby stands on his toes, and not on his entire foot.

Symptoms of hypotension:

sick baby is lethargic,
he doesn't move his limbs much,
cannot hold a toy in his hand,
screams weakly
the child throws his head back and cannot hold it for a long time,
does not begin to crawl, sit and stand up in time,
does not maintain balance in a sitting position, staggers from side to side.

There are several forms of pathology:

With predominant defeat legs - the child moves his arms, “drags” his legs, begins to walk late;
unilateral damage to the muscles of the entire body with impaired swallowing and speech function, mental retardation;
disorder of motor functions due to damage to both limbs - inability to crawl, stand and walk;
complete immobility of the child, mental retardation, mental instability.

If a child has been diagnosed with SDN, it is necessary to act and not despair. Children's body when provided with qualified medical care, it can resist the disease. It happens that neurologists make mistakes or make similar diagnosis, playing it safe, especially if the symptoms are subtle. As a result of careful observation of such children, the diagnosis is removed. The child grows up completely healthy.

Stages of development of movement disorder syndrome:

The early stage is manifested by impaired muscle tone. Babies 3-4 months old with SDN often do not turn their heads, and babies 5-6 months old do not reach for toys or suffer from seizures.
The second stage manifests itself with more noticeable signs: patients cannot hold their head up for 10 months, but try to sit down, turn around, walk or stand in an unnatural position. At this time, uneven development of the child occurs.
The late stage of the syndrome occurs after 3 years. This is an irreversible stage characterized by skeletal deformation, the formation of joint contractures, problems with hearing, vision and swallowing, speech impairment and psychophysical development, cramps.

Normal stages of child development

IN pathological process Internal organs are involved, which is manifested by impaired excretion of urine and feces, disarticulation, and incoordination of movements. The syndrome is often combined with epilepsy, mental and mental development disorders. Sick children perceive information poorly and have difficulty eating and breathing. In the future, sick children have problems with learning. This is associated with impaired memory and ability to concentrate. Hyperactive children suffer from restlessness and lack interest in activities.

Timely contact with specialists helps to avoid serious consequences. Late detection of the syndrome complicates the situation. Normal children in the first or second year of life pronounce individual sounds, whole syllables and simple words, and kids with SDN are just incomprehensible whining. Heavy breathing is accompanied by uncontrolled opening of the mouth, a nasal tone of voice, and the pronunciation of inarticulate sounds. Disruption of the normal structure of the nervous tissue limits the child’s independence of free movement and only partially preserves the ability for self-care.

Diagnostics

The diagnosis and treatment of the syndrome is carried out by specialists in the field of neurology and pediatrics, who make their diagnosis based on data obtained from the history of pregnancy and childbirth of the mother. Results matter laboratory tests, Ultrasound, tomography and encephalography.

Perinatal history - intrauterine infection, severe intoxication of the body, oxygen starvation of the brain.
Assessment of a newborn using the Apgar scale allows you to characterize the vitality of the baby at birth.
Neurosonography is an examination of a newborn that involves scanning the brain with ultrasound.
Ultrasound with Doppler - study of cerebral blood flow through the fontanel.
Electroencephalography – research method electrical activity brain, removed from the surface of the scalp, with a recording of such potentials.
Electroneuromyography is performed to assess muscle tone.
A CT or MRI scan of the brain can detect lesions.
Examination by an ophthalmologist, ENT specialist, psychiatrist, orthopedic traumatologist.

Treatment

A child with SDN should be observed by a neurologist and undergo complex treatment. Currently, there are effective techniques that can quickly eliminate the disease. How earlier syndrome detected, the easier it is to fight it.

Complex therapeutic measures, used for SDN:

Massage - effective remedy, allowing to achieve excellent results. Before the session, the child is warmed up, and after it, he is wrapped in a woolen blanket. A massage therapist must specialize in working with newborns and infants. After 10-15 sessions, the patient’s condition improves significantly.
Therapeutic exercise restores motor functions and coordination of movements.
Osteopathy is an effect on certain points of the body.
Reflexology is indicated for children with delays in maturation of the nervous system and development.
Homeopathy activates brain processes.
Physiotherapy - myostimulation for muscle hypotonia, paraffin therapy, hydromassage, baths, electrophoresis, magnetic therapy.
Diet therapy - eating foods containing vitamin B.
Balneotherapy, mud therapy, animal therapy - communication with dolphins and horses.
Pedagogical correction, special mode and speech therapy techniques.
Use of auxiliary devices - walkers, chairs, stand-up machines, bicycles, exercise equipment, pneumatic suits.
Sanatorium – spa treatment in Crimea and Black Sea coast Krasnodar region.

Drug treatment consists of the use of anticonvulsants and muscle relaxants; diuretics; drugs that reduce intracranial pressure; B vitamins; drugs that improve microcirculation in brain tissue; antihypoxants; drugs that tonic blood vessels. Patients are prescribed “Cerebrolysin”, “Cortexin”, “Ceraxon”, “Actovegin”, “Piracetam”, “Glycine”, “Neurovitan”, “Mydocalm”, “ATP”, “Proserin”.

Surgery for hydrocephalus allows you to restore the outflow of cerebrospinal fluid. Surgeons perform tendon and muscle plastic surgery and remove contractures. In order to correct disorders in the nervous tissue, neurosurgical interventions are performed.

SDN responds well to treatment if it is started correctly and on time. The prognosis of the pathology largely depends on the observation of parents and the professionalism of doctors. If the syndrome is not treated, it may develop serious consequences functional failure CNS – cerebral paralysis and epilepsy, which require longer and more severe therapy.

Video: example of massage for the treatment of SDN

Prevention and prognosis

Preventive measures to avoid the development of the syndrome:

protection of motherhood and childhood;
eliminating bad habits in pregnant women;
the child’s interest in learning about the world around him with the help of colorful pictures and bright toys;
barefoot walking, exercise therapy, therapeutic massage, fitball exercises,
frequent finger play, walking on textured surfaces.

SDR is a treatable disease that needs to be fought. Light form pathology responds well to adequate therapy. More severe cases require a special approach. If parents don't notice dangerous symptoms and do not consult a doctor on time, the child will have difficulties with walking and learning. Launched forms complicated by mental retardation and epilepsy. Any delay in treatment can turn easy case into a complex process.

The physical activity of a baby is one of the main factors by which it is customary to judge the state of his health. But there are cases when parents of a baby hear from a neurologist a diagnosis of “motor disorder syndrome.” What is this? What symptoms accompany the disease? Is it possible to get rid of it? Are there ways to help avoid such troubles? The article will discuss the answers to these and some other questions.

What is neonatal movement disorder syndrome?

This disease is diagnosed in cases where an infant experiences a decrease or increase in motor activity and weakening muscle strength. Babies aged 2 to 4 months are most susceptible to it.

Movement disorder syndrome is divided into several main types:

Muscle hypertonicity.
Muscular hypotonia.
Cerebellar syndrome.
Cerebellar dysarthria.
Symmetrical cervical tonic reflex.
Tonic labyrinthine reflex.

Each type of disease has its own characteristics. We'll talk about this later when considering the symptoms of movement disorder syndrome.

Causes of the disease

Movement disorder syndrome in infants can occur as a result of exposure to certain factors.

Firstly, the cause of the disease can be hypoxia. This phenomenon is accompanied by a disruption of the blood supply to the brain, which leads to its damage.

Secondly, movement disorder syndrome can occur as a result of an intrauterine infection.

Third, common cause diseases are received birth injuries as a result of too much weight of the fetus, breech presentation, incorrect insertion of the head, and so on. In all these cases it may be affected spinal cord newborn

The fourth and final reason is the wrong device.

Symptoms of hypertension

Movement disorder syndrome in a newborn, manifested as hypertonicity, may be accompanied by the following symptoms:

The baby's body in a supine position bends in the form of an arc;
the baby learned to hold his head before even reaching one month of age;
by the age of three months, the child has not learned to open his hand in order to take a toy or other object, he presses his clenched fists to his body;
the baby's head is always turned in one direction;
if you put the baby on his feet, he will not stand on his full foot, but on just his toes;
the child can only roll over on one side;
V one year old does not use both hands, but prefers one.

All of the above signs mean that an excessive number of impulses are coming from the central nervous system. You shouldn’t put off going to a neurologist.

Symptoms of hypotension

Unlike the previous option, hypotonicity is characterized by a reduced supply of impulses from the central nervous system to muscle tissue, as a result of which their tension also decreases.

This type of movement disorder syndrome is accompanied by the following symptoms:

lethargy of the baby, he makes very few movements with his legs and arms;
the baby cannot hold the toy in his hand;
the baby's cry is very weak;
the baby cannot hold his head in vertical position for long period time and constantly throws it back;
the baby does not begin to crawl, sit and stand up at the appropriate time;
the child begins to smile much later than expected;
Children with hypotonia have very poor balance while sitting: even at 6-7 months they sway from side to side.

This type of disease has a very bad effect on the spine and posture, causing high risk joint dislocations. Severe forms can make it difficult even important processes, like breastfeeding, chewing and swallowing food. In addition, children with this type of disease long time do not show speech skills.

General symptoms of the disease

What else can be accompanied by movement disorder syndrome? Symptoms by which one can judge the disease are also the following:

The child cannot take pathological positions. It is very difficult for him to bend and unbend upper limbs. In addition, he cannot bend his fingers.
Another sign is the monotony of the baby’s screaming and crying.
Significant delay in auditory and visual reactions.
The baby is lagging behind in physical development, it is more difficult for him to learn to roll over, sit down, maintain balance, and so on.

Diagnosis of the disease

Even if there are obvious signs of a problem, you should not make a diagnosis yourself, much less self-medicate. It is necessary to contact a neurologist who will conduct full examination and based on its results will be able to determine the presence of the disease and its type.

During diagnosis, the perinatal history is first taken into account. The doctor needs to know whether the child has had previous infections, toxic-metabolic disorders, or signs of hypoxia. Special attention is paid to assessing the condition of a newborn baby using the Apgar scale.

If there is a baby being examined whose fontanelle has not yet become overgrown, he is prescribed a Doppler study of cerebral blood flow and neurosonography. In particularly severe cases, a CT or MRI of the brain may be needed.

Additionally, the child’s skills are compared with developmental standards for his age. Neurologists and pediatricians in in this case use special tables.

Movement disorder syndrome in children: treatment of the disease

Do not despair if your child has been given such a terrible, at first glance, diagnosis. To date, a lot has been developed effective ways, which will help get rid of such a problem as movement disorder syndrome. Treatment may include massage, reflexology, osteopathy, and physical therapy. Let's look briefly at each of these methods.

Let's start with physical therapy and massage. To carry them out, it is usually necessary to use special ointments. The specialist will tell you which ones before performing the procedures. Special attention in this case it is usually given to the lower extremities. There are two more small but important nuances: before starting massage and physical education, you need to wrap the baby’s legs in wool clothes, and at the end, make baths with boiled oats or paraffin boots.

In order to determine the set of necessary exercises, the doctor focuses primarily on where exactly the disorders are observed: in sitting, crawling, walking, and so on.

Children under one year of age must complete at least four courses therapeutic massage and physical education. Moreover, one course includes about 20 sessions, which consist of a clearly established set of exercises.

Parents need to remember that they should not relax between sessions with a specialist. During this period, they must massage the baby themselves.

Next, let's look at what osteopathy is. The procedure is an alternative to official medicine. Positive effect in this case, it is achieved by influencing the desired points of the body and massaging the internal organs.

Reflexology is used in cases where the syndrome of movement disorders in children is accompanied by delays in maturation and development. This type of therapy shows the greatest effectiveness.

In some cases, in order to eliminate movement disorder syndrome in newborns, the doctor may prescribe the use of homeopathic medicines. Their choice will depend on the nature of the disease and the characteristics of the baby’s body.

A properly formed child’s diet also plays an equally important role. It should contain a large amount of vitamin B. B otherwise you will need to give injections.

Forecast for the future

How successful the treatment will be depends primarily on the type of disease.

Movement disorder syndrome light form(provided there is no persistent hypoxia) can be overcome within the first year of the baby’s life.

More severe types of the disease can cause many complications: mental retardation, epilepsy, difficulties with walking, learning and concentrating, weather sensitivity, headaches, manifestations of vegetative-vascular dystonia.

Disease prevention

The main prevention of movement disorder syndrome is to provide the child with freedom of action. Of course, within the limits of safety rules. There is no need to limit its space with a cradle. If possible, it is recommended to allocate a separate room for the baby.

The baby must develop and learn something new. Colorful pictures, bright toys, and so on can help in this matter.

Additionally, you can let your child walk barefoot, practice with a fitball, perform therapeutic massage and gymnastics. Touching objects of different textures is also very useful.

Let's sum it up

Many mothers perceive movement disorder syndrome as a death sentence and give up, having lost hope that their baby will recover. Under no circumstances should you do this! As you can see, this disease today is no longer included in the group of incurables, which means that the chances of full recovery The child's are very large. As a rule, by the age of two, all signs of the disease disappear in 90% of children. This is especially true in cases where the problem was detected early enough and has not yet had time to worsen. The only thing that is needed from parents in such a situation is to show perseverance and patience. And then everything will be fine with their beloved baby. Be healthy!

Movement disorder syndrome is one of the disorders of the human motor system in which brain damage occurs, causing a malfunction of the central nervous system. The disease can affect one or more parts of the brain, leading to various consequences. Among typical manifestations The disease is characterized by deterioration of muscle tone and problems with movement.

In children suffering from movement disorder syndrome, the speech development

Most often, the disease develops against the background brain injuries or hypoxia suffered by the infant. Children aged 2-4 months are at risk. A unique impetus for the development of the syndrome is the negative factors affecting the fetus during its intrauterine development. When detected in a child muscle hypotonia or seizure activity muscles, immediate treatment is necessary.

The clinical manifestation of movement disorder syndrome in infants occurs very early, starting from the first days of the baby’s life. Most often, the development of the disease is indicated by hyper- or hypotonicity of the muscles, a disorder of spontaneous motor activity, while reflex activity is suppressed against the background of deteriorated mobility of the limbs.

A child suffering from movement disorder syndrome lags behind his peers in development, unable to cope with the coordination of movements. Such children develop problems with vision and hearing, and sometimes with speech. Muscle develops unevenly on different limbs.

Such a situation can result in mental development disorders and intellectual problems. As a rule, in children suffering from motor impairment syndrome, psychoemotional and speech development slows down. They begin to crawl and sit later than their peers. Some babies are unable to hold their head up on their own at one year of age.

Due to developmental disorders of the laryngeal muscles, problems arise with swallowing reflex. This sign indicates the development of a serious stage of SDN, in which it is necessary to immediately carry out therapeutic measures, which allow you to eliminate dangerous symptoms.

Important! This syndrome is not prone to active progression. Therefore, timely and competent treatment can significantly improve the patient’s quality of life.

ICD-10 movement disorder syndrome code: G25.

Causes

Smoking during pregnancy can cause the child to develop movement disorder syndrome

In modern medicine, there are a number of factors that provoke the development of this syndrome:

A birth injury that was sustained by a child as a result of the obstetrician using excessive physical force in an attempt to speed up the delivery.
Long and difficult labor, during which there was a delay in the expulsion of the fetus.
The development of hypoxia, as a result of which the brain cells responsible for the course of various muscle processes are affected.
Neuroinfections of the intrauterine type that penetrate the placenta from an infected mother to the fetus.
Presence in mother hidden infections such as toxoplasmosis and rubella.
Congenital anomalies of joints and bones.
The mother has sexually transmitted diseases.
Various disorders operating at the chromosomal level.
Smoking, alcoholism and drug addiction during pregnancy.
Development of fetoplacental insufficiency.
The umbilical cord is entwined around the body and neck of the fetus.
Hydrocephalus, which developed due to the outflow of cerebrospinal fluid in the brain.

In most cases, the development of the syndrome is caused by the simultaneous impact of several negative factors on the child’s body. Usually only one of them acts as the leader, while the others help enhance the effect.

Symptoms

Visual and auditory reactions are somewhat delayed in children with motor impairment syndrome

The occurrence of changes in the brain structure can cause a number of movement disorders. Most often they develop due to problems with transmission nerve impulses, coming from the brain to the muscles. With SDN possible pathological changes in the muscle structure.

As the disease develops, the infant may have the following types of motor dysfunction:

the presence of paresis and paralysis;
muscle strength is significantly reduced;
due to severe hypotension, the limbs may become thinner, and dystrophic processes develop in the muscles;
the baby’s basic reflexes, such as swallowing and sucking, are impaired;
the muscles become so overstrained that numerous spasms and convulsions develop, which can be protracted;
tendon reflexes may be weakened or strengthened;
problems with articulation;
the child’s inability to independently bend and lift his limbs and hold his head;
involuntary movements;
visual and auditory reactions are somewhat delayed;
lack of smiles due to poor facial expressions;
slow movements, weakened muscles;
cyanosis of the skin, development of convulsive syndrome;
difficulties during breastfeeding.

Infants with movement disorder syndrome may stare at one point for a long time and sit for a long time, periodically shuddering convulsively. They need help turning their head. As a rule, one arm of the patient is pressed tightly to the body, the other can move and grasp various objects.

The relaxation of the body is replaced by its tension. It is possible to develop visual dysfunction, in which the baby is not able to reach the thing he needs on the first try.

Against the background of this syndrome, the baby may have both hypertonicity and hypotonicity of the muscles. In the first case, the symptoms will be as follows:

the baby arches his body;
the head is always turned in one direction;
the baby cannot stand on his entire foot and always stands on his toes;
the child clenches his hands into fists and presses them to his body;
The baby begins to pick up toys and hold his head quite early.

Muscle hypotonia suggests the development of the following symptoms:

the child screams faintly;
unable to crawl, sit or stand up independently;
practically does not move his limbs;
often throws his head back, but is unable to hold it in this position for a long time;
when sitting, he is unable to maintain balance - he constantly sways from side to side;
the general weakness of the child and sluggishness of his movements are noticeable.

Classification

At late stage syndrome, the child may have more frequent seizures

Modern medicine distinguishes several forms of this pathology:

The disease primarily affects the legs. In this case, the baby is capable of active movements with his arms, but gets to his feet late.
The lesion of the trunk is unilateral. At the same time, the baby’s swallowing function is impaired, he is noticeably behind in mental development and has speech problems.
The disease affects the legs. As a result, the child is unable to stand, crawl or walk. Observed severe upset motor function.
The child is absolutely incapable of independent movement. At the same time, he is mentally unstable and prone to developing mental retardation.

Important! When a child is diagnosed with movement disorder syndrome, he needs professional treatment. His body cannot cope with this pathology on its own.

In some cases, neurologists put misdiagnosis due to the inconspicuousness of symptoms on early stages illness. Subsequently, the diagnosis can be removed, and the child will be declared healthy.

SDN may involve the following stages:

Early. The disease manifests itself mildly, but already at this stage the baby’s muscle tone is impaired. Most babies lose the ability to turn their head independently by 4 months. Severe seizures may develop.
Second stage. Signs of the disease worsen, becoming more obvious. Ten-month-old children are not able to hold their head up on their own, but they make attempts to turn, sit down and even walk, maintaining an unnatural posture. During this period of life, a child develops unevenly.
Late stage. Develops after three years old. The consequences in this case are irreversible. The child develops problems in the structure of the skeleton, expressed in multiple deformities, joint contractures form, hearing and vision deteriorate significantly. The child has difficulty swallowing, speaks very poorly and is mentally unstable. Convulsions become more frequent and last longer.

As complications of movement disorder syndrome in children, internal organs are involved in the pathological process. As a result of such changes, the child has problems with defecation and urination, and coordination of movements is significantly impaired. Strong people often appear epileptic seizures. The child has difficulty eating and breathing. Learning is difficult due to problems with concentration and memory disorders.

Diagnostics

A comprehensive examination includes the following diagnostic techniques:

Perinatal history. Using this technique, specialists can detect the presence of severe brain intoxication, oxygen starvation, as well as infection of the fetus in the womb.
Ultrasound with Doppler. Allows you to obtain accurate information regarding cerebral blood flow.
Apgar score. Allows you to assess the baby's vitality.
MRI and CT. One of the most informative techniques through which specialists are able to identify lesions.
Neurosonography. A procedure that involves scanning the brain using ultrasound.

Treatment

Relaxation massage is one of the most effective methods of therapy (massage should only be performed by a qualified specialist)

Therapy for this syndrome is prescribed by a neurologist. Modern medicine has a number of techniques that help quick elimination illness. It should be remembered that the earlier the syndrome is identified, the easier it will be to fight it.

Treatment of SDN according to Dr. Komarovsky involves the following methods:

Massage. Properly carried out procedures provide truly high results.
Homeopathy can be used to activate brain processes.
Physical therapy can be used to improve coordination of movements. It also allows you to restore the patient’s motor functions.
Physiotherapy. In this case, they can be applied various techniques determined by the doctor. The most popular of them are: magnetic therapy, hydromassage, electrophoresis.
High treatment results are ensured by mud therapy, as well as communication between patients and animals – dolphins and horses.
Pedagogical correction. At the moment, several effective speech therapy techniques have been developed.

Often in medical records newborn children can see the abbreviation PEP, which frightens young mothers. The term “perinatal encephalopathy” itself was proposed in 1976 and comes from four Greek words: the prefix “peri” - located near, at something, “natus” - birth, “pathos” - disease and “enkefalos” - brain.

The perinatal period is the time from the 28th week of pregnancy until the seventh day after birth (up to the 28th day in premature babies), and encephalopathy is the term that means various pathologies brain

Thus, PEP is a kind of collective diagnosis to designate neurological disorders in newborns, and the specific symptoms, causes and severity of this condition may vary.

IN international classification exist different kinds encephalopathy, their names indicate the cause of the disease (for example, hypoxic or diabetic encephalopathy), but there is no perinatal form, since this term only indicates the time interval for the appearance of disorders.

IN last years Russian pediatric neurologists are also increasingly using other diagnoses, for example, perinatal asphyxia and hypoxic-ischemic encephalopathy.

The prenatal development of the brain and nervous system as a whole is influenced by various unfavorable factors, in particular maternal health and condition environment.

Complications can also arise during childbirth.

Hypoxia. When a child in the womb or during childbirth lacks oxygen, all body systems suffer, but primarily the brain. Hypoxia may be caused by chronic diseases mothers, infections, incompatibility by blood group or Rh factor, age, bad habits, polyhydramnios, malformations, unsuccessful pregnancy, unsuccessful childbirth and many others.
Birth injury, causing hypoxic or mechanical injuries(fractures, deformations, hemorrhages). The following can cause injury: weak labor, quick birth, poor fetal position or obstetrician error.
Toxic lesions. This group of reasons is associated with bad habits and intake of toxic substances during pregnancy (alcohol, drugs, some medicines), as well as environmental influences (radiation, industrial waste in air and water, heavy metal salts).
Maternal infections– acute and chronic. The greatest danger is posed by infection of a woman while carrying a child, since in this case the risk of infection of the fetus is very high. For example, toxoplasmosis, herpes, rubella, and syphilis rarely cause symptoms in the fetus infectious disease, but cause serious disturbances in the development of the brain and other organs.
Developmental and metabolic disorders. These can be congenital diseases of both mother and child, prematurity of the fetus, and developmental defects. Often the cause of PEP is severe in the first months of pregnancy or gestosis in the last.

The above factors can cause various types of disease. The most common are the following:

hemorrhagic form, caused by bleeding in the brain;
ischemic, caused by problems with blood supply and oxygen supply to brain tissue;
dysmetabolic is a pathology of metabolism in tissues.

Symptoms and prognosis

Immediately after birth, the child’s well-being is assessed on a ten-point scale, which takes into account heartbeat, breathing parameters, muscle tone, skin color, and reflexes. Scores of 8/9 and 7/8 are given to healthy newborns without signs of perinatal encephalopathy.

According to research, the severity and prognosis of the disease can be correlated with the scores obtained:

6–7 points – mild degree violations, in 96–100% of cases restoration is unnecessary drug treatment and without further consequences;
4–5 points – average degree, in 20–30% of cases leads to pathologies of the nervous system;
0–3 points – severe, most often leading to serious violations functioning of the brain.

Doctors distinguish three stages of encephalopathy - acute (during the first month of life), recovery (up to six months), late recovery (up to 2 years) and the period of residual effects.

Neonatologists and obstetricians speak of encephalopathy if a child under the age of one month has the following syndromes:

Nervous system depression syndrome. Characterized by lethargy, decreased muscle tone, reflexes, and consciousness. Occurs in children with average degree severity of the disease.
Comatose syndrome. The child is lethargic, sometimes to such an extent that there is no motor activity. Cardiac activity and breathing are inhibited. Basic reflexes (searching, sucking, swallowing) are absent. This syndrome occurs as a result of hemorrhage, birth asphyxia, or cerebral edema and leads to the need to place the child in intensive care with the connection of an artificial respiration apparatus.
Increased neuro-reflex excitability. Anxiety, shuddering, frequent, unreasonable crying, similar to hysterical, poor sleep, arms and legs. Premature babies are more likely to have seizures, e.g. high temperature, up to development. This syndrome is observed in mild forms of PEP.
Convulsive syndrome. Unmotivated paroxysmal movements of the head and limbs, tension in the arms and legs, shuddering, twitching.
Hypertensive-hydrocephalic syndrome. Characterized by an increase in the number cerebrospinal fluid and increase intracranial pressure. At the same time, the head circumference grows faster than normal (more than 1 cm weekly), and the size of the large fontanel also does not correspond to age. The child's sleep becomes restless, there is monotonous prolonged crying, regurgitation, throwing back of the head and bulging of the fontanelle, as well as characteristic trembling of the eyeballs.

During recovery period perinatal encephalopathy is accompanied by symptoms:

Convulsive syndrome.
Syndrome of increased neuro-reflex excitability.
Syndrome of vegetative-visceral changes. Due to the pathological functioning of the autonomic nervous system, the child experiences delayed weight gain, regurgitation, disturbances in breathing rhythm and thermoregulation, changes in the functioning of the stomach and intestines, and “marbling” of the skin.
Hypertensive-hydrocephalic syndrome.
Movement impairment syndrome. Normally, up to a month old, a child’s limbs are semi-bent, but easily unbend, and then immediately return to their original position. If the muscles are flaccid or so tense that it is impossible to straighten the legs and arms, then the cause is decreased or increased tone. In addition, limb movements must be symmetrical. All this interferes with normal motor activity and purposeful movements.
Psychomotor development delay syndrome. Child later than normal begins to raise his head, roll over, sit, walk, smile, and so on.

About 20–30% of children diagnosed with PEP recover completely; in other cases, complications develop, depending on the severity of the disease, completeness and timeliness of treatment.

Perinatal encephalopathy can lead to the following consequences:

attention deficit disorder;
delayed speech and mental development, brain dysfunction;
epilepsy;
Cerebral palsy (cerebral palsy);
mental retardation;
progressive hydrocephalus;
vegetative-vascular dystonia.

Diagnostics

Perinatal encephalopathy is diagnosed by a pediatrician and pediatric neurologist based on examination data, tests and examinations of the child, as well as information about pregnancy, childbirth and the health of the mother.

The most effective and modern methods diagnostics are as follows:

Neurosonography (NSG) – ultrasound examination brain through the fontanel to identify intracranial damage and the condition of brain tissue.
Electroencephalogram (EEG) – records the electrical potentials of the brain and is of particular value in diagnosing PEP with convulsive syndrome. Also, using this method, it is possible to establish the asymmetry of the brain hemispheres and the degree of delay in their development.
Doppler ultrasound to evaluate blood flow in the tissues of the brain and neck, narrowing or blockage of blood vessels.
Video monitoring. Video recording is used to establish spontaneous movements.
Electroneuromyography (ENMG) – electrical stimulation nerve to establish a violation of the interaction between nerves and muscles.
Positron emission tomography (PET), based on the introduction into the body of a radioactive tracer, which accumulates in tissues with the most intense metabolism. It is used to assess metabolism and blood flow in various parts and tissues of the brain.
Magnetic resonance imaging (MRI) is the study of internal organs using magnetic fields.
Computed tomography (CT) is a series of x-rays used to create a complete picture of all brain tissue. This study makes it possible to clarify hypoxic disorders that are not clearly identified in NSH.

For diagnosis, NSG and EEG are the most informative and most often used. Without fail, the child must be sent to an ophthalmologist for examination of the fundus, condition optic nerves and identification of congenital disorders.

It is worth noting that, according to various sources, in Russia perinatal encephalopathy is diagnosed in 30–70% of newborns, while according to foreign research only about 5% of children actually suffer from this disease. There is overdiagnosis.

Reasons for this may include failure to comply with inspection standards (e.g. increased excitability in a child examined in a cold room strangers), attributing transient phenomena (for example, throwing up limbs) or ordinary signals of needs (crying) to pathology.

Treatment

The central nervous system of newborns is plastic, capable of development and recovery, so treatment of encephalopathy must begin as early as possible. It depends on the severity of the disease and specific symptoms.

If brain dysfunction is mild or moderate, the child remains on home treatment. In this case, use:

individual mode, calm environment in the house, balanced diet, lack of stress;
assistance from correctional teachers, psychologists, speech therapists for alalia and dysarthria
massage and physical therapy to normalize tone, develop motor functions and coordination of movements
physiotherapy;
herbal medicine (various sedative charges and herbs to normalize water-salt metabolism).

With pronounced motor movements, nervous disorders, delayed child development and other PEP syndromes, medications are used. The doctor prescribes medications, as well as other treatment methods, based on the manifestations of the disease:

For movement disorders, dibazole and galantamine are most often prescribed. At increased tone muscles - Baclofen and Mydocalm to reduce it. These drugs are introduced into the body, including using electrophoresis. Massage is also used special exercises, physiotherapy.
If PEP is accompanied by convulsive syndrome, the doctor prescribes anticonvulsant drugs. For seizures, physiotherapy and massage are contraindicated.
Delayed psychomotor development is a reason for prescribing drugs to stimulate brain activity and increase blood circulation in it. These are Actovegin, Pantogam, Nootropil and others.
For hypertensive-hydrocephalic syndrome, herbal medicine is used, and in severe cases– Diacarb to accelerate the outflow of cerebrospinal fluid. Sometimes part of the cerebrospinal fluid is removed through a puncture of the fontanel.

For AED treatment of any severity, B vitamins are prescribed, as they are necessary for normal development and functioning of the nervous system. In many cases, swimming, salt baths, or herbal infusions, osteopathy.

Perinatal encephalopathy is one of the most common diagnoses among pediatric neurologists. This is due to the fact that PEP is a collective term denoting disorders of the child’s brain function in perinatal period having various reasons including maternal health, the course of pregnancy, lack of congenital diseases, complications during childbirth, ecology and other circumstances.

Symptoms can be different, relating to disorders of the nerves, muscles, internal organs, metabolism, therefore for accurate diagnosis the doctor must not only examine the child, but also collect the entire medical history regarding the health of the mother and father, complications during pregnancy, labor activity, as well as order additional examinations.