Signs and causes of cerebral palsy in a child, types, forms. How does cerebral palsy manifest itself in different forms and what complications can there be? What causes cerebral palsy in children?

In children under 1 year of age, signs of cerebral palsy should be recognized as early as possible. Early detection of symptoms of cerebral palsy in newborns will lead to successful treatment. In this case, it is possible to prevent serious consequences of the disease that will prevent the child from developing normally. After all, a person with cerebral palsy will not be able to move or coordinate their movements. Even as an adult, he will have problems with communication and socialization in a team.

Cerebral palsy is a pathology caused by damage to parts of the brain. As a result of the disorder, problems arise with coordination of movements, difficulties with hearing, speech, and vision. The infant exhibits mental retardation and may even experience convulsions.

Cerebral palsy appears in newborns more often than in children after a year of life. A feature of the pathology is that the symptoms of the disease do not progress. The damage to parts of the brain that has occurred will appear less in the future if you pay attention to the condition of the baby in time. If cerebral palsy is detected early in a child, then timely massage therapy and physical therapy will reduce movement disorders.

The main causes of pathology

The causes of pathology of the nervous system are based on disruptions in the intrauterine development of the fetus. That is why the first signs of cerebral palsy are detected in newborns immediately after birth.

The health of pregnant women plays an important role in the occurrence of paralysis in infants. During pregnancy, women may experience infections. And hypoxia during childbirth is considered the main cause of damage to parts of the fetal brain.

Cases of cerebral palsy occur due to:

• severe infections in an infant;
• exposure to radiation and x-rays on a child’s body;
• poisoning of both mother and baby with drugs, chemicals, and food.

The causes of cerebral palsy in children are associated with chromosomal abnormalities. More than four hundred reasons provoke a terrible disease. If a newborn has decreased or increased muscle tone, then you should immediately seek help from a pediatrician.

Stages of the disease

A disease such as cerebral palsy in newborns appears gradually, developing from two months to three years:

1. At an early stage, the child notices a lag in movements from a normal peer. Even at four months, the baby will not reach for toys or turn towards the sound. This is due to decreased muscle tone. Some experience limb cramps.
2. Since the brain of a newborn works with deviations from the norm, the development of a child up to three years is chaotic. At 8 months he cannot hold his head up, but he tries to sit up.
3. At the late stage, residual, signs of paralysis appear clearly with skeletal deformation, lack of coordination, mental and mental retardation.

Parents themselves may notice deviations in the child’s behavior. To do this, you need to carefully monitor the behavior of the baby from the first months of life.

Main symptoms

You can detect the disease by knowing the signs of infantile paralysis. Symptoms of cerebral palsy in children under one year of age are associated with paralysis and muscle weakness, involuntary movements, and lack of coordination.

The child does not have a fold between the buttocks, one side of the body is asymmetrical in relation to the other. In newborn infantile paralysis, the muscles are either relaxed or tense and twitching. And the child’s movements are unnatural and chaotic. In addition, anxiety is felt in the baby’s behavior and loss of appetite.

Paralysis in an older child can be determined more quickly. The disease is diagnosed by spinal curvature and hip dysfunction.

The first symptoms of cerebral palsy are...

Among the initial signs of cerebral palsy in a child under one year old are those that prompt parents to urgently examine the baby. If the functions of parts of the brain are impaired in a newborn, the following is noted:

• lethargy;
• anxiety;
• convulsions;
• inability to turn your head in one direction or another;
• tension or complete relaxation of the upper and lower extremities;
• asymmetry of movements.

Characteristic signs of developing pathology are associated with the condition of the baby’s muscles and his motor activity.

Symptoms for different forms of cerebral palsy

Signs of cerebral palsy in a newborn manifest themselves differently and depend on what form of paralysis the baby suffers from:

1. With spastic diplegia, or Little's disease, the lower extremities are affected, and less often the upper extremities. Symptoms appear from the first months of life. When bathing or swaddling a child, they notice an increase in muscle tone. Children with the syndrome begin to walk later and move their legs with difficulty, relying only on their toes. They cannot sit up on their own.
2. Spastic hemiplegia develops against the background of trauma or encephalitis suffered at an early age. After the cessation of the acute period with convulsions, consciousness returns, but paralysis of one half of the body remains.
3. In patients with atonic-astatic form of paralysis, in addition to the lack of movements, mental retardation and instability of the mental state are noted.
4. Uncontrolled movements in the fingers and toes, and the production of involuntary sounds are characteristic of the hyperkinetic type of cerebral palsy. Along with hyperkinesis, spastic symptoms are also observed. The child has difficulty grasping objects with his hands. The baby is capricious, crying for no reason.

The prognosis of the disease depends on the degree of brain damage and the timeliness of treatment of the disease.

How to recognize the disease?

In children with cerebral palsy, abnormalities can be detected quickly if the baby actively moves the limbs on only one side of the body. In addition, the child cannot turn his head or hold it independently. Depending on the age of the baby, the presence of paralysis is determined:

1. At two months old, the baby's legs cross with scissors and are stiff. Increased muscle tone in the arms and trembling of the limbs are noted. The baby finds it difficult to suck. He lacks characteristic reflexes. Constantly nodding the head or freezing in one position is typical for a child with cerebral palsy.
2. At 3 months of life, the disease often manifests itself as excessive lethargy or irritability. Head movements are poorly controlled by the baby. When checking the palm-oral reflex, when the child opens his mouth while pressing the palm, its absence is noted. Also, when a healthy child is placed on his feet, he rests on his entire foot. A sick baby stands on his toes. During this period, muscle hypertonicity is noticed on one side of the body and a lack of tone on the other.
3. At 4–5 months, a newborn with cerebral palsy moves one arm and holds the other to the body. The patient's movements are awkward. Even on the face, muscle asymmetry is visible. Often a child suffers from strabismus.
4. From 6 and 7 months, the child is unable to roll over on his own. The control of raising the head continues to decline.
5. At 8 months, the baby is noted to be behind in development compared to his peers: he does not sit independently and moves with difficulty. At 10 months, deviations from the norm become more obvious.

The older the child gets, the more pronounced the problems in his development become. And here not only motor function suffers, but also mental activity.

More often, the presence of paralysis can be determined by the absence of characteristic reflexes.

Here are the main such reflexes

Parents can determine the presence of pathology in a child by checking his reflex:

• Moro, when they lift a child up, the baby waves his arms;
• crawling while supporting your heels with your hand;
• imitation of walking while in an upright position.

Not only impaired muscle function is a sign of paralysis. A sick child is characterized by an indifferent attitude towards toys and staying in one position for a long time.

The main methods for diagnosing cerebral palsy in newborns are in the hands of a pediatrician, who will use them to identify the disease.

Diagnostics

The diagnosis begins with examining the child, checking his reflexes and muscle tone. The child's movements will differ from the normal movements of peers.

If a sign of cerebral palsy is present, then consultation with a neuropsychiatrist is required. It is possible to differentiate the diagnosis from similar disorders by using diagnostic methods such as brain tomography and ultrasound examination of a small patient.

An accurate diagnosis of cerebral palsy in newborns is made by specialists who select ways to correct the baby’s development.

To make a diagnosis, the pediatrician must:

• conduct an anamnestic analysis, focusing on the course of the mother’s pregnancy, the peculiarities of the birth of the baby;
• examine the baby to check his basic reflexes;
• write out a referral for tests to determine the causes of the pathology.

Therapy for infantile paralysis will be successful, and the baby will be able to live happily ever after if timely measures are taken to rehabilitate the child.

How to cope with adversity?

For parents, the diagnosis of cerebral palsy in their child is considered a serious death sentence. But a properly selected treatment system will do its job. Together, therapy will give the child a chance to become a full-fledged member of society.

To correct muscle weakness, therapeutic exercises, massage, and acupuncture are selected. Therapy with the help of horses is effective - hippotherapy.

Together with drug treatment and physical methods, complete correction of a child with cerebral palsy is possible. The signs of paralysis will not go away completely, but the patient will feel the taste of life and learn to overcome difficulties physically and emotionally.

And the main role here is played by early recognition of the disease and the first signs of infantile paralysis.

Cerebral palsy (CP) is a disorder caused by permanent damage to a child's brain in utero, birth, or early development. The most common problems relate to coordination of movements of varying degrees of severity or muscle weakness. In some cases, there are seizures, problems with vision and hearing. Children with cerebral palsy often acquire the ability to spin, sit, crawl and walk at a later age than their healthy peers. About a third progress to seizures. Symptoms of the disease may become more noticeable as the child gets older, but this does not mean that the disease is progressing.

According to statistics, cerebral palsy is most often found in premature babies or those with low birth weight for other reasons (42% of all cases of cerebral palsy), twins or triplets (11%). In addition, it is observed slightly more often in boys than in girls – 57% versus 43%.

Cerebral palsy can be diagnosed as early as one month of age, but this happens very rarely. This is explained by the fact that clinical signs of pathology develop in parallel with the development of the human nervous system. Therefore, the diagnosis of cerebral palsy, as a rule, requires several visits to a pediatrician and a pediatric neurologist, who, based on the dynamics of the child’s motor development, may suspect abnormalities. In addition, diagnostic time frames are often needed for different types of cerebral palsy.

In most cases, cerebral palsy in newborns (the first 4 weeks of life) cannot be detected, but pathology is noticed already in infants (children under one year old).

Parents are often the first to notice signs of cerebral palsy in a child under one year old. In fact, in 70-80% of cases, it is the parents themselves who initially draw attention to developmental deviations. However, doctors should do regular and appropriate examinations of all infants and young children.

If there is any suspicion that the baby's brain has suffered from oxygen deprivation, which may be caused by problems with the placenta, uterine diseases, infectious diseases, a long, rapid or difficult labor process, then an MRI should be performed soon after birth to assess any potential brain damage brain MRIs should be performed at regular intervals so that doctors can monitor the severity of cerebral ischemia.

Signs of cerebral palsy in a child

The symptoms caused by cerebral palsy tend to be comparable in severity to the severity of brain damage.

Early signs of cerebral palsy

1. Delayed motor development.

The most common early sign of cerebral palsy in children under one year of age is motor delay. Parents notice that the child:

• starts to hold his head up late or does it poorly;
• does not pay attention to bright sounds and toys, does not try to reach the toy;
• does not roll over from back to stomach and from stomach to back;
• does not sit without support;
• does not try to crawl, stand at a support, try to walk by hand or independently, or lags behind in these skills in terms of timing.

1. Reflexes of a newborn.

Certain reflexes that are present in a newborn child normally fade away with age. But in children with cerebral palsy, the physiological reflexes of a newborn are preserved for a very long time (Galant reflex, Moro reflex, grasping reflex, proboscis reflex and others). In order to check them, you need a mandatory visit to a pediatric neurologist at 1, 3 and 6 months.

Examples of some reflexes that newborns should have and disappear after a few months. Their longer presence may be a sign of cerebral palsy

1. Dysfunction of the muscles of the mouth and face

Cerebral palsy in children under one year of age primarily affects muscle tone, gross and fine motor functions. Early signs of cerebral palsy are associated with dysfunction of the muscles of the mouth and face. Parents may independently discover problems with the child's feeding, swallowing, and ability to express emotions on the face.

1. Posture and body coordination

The child cannot sit down without the support of his hands. Since the strength of contractions of different muscles differs, there is a skew in the position of the torso, head and limbs, while the latter are very often located asymmetrically relative to each other.

1. Visual impairment

The child shows a lack of interest and eye contact with parents and bright objects. Strabismus occurs very often.

1. Hearing impairment.
2. Convulsions(also associated with hypoxic brain damage).

Later signs of cerebral palsy

1. General motor function is impaired.

Limitation of the degree of mobility in general, the ability to lift, crawl, stand, and balance the body.

1. Impaired fine motor skills.

The child cannot grasp small objects and hold them between the index finger and thumb. Hold and use pencils and turn pages.

1. Mental retardation (not typical for all forms of cerebral palsy).
2. Speech impairment (due to poor coordination of the muscles of the mouth, tongue and facial muscles).
3. Joint contractures (incomplete flexion or extension).
4. Hearing loss
5. Disorders of defecation and urination.

Signs of cerebral palsy in infants and infants by week

2 months and older

• There are difficulties in controlling the head when lifting.
• Stiff legs that cross or become scissored when raised.
• Rigid or shaky hands and/or feet.
• There are problems with feeding (weak sucking, stubborn tongue, difficulty biting when lying on the back or stomach).

6 months and older

• Continues to have poor head control when lifting.
• Can extend only one hand, clenching the other into a fist.
• There are problems with eating.
• May be unable to roll over without assistance.

10 months and older

• Moves with difficulty, pushing off with one arm and leg while dragging the opposite arm and leg.
• Doesn't babble.
• Unable to sit down or sit independently.
• Doesn't respond to his own name.

12 months and older

• Doesn't crawl.
• Unable to stand without support.
• Doesn't look for things that are hidden so that he can see them.
• Doesn't say single words like "mom" or "dad".

Diagnostics

Diagnosing cerebral palsy is a very labor-intensive and complex process. In addition to monitoring the child, ultrasound of the brain, EEG, EchoEG, and MRI of the brain are necessary.

Treatment

When treating cerebral palsy, the main principle is that the earlier the diagnosis is made, the greater success in treatment can be achieved. Children have a much higher regenerative capacity than adults.

Cerebral palsy (CP) is a collective term for a group of neurological diseases that cause impairment of motor function and coordination.

Cerebral palsy occurs due to damage to the part of the brain responsible for muscle activity. The disease may be caused by abnormal brain development or injury to the brain before, during, or shortly after childbirth.

The cause of cerebral palsy in most cases begins during the fetal development of the baby and is associated with diseases of the pregnant woman, pregnancy pathology or mutations. And in rare cases - with problems during childbirth and injuries received after birth.

According to statistics, the main cause of disability in children is damage to the nervous system (47.9%), and the most common pathology in this group is cerebral palsy. Approximately 1 in 400–500 people in Russia has cerebral palsy.

As a rule, symptoms of cerebral palsy appear during the first three years of a child’s life.

Initial stage of cerebral palsy appears immediately after birth. Changes in the child’s behavior are associated with disruption of signal transmission from damaged parts of the brain. The baby’s movements are constrained due to constant muscle tension or, on the contrary, muscle weakness and lethargy. The child may shudder periodically, convulsions and trembling in the body are possible. Parents can pay attention to the fact that the baby cannot fix his gaze and sucks poorly. All these changes often occur against the background of a serious general condition of the child: problems with breathing, heartbeat, intracranial pressure, etc.

Early residual stage of cerebral palsy begins at 2–4 months of age. In parallel with the child growing up, disorders appear, determined by the location and extent of brain damage. Developmental delay is observed, such children begin to sit, crawl, walk, talk late, and stiffness and unnatural movements of the damaged part of the body become clearly noticeable. For example, a child can perform all movements with only one hand, and tuck the other one towards the body, walk on tiptoes, and so on.

Late residual stage of cerebral palsy occurs in older children. No new symptoms appear. Due to the lack of full movements, the development of irreversible body deformations, muscle atrophy, and the formation of a specific gait are observed.

There are various treatment methods that can reduce the symptoms of cerebral palsy and increase the child's independence. These include physical therapy, occupational therapy, and medications to relieve muscle tension and spasms. In some cases, surgery may be required.

Symptoms of cerebral palsy in a child

Typically, symptoms of cerebral palsy appear during the first three years of life. A child with cerebral palsy may be slower to reach important developmental milestones such as crawling, walking and speaking.

There are four main forms of cerebral palsy:

• Spastic. This is the most common form of the disease. With it, the muscles are in constant tension, so the child is poorly able to make quick and precise movements. The arms are bent at the elbows, the legs are often brought together or crossed, which makes swaddling the baby difficult. The degree of damage to cerebral palsy can vary - from severe paralysis to slight awkwardness in movements, which are noticeable only when performing complex manipulations.
• Dyskinetic. It can manifest itself as either muscle tension or flaccidity. As a rule, newborn children with a dyskinetic form of cerebral palsy behave sluggishly and hardly move. At the age of 2–3 months, attacks of a sudden increase in muscle tone (sharp muscle tension) appear in response to strong emotions, loud sounds, and bright light. After 1–1.5 years, hyperkinesis appears - slow worm-like movements of the arms and legs (athetosis), fast and jerky movements (choreic cerebral palsy) or contractions of the trunk muscles, which lead to its rotation, head turns and other changes in posture (torsion movements). Hyperkinesis usually does not appear at rest and disappears when the child sleeps. Children with this form of cerebral palsy often experience decreased hearing and speech, as well as difficulty eating. At the same time, mental development suffers less frequently than in other forms of the disease.
• Ataxic. With this form of cerebral palsy, imbalances and coordination come to the fore, causing movements to become jerky and awkward. Children begin to stand and walk at the age of 1.5–2 years, but these functions still have to be brought to automaticity for a long time. Tremor (involuntary shaking) of the hands and head may also be observed. Possible decrease in intelligence.
• Mixed. With it, patients exhibit signs of more than one of the forms of cerebral palsy described above.

The severity of symptoms can vary greatly from person to person. For some, the symptoms are mild, while for others the disease turns them into disabled people.

Cerebral palsy can also affect different parts of the body. In some, the right or left side of the body is affected, in others, the legs are primarily affected, and in others, both legs and arms are affected. Depending on which part of the brain is damaged, cerebral palsy may be accompanied by a violation of not only motor, but also other functions of the body. Therefore, children with cerebral palsy may experience the following symptoms:

• repeated convulsions or seizures (epilepsy);
• drooling and difficulty swallowing (dysphagia);
• gastroesophageal reflux disease (GERD);
• skeletal disorders or abnormalities, especially hip dislocation or spinal curvature (scoliosis);
• problems with controlling bladder emptying (urinary incontinence);
• speech disorder (dysarthria);
• visual impairment;
• learning difficulties (although mental abilities are often not impaired).

Causes of cerebral palsy

In the recent past, doctors believed that the cause of cerebral palsy was damage to the brain during childbirth due to a temporary lack of oxygen (hypoxia). However, in the 1980s. A large study was conducted, during which it was proven that hypoxia during childbirth causes cerebral palsy in no more than 10% of cases. Also, sometimes brain damage can occur during the first few months of a child's life. This condition can be caused by an infection (such as meningitis), very low blood sugar, severe head injury, or stroke.

Much more often, the disease develops due to brain damage that occurs before the birth of the child. Researchers believe that damage to the baby's brain in the womb, leading to cerebral palsy, occurs for three main reasons.

Cause No. 1 - periventricular leukomalacia. This is a lesion of the white matter of the brain. White matter is a collection of nerve fibers that connect the nerve cells responsible for mental activity with the rest of the body. When white matter is damaged, the connection between the brain and organs and parts of the body is disrupted.

It is believed that the damage is caused by a reduction in the volume of blood flowing to the fetal head, or a lack of oxygen. In the future, this is fraught with serious consequences for the child’s muscular system, since the white matter is responsible, among other things, for transmitting signals from the brain to the muscles of the body.

The exact cause of periventricular leukomalacia is unclear. But it is believed that risk factors may include:

• very low maternal blood pressure - for example, due to a caesarean section;
• premature birth, especially before the 32nd week of pregnancy.

Reason number 2 is a violation of brain development. Any damage to the brain can disrupt the transmission of signals from nerve cells to muscles and other parts of the body, and therefore can cause cerebral palsy in children.

The following factors can affect brain development:

• changes (mutations) in genes affecting brain development;
• an infectious disease suffered by a woman during pregnancy;
• fetal head injury.

Reason number 3 - intracranial hemorrhage and stroke. Intracranial hemorrhage is bleeding in the brain. This is potentially dangerous, since if there is a lack of blood, parts of the brain can die, and the accumulation of blood itself can damage surrounding tissue. Intracranial hemorrhage usually occurs in premature babies, but can also occur after a stroke in a child in the womb.

Factors that increase the risk of fetal stroke:

• initial weakness or pathology of the blood vessels of the fetus or maternal placenta;
• maternal high blood pressure;
• an infectious disease in a woman during pregnancy, especially chlamydia, trichomoniasis and other sexually transmitted diseases.

Diagnosis of cerebral palsy

If you notice signs of cerebral palsy in a child, contact your pediatrician. If a disease is suspected, he will write out a referral for a consultation with a pediatric neurologist, who will check the baby’s reflexes, posture, muscle tone and movements. If the diagnosis is confirmed, you will undergo additional examination by an orthopedist, who will prescribe treatment and develop a habilitation (adaptation to life) program. Depending on the child's age, they may also be referred to a psychologist to evaluate their intellectual development.

To exclude similar diseases and confirm the diagnosis of cerebral palsy, the doctor may prescribe additional examination, for example:

• magnetic resonance imaging (MRI) - creating a detailed image of the brain using magnetic fields and radio waves;
• Ultrasound (ultrasound) - creating images of brain tissue using sound waves;
• computed tomography (CT) - the creation of a series of X-rays that are assembled by a computer into a detailed three-dimensional image of the child’s brain;
• electroencephalogram (EEG) - monitoring brain activity using small electrodes attached to the head;
• electromyogram (EMG) - a test of muscle activity and the function of peripheral nerves (the network of nerves running from the brain and spinal cord to other parts of the body);
• blood tests.

Sometimes the diagnosis of cerebral palsy is made for a child while still in the maternity hospital. However, in most cases, this disease can be suspected only after several months or years of monitoring the baby. It is possible to definitively determine the degree and type of paralysis only at the age of 4–5 years.

Treatment of cerebral palsy

There is no cure for cerebral palsy, but there are approaches to relieve symptoms and help your child be as independent as possible.

Rehabilitation treatment must begin early, since the children's brain has great compensatory capabilities. In the first years of life, children are prescribed therapeutic measures to help the proper development of various parts of the nervous system. In the future, to improve motor function, children with cerebral palsy may be recommended surgical treatment in combination with conservative therapy.

Help for patients with cerebral palsy is provided in neurological and orthopedic departments, specialized children's sanatoriums and boarding schools. Some basic treatment methods are described below.

Physiotherapy for cerebral palsy

Typically, physical therapy begins immediately after a diagnosis of cerebral palsy is made, as it is one of the most important ways to help a child manage the condition.

The two main goals of physical therapy for cerebral palsy are:

• prevent weakening of muscles that your child does not usually use;
• prevent muscles from contracting and losing their normal range of motion (this is called muscle contracture).

The risk of developing contractures is increased in children who find it difficult to stretch their muscles due to their stiffness. If muscles cannot stretch, they cannot grow as quickly as bones. This can lead to curvature of the body, causing pain and discomfort to the child.

The physical therapist teaches the child a series of physical exercises to strengthen and stretch the muscles that need to be performed every day. Also, special orthopedic attachments for arms or legs can be used to stretch muscles and correct posture.

Speech development in children with cerebral palsy

Salivation control and nutritional problems in cerebral palsy

Children who cannot control their mouth muscles often have difficulty swallowing food and maintaining saliva flow. This can lead to serious consequences, so nutritional problems in cerebral palsy require treatment.

If you have difficulty swallowing (dysphagia), tiny particles of food can enter the lungs, which is accompanied by the development of a dangerous disease - aspiration pneumonia.

If dysphagia is mild, the doctor can teach the child how to cope with it. A diet consisting of soft foods is also recommended. More severe dysphagia may require tube feeding. This is a tube that is passed into the stomach through the nose or mouth (nasogastric tube) or directly through the abdominal wall (gastrostomy tube).

Drooling causes irritation of the skin around the mouth, chin and neck, increasing the risk of inflammation in these areas. There are a number of methods to combat drooling in cerebral palsy:

• an anticholinergic medicine in tablet or patch form that reduces saliva production;
• botulinum toxin injections into the salivary glands (although this is only a temporary solution);
• movement of the ducts of the salivary gland through surgery, as a result of which saliva is released deeper into the oral cavity and is easier to swallow;
• a special device placed in the oral cavity, which promotes the correct position of the tongue and regular swallowing of saliva;
• training in self-monitoring skills for the physiological state of the body, during which the child is taught to recognize when he is salivating and swallow it in time.

Surgery for cerebral palsy

Sometimes, to correct bone and joint deformities, surgery is prescribed to lengthen muscles and tendons that are too short and cause discomfort. This type of surgery is called orthopedic surgery and is prescribed if a child with cerebral palsy experiences pain when moving. Surgery can also improve posture and ease of movement, as well as improve a child's self-esteem.

However, it is not possible to feel all the benefits of the operation immediately after the intervention. Sometimes this takes several years, during which the child needs repeated courses of physical therapy.

Surgery may be performed to correct spinal curvature (scoliosis) or urinary incontinence. The child’s condition will be carefully monitored in order to promptly identify those disorders that can be effectively corrected with surgical intervention. As an examination, regular x-rays of the hip joint or spine may be prescribed.

Selective dorsal rhizotomy (SDR) is a surgical operation that is prescribed to improve the gait of children with high muscle rigidity (increased tone). As a rule, it is recommended only in cases where examinations have shown that the child has damage to the white matter of the brain (periventricular leukomalacia) and other methods of treating rigidity have not helped.

During the operation, the surgeon cuts some of the nerve fibers in the lower spine to relieve tension in the leg muscles. However, after surgery, several months of intensive physical therapy are required to re-teach the child to control his movements.

Like any other surgery, SRD has a risk of complications, including temporary problems emptying the bladder (urinary incontinence), scoliosis, and changes in sensation in the legs.

There are other methods of surgical correction of cerebral palsy. The intervention depends on the severity and prevalence of paralysis, the nature of the musculoskeletal system disorders, the age of the patient and his mental state. The optimal age for surgery is 8–16 years.

Discuss the potential benefits and risks of surgery with the surgeon, along with your child (if he is able to understand the consequences of the procedure).

Complications of cerebral palsy

The brain disorder that causes cerebral palsy does not get worse with age, but a person with the condition may experience physical and psychological difficulties as they get older.

Thus, many adults under the influence of cerebral palsy develop additional diseases (for example, osteoarthritis), which cause pain, fatigue and weakness. Basically, these diseases are associated with pathology of the muscles and bones inherent in cerebral palsy, which create a large load on the body. Therefore, people with cerebral palsy may take much more effort to carry out ordinary activities than those who do not suffer from this disease.

Additional physical therapy sessions and the use of mobility aids, such as a wheelchair for cerebral palsy or special walkers, can help alleviate the physical difficulties that develop over time as a result of the disease.

Charitable educational foundation for promoting habilitation of children with special needs;

You can easily find doctors who diagnose and treat cerebral palsy using the NaPopravka service. The “Who Treats It” section on our website will help you decide on the right doctor. If in doubt, consult your pediatrician. He will conduct an initial diagnosis and refer you for a consultation with a doctor of the required profile.

The first signs of cerebral palsy can be detected in newborns in the first days of life and up to one year. Professionals and even parents can determine the presence of the disease in the early stages of development, which is necessary to prevent exacerbations. Cerebral palsy in children often manifests itself as a complex of symptoms that need to be recognized in a short time.

Doctors do not always properly examine the child in order to promptly identify the symptoms of cerebral palsy. Parents spend a lot of time with their baby, which gives them a chance to independently detect the disease. The most characteristic appearances of cerebral palsy at an early age:

1. Inability to detect folds between buttocks.
2. Lack of lumbar curve.
3. Asymmetry of two areas of the body.

In the first days of life with severe cerebral palsy, the following signs can be diagnosed:

1. Excessive muscle tone or being too relaxed.
2. In the first days of life, optimal muscle tone is visible, but disappears after some time.
3. If hypertonicity occurs, the child’s movements look unnatural and are often carried out too slowly.
4. Unconditioned reflexes do not disappear, and the child does not begin to sit or hold his head up on his own for too long.
5. Asymmetry of various parts of the body. On the one hand, symptoms of hypertonicity occur, on the other, muscle weakening may follow.
6. Muscle twitching, in some cases complete or partial paralysis is possible.
7. Unreasonably increased anxiety, frequent loss of appetite.

On a note! If a child actively uses only one side of the body, gradual muscle atrophy occurs on the other part, the limbs do not develop fully, and often do not grow to the required parameters. There is a curvature of the spine, disturbances in the function and structure of the hip joints.

Most often, cerebral palsy in children is detected quickly, since they make active movements with the limbs located on one side. Often patients hardly use the arm with weakened tone, which is rarely separated from the body. The child does not turn his head without great effort, even several months after birth. Often parents need to turn their baby over on their own from time to time.

Even if you do not notice dangerous signs or doubt their presence, it is necessary to conduct regular diagnostic examinations. Be attentive to the health of the child if he was born premature, develops too slowly, or you notice problems during childbirth.

On a note! If you discover serious deviations in the development or behavioral characteristics of the baby, you should consult a doctor for advice.

Methods for self-diagnosis of cerebral palsy:

How to identify cerebral palsy in a three-month-old child?

In the period from 3 months to six months, the child exhibits congenital reflexes, including hand-to-mouth and heel reflexes. The presence of the first can be checked by pressing your fingers on the inside of the hand, while the child opens his mouth. To check for the presence of a heel reflex, you need to lift the child by placing him on his feet. Usually babies try to move around. In a healthy state, the child stands on his full foot. If cerebral palsy manifests itself, he rests only on his fingertips or cannot use his legs for support at all.

At 3 months, cerebral palsy can be quickly diagnosed if the child actively uses only one side of the body. In many cases, this symptom can be detected within a few days after the baby is born. Insufficient muscle tone on the one hand and hypertonicity on the other are caused by pathologies of the relationship between the two hemispheres of the brain.

If the innervation is carried out incorrectly, the child's movements become clumsy, he uses opposite parts of the body in different ways, and an inhibited reaction appears. Manifestations of cerebral palsy can be seen even on the face. There may be a complete absence of chewing muscles, which causes asymmetry of the facial muscles. Strabismus often develops.

On a note! Sick children often cannot sit independently, and this deviation can persist for up to six months or longer.

How to recognize cerebral palsy in an infant?

If the brain damage is minimal, typical symptoms are difficult to identify not only for parents, but even for professional specialists. Clumsy movements and overstrain of muscle tissue are observed only with severe damage to brain cells.

You can suspect the presence of brain disorders if you have the following symptoms:

1. Sleep pathologies.
2. Inability to roll over independently.
3. The child cannot hold his head up.
4. Conditioned reflexes apply to only one side of the body.
5. The baby often remains in one position without moving for a long time.
6. Periodically there are cramps in the limbs.
7. Facial asymmetry of varying degrees of severity.
8. The limbs vary in length.

Common signs of cerebral palsy

The clinical picture may vary depending on the form of the disease. Each of them is characterized by specific symptoms that affect the child’s life in different ways.

Diplegic form

Occurs when brain damage occurs during fetal development. These disorders can be noticed by muscle hypertonicity. Sick children are in a characteristic position, as their legs are extended and often crossed.

Until one year of age, you may notice that the child practically does not use the lower limbs when moving. Often children do not try to sit up or even roll over. As the course of the disease worsens, serious deviations in physical development may develop.

It is quite easy to detect the presence of this form of the disease. To do this, it is enough to try to put the child on his feet. In this case, a sharp increase in muscle tone appears. The child moves, while leaning only on tiptoes. The gait is unsteady; with each new step, the child touches one leg with the other, moving the limbs straight in front of him.

On a note! In the diplegic form of the disease, deviations in mental development often appear.

Hemiplegic form

The disease often occurs when one of the cerebral hemispheres is damaged. A high risk of developing hemiplegic cerebral palsy remains in children suffering from intrauterine infection. This disease can occur even with minor hemorrhage during childbirth.

The hemiplegic form of cerebral palsy is manifested by limited movements in the limbs, while persistently increased muscle tone remains. The child moves actively, but at the same time he is diagnosed with too frequent muscle contractions in the part of the body, the innervation of which is responsible for the affected area of ​​the brain.

Video - How to recognize cerebral palsy

Hyperkinetic form

Occurs when there are structural disorders of the subcortical ganglia responsible for innervation. Often the disease manifests itself as a result of negative immune activity in the mother’s body in relation to the child. In this case, the symptoms of cerebral palsy are also pronounced. The child’s muscle tone often stabilizes, but after a while it increases. In some cases, muscle tone does not increase, but decreases. The child's movements become awkward, he takes uncomfortable and unnatural poses. In many cases, with this form of the disease, intelligence is preserved, which is why the prognosis with timely treatment is considered conditionally favorable.

When should you be wary?

There are several types of symptoms that can be used to determine the severity and form of the disease. Often negative signs appear very clearly, making them almost impossible not to notice even before the age of one year. In most cases, cerebral palsy manifests itself with severe symptoms; disorders often lead to impairment of motor and coordination functions.

Motor signs of cerebral palsy:

1. Hyperkinetic form of this disease.
2. Dystonia and related disorders.
3. Development of motor skills in only one limb.
4. Muscle spasticity.
5. Periodic appearance of paresis, paralysis.

Dystonia with cerebral palsy steadily progresses, after some time additional negative symptoms arise, which can lead to a number of complications. Often it is not cerebral palsy that progresses, but the disorders and diseases associated with it. During the active growth of the child, the intensity of negative symptoms can either increase or decrease.

Often, after some time, cerebral palsy is complicated by structural pathology of the joints and muscle disorders. These deviations are almost impossible to stop if you refuse to use surgical intervention.

On a note! Often, pathologies arise as a result of disruptions in the functioning of certain parts of the brain. As a result, patients suffer from improper muscle function, and deviations in the functioning of internal organs are also possible.

If disturbances in the functioning of the brain occur, the following disorders may form:

1. Non-standard, illogical behavior.
2. Inability to learn something new, speak simple words.
3. Intellectual failure.
4. Hearing impairment, speech pathology.
5. Regular occurrence of problems with swallowing.
6. Lack of appetite.

If muscle and neurological disorders occur with cerebral palsy, the quality of life of children is greatly reduced. In some cases, concomitant diseases affect the human body more strongly than the primary pathologies. Often cerebral palsy is accompanied by a decrease in intelligence and damage to various brain structures.

Cerebral palsy in children is often characterized by standard features, but can occur in a unique pattern. To determine the presence of cerebral palsy, especially in mild forms, special tests are used. Based on a group of symptoms, a disease is identified. Doctors take into account a combination of signs from muscle tissue and the nervous system.

To make an accurate diagnosis and determine the dynamics of the disease, doctors use various diagnostic measures. Negative signs often appear from the first days or weeks of a baby’s life. It is possible to make a diagnosis and characterize the course of the disease up to a year, but the information obtained is clarified at an older age.

Diagnosis of cerebral palsy is carried out by assessing the general condition of the brain. Modern instrumental technologies are used, including MRI, CT, ultrasound. Using these diagnostic studies, it is possible to identify pathological foci, disturbances in the structure of the brain, as well as areas of hemorrhage.

The worsening of the clinical picture can be traced using neurophysiological research methods. Electromyography and similar measures are performed. Laboratory and genetic diagnostic methods are used to determine symptoms characteristic of cerebral palsy.

Children diagnosed with cerebral palsy, or cerebral palsy, are often called other children, or simply angels. According to statistics, in our country about 120 thousand people suffer from this serious illness, not counting those who have not been accurately diagnosed. But in 75% of patients, disorders associated with cerebral palsy can be easily corrected - the main thing is to notice the signs of the disease in time and begin adequate therapy. How to recognize cerebral palsy at the very beginning of a baby’s life?

Cerebral palsy is not a separate disease, but a whole complex of central nervous system lesions that affect one or more parts of the brain. As a result, the child’s muscle activity, coordination of movements and motor functions are impaired, problems with hearing, speech, psychomotor development arise, and intelligence suffers. The main feature of cerebral palsy is that the disease is not progressive, that is, it can and should be treated.

Causes and risk factors

There can be many reasons for damage to the central nervous system of a child and the development of cerebral palsy, but the main ones include the following factors.

1. Complications during pregnancy. The baby’s nerve cells begin to form from the first weeks, and the key period in the formation of the central nervous system is the period from the 10th to the 18th week. Defects in the nervous system can cause chronic diseases of the mother (heart defects, diabetes, hypertension), severe toxicosis, food and chemical poisoning, exposure to radiation, etc.
2. Genetic disorders. Doctors call mutations in chromosomes one of the factors that influence the development of cerebral palsy. The exact mechanism of development of such disorders is unknown, so any malfunctions in the genetic apparatus of the parents can lead to the disease.
3. Intrauterine infections. Diseases that can have a negative impact on a child’s brain include rubella, chlamydia, cytomegalovirus, herpes, mycoplasmosis, and ureaplasmosis. Among other things, they can cause diseases of the placenta, which causes the fetus to become deficient in oxygen and nutrients.
4. Complications during delivery. Difficult childbirth, a long anhydrous period, entanglement of the umbilical cord, mechanical injuries to the fetus - all this leads to hypoxia and, accordingly, damage to the fetal brain.
5. Premature birth. According to statistics, 40-50% of patients with cerebral palsy were born prematurely, and many of them were on a ventilator. Such children are most susceptible to damage to the central nervous system and brain - in healthy, full-term babies, even in the presence of hypoxia, the blood is distributed so that all parts of the brain function normally. Premature, weakened children do not have this ability, so their brain suffers from a lack of oxygen especially severely.
6. Hemolytic disease. This phenomenon occurs when there is a complex conflict between the Rh factors of mother and child, as well as with prolonged jaundice in newborns (bilirubin has a toxic effect on brain cells).

The presence of one or more of the above factors does not always lead to the development of cerebral palsy. If the lesions are minimal, the matter may be limited to the diagnosis of PEP (perinatal encephalopathy), but even such children require increased attention from parents and doctors.

How to determine cerebral palsy in newborns?

Symptoms of cerebral palsy can be noticed immediately after the birth of a child, but the final diagnosis must be made exclusively by a specialist. What signs require special attention and immediate medical attention?

1. The presence of one or more risk factors during pregnancy or childbirth.
2. Violation of development norms. There are certain periods when the baby should be able to hold his head, roll over, sit down, hold objects - a serious lag behind this schedule should seriously alert the mother. For example, if at four months the child does not turn his head in the direction of the emanating sound or does not reach for a toy, you should consult a specialist as soon as possible.
3. Disturbance of psycho-emotional development. The psycho-emotional development of the baby also fits into certain norms: in a month he must learn to smile, in 2 months he must learn to make sounds, etc. This factor also plays an important role in the diagnosis of cerebral palsy.
4. Impaired muscle tone. Children are born with hypertonicity syndrome, which disappears by a certain time. At 1.5 months, hypertonicity of the upper extremities disappears, at 3-4 months, muscle tone of the lower extremities decreases. If this does not happen, the development of cerebral palsy and other diseases can be suspected. Hypotonicity of muscles (“rag” limbs) is also an alarming sign.
5. Body asymmetry. The muscles and limbs of a healthy child develop symmetrically, and any violations of this symmetry require a more thorough examination. For example, the so-called fencing pose, when one arm of the baby is bent and tense, and the second is relaxed and lies freely along the body. There is also asymmetry of movements - it consists in the fact that the baby moves one limb better and more actively than the other. There may also be different thicknesses of the arms and legs, which is very important to notice in a timely manner.
6. Violent movements. This phenomenon is observed in the majority of patients with cerebral palsy. Such movements are always involuntary and come in several types: sharp, rapid twitching of the lower extremities or slow, wave-like movements of the feet and hands. They tend to intensify in stressful situations, at rest their activity decreases, and during sleep they completely disappear.
7. Frequent restlessness of the child. Children never cry just like that - if the baby is not hungry, dry and does not suffer from colic, he will not scream. Frequent crying for no reason, poor sleep and anxiety can be signs of various diseases, including cerebral palsy.

   

8. Convulsive syndrome. Some mothers experience seizures in their children at high temperatures. In addition, convulsive syndrome is manifested by shudders, tremors and sudden stopping of gaze.
9. Manifestations on the skin, eyes and other organs and systems. Symptoms of developing cerebral palsy often include marbling or bluish skin, excessive sweating, unexpected strabismus and asymmetry of the pupils, and constant choking.

It should be noted that such symptoms can not only be a sign of cerebral palsy, but also indicate other diseases, and in some cases they are a physiological norm or individual characteristics of the baby’s development - only a specialist will be more precise after a detailed study.

Types of cerebral palsy

Cerebral palsy has many manifestations, so doctors distinguish between several types of this disease. Each of them is characterized by certain changes in the brain and a disorder of certain organs or systems.

The severity of the disease depends on how severely the child's brain is affected. With mild cerebral palsy, children can move independently, look after themselves and perform simple tasks. They are able to study in a regular school and engage in almost all types of professional activities. Patients with moderate damage cannot do without outside help, but are able to live in society and even work. A severe degree of cerebral palsy means that the child will be completely dependent on others and will not be able to care for himself.

Video - Cerebral palsy. Symptoms, signs and treatments

Diagnosis of cerebral palsy

The prognosis of the disease and the effectiveness of treatment largely depend on timely diagnosis. Children who are at risk require special attention:

• premature newborns or those born with severe underweight;
• children with congenital malformations (including minor ones);
• infected with various diseases that were transmitted from the mother during pregnancy;
• babies born with the use of any obstetric devices;
• children who received a low (below 5 points) Apgar score;
• newborns with severe jaundice.

The goal of diagnosing cerebral palsy is not only to identify the disease and determine its degree, but also to exclude diseases with similar symptoms.

Diagnostic measures in this case include:

• collecting information about the course of the mother’s pregnancy, concomitant diseases and complications, as well as how the birth went;
• collecting data on the child’s psychomotor and emotional development, identifying delays and delays;
• physical examination of the child, identification of remaining reflexes, assessment of muscle tone, posture, hearing and vision functions;
• Ultrasound of the brain (prescribed if there are specific complaints and signs);
• electroencephalography is performed for convulsive syndrome;
• CT and MRI can detect brain lesions, including cysts, hemorrhages, neoplasms, etc.

At what age can cerebral palsy be diagnosed?

Despite the fact that the disease is present in most patients with cerebral palsy from the moment of birth, it can be very difficult to identify it in the first weeks of life. The fact is that newborns spend almost all their time sleeping, and their movements are limited, so at this stage only severe forms of the disease are detected.

At 3-4 months, babies with normal health lose some of their reflexes (Moro, crawling, etc.), which makes it possible to develop normally and acquire new skills. In children diagnosed with cerebral palsy, these reflexes persist, interfering with their further development, so it is at this stage that the presence of the disease can be suspected.

Video - Moro reflexes and support reflexes

Treatment of cerebral palsy

It is impossible to completely cure cerebral palsy, since brain damage is irreversible, but modern treatment methods make it possible to partially restore motor functions and socialize the child. Infants diagnosed with cerebral palsy are prescribed therapeutic massage and wearing orthopedic devices that support muscles and improve their tone and function.

In the absence of convulsive syndrome, patients are prescribed physical therapy (in particular, electrophoresis, myostimulation, electroreflexotherapy) - they restore the activity of neurons in the cerebral cortex, eliminate hypertonicity, correct speech, diction and coordination of movements. On the recommendation of doctors, you can use medications that improve the nutrition of nerve tissue and blood microcirculation. After the child grows up a little, he is prescribed therapeutic exercises, special programs for training mental functions, correcting hearing and speech, and developing social skills.

The diagnosis of cerebral palsy is a difficult test for parents, but this disease is not a death sentence. The capabilities of modern medicine, in combination with regular treatment and rehabilitation measures, can significantly improve the child’s quality of life, and sometimes give him the opportunity to lead a normal existence.