Clinical illustrations. Consequences of early residual organic damage to the central nervous system with cerebrasthenic, neurosis-like, psychopath-like syndromes. Symptoms of damage to the nervous system in a child

The central nervous system is the main regulator of the functioning of the entire body. After all, in the cortical structures of the brain there are departments responsible for the functioning of each system. Thanks to the central nervous system, the normal functioning of all internal organs, regulation of hormone secretion, and psycho-emotional balance are ensured. Under the influence of unfavorable factors, organic damage to the structure of the brain occurs. Pathologies often develop in the first year of a child’s life, but can also be diagnosed in adults. Despite the fact that the central nervous system is directly connected to the organs thanks to nerve processes (axons), damage to the cortex is dangerous due to the development of severe consequences even in the normal state of all functional systems. Treatment of brain diseases should begin as early as possible; in most cases, it is carried out for a long time - over several months or years.

Description of residual organic damage to the central nervous system

As you know, the central nervous system is a coherent system in which each of the links performs an important function. As a result, damage to even a small area of the brain can lead to disruption in the functioning of the body. In recent years, damage to nervous tissue has been increasingly observed in pediatric patients. To a greater extent, this applies only to born babies. In such situations, a diagnosis of “residual organic damage to the central nervous system in children” is made. What is it and is this disease treatable? The answers to these questions worry every parent. It is worth keeping in mind that such a diagnosis is a collective concept that can include many different pathologies. The selection of therapeutic measures and their effectiveness depend on the extent of the damage and the general condition of the patient. Sometimes residual organic damage to the central nervous system occurs in adults. Often, pathology occurs as a result of previous injuries, inflammatory diseases, and intoxication. The concept of “residual organic damage to the central nervous system” implies any residual effects after damage to nerve structures. The prognosis, as well as the consequences of such a pathology, depend on how severely the brain function is impaired. In addition, great importance is attached to topical diagnosis and identification of the site of damage. After all, each of the brain structures must perform certain functions.

Causes of residual organic brain damage in children

Residual organic damage to the central nervous system in children is diagnosed quite often. The causes of nervous disorders can occur both after the birth of a child and during pregnancy. In some cases, damage to the central nervous system occurs due to complications of childbirth. The main mechanisms for the development of residual organic damage are trauma and hypoxia. There are many factors that provoke nervous system disorders in a child. Among them:

Genetic predisposition. If parents have any psycho-emotional disorders, then the risk of their development in the baby increases. Examples include pathologies such as schizophrenia, neuroses, and epilepsy.
Chromosomal abnormalities. The cause of their occurrence is unknown. Incorrect DNA construction is associated with unfavorable environmental factors and stress. Due to chromosomal abnormalities, pathologies such as Shershevsky-Turner syndrome, Patau syndrome, etc. occur.
The impact of physical and chemical factors on the fetus. This refers to unfavorable environmental conditions, ionizing radiation, and the use of drugs and medications.
Infectious and inflammatory diseases during the formation of the nervous tissue of the embryo.
Toxicoses of pregnancy. Late gestosis (pre- and eclampsia) is especially dangerous for the condition of the fetus.
Impaired placental circulation, iron deficiency anemia. These conditions lead to fetal ischemia.
Complicated childbirth (weakness of uterine contractions, narrow pelvis, placental abruption).

Residual organic damage to the central nervous system in children can develop not only during the perinatal period, but also after it. The most common cause is head trauma at an early age. Risk factors also include taking drugs that have a teratogenic effect and narcotic substances during breastfeeding.

The occurrence of residual organic brain damage in adults

In adulthood, signs of residual organic damage are observed less frequently, however, they are present in some patients. Often the cause of such episodes is trauma received in early childhood. At the same time, neuropsychic abnormalities are long-term consequences. Residual organic brain damage occurs for the following reasons:

Post-traumatic illness. Regardless of when the damage to the central nervous system occurred, residual symptoms remain. These often include headaches, seizures, and mental disorders.
Condition after surgery. This is especially true for brain tumors, which are removed using nearby nerve tissue.
Taking drugs. Depending on the type of substance, the symptoms of residual organic damage may differ. Most often, serious disorders are observed with long-term use of opiates, cannabinoids, and synthetic drugs.
Chronic alcoholism.

In some cases, residual organic damage to the central nervous system is observed after inflammatory diseases. These include meningitis and various types of encephalitis (bacterial, tick-borne, post-vaccination).

Mechanism of development of central nervous system lesions

Residual damage to the central nervous system is always caused by unfavorable factors that preceded it. In most cases, the basis for the pathogenesis of such symptoms is cerebral ischemia. In children, it develops even during the period. Due to insufficient blood supply to the placenta, the fetus receives little oxygen. As a result, the full development of nervous tissue is disrupted, and fetopathy occurs. Significant ischemia leads to intrauterine growth retardation and the birth of a child before the gestational age. Symptoms of cerebral hypoxia can appear already in the first days and months of life. Residual organic damage to the central nervous system in adults often develops due to traumatic and infectious causes. Sometimes the pathogenesis of nervous disorders is associated with metabolic (hormonal) disorders.

Syndromes with residual organic damage to the central nervous system

In neurology and psychiatry, several main syndromes are distinguished, which can occur either independently (against the background of a brain disease) or be regarded as a residual lesion of the central nervous system. In some cases, a combination of these is observed. The following signs of residual organic damage are distinguished:

What could be the consequences of residual organic damage?

The consequences of residual organic damage to the central nervous system depend on the degree of the disease and the approach to treatment. For mild disorders, complete recovery can be achieved. Severe damage to the central nervous system is dangerous due to the development of conditions such as cerebral edema, spasm of the respiratory muscles, and damage to the cardiovascular center. To avoid such complications, constant monitoring of the patient is necessary.

Disability due to residual organic damage

Treatment must begin as soon as the appropriate diagnosis is established - “residual organic damage to the central nervous system.” Disability for this disease is not always assigned. In case of pronounced disorders and lack of treatment effectiveness, a more accurate diagnosis is established. Most often this is “post-traumatic brain disease”, “epilepsy”, etc. Depending on the severity of the condition, disability group 2 or 3 is assigned.

Prevention of residual organic damage to the central nervous system

To avoid residual organic damage to the central nervous system, it is necessary to be observed by a doctor during pregnancy. If there are any deviations, you should seek medical help. You should also refrain from taking medications and bad habits.

No living organism can function without organs responsible for transmitting impulses through nerve cells. Damage to the central nervous system has a direct impact on the functionality of brain cells (both spinal and brain) and leads to disorders of these organs. And this, in turn, plays a primary role in determining the quality of human life.

Types of lesions and their characteristics

The nervous system of the human body is the network of cells and nerve endings located in the structure of the brain. The functions of the central nervous system are to regulate the activity of any of the organs individually and the entire organism as a whole. When the central nervous system is damaged, these functions are disrupted, which leads to serious disruptions.

Today, all problems with the nervous system are divided into the following types:

organic;
perinatal.

Organic damage to the central nervous system is characterized by pathomorphological changes in the structure of brain cells. Depending on the severity of the lesion, 3 degrees of pathology are determined: mild, moderate and severe. As a rule, a mild degree of damage can be observed in any person (regardless of his age), without affecting health and quality of life. But moderate and severe degrees already signal serious disturbances in the activity of the nervous system.

It suggests damage to the structure of cells located in the brain in newborns and children of the first year of life, which arose during the perinatal period. This time includes the antenatal (from the 28th week of pregnancy until childbirth), intranatal (the moment of birth) and neonatal (the first 7 days of the baby’s life) periods.

What factors contribute to the occurrence of damage?

Organic lesions can be acquired or congenital. Congenital injuries occur while the fetus is in the womb. The following factors influence the occurrence of pathology:

use by a pregnant woman of certain types of medications, alcohol;
smoking;
illness during pregnancy with infectious diseases (sore throat, flu, etc.);
emotional overstrain, during which stress hormones attack the fetus;
exposure to toxic and chemical substances, radiation;
pathological course of pregnancy;
unfavorable heredity, etc.

Acquired injuries can develop as a result of mechanical injuries to the child. In some cases, this pathology is called residual. The diagnosis of residual organic damage to the central nervous system is made by a doctor when there are symptoms indicating the presence of residual effects of brain disorders after birth injuries.

In recent years, the number of children with residual effects of residual lesions has been increasing. Medicine is inclined to explain this by the unfavorable environmental situation in some countries of the world, chemical and radiation pollution, and young people’s passion for dietary supplements and medications. In addition, one of the negative factors is the unjustified use of cesarean section, in which both mother and child receive a dose of anesthesia that does not always have a good effect on the state of the nervous system.

The cause of perinatal disorders is most often acute asphyxia (oxygen starvation) of the fetus during childbirth. It can occur as a result of the pathological course of labor, with incorrect position of the umbilical cord, manifest itself in the form of cerebral hemorrhages, ischemia, etc. The risk of perinatal damage increases many times in children born prematurely or during childbirth outside the maternity hospital.

Main manifestations of damage

The main symptoms of the lesion depend on its type. As a rule, patients experience:

increased excitability;
insomnia;
daytime enuresis;
repetition of phrases, etc.

Children have a decrease in immunity; they are more likely than their peers to be susceptible to various colds and infectious diseases. In some cases, there is a lack of coordination of movements, deterioration of vision and hearing.

Signs of perinatal damage depend entirely on the type of brain damage, its severity, the stage of the disease and the age of the child. Thus, the main symptoms of damage in children born prematurely are short-term convulsions, depression of motor activity and impaired respiratory functions.

Newborns born at term suffer from both suppression of motor activity and increased excitability, manifested in irritated screaming and restlessness, and convulsions of significant duration. 30 days after the birth of the baby, lethargy and apathy are replaced by an increase in muscle tone, excessive tension, and incorrect formation of the position of the limbs occurs (clubfoot occurs, etc.). In this case, hydrocephalus (internal or external dropsy of the brain) may occur.

With spinal cord injuries, symptoms depend entirely on the location of the injury. Thus, when the nerve plexuses or spinal cord in the cervical spine are injured, a condition called obstetric paralysis appears typical. This pathology is characterized by immobility or sagging of the upper limb on the affected side.

With lesions classified as moderate, the following symptoms are observed:

constipation or increased bowel movements;
violations of thermoregulation, expressed in the body’s incorrect response to cold or heat;
bloating;
pallor of the skin.

A severe form of perinatal damage to the central nervous system (PPCNS) is characterized by a delay in the development and formation of the baby’s psyche, which is observed already within 1 month of life. There is a sluggish reaction during communication, a monotonous cry with a lack of emotionality. At 3-4 months, the child’s movements may become permanently impaired (like cerebral palsy).

In some cases, PPCNS are asymptomatic and appear only after 3 months of the baby’s life. Signs of concern for parents should be excess or insufficient movements, excessive anxiety, apathy of the baby, and insensitivity to sounds and visual stimuli.

Methods for diagnosing and treating injuries

Diagnosing congenital organic lesions of the central nervous system in children is quite easy. An experienced doctor can determine the presence of pathology just by looking at the baby’s face. The main diagnosis is established after a series of mandatory examinations, which include an electroencephalogram, rheoencephalogram and ultrasound of the brain.

To confirm perinatal disorders, ultrasound of the brain and Dopplerography of blood vessels, X-rays of the skull and spinal column, and various types of tomography are used.

Treatment of organic and residual organic lesions of the central nervous system is a very long process, mainly based on the use of drug therapy.

Nootropic drugs that improve brain functionality and vascular medications are used. Children with residual organic damage are prescribed classes with specialists in the field of psychology and speech therapy, during which exercises are performed to correct attention, etc.

If the perinatal disorder is severe, the baby is placed in the intensive care unit at the maternity hospital. Here measures are taken to eliminate disturbances in the functioning of the main body systems and convulsive attacks. Intravenous injections, ventilation, and parenteral nutrition may be provided.

Further treatment depends on the severity of damage to cells and brain structures. Typically, medications with anticonvulsant effects, dehydration agents, and brain nutritional agents are used. The same medications are also used to treat a baby in the first year of life.

The recovery period (after the first year of life) is characterized by the use of non-drug therapy. Rehabilitation methods such as swimming and exercises in water, therapeutic exercise and massage, physiotherapy, sound therapy (healing a child with the help of music) are used.

The consequences of organic and perinatal disorders depend on the severity of the pathology. With proper treatment, recovery or residual effects in the form of deviations in the child’s development are possible: delayed speech, motor functions, neurological problems, etc. Full rehabilitation in the first year of life gives a good chance of recovery.

Diseases in this section have a diverse nature and different mechanisms of development. They are characterized by many variants of psychopathic or neurotic disorders. The wide range of clinical manifestations is explained by the different size of the lesion, the area of the defect, as well as the basic individual personality qualities of a person. The greater the depth of the destruction, the clearer the deficiency, which most often consists of a change in the function of thinking.

Why do organic lesions develop?

The causes of organic damage to the central nervous system include:

1. Peri- and intrapartum pathology(brain damage during pregnancy and childbirth).
2. Traumatic brain injuries(open and closed).
3. Infectious diseases(meningitis, encephalitis, arachnoiditis, abscess).
4. Intoxication(abuse of alcohol, drugs, smoking).
5. Vascular diseases of the brain(ischemic and hemorrhagic strokes, encephalopathy) and neoplasms (tumors).
6. Demyelinating diseases(multiple sclerosis).
7. Neurodegenerative diseases(Parkinson's disease, Alzheimer's disease).

A huge number of cases of the development of organic brain damage occurs due to the fault of the patient himself (due to acute or chronic intoxication, traumatic brain injury, incorrectly treated infectious diseases, etc.)

Let us consider in more detail each cause of central nervous system damage.

Peri- and intrapartum pathology

There are several critical moments during pregnancy and childbirth when even the slightest impact on the mother's body can affect the health of the child. Oxygen starvation of the fetus (asphyxia), prolonged labor, premature placental abruption, decreased uterine tone and other reasons can cause irreversible changes in the fetal brain cells.

Sometimes these changes lead to the early death of a child before the age of 5-15. If life is saved, then such children become disabled from a very early age. Almost always, the disorders listed above are accompanied by varying degrees of severity of disharmony in the mental sphere. With reduced mental potential, positive character traits are not always sharpened.

Mental disorders in children can manifest themselves:

- in preschool age: in the form of delayed speech development, motor disinhibition, poor sleep, lack of interest, rapid mood swings, lethargy;
- during school period: in the form of emotional instability, incontinence, sexual disinhibition, impaired cognitive processes.

Traumatic brain injuries

Traumatic brain injury (TBI) is a traumatic injury to the skull, soft tissues of the head and brain. The most common causes of TBI are car accidents and household injuries. Traumatic brain injuries can be open or closed. If there is communication between the external environment and the cranial cavity, we are talking about an open injury; if not, it is a closed injury. The clinic presents neurological and mental disorders. Neurological include limitation of limb movements, disturbances of speech and consciousness, the occurrence of epileptic seizures, and damage to the cranial nerves.

Mental disorders include cognitive impairment and behavioral disorders. Cognitive disorders are manifested by a violation of the ability to mentally perceive and process information received from the outside. Clarity of thinking and logic suffer, memory decreases, and the ability to learn, make decisions and plan ahead is lost. Behavioral disorders manifest themselves in the form of aggression, slow reactions, fears, sudden mood swings, disorganization and asthenia.

Infectious diseases of the central nervous system

The range of infectious agents that cause brain damage is quite large. The main ones among them are: Coxsackie virus, ECHO, herpes infection, staphylococcus. All of them can lead to the development of meningitis, encephalitis, and arachnoiditis. Also, lesions of the central nervous system are observed during HIV infection in its final stages, most often in the form of brain abscesses and leukoencephalopathies.

Mental disorders due to infectious pathology manifest themselves in the form of:

Asthenic syndrome - general weakness, increased fatigue, decreased performance;
- psychological disorganization;
- affective disorders;
- personality disorders;
- obsessive-convulsive disorders;
- panic attacks;
- hysterical, hypochondriacal and paranoid psychoses.

Intoxication

Intoxication of the body is caused by the use of alcohol, drugs, smoking, poisoning with mushrooms, carbon monoxide, salts of heavy metals and various medications. Clinical manifestations are characterized by a variety of symptoms depending on the specific toxic substance. The development of non-psychotic disorders, neurosis-like disorders and psychoses is possible.

Acute intoxication due to poisoning with atropine, diphenhydramine, antidepressants, carbon monoxide or mushrooms most often manifests itself as delirium. When poisoning with psychostimulants, intoxication paranoid is observed, which is characterized by vivid visual, tactile and auditory hallucinations, as well as delusional ideas. It is possible to develop a manic-like state, which is characterized by all the signs of a manic syndrome: euphoria, motor and sexual disinhibition, acceleration of thinking.

Chronic intoxication (alcohol, smoking, drugs) manifests itself:

- neurosis-like syndrome- the phenomenon of exhaustion, lethargy, decreased performance along with hypochondria and depressive disorders;
- cognitive impairment(impaired memory, attention, decreased intelligence).

Vascular diseases of the brain and neoplasms

Vascular diseases of the brain include hemorrhagic and ischemic strokes, as well as discirculatory encephalopathy. Hemorrhagic strokes occur when brain aneurysms rupture or blood seeps through the walls of blood vessels, forming hematomas. Ischemic stroke is characterized by the development of a lesion that lacks oxygen and nutrients due to blockage of the supply vessel by a thrombus or atherosclerotic plaque.

Discirculatory encephalopathy develops with chronic hypoxia (lack of oxygen) and is characterized by the formation of many small foci throughout the brain. Brain tumors arise from a variety of causes, including genetic predisposition, ionizing radiation and exposure to chemicals. Doctors are discussing the impact of cell phones, bruises and head injuries.

Mental disorders in vascular pathology and neoplasms depend on the location of the lesion. Most often they occur with damage to the right hemisphere and manifest themselves in the form of:

Cognitive impairment (to mask this phenomenon, patients begin to use notebooks and tie knots “as a keepsake”);
- reducing criticism of one’s condition;
- nighttime “states of confusion”;
- depression;
- insomnia (sleep disturbance);
- asthenic syndrome;
- aggressive behavior.

Vascular dementia

Separately, we should talk about vascular dementia. It is divided into various types: stroke-related (multi-infarct dementia, dementia due to infarctions in “strategic” areas, dementia after hemorrhagic stroke), non-stroke (macro- and microangiopathic), and variants due to disorders of the cerebral blood supply.

Patients with this pathology are characterized by slowing down, rigidity of all mental processes and their lability, and a narrowing of the range of interests. The severity of cognitive impairment in vascular lesions of the brain is determined by a number of factors that have not been fully studied, including the age of the patients.

Demyelinating diseases

The main disease in this nosology is multiple sclerosis. It is characterized by the formation of lesions with destroyed nerve endings (myelin).

Mental disorders in this pathology:

Asthenic syndrome (general weakness, increased fatigue, decreased performance);
- cognitive impairment (impaired memory, attention, decreased intelligence);
- depression;
- affective insanity.

Neurodegenerative diseases

These include: Parkinson's disease and Alzheimer's disease. These pathologies are characterized by the onset of the disease in old age.

The most common mental disorder in Parkinson's disease (PD) is depression. Its main symptoms are a feeling of emptiness and hopelessness, emotional poverty, decreased feelings of joy and pleasure (anhedonia). Dysphoric symptoms (irritability, sadness, pessimism) are also typical manifestations. Depression is often combined with anxiety disorders. Thus, symptoms of anxiety are detected in 60-75% of patients.

Alzheimer's disease is a degenerative disease of the central nervous system characterized by progressive cognitive decline, personality disorder, and behavioral changes. Patients with this pathology are forgetful, cannot remember recent events, and are unable to recognize familiar objects. They are characterized by emotional disorders, depression, anxiety, disorientation, and indifference to the world around them.

Treatment of organic pathology and mental disorders

First of all, the cause of organic pathology should be established. Treatment tactics will depend on this.

In case of infectious pathology, antibiotics sensitive to the pathogen should be prescribed. For viral infections - antiviral drugs and immunostimulants. For hemorrhagic strokes, surgical removal of the hematoma is indicated, and for ischemic strokes, decongestant, vascular, nootropic, and anticoagulant therapy is indicated. For Parkinson's disease, specific therapy is prescribed - levodopa-containing drugs, amantadine, etc.

Correction of mental disorders can be medicinal and non-medicinal. The best effect is shown by a combination of both methods. Drug therapy includes the prescription of nootropic (piracetam) and cerebroprotective (citicoline) drugs, as well as tranquilizers (lorazepam, tofisopam) and antidepressants (amitriptyline, fluoxetine). To correct sleep disturbances, hypnotics (bromizoval, phenobarbital) are used.

Psychotherapy plays an important role in treatment. Hypnosis, auto-training, Gestalt therapy, psychoanalysis, and art therapy have proven themselves well. This is especially important when treating children due to possible side effects of drug therapy.

Information for relatives

It should be remembered that patients with organic brain damage often forget to take prescribed medications and attend a psychotherapy group. You should always remind them of this and ensure that all doctor’s instructions are followed in full.

If you suspect a psychoorganic syndrome in your relatives, contact a specialist (psychiatrist, psychotherapist or neurologist) as soon as possible. Early diagnosis is the key to successful treatment of such patients.

The central nervous system is precisely the mechanism that helps a person grow and navigate in this world. But sometimes this mechanism malfunctions and “breaks.” It is especially scary if this happens in the first minutes and days of a child’s independent life or even before he is born. We will talk about why a child’s central nervous system is affected and how to help the baby in this article.

What it is

The central nervous system is a close “ligament” of two important links - the brain and spinal cord. The main function that nature assigned to the central nervous system is to provide reflexes, both simple (swallowing, sucking, breathing) and complex. The central nervous system, or more precisely, its middle and lower sections, regulate the activities of all organs and systems, ensure communication between them. The highest section is the cerebral cortex. It is responsible for self-awareness and self-awareness, for a person’s connection with the world, with the reality surrounding the child.

Disorders, and consequently, damage to the central nervous system, can begin during the development of the fetus in the mother’s womb, or can occur under the influence of certain factors immediately or some time after birth.

Which part of the central nervous system is affected will determine which body functions will be impaired, and the degree of damage will determine the extent of the consequences.

Causes

In children with central nervous system disorders, about half of all cases occur due to intrauterine lesions; doctors call this perinatal pathologies of the central nervous system. Moreover, more than 70% of them are premature babies, which appeared earlier than the due obstetric period. In this case, the main root cause lies in the immaturity of all organs and systems, including the nervous system; it is not ready for autonomous work.

Approximately 9-10% of toddlers born with lesions of the central nervous system were born on time with normal weight. Experts believe that the state of the nervous system in this case is influenced by negative intrauterine factors, such as prolonged hypoxia, which the baby experienced in the mother’s womb during gestation, birth injuries, as well as a state of acute oxygen starvation during a difficult delivery, metabolic disorders of the child, which Infectious diseases suffered by the expectant mother and complications of pregnancy began even before birth. All lesions that resulted from the above factors during pregnancy or immediately after childbirth are also called residual organic:

Fetal hypoxia. Most often, babies whose mothers abuse alcohol, drugs, smoke or work in hazardous industries suffer from a lack of oxygen in the blood during pregnancy. The number of abortions that preceded this birth is also of great importance, since the changes that occur in the tissues of the uterus after termination of pregnancy contribute to the disruption of uterine blood flow during subsequent pregnancies.

Traumatic causes. Birth injuries can be associated with both incorrectly chosen delivery tactics and medical errors during the birth process. Injuries also include actions that lead to disruption of the child’s central nervous system after childbirth, in the first hours after birth.
Fetal metabolic disorders. Such processes usually begin in the first - early second trimester. They are directly related to disruption of the functioning of the organs and systems of the baby’s body under the influence of poisons, toxins, and certain medications.
Infections in the mother. Diseases that are caused by viruses (measles, rubella, chickenpox, cytomegalovirus infection and a number of other ailments) are especially dangerous if the disease occurs in the first trimester of pregnancy.

Pathologies of pregnancy. The state of the child’s central nervous system is influenced by a variety of features of the gestation period - polyhydramnios and oligohydramnios, pregnancy with twins or triplets, placental abruption and other reasons.
Severe genetic diseases. Typically, pathologies such as Down and Edwards syndromes, trisomy and a number of others are accompanied by significant organic changes in the central nervous system.

At the current level of development of medicine, CNS pathologies become obvious to neonatologists already in the first hours after the baby is born. Less often - in the first weeks.

Sometimes, especially with organic lesions of mixed origin, the true cause cannot be established, especially if it is related to the perinatal period.

Classification and symptoms

The list of possible symptoms depends on the causes, degree and extent of damage to the brain or spinal cord, or combined damage. The outcome is also influenced by the time of negative impact - how long the child was exposed to factors that affected the activity and functionality of the central nervous system. It is important to quickly determine the period of the disease - acute, early recovery, late recovery or the period of residual effects.

All pathologies of the central nervous system have three degrees of severity:

Easy. This degree is manifested by a slight increase or decrease in the baby’s muscle tone, and convergent strabismus may be observed.

Average. With such lesions, muscle tone is always reduced, reflexes are completely or partially absent. This condition is replaced by hypertonicity and convulsions. Characteristic oculomotor disturbances appear.
Heavy. Not only motor function and muscle tone suffer, but also internal organs. If the central nervous system is severely depressed, convulsions of varying intensity may begin. Problems with cardiac and renal activity can be severe, as can the development of respiratory failure. The intestines may be paralyzed. The adrenal glands do not produce the necessary hormones in the required quantities.

According to the etiology of the cause that caused problems with the activity of the brain or spinal cord, pathologies are divided (however, very arbitrarily) into:

Hypoxic (ischemic, intracranial hemorrhages, combined).
Traumatic (birth injuries of the skull, birth spinal lesions, birth pathologies of peripheral nerves).
Dysmetabolic (kernicterus, excess levels of calcium, magnesium, potassium in the child’s blood and tissues).
Infectious (consequences of infections suffered by the mother, hydrocephalus, intracranial hypertension).

The clinical manifestations of different types of lesions also differ significantly from each other:

Ischemic lesions. The most “harmless” disease is grade 1 cerebral ischemia. With it, the child demonstrates central nervous system disorders only in the first 7 days after birth. The reason most often lies in fetal hypoxia. At this time, relatively mild signs of excitement or depression of the central nervous system can be observed in the baby.
The second degree of this disease is diagnosed when if disturbances and even seizures last more than a week after birth. We can talk about the third degree if the child has constantly increased intracranial pressure, frequent and severe convulsions are observed, and there are other autonomic disorders.

Typically, this degree of cerebral ischemia tends to progress, the child’s condition worsens, and the baby may fall into a coma.

Hypoxic cerebral hemorrhages. If, as a result of oxygen starvation, a child has hemorrhage inside the ventricles of the brain, then in the first degree there may be no symptoms and signs at all. But the second and third degrees of such hemorrhage lead to severe brain damage - convulsive syndrome, the development of shock. The child may fall into a coma. If blood enters the subarachnoid cavity, the child will be diagnosed with overexcitation of the central nervous system. There is a high probability of developing acute dropsy of the brain.

Bleeding into the underlying substance of the brain is not always noticeable at all. Much depends on which part of the brain is affected.

Traumatic lesions, birth injuries. If during the birth process doctors had to use forceps on the baby’s head and something went wrong, if acute hypoxia occurred, then most often this is followed by a cerebral hemorrhage. During birth trauma, the child experiences convulsions to a more or less pronounced degree, the pupil on one side (the one where the hemorrhage occurred) increases in size. The main sign of traumatic injury to the central nervous system is increased pressure inside the child's skull. Acute hydrocephalus may develop. The neurologist testifies that in this case the central nervous system is more often excited than depressed. Not only the brain, but also the spinal cord can be injured. This most often manifests itself as sprains, tears, and hemorrhage. In children, breathing is impaired, hypotension of all muscles, and spinal shock are observed.
Dysmetabolic lesions. With such pathologies, in the overwhelming majority of cases, the child has increased blood pressure, convulsive attacks are observed, and consciousness is quite clearly depressed. The cause can be determined by blood tests that show either a critical deficiency of calcium, or a lack of sodium, or another imbalance of other substances.

Periods

The prognosis and course of the disease depends on what period the baby is in. There are three main periods of development of pathology:

Spicy. The violations have just begun and have not yet had time to cause serious consequences. This is usually the first month of a child’s independent life, the newborn period. At this time, a baby with lesions of the central nervous system usually sleeps poorly and restlessly, cries often and for no apparent reason, he is excitable, and can flinch without a stimulus even in his sleep. Muscle tone is increased or decreased. If the degree of damage is higher than the first, then reflexes may weaken, in particular, the baby will begin to suck and swallow worse and weaker. During this period, the baby may begin to develop hydrocephalus, which will be manifested by noticeable head growth and strange eye movements.

Restorative. It can be early or late. If the baby is aged 2-4 months, then they talk about early recovery, if he is already from 5 to 12 months, then about late recovery. Sometimes parents notice disturbances in the functioning of the central nervous system in their baby for the first time in the early period. At 2 months, such toddlers hardly express any emotions and are not interested in bright hanging toys. In the late period, the child noticeably lags behind in his development, does not sit, does not walk, his cry is quiet and usually very monotonous, without emotional coloration.
Consequences. This period begins after the child turns one year old. At this age, the doctor is able to most accurately assess the consequences of a central nervous system disorder in this particular case. Symptoms may disappear, but the disease does not go away. Most often, doctors make such verdicts per year on such children as hyperactivity syndrome, developmental delay (speech, physical, mental).

The most severe diagnoses that can indicate the consequences of central nervous system pathologies are hydrocephalus, cerebral palsy, epilepsy.

Treatment

We can talk about treatment when lesions of the central nervous system are diagnosed with maximum accuracy. Unfortunately, in modern medical practice, there is a problem of overdiagnosis, in other words, every baby whose chin trembles during a monthly examination, who eats poorly and sleeps restlessly, can easily be diagnosed with “cerebral ischemia.” If a neurologist claims that your baby has central nervous system lesions, you should definitely insist on a comprehensive diagnosis, which will include an ultrasound of the brain (through the fontanel), computed tomography, and in special cases, an x-ray of the skull or spine.

Each diagnosis that is in some way associated with lesions of the central nervous system must be diagnostically confirmed. If signs of a central nervous system disorder are noticed in the maternity hospital, then timely assistance provided by neonatologists helps to minimize the severity of possible consequences. It just sounds scary - damage to the central nervous system. In fact, most of these pathologies are reversible and subject to correction if detected in time.

For treatment, medications that improve blood flow and blood supply to the brain are usually used - a large group of nootropic drugs, vitamin therapy, anticonvulsants.

Only a doctor can give an exact list of medications, since this list depends on the causes, degree, period and depth of the lesion. Drug treatment for newborns and infants is usually provided in a hospital setting. After relief of symptoms, the main stage of therapy begins, aimed at restoring proper functioning of the central nervous system. This stage usually takes place at home, and parents bear a great deal of responsibility for following numerous medical recommendations.

Children with functional and organic disorders of the central nervous system need:

therapeutic massage, including hydromassage (procedures take place in water);
electrophoresis, exposure to magnetic fields;
Vojta therapy (a set of exercises that allows you to destroy reflex incorrect connections and create new - correct ones, thereby correcting movement disorders);
Physiotherapy for the development and stimulation of the development of sensory organs (music therapy, light therapy, color therapy).

Such influences are allowed for children from 1 month and must be supervised by specialists.

A little later, parents will be able to master the techniques of therapeutic massage on their own, but for several sessions it is better to go to a professional, although this is quite an expensive pleasure.

Consequences and forecasts

The future prognosis for a child with lesions of the central nervous system can be quite favorable, provided that he is provided with prompt and timely medical care in the acute or early recovery period. This statement is true only for mild and moderate lesions of the central nervous system. In this case, the main prognosis includes full recovery and restoration of all functions, minor developmental delay, subsequent development of hyperactivity or attention deficit disorder.

In severe forms, the prognosis is not so optimistic. The child may remain disabled, and deaths at an early age are not excluded. Most often, lesions of the central nervous system of this kind lead to the development of hydrocephalus, cerebral palsy, and epileptic seizures. As a rule, some internal organs also suffer; the child simultaneously experiences chronic diseases of the kidneys, respiratory and cardiovascular systems, and marbled skin.

Prevention

Prevention of pathologies from the central nervous system in a child is the task of the expectant mother. At risk are women who do not give up bad habits while carrying a baby - smoking, drinking alcohol or using drugs.

All pregnant women must be registered with an obstetrician-gynecologist in the antenatal clinic. During pregnancy, they will be asked to undergo so-called screening three times, which identifies the risks of having a child with genetic disorders from that particular pregnancy. Many gross pathologies of the fetal central nervous system become noticeable even during pregnancy; some problems can be corrected with medications, for example, disturbances in uteroplacental blood flow, fetal hypoxia, and the threat of miscarriage due to a small detachment.

A pregnant woman needs to monitor her diet, take vitamin complexes for expectant mothers, not self-medicate, and be careful about various medications that have to be taken during the period of bearing a child.

This will avoid metabolic disorders in the baby. You should be especially careful when choosing a maternity home (the birth certificate that all pregnant women receive allows you to make any choice). After all, the actions of personnel during the birth of a child play a large role in the possible risks of traumatic lesions of the central nervous system in the baby.

After the birth of a healthy baby, it is very important to regularly visit the pediatrician, protect the baby from injuries to the skull and spine, and get age-appropriate vaccinations that will protect the little one from dangerous infectious diseases, which at an early age can also lead to the development of pathologies of the central nervous system.

In the next video you will learn about signs of a nervous system disorder in a newborn, which you can determine yourself.

From this article you will learn the main symptoms and signs of damage to the nervous system in a child, how damage to the central nervous system in a child is treated, and what causes perinatal damage to the nervous system in a newborn.

Treatment of nervous system damage in a child

Some children are so worried on the eve of exo-amen that they literally get sick.

Drugs for the treatment of the nervous system

Anacardium is a drug for the treatment of the nervous system.

As soon as a child sits down to write, he loses all self-confidence and remembers absolutely nothing.

Argentum nitricum is a drug for the treatment of the nervous system.

On the eve of the exam, the child is hurried, excited, irritable and nervous.
Diarrhea on the eve of an exam.
The child may ask for sweets.

Gelsemium is a drug for the treatment of the nervous system.

Weakness and trembling on the eve of an important event or exam.
Diarrhea is possible.

Picric acid is a drug for the treatment of the nervous system.

For good students who have studied hard but can no longer continue teaching - they would even like to throw away their textbooks.
The child is afraid that he will forget everything during the exam.
The child is very tired from studying.

Potential and number of doses:

One dose of 30C the evening before the exam, one in the morning and one just before the exam.

Symptoms of nervous system damage in a child

Most diseases of the nervous system at an early age are accompanied by delayed psychomotor development. When diagnosing them, the assessment of the presence of neurological syndromes, as well as the identification of lesions of the nervous system, is of key importance.

Hypoexcitability syndrome - a symptom of damage to the nervous system

Hypoexcitability syndrome is characterized by low motor and mental activity of the child, a long latent period for the occurrence of all reflexes (including innate ones), hyporeflexia, and hypotension. The syndrome occurs predominantly due to dysfunction of the diencephalic-limbic parts of the brain, which is accompanied by vegetative-visceral disorders.

Hypoexcitability syndrome develops with perinatal brain damage, some hereditary and congenital diseases (Down's disease, phenylketonuria, etc.), metabolic disorders (hypoglycemia, metabolic acidosis, hypermagnesemia, etc.), as well as with many severe somatic diseases.

Hyperexcitability syndrome - a symptom of damage to the nervous system

Hyperexcitability syndrome is characterized by motor restlessness, emotional lability, sleep disturbance, increased innate reflexes, and a decreased threshold for convulsive readiness. It is often combined with increased muscle tone and rapid neuropsychic exhaustion. Hyperexcitability syndrome can develop in children with perinatal pathology of the central nervous system, some hereditary fermentopathies, and metabolic disorders.

Intracranial hypertension syndrome is a symptom of damage to the nervous system

The syndrome is characterized by increased intracranial pressure, often combined with dilation of the cerebral ventricles and subarachnoid spaces. In most cases, there is an increase in the size of the head, divergence of cranial sutures in infants, bulging and enlargement of the large fontanelle, and disproportion between the cerebral and facial parts of the skull (hypertensive-hydrocephalic syndrome).

The cry of such children is piercing, painful, “cerebral.” Older children often complain of a symptom such as headache, although this complaint is not specific to this syndrome. Damage to the VI pair of cranial nerves, the “setting sun” symptom (the appearance of a clearly defined strip of sclera between the upper eyelid and the iris, which creates the impression of the eyeball “falling down”), spastic tendon reflexes are late symptoms of persistent intracranial hypertension.

When percussing the skull, the sound of a “cracked pot” is sometimes detected. Sometimes horizontal, vertical or rotatory nystagmus appears.

Perinatal damage to the nervous system

Perinatal damage to the nervous system is a group of pathological conditions caused by exposure of the fetus (newborn) to adverse factors in the antenatal period, during childbirth and in the first days after birth.

There is no uniform terminology for perinatal lesions of the nervous system. The terms “perinatal encephalopathy”, “cerebrovascular accident”, “cerebral dysfunction”, “hypoxic-ischemic encephalopathy”, etc. are usually used.

The lack of a unified terminology is due to the uniformity of the clinical picture with different mechanisms of brain damage, which is due to the immaturity of the nervous tissue of the newborn and its tendency to generalized reactions in the form of edematous, hemorrhagic and ischemic phenomena, manifested by symptoms of cerebral disorders.

Classification of perinatal lesions of the nervous system

The classification involves identifying the period of action of the harmful factor, the dominant etiological factor, the period of the disease [acute (7-10 days, sometimes up to 1 month in very premature infants), early recovery (up to 4-6 months), late recovery (up to 1-2 years) , residual effects], degree of severity (for the acute period - mild, moderate, severe) and main clinical syndromes.

Causes of perinatal lesions of the nervous system in children

The main cause of brain damage in the fetus and newborn is hypoxia, which develops during an unfavorable course of pregnancy, asphyxia, and also accompanies birth injuries, tension-type headaches, infectious and other diseases of the fetus and newborn. Hemodynamic and metabolic disorders that occur during hypoxia lead to the development of hypoxic-ischemic lesions of the brain substance and intracranial hemorrhages. In recent years, much attention has been paid to IUI in the etiology of perinatal CNS damage. The mechanical factor in perinatal brain damage is less important.

The main cause of spinal cord lesions is traumatic obstetric care with a large fetal mass, incorrect insertion of the head, breech presentation, excessive rotation of the head during its removal, traction on the head, etc.

Signs of perinatal lesions of the nervous system

The clinical picture of perinatal brain lesions depends on the period of the disease and severity (table).

In the acute period, the syndrome of central nervous system depression often develops (the following symptoms appear: lethargy, physical inactivity, hyporeflexia, diffuse muscle hypotonia, etc.), less often the syndrome of central nervous system hyperexcitability (increased spontaneous muscle activity, superficial restless sleep, tremor of the chin and limbs, etc.). d.).

In the early recovery period, the severity of cerebral symptoms decreases, and signs of focal brain damage become obvious.

The main syndromes of the early recovery period are as follows:

The syndrome of motor disorders is manifested by muscle hypo, hyper dystonia, paresis and paralysis, hyperkinesis.
Hydrocephalic syndrome is manifested by an increase in head circumference, divergence of sutures, enlargement and bulging of the fontanelles, expansion of the venous network on the forehead, temples, scalp, and a predominance of the size of the brain skull over the size of the facial skull.
Vegetovisceral syndrome is characterized by microcirculation disorders (marbling and pallor of the skin, transient acrocyanosis, cold hands and feet), thermoregulation disorders, gastrointestinal dyskinesia, lability of the cardiovascular and respiratory systems, etc.

In the late recovery period, normalization of muscle tone and static functions gradually occurs. The completeness of recovery depends on the degree of damage to the central nervous system during the perinatal period.

Children in the period of residual effects can be divided into two groups: the first - with obvious psychoneurological disorders (about 20%), the second - with normalization of neurological changes (about 80%). However, normalization of the neurological status cannot be equivalent to recovery.

Increased neuroreflex excitability, moderate increase or decrease in muscle tone and reflexes. Horizontal nystagmus, convergent strabismus. Sometimes, after 7-10 days, symptoms of mild depression of the central nervous system are replaced by agitation with tremors of the hands, chin, and motor restlessness.

Usually, symptoms of central nervous system depression, muscle hypotonia, and hyporeflexia appear first, followed by muscle hypertonicity after a few days. Sometimes short-term convulsions, anxiety, hyperesthesia, oculomotor disorders (Graefe's symptom, "setting sun" symptom, horizontal and vertical nystagmus, etc.) appear. Vegetovisceral disorders often occur. Severe cerebral (severe depression of the central nervous system, convulsions) and somatic (respiratory, cardiac, renal, intestinal paresis, adrenal hypofunction) disorders. The clinical picture of spinal cord injury depends on the location and extent of the lesion. With massive hemorrhages and ruptures of the spinal cord, spinal shock develops (lethargy, adynamia, severe muscle hypotonia, severe depression or absence of reflexes, etc.). If the child remains alive, then local symptoms of damage become more clear - paresis and paralysis, dysfunction of the sphincters, loss of sensitivity. In children of the first years of life, it is sometimes very difficult to determine the exact level of damage due to the difficulties of identifying the boundaries of sensory disorders and the difficulties of differentiating central and peripheral paresis.

Diagnosis of perinatal lesions of the nervous system

The diagnosis is based on anamnestic (sociobiological factors, the mother’s health status, her obstetric and gynecological history, the course of pregnancy and childbirth) and clinical data and is confirmed by instrumental studies. Neurosonography is widely used. X-ray examinations of the skull and spine, and, if necessary, CT and MRI, help in diagnosis. Thus, in 25-50% of newborns with cephalohematoma, a skull fracture is detected, and in case of birth injuries of the spinal cord, vertebral dislocation or fracture is detected.

Perinatal lesions of the nervous system in children are differentiated from congenital malformations, hereditary metabolic disorders, often amino acids (manifest only a few months after birth), rickets [rapid increase in head circumference in the first months of life, muscle hypotonia, autonomic disorders (sweating, marbling, anxiety) are often associated not with the onset of rickets, but with hypertensive-hydrocephalic syndrome and vegetovisceral disorders in perinatal encephalopathy].

Treatment of perinatal lesions of the nervous system in children

Treatment of damage to the nervous system in the acute period.

The basic principles of treatment for cerebrovascular accidents in the acute period (after resuscitation measures) are as follows.

Elimination of cerebral edema. For this purpose, dehydration therapy is carried out (mannitol, GHB, albumin, plasma, Lasix, dexamethasone, etc.).
Elimination or prevention of convulsive syndrome (seduxen, phenobarbital, diphenine).
Reduced vascular wall permeability (vitamin C, rutin, calcium gluconate).
Improving myocardial contractility (carnitine chloride, magnesium preparations, panangin).
Normalization of the metabolism of nervous tissue and increasing its resistance to hypoxia (glucose, dibazol, alphatocopherol, actovegin).
Creating a gentle regime.

Treatment of damage to the nervous system during the recovery period.

In the recovery period, in addition to syndromic therapy, treatment is carried out aimed at stimulating the growth of brain capillaries and improving the trophism of damaged tissues.

Stimulating therapy (vitamins B, B 6, cerebrolysin, ATP, aloe extract).
Nootropics (piracetam, phenibut, pantogam, encephabol, cogitum, glycine, limontar, biotredin, aminalon, etc.).
To improve cerebral circulation, angioprotectors are prescribed (Cavinton, cinnarizine, trental, tanakan, sermion, instenon).
In case of increased excitability and convulsive readiness, sedative therapy is carried out (seduxen, phenobarbital, radedorm).
Physiotherapy, massage and physical therapy (physical therapy).

Children with perinatal lesions of the central nervous system should be under the supervision of a neurologist. Periodic courses of treatment are required (23 months twice a year for several years).

Prevention of perinatal lesions of the nervous system

Prevention consists primarily of preventing intrauterine fetal hypoxia, starting from the first months of pregnancy. This requires timely elimination of unfavorable socio-biological factors and chronic diseases of the woman, identification of early signs of the pathological course of pregnancy. Measures to reduce birth injuries are also of great importance.

Treatment prognosis

The prognosis for perinatal lesions of the central nervous system depends on the severity and nature of the damage to the central nervous system, the completeness and timeliness of treatment measures.

Severe asphyxia and intracerebral hemorrhages often result in death. Severe consequences in the form of severe disturbances in psychomotor development rarely occur (in 35% of full-term and 10-20% of very premature children). However, almost all children with perinatal brain damage, even mild ones, continue to have signs of minimal brain dysfunction for a long time - headaches, speech disorders, tics, impaired coordination of fine movements. They are characterized by increased neuropsychic exhaustion and “school maladjustment.”

The consequences of spinal cord injury during childbirth depend on the severity of the injury. With massive hemorrhages, newborns die in the first days of life. Those who survive the acute period experience a gradual recovery of motor functions.