Mild pyramidal insufficiency in children. Pyramidal insufficiency in children. Causes of pyramidal insufficiency

Pyramidal syndrome or pyramidal insufficiency syndrome is also called ballerina tiptoe syndrome or equinus foot placement.

This violation may be the result of a whole range of factors. In the vast majority of cases, it is accompanied by muscular dystrophy of varying degrees, associated with hypertonicity of the lower leg and foot.

Bilateral damage to the pyramidal tracts is usually diagnosed in newborns or children in the first year of life; less often it occurs in children two to three years old.

Anatomical certificate

The medulla oblongata, which connects the brain to the spinal cord, is responsible for complex reflexes. This organ consists of cells of a special pyramidal shape, which are called pyramids. That is why the syndrome is called pyramidal. Impaired coordination of movements is a consequence of damage to the above-mentioned cells.

It is curious that there is no official symptom of “pyramidal insufficiency”. However, it is given to young children - and not always justified.

The main reason for the development of such a pathology in an infant is mechanical or ischemic intrauterine injury to the cervical spinal cord. When blood flow in the cervical thickening and brain stem is disrupted, the muscle tone of the limb flexors undergoes a significant deviation from the norm.

The severity of the syndrome is directly dependent on the severity of brain damage. A mild form of insufficiency manifests itself in stiffness of the arms, and more common ischemia adds to the symptoms of impaired motor activity of the lower extremities: when trying to put the baby on his feet, he stubbornly rests only on his toes, that is, the distal part of the foot works.

Pyramidal insufficiency syndrome in children

In babies in the first months of life, pyramidal syndrome usually manifests itself (they become very tense), the inability to hold their head, curling of their fingers when testing the step reflex (walking on their toes), and other similar signs.

Older children suffering from pyramidal syndrome may stand and/or tiptoe all the time, get tired quickly and constantly ask to be held. Some young patients do not want to walk at all and complain of pain in their legs. It is difficult for parents to separate complaints of this kind from simple whims, because two to three year olds cannot explain them clearly.

In the question of whether it is necessary to treat this disorder, the main thing is the severity of the problem. If the baby is slightly affected, you should simply see a local neurologist. It is also necessary to independently help the child with massage, baths and a specially designed set of physical exercises.

With more extensive damage or untimely or improper treatment, the child may begin to lag behind the norms of motor development. In this case, signs of neurological deficit that were not seen at the initial examination may appear. Such children should begin treatment immediately.

It is important for parents of infants with pyramidal insufficiency to understand that “simple” tiptoeing in the absence of timely qualified assistance can develop into persistent impairment of motor functions, sometimes leading to complete failure.

About causes and symptoms

Pyramidal insufficiency in the legs in children can develop against the background of the following pathologies:

Externally expressed symptoms:

• trembling of the chin, as well as legs and arms;
• difficulty holding onto things;
• throwing back the head;
• poor finger control;
• walking on tiptoes;
• speech disorder;
• reduced intelligence.

Pyramidal insufficiency syndrome in children cannot be diagnosed with 100% accuracy solely based on a medical examination. To obtain comprehensive data, you must pass all tests prescribed by your doctor. Only on the basis of their results is it possible to make a correct diagnosis.

"Adult" reasons

Pyramidal insufficiency is not a disease, but a syndrome. However, this does not prevent many doctors from classifying pathology as a disease and making an unambiguous diagnosis. Doctors often refer to it as or.

If pyramidal insufficiency syndrome in very young children can be a consequence of birth injuries or intrauterine development anomalies, then in adulthood the syndrome is most often observed in people suffering from cancer or vascular or heart diseases.

Pyramidal insufficiency in adults develops due to the following reasons:

• inflammatory processes in brain tissue (or similar diseases);
• pathological changes in cerebral circulation (for example, due to suffering);
• mechanical damage to the skull, resulting in disturbances in the transmission of nerve impulses;

Pyramidal syndrome in adult patients is an acquired pathology, the treatment of which involves eliminating not only the symptoms, but also the root cause of the disorder.

Clinical picture and diagnostic methods

To identify pyramidal syndrome in adults, a simple examination by a neurologist is not enough. The patient must undergo a series of modern diagnostic procedures. To obtain comprehensive information about the patient’s health status, the neurologist will need the results of the following examinations:

• (prescribed if there is or suspicion of);
• which helps to trace hidden seizures (in most cases they occur during sleep and therefore cannot be detected during an examination by a neurologist);
• electromyography, which allows you to determine the electrical potential of muscles;
• (if tumor formations are suspected).

Pyramidal insufficiency in adulthood also manifests itself in more noticeable symptoms that can be detected during a medical examination:

• hypertension;
• increased arms and legs;
• full or partial of different parts of the body;
• violations of reflex activity, in particular, a decrease in its speed;
• in some cases, especially if the damage has occurred to the hypothalamic-pituitary system, sexual dysfunction and increased body weight may be observed.

How to treat and is it necessary?

If pyramidal insufficiency is not accompanied by another, more serious diagnosis (from the lists above), physiotherapy procedures are sufficient to eliminate it. Massage is widely used to treat children. Professional massage therapist helps strengthen muscles and relieve hypertension. Parents perform a set of special preventive exercises with their child at home.

Swimming, gymnastics, exercises for coordination of movements, and balneotherapy (healing baths) also help to improve motor activity and strengthen the body. This recommendation is relevant for both children and adults.

In addition, the doctor may prescribe vitamins that activate microcirculation, vasoactive substances or drugs to improve the metabolism of nerve cells (Cerebrolysin, Encephabol and others). Prozerin and Dibazol help normalize the conduction of nerve impulses. You can improve muscle tone with the help of vitamins E and B, as well as the drugs Baclofen, Lioresal and.

Neurosurgical therapy is prescribed if spinal or brain injuries or tumors occur. Surgical intervention is used for, as well as for thrombosis of extracerebral arteries.

Persons suffering from this pathology, especially children who are just learning to walk, need to wear special orthopedic shoes. It is distinguished by a closed front and a rigid back.

Also, parents of babies under one year old should remember: the child should not be put on his feet prematurely, and should not be put in a walker - this can interfere with the normal development of the foot. When the time comes, the baby will try to walk on his own - and he will definitely succeed!

For the treatment of pyramidal insufficiency, adults are prescribed significant physical activity: running, swimming, walking, physical therapy and sports. Acupressure and acupressure give excellent results.

If the syndrome occurs against the background of another disease, the main emphasis should be on healing from it. It is also important to restore the patient’s motor activity if there is paralysis. However, we should not forget about the need to relieve the symptoms of the described pathology; This is especially important for young patients.

To avoid such an unpleasant and dangerous pathological condition with its complications as pyramidal insufficiency, it is necessary:

• carefully monitor your health and the health of your children;
• take all necessary measures to prevent injuries that could provoke the development of pathology;
• promptly treat diseases that may cause the syndrome, and also take measures to prevent them.

Pyramidal (pyramidal) insufficiency is a complex of symptoms that are associated with a disorder of the nervous system. Most often, this disease occurs in children under 5 years of age.
Other names for the disease: ballerina symptom, walking on tiptoes/toes, central paralysis, paresis.
This disease bears this name due to the fact that the medulla oblongata consists of a large number of anatomical cells - pyramids. And if at least one part of these cells begins to work incorrectly, then the child will experience a lack of coordination of movement.

Symptoms

Symptoms of pyramidal insufficiency in children include the following:
- trembling of hands, legs, chin;
- throwing back the head;
- poorly developed intelligence;
— disturbance of gait, coordination of movements;
- walking on tiptoes.
- violation of speech function.

Note that in babies under three months of age, this pathology does not cause discomfort. The fact is that during this period they have natural muscle hypertonicity. However, in older children, diagnosing this disease is of concern, as it is fraught with movement disorder syndrome. Such children, as a rule, develop reflexes and motor skills late.

Causes

The causes of pyramidal insufficiency in children can be hypoxia, infectious diseases, inflammatory processes, birth injuries, and intrauterine developmental anomalies. In addition, experts identify a number of neurological problems that may accompany this disease:

● various injuries received during childbirth;
● congenital diseases of the nervous system (cerebral palsy, spinal dysraphism, infantile hydrocephalus, etc.);
● brain hypoxia;
● diseases caused by the penetration of pathogenic microorganisms and viruses into the body;
● various tumors;
● purulent inflammation in the spinal cord or brain;
● disturbances in the production and outflow of cerebrospinal fluid;
● encephalitis and meningitis.

Diagnostics

This pathology is diagnosed using magnetic resonance imaging, computed tomography of the brain, electromyography, ultrasound examination of the brain, and electroencephalogram. In addition to these methods, diagnosis is carried out by a neuropsychologist and neurologist.

Treatment

For children diagnosed with this disease, a neurologist or neuropsychologist recommend body therapy, neuromotor correction, LHC Synchro-S, Tomatis, sensory integration.

In addition, for the treatment of pyramidal insufficiency, various kinds of orthopedic products and health baths may be needed. A special place in treatment is occupied by acupressure and relaxing massage, which helps reduce tone and strengthen muscles. We also must not forget about special exercises that are aimed at improving movement coordination.

Correction methods:

• Bioacoustic correction method - restoration of the functional state of the central nervous system and activation of the body's natural resources.

• Movement is one of the most important functions of a living organism, including humans. With its help, we carry out both simple and complex movements, movements that require a minimum of force and a lot of effort from us.

  
  

  All the variety of movements is carried out by the nervous system, in particular its sections responsible for this function, such as the pyramidal system, extrapyramidal system and the cerebellum with its connections with the cerebral cortex and the spinal cord.

  
  

  Let's focus on the pyramid system. Thanks to it, we can carry out any movements we want, we can stop the movement at any time, change it. It’s so simple that we don’t even think about it, and we get the impression that the movement is original. Although this is not true. Everything we do meaningfully originates in the cerebral cortex. The brain is an amazing system that is responsible for a huge number of functions in the body, including the one we are talking about here. Whatever the function, it has its representation in the cerebral cortex.

  
  

  You know that there are cerebral hemispheres, as well as gyri. There is also a division into the cortex and subcortical system. The Kara consists of six layers, each layer is a group of specific cells responsible for the following functions:

  
  

  the third and fourth layers are sensitive, the fifth and sixth are responsible for movements, the fourth and second are for analyzing information from the senses, and the first layer connects individual areas and areas. In the fifth layer there are Betz cells or giant pyramidal cells, they were named so for their shape and relatively large size. Each nerve cell has a body and two types of processes through which it connects with other cells. The axon is the only one, it is long and practically does not branch; it connects with other neurons located far from the cell body, as well as directly with organs, in our case with muscles. Another type of processes is the dendrite; on the contrary, it has a short length and a large number of processes; it connects with cells located nearby.

  
  

  The axons of Betz cells form a pyramidal tract, which, going down, connects with the extrapyramidal system, as well as with the subcortical nuclei, then in the brain stem it crosses to the opposite side, where it connects with the cells that are located in the spinal cord, from them a signal, according to them the axons go directly to the muscle fiber and the latter contracts. Nerve cells located in the spinal cord are located segmentally, i.e. each level of the spinal cord is responsible for a specific area of ​​the body (the cervical spinal cord for the innervation of the arms, the thoracic for the torso, and the lumbar for the legs),

  
  

  As you can see, the system is very complex and in fact everything is done much faster than it is explained.

  
  

  What happens when this system is violated at one or another level. Maybe. You've heard about paralysis; it can be spastic when muscle tone is increased and flaccid when, on the contrary, it decreases. In case of pyramidal insufficiency, i.e. when the Betz nerve cell itself or its axon is damaged, the neuron located in the spinal cord is disinhibited and it begins to send an excessive number of nerve impulses to the muscles. Muscle tone increases, reflexes increase, and tremors occur. This condition is called central paralysis, and with incomplete loss of voluntary movements - central paresis.

  
  

  Flaccid paralysis or peripheral (with incomplete loss of function - paresis), occurs when a nerve cell in the spinal cord and its process is damaged. In this case, a decrease in muscle tone occurs, up to complete paralysis of the muscle, reflexes also decrease or disappear completely, and hypotrophy of the innervated area occurs.

  
  

  Clinically, central paralysis (paresis) is manifested by tremors and tension in the limbs, increased tone, changes in the quality and quantity of free movements. With paralysis (paresis) in the legs, the gait changes. The leg is poorly straightened at the knee and hip joints, the foot is placed on the toe, and the impression of a “rooster gait” is created. If the hands are affected, then trembling occurs in them, movement requires a lot of effort, because muscle tone is increased. There is a malnutrition of the limb, malnutrition or atrophy occurs.

  Methods for diagnosing pyramidal insufficiency.

  Computed tomography of the brain and magnetic resonance imaging (CT and MRI of the brain).

  When a pathological focus forms in the brain, in the area of ​​the pyramidal system, or when the blood supply to this area is disrupted, central paralysis occurs. This change can be seen by computed tomography of the brain (CT brain) and magnetic resonance imaging (MRI).

  
  

  Moreover, MRI is a mandatory method of examination for epilepsy and seizures. According to the recommendation of the International League Against Epilepsy, CT is done as an additional examination method or when it is not possible to do an MRI.

  
  

  Electromyography.

  
  

  Electromyography is a method for studying the neuromuscular system by recording the electrical potentials of muscles.

  
  

  The functional element of skeletal muscle is the muscle fiber. Contraction of a muscle fiber occurs as a result of excitation arriving at it via motor nerve fibers.

  When a muscle contracts, an electrical discharge occurs, which can be recorded using a special device - a myograph. When muscle tone decreases or increases, muscle contraction changes. When the tone decreases, the voltage decreases; when it rises, on the contrary, the amplitude of the wave of muscle contraction increases.

  
  

  EEG study.

  
  

  For cerebral palsy, birth trauma, consequences of strokes and injuries.

  
  

  Almost all central paresis and paralysis, especially with cerebral palsy, congenital and acquired at an early age, brain diseases are accompanied by hidden or obvious convulsions.

  
  

  Seizures further increase the area of ​​brain damage. It is very important to know that more than 65% of seizures occur during sleep. And therefore it is necessary to record an EEG during physiological, natural sleep! Especially the little ones. Convulsions are not constant, and therefore you should not calm down if they are absent from a short EEG recording. Long-term monitoring (video or Holter) is necessary. As a result, you can detect: changes of a widespread nature: in the form of the appearance of diffuse delta waves, as well as synchronization of Tata waves. Epileptiform activity may occur.

  Ultrasound of the brain.

  
  

  Signs of increased pressure in the brain may be seen, which has an irritating effect and can cause central paralysis.

  
  

  In treatment it is necessary to adhere to the principle: There is no such thing as too much movement!

  
  

  The more physical exercises are performed with the patient, the greater the benefit.

  
  

  We will continue to talk about treatment in the next issue of the magazine.

  Sitnikov I.Yu. 03/30/2006

  
  
  

  Movement.

  Pyramid system (system of voluntary movements).

  
  

  The main efferent structure is the central motor neuron, the Betz giant pyramidal cell of the 5th layer of the projection motor cortex (prerolandic gyrus and paracentral lobule, 4th field). The set of processes of Betz cells is part of the pyramidal tract. Most of the pyramidal tract ends in the formations of the extrapyramidal system - the striatum, globus pallidus, substantia nigra, red nucleus, as well as in the reticular formation of the brain stem, interacting between these systems. Other fibers, especially thickly myelinated ones, starting from the Betz giant cells of the projection motor cortex, end on the dendrites of the peripheral motor neuron.

  
  

  The motor neuron is located in two places - the anterior horns of the spinal cord and in the motor nuclei of the cranial nerve; 2 pathways are formed - corticospinal, corticonuclear.

  
  

  The motor fibers of the corticonuclear tract at the border of the medulla oblongata and the spinal cord pass to the other side, run in the lateral cords of the spinal cord and end segmentally.

  
  

  The functional principle of somatotopic localization is implemented in the projection cortex. Precentral gyrus. Anterior to the projection motor cortex is the premotor cortex, which forms actions from movements. And in front of the premotor cortex is the prefrontal cortex, responsible for the implementation of holistic activities. The premotor cortex is also part of the extrapyramidal system.

  Damage to the projection zone is central paralysis.

  
  

  Premotor – disturbances of action (praxis).

  
  

  Prefrontal – disorders of standing and walking.

  
  

  Pyramidal insufficiency - spastic ataxia, Pierre Marie's disease.

  
  

  Pyramidal insufficiency manifests itself in the form of increased tendon reflexes and periosteal reflexes, foot clonus, and increased muscle tone.

  
  

  Hereditary cerebellar ataxia Pierre Marie.

  
  

  Clinic: dysfunction of the cerebellum and its connections. Ataxia during coordination tests, gait disturbance, scanned speech, intention tremor, nystagmus.

  
  

  Symptoms of pyramidal insufficiency, as well as visual and oculomotor disorders. Decrease in intelligence.

  
  

  Treatment is symptomatic.

  In general, all issues related to the field of child neurology are very complex and it is not at all easy for uninitiated people to understand. Well, you must admit that most parents are capable of curing sniffles in a child, but what to do if the baby begins to throw back his head or walks on his toes? After all, you most likely will not be able to figure this out and find the reason on your own. But an experienced neuropathologist, unfortunately, is a rarity, and sometimes it is almost impossible to find one. Often, an appeal to a neurologist ends with a referral for a massage and an endlessly long list of medications, most of which are scary to take even on your own, and not what to give to a child. In addition, many diagnoses, such as pyramidal insufficiency, although they sound very smart, cause quite a bit of suspicion.

  It makes no sense to argue with a neurologist, even if he is wrong, especially since he still will not admit that he was wrong, and will simply drown you in a huge amount of specific terminology. This is a completely standard, defensive reaction of any doctor to whom an ordinary “mortal” points out his mistakes.

  Pyramidal insufficiency is a diagnosis that does not exist.

  It’s up to you to follow your doctor’s instructions or not, but in order for you to make a really right decision, let’s try to figure out what kind of disease this is - pyramidal insufficiency, or as it is also called - pyramidal insufficiency.

  First, let's figure out where this name came from - pyramidal. The medulla oblongata is responsible for performing complex reflexes. It is part of the brain and connects it with the spinal cord. It consists of many anatomical cells - pyramids, hence the name - pyramidal. As a result of damage to part of these pyramidal cells, some kind of movement disorder may occur. If we talk about what pyramidal insufficiency is, then everything is much more complicated here, since this diagnosis is not mentioned either in the international classification of diseases, or in textbooks and reference books on child neurology. It simply doesn't exist. However, this does not stop most neurologists from giving it to thousands of children.

  Treatment of pyramidal insufficiency.

  It should be noted that pyramidal insufficiency is far from the only non-existent diagnosis. It means that the child has some problems in the motor sphere, but it is possible to understand the cause of their occurrence, that is, make a diagnosis, and therefore prescribe the correct treatment, only if there are a number of other accompanying symptoms. But in most cases, the diagnosis of pyramidal insufficiency is made when there are no other symptoms, or they have not yet manifested themselves, which means there is no point in prescribing treatment. However, treatment is prescribed, and it’s good if it’s just a massage, which most likely will not harm your baby in any way. But if you have already visited a neurologist, then you probably know that most of the medications they prescribe are far from harmless; this is not ascorbic acid or even an aspirin tablet.

  Therefore, if your neurologist tells you, “Mom, go home, your child is completely healthy.” Do just that, maybe you were just lucky and found a good doctor.

  I think there is no point in treating a non-existent disease. But do not forget that the diagnosis of pyramidal insufficiency, although it is a so-called “excuse”, does not mean that there is no problem at all, therefore, watch the child at home for some time, perhaps some additional symptoms will appear, the presence of which will help the doctor make the correct diagnosis and prescribe treatment that will be effective and really help eliminate the problem.

  In addition, most of the symptoms that are most often used to diagnose pyramidal insufficiency, such as.

  Ballerina's symptom, walking on tiptoes or on tiptoes, equinus planting of the feet - all these are names of one pathology - pyramidal insufficiency syndrome. The disorder can be caused by a huge number of reasons, but is invariably accompanied by moderate/severe muscle dystonia with hypertonicity of the foot and leg. Pyramidal insufficiency with bilateral dystonia, as usual, is monitored in newborns and babies in the first year of life, and is less often diagnosed in children 2-3 years of age.

  Why does pyramidal insufficiency occur?

  The medulla oblongata is responsible for difficult reflexes. It is part of the brain and connects the terminal to the spinal cord. The organ consists of anatomical cells - pyramids. Hence the name – pyramidal.

  When these cells are damaged, movement disorders occur. It is worth noting that in medicine there is no diagnosis of “pyramidal or pyramidal insufficiency”. However, it is given to many children and not always for good reason.

  The cause of pathology in a child is perinatal mechanical or ischemic injury to the cervical spinal cord. When the blood circulation of the cervical thickening and the brain stem is disrupted, a daring deviation of the muscle tone of the flexors in the limbs is formed.

  The severity depends on the severity of the lesion. The arms become stiff, and with more widespread ischemia, disturbances are also observed in the legs - when the baby is placed on his legs, he unwaveringly rests on his toes (distal parts of the foot).

  Symptoms and signs

  Key signs of pyramidal insufficiency:

  • Trembling chin;
  • Hand tremors;
  • Throwing the head back;
  • Poor grasp reflex;
  • Difficulty holding objects;
  • Curling your toes in a standing position;
  • Walking on your toes.

  In children under 2-3 months of age, this condition does not cause concern, because they have normal muscle hypertonicity. When the vertical position of the body becomes physiologically intensified, and the baby does not walk normally, it is necessary to determine muscular dystonia - the main symptom of pyramidal insufficiency or spastic paresis of the lower extremities.

  The diagnosis is confirmed by the presence of high tendon reflexes, the Babinski reflex persisting for 2-3 months, revival of the tendon reflexes of the hands, delayed reduction of others (mechanical gait, mechanical crawling, Moro, etc.).

  Pyramidal insufficiency syndrome can be detected in an infant using an original test: the baby is placed on his stomach, the lower leg is bent halfway at the knee, the calf muscles are palpated, and the tone of the buttocks is examined. In a typical state, muscle tension is identical.

  If there is a violation, the calf muscles are tense, the buttocks are in a state of hypotension or typical tone. The pathology often affects the rectus femoris muscles: the legs bend immensely at the hip joints, and when you bring them to the tummy, they find it difficult to straighten in a child lying on his back.

  Features of deviation

  Pyramidal insufficiency, diagnosed in children, poses a threat because it entails functional disorders called movement disorder syndrome (MDS). In such children, attitudinal reflexes and motor skills are formed late, that is, their development will be delayed (the child will sit up late, crawl, walk, etc.).

  Essentially, such a diagnosis indicates a disorder of the motor sphere, but treatment can be prescribed only on the basis of other signs and after clarifying the causes of the disorder.

  Almost invariably, the diagnosis of “pyramidal insufficiency” is made when other signs of pathology have not appeared or are absent at all. That is, prescribing any treatment is unsuccessful.

  Tumors, inflammatory processes, some congenital pathologies and infections, hemorrhages are the main causes of deficiency, or rather, it is their symptom and a secondary disorder. Considering which part of the body has stopped moving normally, the neurologist correctly determines the affected area of ​​the pyramidal system.

  Computed tomography is used as the main diagnostic method. The procedure allows you to correctly identify the lesion in a matter of minutes.

  In any case, before prescribing treatment, the doctor must make an accurate, or, one might say, officially present diagnosis. For example, movement disorders can be provoked by minimal brain dysfunction, encephalopathies, and liquor hypertension syndrome.

  True neurological pathologies may occur:

  • birth injuries;
  • congenital diseases of the nervous system;
  • brain damage as a result of hypoxia during childbirth (oxygen deficiency);
  • infectious diseases;
  • tumors;
  • abscesses in the spinal cord or brain;
  • disturbances in the production and outflow of cerebrospinal fluid;
  • encephalitis and meningitis, causing hydrocephalus.

  All of the listed pathologies have characteristic signs and certain methods of treatment; therefore, it is impossible to prescribe any important medical measures on the basis of each only one movement disorder. For example, throwing the head back is one of the signs of meningitis, but no one makes a diagnosis based on this sign alone.

  Treatment of children with pyramidal insufficiency

  If none of the listed diagnoses are confirmed, then the violation can be eliminated without medication. Basically, various physiotherapy procedures are prescribed. Massage is widely used. We need both the support of a qualified expert and the involvement of parents.

  An experienced massage therapist will relieve tone and strengthen muscles. Massage courses traditionally take place every six months. Parents are required to do special preventive exercises with their child every day.

  Gymnastics, swimming, and exercises for coordination of movements have a beneficial effect on the body in general and on physical activity in particular.

  This applies to both adults and children. Vitamins and medications that improve energy metabolism may be prescribed. It is worth noting that it is necessary to choose special orthopedic shoes when the baby tries to walk. It should have a rough back and a closed front.

  If any disease is found that has led to the disorder, treatment is directed both at its elimination and at secondary disorders; it is necessary to stop the signs of pyramidal insufficiency, exclusively in children.

  The following drugs may be prescribed:

  • Improving metabolic processes in nerve cells, say, Nootropil, Encephabol, Cerebrolysin, Aminalon, glutamic acid;
  • To improve the conduction of a nervous impulse, Dibazol and Proserin are prescribed;
  • Vasoactive agents for microcirculation;
  • Substances that normalize muscle tone (eg. Baclofen, Mydocalm, Lioresal);
  • Vitamin E and group B.

  Acupressure and relaxation massage, exercise therapy, reflexology help reduce tone. Orthopedic measures and balneotherapy may also be required. In all cases, treatment methods may differ.

  Surgical interventions are resorted to when injuries/tumors of the brain or spinal cord are diagnosed, severe cerebral circulatory disorders that cannot be eliminated by conservative methods (thrombosis, stenosis of extracerebral arteries, malformations of cerebral vessels, intracerebral hematoma, etc.).

  If there is the slightest doubt about the disease, parents should immediately seek diagnosis and treatment from an expert. Health to you and your children!