Cerebral palsy (cerebral palsy) is a neurological disease. It can develop in a child in the first trimester of pregnancy or occur after childbirth. Hyperkinetic form of cerebral palsy occurs in 25% of cases. It is characterized by a violation of muscle tone with a slight disorder in the mental development of a small patient.
What is cerebral palsy?
Cerebral palsy is a chronic disease. It combines a whole complex of manifestations associated with a disorder of motor functions. Most often develops during fetal development.
Cerebral palsy is non-progressive. This means that the disease does not spread within the body, but rather damages individual parts of the brain. As a result, it becomes difficult for the child to follow the coordination of movements.
There are 3 stages of the pathological process:
- early
- initial chronic-residual;
- final residual.
The first stage lasts about 4 months. It is characterized by: rapid heart rate, periods of respiratory failure, nystagmus, convulsive syndrome. Movement disorders are difficult to distinguish.
The next stage lasts from the fifth month of a child's life to 4 years. During this period, persistent muscle hypertonicity arises. The late residual stage is characterized by the consolidation of motor disorders, the formation of contractures against the background of muscle atrophy.
Varieties of cerebral palsy
There are several typologies of cerebral palsy. In Russia, the classification of K. A. Semenova is used. According to the proposed gradation, the following forms of paralysis are distinguished:
- spastic diplegia;
- double hemiplegia;
- hemiplegia;
- atonic astatic form;
- hyperkinetic form.
In today's article, we will dwell in more detail on the last form of paralysis.
Main reasons
Any kind of pathology is a consequence of malnutrition of the brain of the fetus or newborn. The causes of cerebral palsy of a hyperkinetic form are hidden in defects in the subcortical parts of the brain, more precisely, the striopallid system.
The following pathologies during pregnancy can lead to a disease:
- infectious damage (syphilis, toxoplasmosis, etc.);
- fetoplacental insufficiency;
- prolonged toxicosis;
- rhesus conflict;
- early detachment of the placenta;
- non-maternal diseases (diabetes, heart defects, hypothyroidism).
Directly during childbirth, cerebral palsy can provoke:
- long waterless period;
- birth injury;
- protracted / premature / rapid delivery.
In the postpartum period, the cause of cerebral palsy can be asphyxia of the newborn due to strangulation of the umbilical cord or the amniotic fluid in the lungs.
Characteristic manifestations and disorders
The main symptom of the disorder is inconstancy of muscle tone. It can be normal, reduced or increased. If spastic symptoms appear against the background of paralysis, the disease is diagnosed as a spastic-hyperkinetic form of cerebral palsy.
Familiar movements in children with this diagnosis are impaired: they look awkward and a little sweeping. It is for this form that the appearance of hyperkinesis is characteristic - an involuntary contraction of the facial muscles, legs and arms.
There are several types of hyperkinesis:
- athetosis
- chorea;
- choreoathetosis;
- torsion dystonia.
They can occur singly or in combination. Often disorders of the musculoskeletal system are combined in combination with auditory and speech disorders.
In children with a hyperkinetic form of cerebral palsy, joint deformation and contracture do not occur. However, subluxations may form in the area of small joints of the upper extremities. Another characteristic feature is the violation of the capture of small objects. Difficulties arise with other movements that require concentration.
There are different degrees of severity of the pathology. With a light version, defects in the locomotive apparatus are almost invisible. Such children can attend general education institutions and cope without outside help. However, involuntary and sharp muscle spasms may occur in them, spreading mainly in the upper body. These symptoms are worse after stress and in depressive states.
For a severe degree of hyperkinetic form of cerebral palsy, the following conditions are symptoms:
- involuntary muscle movements appear in the first months of life;
- in the second year of life, moderate downward hyperkinesis occurs;
- muscle contractions of the upper and lower extremities are increasing in nature.
Toddlers with moderate to severe degree of pathology need constant comprehensive assistance.
Correction and Recovery Methods
It is not possible to completely overcome the disease. However, there are various methods by which it is possible to adjust the behavior and movements of the child. The attending physician selects them taking into account the characteristics of the hyperkinetic form of cerebral palsy and the individual characteristics of a small patient.
To ensure the most effective therapy, it is recommended to use an integrated approach. It implies the use of the following methods:
- medical rehabilitation;
- drug treatment;
- speech correction;
- recovery procedures;
- help of teachers.
Each of the methods will be described in detail later in the article.
Drug therapy
Rehabilitation is recommended from an early age. It is better to begin treatment of the hyperkinetic form of cerebral palsy at the age of 4-5 years. At this time, motor disorders characteristic of pathology are minimal.
Drug therapy includes the intake of muscle relaxants to eliminate muscle cramps, anticonvulsants to stop the severity of symptoms. To adjust the emotional background of the child and the central nervous system, the help of neurotrophic medicines is required.
Through properly prescribed drug therapy, it is possible to normalize muscle tone, reduce hyperkinesis. To accelerate the recovery period and improve the effects of drugs, the addition of B vitamins is additionally recommended.
Other treatments
For various disorders against the background of the hyperkinetic form of cerebral palsy, the use of means to ensure their compensation is recommended. We are talking about strollers, stand-ups, crutches, special shoes. In the later stages, advanced methods are used, involving the introduction of suits and training apparatus. With their help, it is possible to compensate for the stress and develop motor skills.
If necessary, a speech therapy and psycho-pedagogical correction is prescribed. The work of the defectologist is usually aimed at reducing the severity of speech defects. The psychologist collaborates not only with the child, but also with his parents to ensure the most comfortable environment in the family. The child is taught to communicate with peers.
With cerebral palsy, massage is widely used. Procedures help improve blood circulation and metabolism. For maximum effectiveness, sessions should be carried out by a qualified specialist.
Physiotherapy exercises are also useful for children with cerebral palsy. Exercises are selected individually. Almost all small patients are recommended swimming. Physiotherapeutic procedures have a good effect.
Features of hippotherapy for cerebral palsy
The listed therapeutic measures help reduce muscle hypertension, but they are not able to teach the child new skills. Therefore, hippotherapy is widely used today in the treatment of synkinesias with the hyperkinetic form of cerebral palsy.
The child’s contact with the horse stimulates the functioning of his subcortical zones of the brain, allows him to learn complex movements and improve his speech skills. In the process of training, hypertonicity of muscles and the severity of hyperkinesis are reduced.
The rider during the ride begins to involuntarily repeat all the movements of the horse, learns to maintain balance and work simultaneously with two legs. In addition, the habit of falling to the sick side disappears, fine motor skills develop. Literally in a few classes, emotional stress is normalized against the background of a sense of inferiority in society.
Even long sessions of hippotherapy practically do not bother children. Each time they gain new skills, experience and experience. Fresh air has a beneficial effect on the state of the whole organism.
Prognosis for recovery
The prognosis for the hyperkinetic form of cerebral palsy is largely determined by the severity of the pathology, the presence of concomitant health problems, and adequate and timely treatment. The disease can not be completely overcome. However, with a competent approach and rehabilitation, developmental defects can be compensated as much as possible.
In the absence of seizures, the disease practically does not progress. Children can independently move from 5-6 years with mild or moderate severity of the hyperkinetic form of cerebral palsy. Their mental development suffers less than their physical development. Therefore, in most cases, they master the school curriculum, receive secondary or higher education.