Cerebral palsy (cerebral palsy) is not a separate pathology, but a whole group of diseases of the central nervous system that occur when brain damage or abnormalities of its development.
Forms of cerebral palsy
This pathology can have various manifestations, both mild and extremely severe. Cerebral palsy was divided into separate types depending on the manifestations. The most common is the hemiparetic form of cerebral palsy. In addition to it, the following forms are also distinguished:
- spastic diplegia - manifests itself with complete paralysis of the extremities, occurs when the part of the nervous system responsible for the movement of arms and legs is affected;
- double diplegia - the most severe form of cerebral palsy, characterized by damage to the cerebral hemispheres; the child is not able to hold his head, sit, move;
- hyperkinetic form - caused by damage to brain structures located below the cortex, the so-called subcortical structures (its manifestations are sudden movements that cannot be controlled by consciousness);
- atonic-astatic form - occurs when the main center of coordination, the cerebellum, is affected, is characterized by unsteadiness of the gait and decreased muscle tone.
Features of hemiparetic form
The hemiparetic form of cerebral palsy is one of the most common. It develops when the brain is damaged during fetal development and is characterized by a violation of the structure of the structures of the central nervous system. And its main manifestation is central paresis (weakness in the arm or leg) and paralysis (complete immobilization of the limbs).
Since brain damage in this pathology is one-sided, a violation of motor activity is also observed only on one side of the body. However, it is characteristic that paresis and paralysis affect the side opposite to the side of brain damage!
Clinical manifestations
The main characteristics of the hemiparetic form of cerebral palsy, in addition to the presence of unilateral paresis and paralysis, include:
- increased tone of the limbs on the side of the paresis;
- hyperreflexia (increased reflexes) on the same side;
- delayed speech development;
- retardation of motor development;
- pronunciation difficulties due to facial paralysis;
- in half of the cases, the presence of hyperkinesis (spontaneous increased motor activity) is characteristic;
- often - epileptic seizures;
- with a prolonged course of the disease, a violation of intelligence and mental disorders are possible.
Double hemiplegia
The double hemiparetic form of cerebral palsy is the most severe. It is manifested by impaired movement in all limbs. These changes are often asymmetrical and expressed in different ways. In addition to motor disorders, disorders of swallowing, speech, up to its complete absence (anarthria), are characteristic. Seizures often occur.
The primary damage to the brain, the lack of speech, which leads to the inability to contact with peers and learning, ultimately cause mental and intellectual disorders.
This form of cerebral palsy is often accompanied by various developmental abnormalities. For example, microcephaly - a small head size.
The prognosis of this most severe form of cerebral palsy is extremely unfavorable.
Diagnostics
The diagnosis is made mainly on clinical grounds. However, a carefully compiled case history of the hemiparetic form of cerebral palsy is also important. It is necessary to pay attention to the obstetric history: a burdened period of pregnancy or childbirth with gestosis, toxicosis, eclampsia, bad habits of the mother can lead to a correct diagnosis. A burdened family history may also occur with cerebral palsy.
If the clinical picture is erased, and the doctor is not sure of the diagnosis, additional laboratory examination methods may be used. There are studies by Russian scientists confirming the development of metabolic disorders in the spastic form of cerebral palsy, including hypoxia of cells and tissues (reduced oxygen content), and increased activity of the antioxidant system. As a result of this, the development of rickets, hypo- and atrophy, anemia is possible. Therefore, the control of biochemical blood parameters is important in the diagnosis of cerebral palsy and especially in its treatment to control the activity of the process.
Treatment
The characteristics and treatment of the hemiparetic form of cerebral palsy are inextricably linked, as the main therapy is aimed specifically at eliminating the symptoms and facilitating the patient's life. For maximum effectiveness, continuity and lifelong treatment are also important.
One of the most effective methods is massage. Since the hemiparetic form of cerebral palsy is manifested by increased muscle tone, massage helps to remove it. Physical therapy is also widely used, which helps to increase the range of movements and reduce coordination disorders, if any.
Physiotherapy is also used - electrophoresis, myostimulation. However, in the presence of seizures, this type of therapy is contraindicated.
With the development of intellectual disorders, drugs are shown that improve the metabolism of brain cells and increase the concentration of oxygen in it. This is a group of nootropics: Cerebrolysin, Piracetam.
Although the hemiparetic form of cerebral palsy is a serious disease that requires tremendous effort to combat it, this is not a sentence. Continuous therapeutic exercises, massage and physiotherapy throughout life give an excellent result, and adults with cerebral palsy can live a full life.