Spastic tetraparesis occurs for a variety of reasons. These include spinal cord injuries, the consequences of a traumatic brain injury, spinal and cerebral strokes, acute cerebrovascular accident , the effects of neurosurgery, neurodegenerative diseases, in particular multiple sclerosis.
There are several clinical types of disease, depending on the nature of the lesions. Spastic tetraparesis is an increase in muscle tone and is manifested in the stiffness of the muscles of the lower and upper extremities.
Sometimes spastic tetraparesis appears as triparesis when one of
limbs do not suffer. Intelligence is impaired in the vast majority of cases
diseases. Spastic tetraparesis may occur in some cases
due to high intracranial pressure and hydrocephalus.
The most severe form of the disease with significant damage to the upper limbs is double hemiplegia, in which oligophrenia is observed in the degree of severe imbecility, debility or idiocy. The disease is accompanied by significant motor disorders of all limbs, but the hands suffer more. Muscle tone is asymmetric, severe damage to the arms, trunk muscles and facial muscles is noted. The disease entails a pronounced delay in mental and speech development. Children with this disease cannot sit walking, take care of themselves.
Tetraparesis in children is often combined with developmental abnormalities and microcephaly, which is evidence of intrauterine damage to the brain of the child.
In sick children with this form of paralysis in the first years of life, they appear
symptoms of cerebellar lesions. Children with this disease do not hold their heads, do not
sit, do not walk, cannot maintain balance. There is a clear delay
mental development, the depth of which mainly depends on localization
brain damage. The deepest developmental delay occurs in lesions
frontal lobes. Disorders in the cerebellum cause less developmental delay, but in
in this case, the symptoms of cerebellar lesions prevail . Spastic tetraparesis and
lower paraparesis account for more than half of all cases of childhood
cerebral palsy. The causes of the syndrome are damage.
extrapyramidal structures of the brain. As a result of this is reduced
inhibitory control of the segmental apparatus of the spinal cord. Arises
pathological activation of the stretch reflex, which leads to increased tone
muscles with a disease such as tetraparesis. Treatment today includes the use of conservative methods of therapy. Also used
neurosurgical and orthopedic surgical treatment, rehabilitation.
The main objective of therapy is the correction of disorders of the motor apparatus, reduction of spasticity, the formation of the correct motor stereotype. International studies show that conservative treatment is not effective enough to adequately correct spastic tetraparesis in cerebral palsy. In Russia, unlike in Western countries, conservative therapy is the main treatment method. Its main task is to eliminate or reduce spastic syndrome. In turn, this leads to an increase in the volume of passive movements in the upper and lower extremities. Care for a sick child is facilitated, the risk of developing orthopedic deformities and fixed contractures is reduced.
If some strength remains in the affected limbs, then the volume increases
active movements. With reduced spasticity, rehabilitation opportunities
increase sharply.