The diagnosis that scares everyone and everyone is cerebral palsy. Reasons, forms of cerebral palsy - these questions concern any modern parent, if during the bearing of a child the doctor speaks about the high probability of such a deviation or if you had to encounter him after birth.
What is this about?
Cerebral palsy is a collective term, it is applied to several types and types of conditions in which the human support system and the ability to move suffer. The cause of congenital cerebral palsy is damage to the brain centers responsible for the possibility of various voluntary movements. The patient's condition inexorably regresses, sooner or later, pathology becomes the cause of cerebral degeneration. Primary disorders occur even during the development of the fetus in the maternal body, a little less often cerebral palsy due to the characteristics of childbirth. There is a risk that the cause of cerebral palsy will be some events that occurred with the baby shortly after birth and adversely affect the health of the brain. External factors can have such an effect only in the early period after birth.
Even today, doctors know a huge number of factors that can provoke cerebral palsy. The reasons are varied, and protecting your child from them is not always easy. However, from medical statistics it is clear that most often the diagnosis is made to premature babies. Up to half of all cases with cerebral palsy are babies born prematurely. This reason is considered the most significant.
Factors and Risks
Previously, the reason why children were born with cerebral palsy was considered the first and most important trauma received at the time of birth. They can provoke it:
- birth too fast;
- technologies, methods used by obstetricians;
- narrowed maternal pelvis;
- abnormal pelvic anatomy of the mother.
Currently, doctors know for certain that birth injuries lead to cerebral palsy in only a very small percentage of cases. The predominant share is the specifics of the development of the child while in the womb. Previously considered the main cause of cerebral palsy, the problem of childbirth (for example, protracted, very severe) is now classified as a consequence of violations that occurred during the bearing of the child.
Let's consider it in more detail. Modern doctors, finding out the reasons why children with cerebral palsy are born , have analyzed the statistics of the influence of autoimmune mechanisms. As it was revealed, some factors have a significant effect on tissue formation at the stage of embryo emergence. Modern medicine believes that this is one of the reasons explaining a considerable percentage of cases of health deviations. Autoimmune disorders affect not only while in the mother's body, but also affect the baby after childbirth.
Shortly after birth, a previously healthy baby can become a victim of cerebral palsy due to infection, against which encephalitis developed. Can provoke trouble:
It is known that hemolytic disease, which manifests itself as jaundice due to insufficient functioning of the liver, is among the main causes of cerebral palsy. Sometimes a Rhesus conflict is detected in a child, which can also provoke cerebral palsy.
It is far from always possible to determine the reason why children are born with cerebral palsy. The doctors' reviews are disappointing: even MRI and CT (the most effective and accurate research methods) can not always provide enough data to form a complete picture.
Complexity of the question
If a person is different from others, he attracts attention - this fact is not in doubt. Children with cerebral palsy are always the object of interest of others, from ordinary people to professionals. The particular complexity of the disease is in its effect on the whole organism. With cerebral palsy, the ability to control your own body suffers, since the functionality of the central nervous system is disrupted. Extremities, facial muscles do not obey the patient, and it immediately catches the eye. With cerebral palsy, half of all patients also have developmental delays:
- speech;
- intelligence;
- emotional background.
Often cerebral palsy is accompanied by epilepsy, convulsions, tremors, an improperly formed body, and disproportionate organs - the affected areas grow and develop much more slowly than healthy elements of the body. In some patients, the visual system is disturbed, in others, cerebral palsy is the cause of mental, auditory, and swallowing disorders. Inadequate muscle tone or problems with urination, defecation are possible. The strength of the manifestations is determined by the scale of the violation of brain functionality.
Important Nuances
Such cases are known when patients successfully adapted to society. A normal human life is available to them, full, full of events, joys. Another scenario is possible: if fairly large areas of the brain are damaged during cerebral palsy, this will cause the status of a disabled person to be assigned. Such children are completely dependent on others; as they grow older, their dependence does not become weaker.
To some extent, the future of the child depends on his parents. Some approaches, methods, and technologies are known that make it possible to stabilize and improve the patient's condition. At the same time, one should not count on a miracle: the cause of cerebral palsy is damage to the central nervous system, that is, the disease cannot be cured.
Over time, in some children, the symptoms of cerebral palsy become wider. Doctors disagree on whether this can be considered a disease progress. On the one hand, the root cause does not change, but over time, the child tries to learn new skills, often encountering failure along the way. If you meet a child with cerebral palsy, you should not be afraid of it: the disease is not transmitted from person to person, it is not inherited, therefore, in fact, its only victim is the patient himself.
How to notice? The main symptoms of cerebral palsy
The cause of the violation is a malfunction in the central nervous system, leading to dysfunction of the motor brain centers. For the first time, symptoms can be seen in a baby at the age of three months. Such a child:
- develops with a delay;
- significantly lags behind peers;
- suffers from convulsions;
- makes strange, unusual for kids movements.
A distinctive feature of such an early age is increased brain compensatory capabilities, so the therapeutic course will be more effective if it can be diagnosed early. The later the disease is detected, the worse the prognosis.
Reasons and discussion
The cause of the main symptoms of cerebral palsy is a malfunction of the brain centers. A variety of damages that have formed under the influence of a wide range of factors can provoke this. Some appear even during development in the mother's body, others at birth and soon after. As a rule, cerebral palsy develops only in the first year of life, but not later. In most cases, dysfunction of the following brain regions is detected:
- bark;
- the area under the bark;
- brain stem;
- capsules.
It is believed that with cerebral palsy, the functionality of the spinal cord suffers, but there is currently no confirmation. Injuries to the spinal cord were found in only 1% of patients, so there is no way to conduct reliable studies.
Defects and pathologies
One of the most common causes of the diagnosis of cerebral palsy is defects obtained during fetal development. Modern doctors know the following situations in which there is a high probability of deviations:
- myelination is slower than normal;
- improper cell division of the nervous system;
- violation of the connections between neurons;
- errors in the formation of blood vessels;
- the toxic effect of indirect bilirubin, which led to tissue damage (observed in case of a conflict of Rh factors);
- infection
- scarring;
- neoplasms.
On average, in eight out of ten children, the cause of cerebral palsy is one of these.
Especially dangerous infections are toxoplasmosis, flu, rubella.
It is known that a child with cerebral palsy can be born to a woman suffering from the following diseases:
- diabetes;
- syphilis;
- pathology of the heart;
- vascular disease.
Both infectious and chronic pathological processes in the mother's body are possible causes of cerebral palsy in a child.
The maternal organism and the fetus may have conflicting antigens, Rh factors: this leads to severe violations of the health of the child, including cerebral palsy.
The risks are increased if during pregnancy a woman takes medications that can adversely affect the fetus. Similar dangers are associated with drinking alcohol and smoking. Finding out what is the cause of cerebral palsy, doctors found that more often such children are born in women if the birth is postponed before the age of majority or over forty. At the same time, one cannot say that the listed reasons are guaranteed to provoke cerebral palsy. All of them only increase the risk of deviations, are recognized patterns, which must be taken into account when planning a child and bearing a fetus.
I can not breathe!
Hypoxia is a common cause of cerebral palsy in children. Treatment of a pathology, if it is provoked precisely by a lack of oxygen, is no different from other reasons. As such, there will be no recovery over time, but with early detection of symptoms, an adequate course of patient rehabilitation can be started.
Hypoxia is possible both during gestation and during childbirth. If the weight of the baby is less than normal, there is every reason to assume that hypoxia accompanied a certain stage of pregnancy. Diseases of the heart, blood vessels, endocrine organs, virus infection, and kidney disorders can provoke the condition. Sometimes hypoxia is provoked by toxicosis in severe form or in the later stages. One of the causes of cerebral palsy in children is a violation of blood flow in the pelvis of the mother during gestation.
These factors negatively affect the supply of the placenta with blood, from which the cells of the embryo receive nutrients and oxygen, which are vital for proper development. In case of impaired blood flow, metabolism weakens, the embryo develops slowly, there is a possibility of low weight or growth, impaired functionality of different systems and organs, including the central nervous system. They talk about underweight if a newborn weighs 2.5 kg or less. There is a classification:
- children born before 37 weeks of gestation with adequate weight for their age;
- premature babies with a small mass;
- low birth weight children born on time or later.
About hypoxia, developmental delay speak only in relation to the last two groups. The first is considered the norm. For premature babies born on time and later in life of children with a lack of mass, the risk of developing cerebral palsy is estimated to be quite high.
Baby's health depends on mother
Mostly the causes of cerebral palsy in children are due to the period of development in the mother's body. Anomalies in the fetus are possible under the influence of various factors, but most often the cause is:
- development of diabetes (an average of three children out of a hundred born to mothers with gestational diabetes);
- disturbances in the work of the heart and blood vessels (heart attack, sudden changes in pressure level);
- infectious agent;
- physical trauma;
- acute poisoning;
- stress.
One of the danger factors is multiple pregnancy. This reason for cerebral palsy in newborns has the following explanation: when several embryos are hatched, the maternal body is faced with increased stress indicators, which means that the probability of having children prematurely and with low weight is significantly higher.
Birth: not so simple
A common cause of cerebral palsy in newborns is birth trauma. Despite the stereotypes that this is possible only in case of obstetrician error, in practice, injuries are much more often explained by the characteristics of the maternal or child organism. For example, a woman in labor may have a very narrow pelvis. Another reason is also possible: the child is very large. During the birth of the child's body can suffer, the harm done to him becomes the cause of various diseases. Often there are clinical manifestations of cerebral palsy in newborns for reasons:
- improper position of the embryo in the uterus;
- placing the head in the pelvis along the wrong axis;
- too fast or too long birth;
- use of inappropriate accessories;
- obstetric errors;
- asphyxia for various reasons.
Currently, one of the safest birth options is considered to be a cesarean section, but even this approach cannot guarantee the absence of birth injury. In particular, there is a chance of damage to the vertebrae of the neck or chest. If at birth they resorted to a cesarean section, it is necessary to show the baby to an osteopath soon after birth to check the adequacy of the condition of the spine.
On average, cerebral palsy occurs in two out of a thousand girls, and for boys the frequency is slightly higher - three cases per thousand infants. There is an opinion that this difference is explained by the large size of the boys' bodies, which means that the risk of injury is higher.
Currently, it is impossible to insure against cerebral palsy, as there is no one hundred percent guarantee to provide for it, to prevent it. In an impressive percentage of cases of the cause of acquired cerebral palsy, congenital, it is possible to establish already after the fact, when anomalies manifest themselves in the development of the child. In some cases, already during pregnancy, there are signs indicating the likelihood of cerebral palsy, but in their bulk they cannot be corrected or are eliminated only with great difficulty. Nevertheless, one should not despair: one can live with cerebral palsy, one can develop, be happy. In modern society, the rehabilitation program for such children is quite actively promoting, equipment is being improved, which means that the negative impact of the disease is mitigated.
Relevance of the issue
Statistical studies show that, on average, under the age of one year, cerebral palsy is diagnosed with a frequency of up to 7 out of a thousand children. In our country, the average statistical indicators are up to 6 per thousand. Among premature infants, the incidence rate is approximately ten times greater than the world average. Doctors believe that cerebral palsy is the first trouble among chronic diseases affecting children. To some extent, the disease is associated with environmental degradation; neonatology is recognized as a certain factor, since even children whose weight is only 500 g can survive in hospital conditions. Of course, this is real progress in science and technology, but the frequency of cerebral palsy among such children is, unfortunately, significantly higher than average, therefore it is important not only to learn how to care for so few children weighing, but also to develop ways to provide them with a full, healthy life.
Features of the disease
Five types of cerebral palsy are distinguished. Most often, spastic diplegia occurs. Various experts estimate the frequency of such cases at 40-80% of the total number of diagnoses. This type of cerebral palsy is established if lesions of the brain centers cause paresis, from which the lower extremities primarily suffer.
One form of cerebral palsy is damage to the motor centers in one half of the brain. This allows you to set the hemiparetic type. Paresis is characteristic of only one half of the body, the opposite of the cerebral hemisphere, which suffered from aggressive factors.
Up to a quarter of all cases are hyperkinetic cerebral palsy, caused by a violation of the activity of the subcortex of the brain. Symptoms of the disease - involuntary movements that are activated if the patient is tired or excited.
If the disorders are concentrated in the cerebellum, the diagnosis sounds like “atonic-astatic cerebral palsy”. The disease is expressed by static disorders, muscle atony, inability to coordinate movements. On average, this type of cerebral palsy is detected in one patient out of ten patients.
The most difficult case is double hemiplegia. Cerebral palsy is caused by an absolute violation of the functionality of the cerebral hemispheres, due to which the muscles are rigid. Such children cannot sit, stand, hold their heads.
In some cases, cerebral palsy develops according to a combined scenario, when symptoms of different forms appear simultaneously. Most often, the hyperkinetic type and spastic diplegia are combined.
All individually
The severity of deviations in cerebral palsy is different, and the clinical manifestations depend not only on the localization of the diseased brain regions, but also on the depth of the disorders. There are such cases when, already in the first hours of life, the baby’s health problems are visible, but in most cases it is possible to make a diagnosis only a few months after birth, when a developmental delay is noticeable.
Cerebral palsy can be suspected if the child does not have time for motor development behind peers. For a long time, the baby cannot learn to hold the head (in some cases this does not happen). He is not interested in toys, he does not try to roll over, consciously move his limbs. When trying to give him a toy, the child does not try to hold it. , , .
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With significant muscle spasticity, the affected limbs can be absolutely motionless. Such parts of the body lag behind in development. This leads to a modification of the skeleton - the chest is deformed, the spine is bent. With cerebral palsy, joint contractures are revealed in the affected limbs, which means that violations associated with attempts to move become even more significant. Most children with cerebral palsy suffer from severe pain due to skeletal disorders. The syndrome is most pronounced in the neck, shoulders, feet, and back.
Manifestations and Symptoms
The hyperkinetic form is indicated by sudden movements that the patient cannot control. Some turn their heads, nod, grimace or twitch, take pretentious poses, make strange movements.
With an atonic astatic form, the patient cannot coordinate movement, when trying to walk is unstable, often falls, cannot maintain balance while standing. Such people are more likely to suffer from tremors, and the muscles are very weak.
Cerebral palsy is often accompanied by strabismus, gastrointestinal disturbances, respiratory dysfunction and urinary incontinence. Up to 40% of patients suffer from epilepsy, and 60% have impaired vision. Some do not hear well, others do not perceive sounds at all. Up to half of all patients have disturbances in the endocrine system, expressed by a malfunction of the hormonal background, excess weight, growth retardation. Often with cerebral palsy, oligophrenia, delayed mental development, and a decrease in the ability to learn are detected. Many patients are characterized by behavioral and perceptual disorders. Up to 35% of patients have a normal level of intelligence, and in every third mental disorders are assessed as mild.
The disease is chronic, regardless of form. When the patient becomes older, previously hidden pathological disorders gradually appear, which is perceived by false progress. Often, the deterioration is due to secondary health difficulties, because with cerebral palsy are frequent:
- strokes
- somatic diseases;
- epilepsy.
Often diagnosed with hemorrhage.
How to detect?
So far, it has not been possible to develop such tests and programs that would allow for the true establishment of cerebral palsy. Some typical manifestations of the disease attract the attention of doctors, due to which the disease can be detected at an early stage of life. Cerebral palsy can be suggested by a low score on the Apgar scale, by impaired muscle tone and motor activity, lag, lack of contact with the next of kin - patients do not respond to their mother. All these manifestations are an occasion for a detailed examination.