The diagnosis that scares everyone and everyone is cerebral palsy. Causes, forms of cerebral palsy - these questions concern any modern parent if, during the bearing of a child, the doctor speaks of a high probability of such a deviation, or if he had to deal with it after birth.
What is it about?
ICP 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 performing various voluntary movements. The patient's condition inexorably regresses, sooner or later the pathology becomes the cause of brain degeneration. Primary disorders occur even during the development of the fetus in the mother's body, somewhat less often cerebral palsy is explained by the characteristics of childbirth. There is a risk that the cause of cerebral palsy will be some events that happened to the child shortly after birth and negatively affected the he alth of the brain. External factors can have such an impact only in the early period after birth.
AlreadyToday, 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
Earlier, of the reasons why children are born with cerebral palsy, the first and most important was the trauma received at the time of birth. They can provoke her:
- too fast birth;
- technologies, methods used by obstetricians;
- narrowed maternal pelvis;
- incorrect maternal pelvic anatomy.
Currently, doctors know for certain that birth injuries lead to cerebral palsy only in a very small percentage of cases. The predominant share is the specificity of the development of the child while in the mother's womb. Previously considered the main cause of cerebral palsy, the problem of childbirth (for example, prolonged, very difficult) is now classified as a consequence of violations that occurred during childbearing.
Let's take a closer look at this. Modern doctors, finding out the reasons why children with cerebral palsy are born, analyzed the statistics of the influence of autoimmune mechanisms. As it was found, some factors have a significant impact on the formation of tissues at the stage of the appearance of the embryo. Modern medicine believes that this is one of the reasons explaining a considerable percentage of cases of deviations.he alth. Autoimmune disorders affect not only while in the mother's body, but also affect the child after childbirth.
Shortly after birth, a previously he althy child may become a victim of cerebral palsy due to infection, against which encephalitis developed. They can provoke trouble:
- measles;
- chickenpox;
- flu.
It is known that the main causes of cerebral palsy include hemolytic disease, which manifests itself as jaundice due to insufficient functioning of the liver. Sometimes a child has an Rhesus conflict, which can also provoke cerebral palsy.
It is far from always possible to determine the reason why children are born with cerebral palsy. Doctors' comments are disappointing: even MRI and CT (the most effective and accurate research methods) cannot always provide enough data to form a complete picture.
Difficulty of the question
If a person is different from others, he attracts attention to himself - this fact is beyond doubt. Children with cerebral palsy are always an object of interest to those around them, from ordinary people to professionals. The particular complexity of the disease lies in its effect on the entire body. With cerebral palsy, the ability to control one's own body suffers, as the functionality of the central nervous system is impaired. Limbs, facial muscles do not obey the patient, and this is immediately evident. With cerebral palsy, half of all patients also have developmental delays:
- speech;
- intelligence;
- emotional background.
OftenCerebral palsy is accompanied by epilepsy, convulsions, tremors, an incorrectly formed body, disproportionate organs - the affected areas grow and develop much more slowly than he althy elements of the body. In some patients, the visual system is disturbed, in others cerebral palsy is the cause of mental, auditory, swallowing disorders. Possible inadequate muscle tone or problems with urination, defecation. The strength of manifestations is determined by the magnitude of the violation of brain functionality.
Important nuances
There are cases when patients have successfully adapted to society. They have access to a normal human life, full, filled with events, joys. Another scenario is also possible: if quite large areas of the brain were affected during cerebral palsy, this will be the reason for assigning the status of a disabled person. Such children are completely dependent on others, as they grow older, the dependence does not become weaker.
To some extent, the future of the child depends on his parents. There are some approaches, methods, technologies that allow 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 more widespread. Doctors disagree on whether this can be considered the progress of the disease. On the one hand, the root cause does not change, but the child tries to learn new skills over time, often encountering failure along the way. Having met with a child with cerebral palsy, you should not be afraid of him: the disease is notis transmitted from person to person, is not inherited, so 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 of 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;
- noticeably behind peers;
- has convulsions;
- makes strange, unusual movements for babies.
A distinctive feature of such an early age is increased cerebral compensatory capabilities, so the therapeutic course will be more effective if it is possible to make an early diagnosis. The later the disease is detected, the worse the prognosis.
Reasons and discussions
The cause of the main symptoms of cerebral palsy is a violation in the work of the brain centers. This can be provoked by a variety of injuries formed under the influence of a wide range of factors. Some appear during development in the mother's body, others at birth and shortly after. As a rule, cerebral palsy develops only in the first year of life, but no later. In most cases, dysfunction of the following brain areas is detected:
- bark;
- area under the bark;
- brain stem;
- capsules.
It is believed that cerebral palsy affects the functionality of the spinal cord, but there is no confirmation at the moment. Spinal cord injuries were found only in1% 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 slower than normal;
- improper cell division of the nervous system;
- violation of connections between neurons;
- errors in vessel formation;
- poisonous effect of indirect bilirubin, which led to tissue damage (observed with a conflict of Rh factors);
- infection;
- scars;
- new growths.
On average, in eight children out of ten patients, the cause of cerebral palsy is one of these.
Toxoplasmosis, influenza, rubella are considered especially dangerous infections.
It is known that a child with cerebral palsy can be born to a woman suffering from the following diseases:
- diabetes mellitus;
- 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.
Maternal body and fetus may have conflicting antigens, Rh factors: this leads to severe he alth problems for the child, including cerebral palsy.
There is an increased risk if a woman takes medication during pregnancy that can adversely affect the fetus. Similar dangers are associated with drinking and smoking. Finding out whatis the cause of cerebral palsy, doctors have found that more often such children are born to women if the birth was postponed before the age of majority or over forty. At the same time, it cannot be said that the listed reasons are guaranteed to provoke cerebral palsy. All of them only increase the risk of deviations, are recognized patterns that must be taken into account when planning a child and bearing a fetus.
Nothing to breathe
Hypoxia is a common cause of cerebral palsy in children. The treatment of pathology, if it is provoked precisely by a lack of oxygen, is no different from other causes. As such, there will be no recovery over time, but with early detection of signs, an adequate course of rehabilitation of the patient can begin.
Hypoxia is possible both during gestation and during childbirth. If the child's weight 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 mother's small pelvis during childbearing.
These factors negatively affect the supply of blood to the placenta, from which the cells of the embryo receive nutrients and oxygen, vital for proper development. If the blood flow is disturbed, the metabolism weakens, the embryo develops slowly, there is a possibility of low weight or growth, impairedfunctionality of various systems and organs, including the central nervous system. They talk about underweight if the 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 low birth weight;
- Low weight babies born on or before term.
On hypoxia, developmental delay speak only in relation to the last two groups. The first is considered normal. For premature, born on time and later than the term of children with a lack of mass, the risk of developing cerebral palsy is estimated to be quite high.
Child's he alth 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 (on average, three out of a hundred children born to mothers with gestational diabetes are affected);
- disturbances in the work of the heart and blood vessels (heart attack, sudden changes in pressure levels);
- infectious agent;
- physical injury;
- acute poisoning;
- stress.
One of the risk factors is multiple pregnancy. This cause of cerebral palsy in newborns has the following explanation: when carrying several embryos at once, the mother's body is faced with increased load indicators, which means that the probability of having children prematurely, with low weight is significantly higher.
Birth: not so easy
CommonThe cause of cerebral palsy in newborns is birth trauma. Despite the stereotypes that this is possible only in the event of an obstetrician's mistake, in practice, injuries are much more often explained by the characteristics of the mother's or child's body. 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, the body of a child may suffer, the harm done to it becomes the cause of various diseases. Often there are clinical manifestations of cerebral palsy in newborns for reasons:
- wrong position of the embryo in the uterus;
- placement of the head in the pelvis along the wrong axis;
- too fast or too long labor;
- use of unsuitable accessories;
- obstetrician's mistakes;
- asphyxia for various reasons.
Currently, one of the safest birth options is caesarean section, but even this approach cannot guarantee the absence of birth trauma. In particular, there is a possibility of damage to the vertebrae of the neck or chest. If a caesarean section was performed at birth, it is necessary to show the baby to an osteopath soon after birth to check the adequacy of the spinal condition.
On average, cerebral palsy occurs in two girls out of a thousand, and for boys the frequency is slightly higher - three cases per thousand babies. There is an opinion that this difference is due to the large body size of the boys, 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 foresee it, to warn. InAn impressive percentage of cases of the cause of acquired cerebral palsy, congenital, can be established 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. And yet, you should not despair: you can live with cerebral palsy, you can develop, be happy. In modern society, a rehabilitation program for such children is being actively promoted, 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 preterm infants, the incidence is approximately ten times higher than the global average. Doctors believe that cerebral palsy is the first trouble among chronic diseases that affect children. To some extent, the disease is associated with environmental degradation; neonatology is recognized as a factor, since even children whose weight is only 500 g can survive in hospital conditions. Of course, this is a real progress in science and technology, but the frequency of cerebral palsy among such children, unfortunately, is significantly higher than average, so it is important not only to learn how to nurse children weighing so little, but also to develop ways to provide them with a full, he althy life.
Features of the disease
Highlight fivetypes of cerebral palsy. The most common is spastic diplegia. 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, which primarily affects the lower limbs.
One of the forms of cerebral palsy is the defeat of 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, opposite to the cerebral hemisphere that has suffered from aggressive factors.
Up to a quarter of all cases is hyperkinetic cerebral palsy, caused by impaired activity of the subcortex of the brain. Symptoms of the disease are involuntary movements that are activated if the patient is tired or agitated.
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.
Everything is individual
The degree of severity of deviations in cerebral palsy is different, and clinical manifestations depend not only onlocalization of diseased brain areas, but also on the depth of disorders. There are cases when already in the first hours of life the he alth problems of the baby are visible, but in most cases it is possible to make a diagnosis only a few months after birth, when a developmental lag is noticeable.
You can suspect cerebral palsy if the child does not keep up with his peers in motor development. For quite 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 you try to give him a toy, the child does not try to keep it. If you put the child on its feet, it will not be able to stand on the foot completely, but will try to rise on tiptoe.
Paresis of a separate limb or one side is possible, all limbs may be affected at once. The organs responsible for speech are not sufficiently innervated, which means that pronunciation is difficult. Sometimes cerebral palsy is diagnosed with dysphagia, that is, the inability to swallow food. This is possible if the paresis is localized in the pharynx, larynx.
With significant muscle spasticity, the affected limbs can be completely immobile. 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, contractures of the joints are detected in the affected limbs, which means that the violations associated with attempts to move become even more significant. Most children with cerebral palsy suffer from fairly severe pain due toskeletal disorders. The syndrome is most pronounced in the neck, shoulders, feet, back.
Signs and symptoms
The hyperkinetic form is indicated by sudden movements that the patient cannot control. Some turn their heads, nod, grimace or twitch, assume ostentatious postures, or make strange movements.
With the atonic astatic form, the patient cannot coordinate movements, is unstable when trying to walk, often falls, cannot maintain balance while standing. Such people are more likely to suffer from tremors, and the muscles are very weak.
CP 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 can't hear well, others can't hear sounds at all. Up to half of all patients have disorders in the endocrine system, expressed by hormonal imbalance, excess weight, growth retardation. Often, with cerebral palsy, oligophrenia, retarded mental development, and a decrease in the ability to learn are revealed. Many patients present with behavioral and perceptual disturbances. Up to 35% of patients have a normal level of intelligence, and every third mental impairment is assessed as mild.
The disease is chronic, regardless of the form. When the patient becomes older, previously hidden pathological disorders gradually appear, which is perceived as false progress. Often, the deterioration of the condition is explained by secondary he alth difficulties, since with cerebral palsy are frequent:
- strokes;
- somatic diseases;
- epilepsy.
Hemorrhages are often diagnosed.
How to detect?
So far, it has not been possible to develop such tests and programs that would allow for certain to establish cerebral palsy. Some typical manifestations of the disease attract the attention of doctors, so that the disease can be detected at an early stage in life. It is possible to suggest cerebral palsy by a low score on the Apgar scale, by violations of muscle tone and motor activity, lagging behind, lack of contact with the next of kin - patients do not respond to their mother. All these manifestations are a reason for a detailed examination.
