Infantile cerebral palsy (ICP) is not a separate pathology, but a whole group of diseases of the central nervous system that occur when the brain is damaged or anomalies in its development.
Forms of cerebral palsy
This pathology can have various manifestations, both mild and extremely severe. Depending on the manifestations, cerebral palsy was divided into separate types. The most common is the hemiparetic form of cerebral palsy. In addition to it, the following forms are also distinguished:
- spastic diplegia - manifested by complete paralysis of the limbs, occurs when the part of the nervous system responsible for the movement of the arms and legs is damaged;
- double diplegia - the most severe type of cerebral palsy, characterized by damage to the cerebral hemispheres; child unable to hold 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 damaged, characterized by unsteady gait, reduced muscle tone.
Features of the 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 the brain damage in this pathology is unilateral, the disturbance 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 the 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 paresis side;
- hyperreflexia (increased reflexes) on the same side;
- speech delay;
- delayed 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 long coursediseases, intellectual impairment and mental disorders are possible.
Double hemiplegia
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 differently expressed. In addition to motor disorders, swallowing and speech disorders are characteristic, up to its complete absence (anarthria). Seizures often occur.
Primary brain damage, lack of speech, which leads to the inability to communicate with peers and learning, eventually causing mental and intellectual disorders.
This form of cerebral palsy is often accompanied by various developmental anomalies. For example, microcephaly - small head size.
The prognosis for this severe form of cerebral palsy is extremely poor.
Diagnosis
Diagnosis is based mainly on clinical signs. However, a carefully collected 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 the correct diagnosis. A burdened family history can also occur with cerebral palsy.
If the clinical picture is erased, and the doctor is not sure of the diagnosis, it is possible to use additional laboratory methods of examination. There are studies by Russian scientists confirming the development ofspastic form of cerebral palsy metabolic disorders, including hypoxia of cells and tissues (reduced oxygen content in them), increased activity of the antioxidant system. As a result, the development of rickets, hypo- and atrophy, anemia is possible. Therefore, the control of blood biochemical parameters is important in the diagnosis of cerebral palsy and especially in its treatment to control the activity of the process.
Treatment
Characteristics and treatment of the hemiparetic form of cerebral palsy are inextricably linked, since the main therapy is aimed specifically at eliminating symptoms and making life easier for the patient. Continuity and lifelong treatment is also important for maximum effectiveness.
One of the most effective methods is massage. Since the hemiparetic form of cerebral palsy is manifested by increased muscle tone, massage helps to relieve it. Physiotherapy exercises are also widely used, which help to increase the range of motion and reduce coordination disorders, if any.
Physiotherapy is also used - electrophoresis, myostimulation. However, in the presence of seizures, this type of therapy is contraindicated.
In 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 huge efforts to combat it, this is not a sentence. Continuous remedial gymnastics, massage and physiotherapy throughout life give an excellentresult, and adults with cerebral palsy can live full lives.
