the initial residual, when it was formed, but have not yet registered pathologically motor and verbal stereotypes
late residual, when formed on the basis of spasticity and rigidity in the joints of pathological settings pathological stereotypes are fixed.
The clinical picture of early CP is composed of cerebral symptoms (ischemic, hypertensive convulsions), pathology unconditioned areas, pathology of muscle tone type spastichnsosti, rigidity or hypotonia.
Feature of the clinical manifestations of this stage is a mosaic. A child can not keep his head still in 8-10 months. And was starting to turn around, sit down. The patient has no support reaction, but the child is already stretched to the toy, captures her in 7-9 months. sits only with support, but it's worth and walks into the arena, although the plant body is defective. If you double hemiplegia child immobilized the question. With the defeat of spastic diplegia of the lower limbs significantly expressed.
Hyperkinesis first appear in the muscles of the tongue and lips, in the future, after 10-12 months. Shall apply to the muscles of the arms and neck, then all the muscles of the body. In the atonic-astatic form of reduced muscle tone, but pronatarah upper extremities and hip flexors increased tone. In all forms of the disease may be impaired speech, phonemic hearing and vision. By 3-5 years earlier and can be detected violations optical-spatial memory. In 50-60% have mental retardation, but the primary intelligence saved. In 20-25% of children diagnosed with cerebral palsy mental retardation.
Treatment of Child cerebral palsy
At an early stage therapeutic interventions should be aimed at addressing the effects of peri-and intra-cerebral lesions: edema, stroke, asphyxia, mechanical destruction of brain tissue. In identifying the viral and bacterial infections should be anti-inflammatory therapy. If there is evidence of the possibility of autoimmune inflammation to assign immunomodulators generalists (deksametozon, timalin). Drug therapy in this period include ascorbic acid, glycine, vitamin. Group B.
Already in the early stages of the disease is prescribed massage to relax spastic muscles and then go to physical therapy. Necessary to carry out activities with a speech therapist to restore the voice, as well as begin work on developing a guideline, visual, auditory and cognitive reactions. The characteristic clinical features of the second stage includes not only the beginning of registration of contractures in the joints of the extremities, increased muscle tone of pathology, but also increase the influence of the muscles of the body tonic reflexes. In children with hyperkinetic and atonic-astoticheskoy forimoy cerebral palsy in the initial residual stage is clearly revealed hyperkinesis, ataxia, gipermetriya, dismetriya. Children with cerebral palsy is a form of gemipareticheskoy distinct shortening of the paretic limbs, especially hands, noticeably decrease in the heel and whole foot paretic leg. Formed kyphosis in the lumbar spine is poorly developed or absent lordosis.
Medical treatment is carried out as well as in the early stages of the disease: lidazy, nootropics, drugs promote myelination of nerve fibers, which developed convulsions use conventional anticonvulsant therapy. It is also prescribed physical therapy and speech therapy sessions. Late residual stage of cerebral palsy is characterized in that already firmly formed abnormal motor and verbal stereotypes took shape hyperkinesis, determine the intensity of ataxia, contractures were formed in the joints. Already formed especially intelligence and mental development, mental retardation may be, but most often it is a normal mental development.
Most effective at this stage of sanatorium treatment: mud applications, hydrogen sulfide baths in combination with plasters.
Child cerebral palsy - a disease with a lesion polietiologicheskoe predominantly central nervous system.
The etiology of cerebral palsy
The most common causes of cerebral palsy are:
neuroinfection
effects of acute and chronic maternal
intoxication
environmental hazards, etc.
However, the focus is on CNS - microbial, viral, damaging brain tissue and its blood vessels. This leads to fetal deficiency of oxygen, delayed the development of neurons and their connections, because of which the normal course of birth does not occur, there is a mechanical birth trauma, stroke, asphyxia at birth. Over the past year prevalence Neuroinfections increased, especially virus - such as influenza, herpes, chlamydia, etc. Along with viral encephalitis and bacterial nature as a consequence of their products as a result of the destruction of nerve cells - brain antigens - is beginning to form non-specific autoimmune inflammation.
The pathogenesis of Child cerebral palsy
Depending on the time of affecting the fetus or newborn, the nature and severity of the brain is formed or that the clinical picture, characterized primarily by various types of motor disorders, speech disorders and cognitive activity.
When cerebral palsy occurs syndrome depending on the tone of the skeletal muscles of the body, lying in the muscle tone in varying degrees, close to normal, but as soon as the patient takes a vertical position, muscle tone or spasticity, acquires the characteristics of rigidity.
Besides, if cerebral palsy is observed pronounced dependence syndrome of muscle tone on the activity of unsuccessful timely tonic reflexes neonatal period. Tetraparesis characterized paresis of the arm muscles in relation to Neuroinfections and to a lesser degree paresis of lower limb muscles.
Motion in the upper extremities, although defective, allow the patient to write, take care of themselves, but the sick do not go, or enjoy some support. It is essential to increasing the activity of the pathological features of stem structures that are not regressing as in healthy children, and slowly progressive over the years, the activity of pathological (in the age aspect) of tonic reflexes. It is this fact leads to many of the complex mechanisms of the pathogenesis of motor disturbances characteristic of cerebral palsy
