Reasons
Brain damage can occur at different stages, and in many cases the exact cause cannot be determined. The common belief that cerebral palsy is always the result of an error in childbirth is incorrect: most cases are associated with events during pregnancy.
- Extreme prematurity and low birth weight are the most important risk factors
- Intrauterine hypoxia and disturbance of placental blood flow
- Intrauterine infections
- Severe asphyxia during childbirth
- Cerebral hemorrhages in a newborn, severe jaundice with brain damage
- Neuroinfections and injuries in the first months of life
Forms
- Spastic forms are the most common: increased muscle tone, restricted movements. This includes spastic diplegia (legs suffer more), hemiplegia (one side of the body), tetraplegia (all limbs)
- Dyskinetic form - involuntary movements, changing tone, difficulty maintaining a pose
- Ataxic form - impaired balance and coordination, trembling during purposeful movements
- Mixed forms - a combination of characteristics
ДЦП не означает автоматически нарушения интеллекта. Многие дети с сохранным интеллектом имеют выраженные двигательные нарушения, и наоборот. Оценивать умственное развитие «по походке» — грубая ошибка.
Early signs
The diagnosis is usually confirmed by 1–2 years, but warning signs are noticeable earlier. What is more important is not a single symptom, but a persistent lag in motor skills and asymmetry.
- Задержка моторного развития: не держит голову, не переворачивается, не сидит и не ходит в ожидаемые сроки.
- Нарушения тонуса: ребёнок либо чрезмерно напряжён, либо необычно вялый.
- Асимметрия: одна рука или нога отстаёт, ребёнок явно предпочитает одну сторону до года.
- Сохранение врождённых рефлексов дольше положенного срока.
- Трудности с сосанием и глотанием, частые поперхивания.
- Ходьба на носках, перекрест ног при вертикализации.
Treatment and rehabilitation
It is impossible to cure cerebral palsy in the sense of restoring the damaged brain. But it is possible and necessary to develop the functions available to the child, prevent secondary deformations and increase independence. The basis is regular, continuous work, and not “every six months” courses.
- Therapeutic physical education and special methods of motor rehabilitation - daily, including at home with parents
- Orthoses, splints, verticalizers and other technical means for the correct position of the limbs
- Botulinum therapy to reduce local spasticity before exercise
- Orthopedic correction and, if necessary, surgery - especially to prevent hip dislocation
- Classes with a speech therapist for speech and swallowing disorders
- Physiotherapy, massage, hydrokinesitherapy as auxiliary methods
- Working with a psychologist and family support
Родителям стоит с осторожностью относиться к дорогим методикам, обещающим «поставить на ноги» за один курс, и к препаратам с недоказанной эффективностью. Устойчивый результат даёт ежедневная работа и правильно подобранные технические средства.
What to pay attention to as you age
- Regular X-ray monitoring of the hip joints - dislocation develops unnoticed
- Track scoliosis and contractures as you grow
- Nutrition and Weight: Difficulty Swallowing Leads to Malnutrition
- Seizures - occur in some children and require separate treatment
- Vision and hearing - impairments often accompany and interfere with development
- Socialization and training: selection of an educational route according to the child’s capabilities