Early treatment of children at risk for cerebral palsy

  Many parents are afraid to talk about cerebral palsy, thinking that cerebral palsy is “stupid” and incurable, so they suffer and give up treatment, or even abandon their children. In fact, this is not the case. So what is cerebral palsy and can it be cured?  Cerebral palsy is a syndrome of non-progressive brain damage caused by any cause in a child from before birth to 1 month after birth. It is characterized by central motor deficits and postural abnormalities. It is often accompanied by intellectual, speech, visual, and auditory impairments, behavioral abnormalities, and epilepsy.  The movement disorders can be divided into spastic, tardive, tonic, ataxic, tremor, hypotonic, mixed, and unclassifiable types. The prevalence of cerebral palsy among children aged 0-6 years in China is 1.2‰ to 2.7‰, with an average of 1.92‰ and about 310,000 people, and is increasing at a rate of 46,000 people per year.  The main risk factors for cerebral palsy are: (1) Prenatal factors: intrauterine giant cells, rubella virus, toxoplasma infection, poisoning (heavy metals, carbon monoxide, benzene, alcohol, smoking), chromosomal abnormalities, exposure to radiation, drugs (hormones, anti-cancer drugs), maternal placenta praevia, pre-eclampsia, anemia, malnutrition, heart and kidney disease, gestational toxicity, hyperemesis, multiple births, multiple interfetal blood transfusions, etc.  (2) Intrapartum factors: neonatal asphyxia, intracranial hemorrhage, hypoxic-ischemic encephalopathy, cord bypass, emergency delivery, preterm delivery, overdue delivery, low birth weight, giant baby, nuclear jaundice, neonatal hypoglycemia, infection during delivery (meningitis), labor difficulties, delay, amniotic fluid abnormalities.  (3) Postpartum factors: central nervous system infection (encephalitis, meningitis), traumatic brain injury, toxicity and cardiopulmonary dysfunction, nutritional disorders, tetanus, etc. The most common domestic high-risk factors: prematurity, asphyxia, nuclear jaundice.  Cerebral palsy treatment advocates early diagnosis and early treatment.  Early diagnosis of cerebral palsy generally refers to the diagnosis between 0-6 months after birth, among which the diagnosis between 0-3 months is also called super early diagnosis. Early diagnosis actually opens up a new way for early treatment of cerebral palsy, which is to start treatment at the early stage of the disease, before the abnormal posture and movement are fixed, which has the potential to change It is possible to turn an incurable disease into a treatable one.  In recent years, scholars from various countries have shown that if early diagnosis and early treatment can be made, all but the most severe cases can be cured or normalized. The reason why early treatment is so effective is that brain tissue in the early infancy (0-6 months), especially in the neonatal period, is not yet mature, and is still in the stage of rapid growth and development, while brain injury is also in the early stage, abnormal posture and movement has not yet been fixed, so this period of brain plasticity, high compensatory capacity, strong recovery ability, timely treatment in this period, the best therapeutic effect can be obtained Therefore, timely treatment during this period can lead to the best treatment effect.  Therefore, early treatment of children with high risk factors for cerebral palsy, especially those born prematurely, asphyxia, and nuclear jaundice, is of great significance, as it not only provides the best treatment effect, but also screens out extremely serious children through early treatment, thus minimizing the disability rate, and the earlier the treatment, the less the cost.  Some parents mistakenly believe that if the CT, MRI or EEG is normal, the child will be fine, but this is not true. CT, MRI and EEG do not play a major role in the diagnosis of cerebral palsy, but CT and MRI can help to understand whether there are any abnormalities in the cranial structures, which may be helpful in exploring the cause of cerebral palsy and determining the prognosis, but they cannot confirm or deny the diagnosis.  EEG can understand whether there is a combination of epilepsy and has reference value in guiding treatment. This means that if there is no problem with CT or MRI does not mean that the child does not have cerebral palsy or brain injury, it must be combined with the child’s symptoms.