How to recognize cerebral palsy caused by neonatal jaundice?

  A significant number of children with cerebral palsy admitted to the Department of Pediatric Neurorehabilitation at Ganzhou Women’s and Children’s Hospital are affected by jaundice during the neonatal period. If left untreated, children with bilirubin bilirubinopathy are usually left with more severe sequelae of brain tissue damage, which is often referred to as cerebral palsy. Specific manifestations include developmental delay, tardive dyskinesia, eye movement disorders, hearing impairment, dental enamel hypoplasia, mental retardation, convulsions or clonus, weakness in head lifting and salivation.  Because the main lesion of cerebral palsy is in the extrapyramidal system, the tardive dyskinesia type is more common. It is characterized by involuntary movements that are difficult to be controlled by the will. The muscles of the neck are also contracted and exerted, which is extremely uncoordinated. The involuntary movements increase when nervous, decrease when quiet, and disappear after sleep. The facial muscles, tongue muscles, and articulatory organs are often involved, and are often accompanied by language impairment. The mental retardation of hand-footed cerebral palsy is not heavy. The tendon reflexes of simple hand-footed cerebral palsy are not hyperactive and do not show positive Bartholomew’s sign. There is a cogwheel increase in muscle tone. In the early stages (within 1 year of age), children with tardive dyskinesia often show hypotonia, usually lying quietly in bed with little to no voluntary movement, with the lower extremities flexed in the supine position, widely abducted, and the ankles dorsiflexed (this position is the opposite of the spastic type), and with increasing age, the muscle tone gradually becomes “rigid”. Children with tardive dyskinesia often have difficulty feeding, sucking and chewing, and often open their mouths and stretch their tongues.  At present, a lot of clinical experience has been accumulated in China on how to rehabilitate children with tardive dyskinesia. The main treatment is based on movement therapy (PT), and the specific program varies from person to person, such as destruction of the fixed abnormal posture, head lifting training and head and neck stability training, improvement of the separateness and selective movement of the two upper limbs and normal sensation of the two hands, and improvement of hand function. Improve the stability of the pelvic girdle and the two lower limbs, enhance the strength of the low back muscles, and establish the balance function, etc. At the same time, it can be supplemented with massage, medium frequency physical therapy, and Chinese herbal medicine, and if necessary, the drugs Antan and dopa can be given, and acupuncture treatment can often have unexpectedly good effects.  Therefore, it is very important to recognize and treat this type of cerebral palsy at an early stage.