What is the significance of early diagnosis and treatment of pediatric cerebral palsy?

  Early detection and treatment can be of great help to the future self-care of the child with cerebral palsy. If the condition is detected before the child is one year old and diagnosed for rehabilitative interventions, it will be even more helpful to their future recovery. Therefore, primary health care providers, especially parents, must learn to recognize abnormalities in children with cerebral palsy at different stages of development, and always catch subtle changes so that the condition can be diagnosed before the age of one.  If the infant has stiffness of both lower limbs when lying supine one month after birth, difficulty in passive flexion and abduction, straightening of the head and neck, retraction of the shoulders and arms, and abduction of both arms …… these are all hints for parents to pay attention to cerebral palsy. Most infants with cerebral palsy do not show signs of spasticity in the neonatal period, but rather varying degrees of hypotonia.  In addition, we can also identify cerebral palsy by the following signs: if a child makes a fist with both hands three months after birth, when the thumb is clenched in the palm of the hand, one hand can open while the other hand is clenched, and also shows difficulty in raising the head when lying prone, these can prompt attention to the existence of cerebral palsy; within 6 months after birth is the most difficult period to recognize cerebral palsy, if there are signs, you should quickly find a specialist to check; 7 or 8 months after birth still can not crawl, can not crawl, can not crawl, can not crawl, can not crawl. If a child reaches the age of 1 year, if he or she often uses one hand to carry things and shows asymmetrical voluntary movements, this is a sign of cerebral palsy.  If we look at spastic cerebral palsy, which has the highest clinical incidence, its main manifestation lies in movement disorders, mainly due to high muscle tone, so they often feel that their muscles are “stiffer” than normal when they move their limbs and have a smaller range of motion (often limited to the middle of the child’s body), such as walking in a cross-step, tiptoeing, etc. The child may walk in a cross-legged manner, tiptoeing, etc. Because of their high muscle tone, children with spastic cerebral palsy have little or no self-regulation, and joint contractures, deformities, muscle atrophy, and shortening are common, and they often exhibit quadriplegia, biparesis, and hemiparesis.  When the muscles of the limbs of children with spastic cerebral palsy are in a highly tense and tight state for a long time, the tendons are easily shortened and the joints are contracted and deformed, for example, the Achilles tendon is shortened to form a pointed foot, so when walking, the heel cannot hit the ground like a normal person, so the child can only walk on tiptoe, the knee joint is flexed and contracted, and the hip joint is also flexed and contracted and cannot be extended (the child cannot do a kick to the back). This symptom is suitable for surgical treatment.  At present, we advocate that children with spastic cerebral palsy should undergo phase I surgery (FSPR surgery) at the age of 2.5 to reduce excessive muscle tone and relieve muscle spasm, while preserving sensory function, which can significantly improve gait and joint deformity caused by muscle spasm.  Phase II cerebral palsy surgery (cerebral palsy muscle tone adjustment, CP-MMA) must be performed simultaneously or in stages with adequate relief of spasticity; otherwise, the possibility of recurrence, poor long-term outcome, and failure of surgery is inevitable. At the same time, it can make people suspicious of the efficacy of the surgery and reluctant to undergo it, making it more difficult to carry out the work.  In conclusion, because of the special nature of pediatric cerebral palsy, its rehabilitation treatment is not as simple as giving injections or taking medication, but a long-term systematic work, a comprehensive treatment system including rehabilitation training, surgery and other methods. At the same time, clinical practice proves that due to the plasticity of immature brain tissue in children, as their nervous system continues to develop, the myelination of nerve fibers continues to improve, and if early intervention is possible, the motor dysfunction and other accompanying dysfunctions caused by brain injury can be improved or even approach normal.