According to statistics, there are about 2.7 children with cerebral palsy out of every 1000 children in China. These children often have abnormal postures such as clenched fists, head tilted back, tense and stiff limbs, standing on their toes, scissor stance, etc. If they are not detected and treated early by their careless parents or quacks, they will suffer from lifelong physical disabilities. Here, we ask Professor Ma Bingxiang, who has devoted himself to the research of pediatric cerebral palsy treatment and rehabilitation for many years, to talk about – Ma Bingxiang, Department of Pediatrics, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine. When you walk into the pediatric cerebral palsy ward of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine, you will be surprised by more than 70 dolls who are doing rehabilitation training and massage on the red and green carpet: these fat and white children are actually These fat and white children are actually children with cerebral palsy who can’t sit or stand up! The best time to treat brain injury is within half a year of the child’s age, but unfortunately, most of these children have been delayed. The best time to treat a child with brain injury is within half a year of age, but unfortunately, most of these children are delayed for the following six reasons: ● They don’t believe their child is sick. According to her mother, when she was 4 or 5 months old, she couldn’t keep her head straight. Nowadays, when she is helped to stand, she always points her toes to the ground and crosses her legs, as if she were dancing in a ballet. The child’s grandmother, however, said, “Our child’s eyes are twinkling and she smiles when we tease her, what could be wrong with her? The reality was cruel, and Shan was diagnosed with cerebral palsy after examination for increased muscle tone and abnormal posture in all four limbs. Many parents are reluctant to believe that their children are sick due to lack of childcare knowledge, and when they come to the clinic, they often miss the best recovery period. Therefore, as a parent, you should know the normal child’s motor development age. For example, a 3-month-old child can hold his head upright, roll over at about 4 months, reach out and grab things at 5 months, sit upright at 6 to 7 months, and crawl at 8 months. Parents can compare their child with other children around them and have their child’s motor development evaluated regularly by a pediatrician. Misdiagnosis of cerebral palsy as “calcium deficiency” is the most common. When his grandson was a year old and could not walk, an old specialist at the local hospital said the child was “calcium deficient”. Listened to his words, has been supplementing calcium until the age of 3, still can not walk, which came to Zhengzhou to see a doctor. He professionally suggested: “We should train the doctors below, so that if a child is born prematurely or in difficult circumstances, we should tell the parents in advance that ‘there is a possibility of cerebral palsy’, and if we find something wrong, we should go to a big hospital for examination as early as possible.” Expert comments] Children with brain injury often have disorders of calcium and phosphorus metabolism, so it is very common for cerebral palsy to be combined with “calcium deficiency”. However, because primary care doctors do not know about this disease or do not do neurological examination, they only see the superficial phenomenon of “calcium deficiency” and do not consider the root cause. If a child has a simple calcium deficiency, the symptoms should be excessive sweating, easily startled, posterior occipital baldness, and rib cage exostosis, but not muscle tension, limb stiffness, and abnormal posture. ● Paralysis and fluke waiting Nan Nan was a premature twin born at two kilograms, and his brother, who weighed even less, died at that time. When he was 5 months old, he went to the hospital because of a soft neck and unstable head lift. The doctor clearly told his parents that Nanan had such high-risk factors as prematurity and low weight (under 2.5 kg at birth is considered low weight), and with the current symptoms, it could be cerebral palsy and should be treated urgently. Nan Nan’s parents, on the other hand, thought that the child was born prematurely and was weaker than other children, so they would wait and see how long it would take. By 10 months, Nan Nan still could not sit before his parents got anxious and brought him to the doctor. However, the best time for treatment had been missed. [Expert Comment] It’s a pity for this child, if treatment had started at the first visit, he might have fully recovered by this time. Even if he could recover now, it would take longer and be more difficult to treat him, and he might have sequelae. There are many cases of this kind of fluke mentality. In fact, as long as there are high-risk factors such as prematurity, low weight, jaundice, obstructed labor, and asphyxia, and there are neurodevelopmental abnormalities such as backward head tilting, inability to extend the fist, and stiffness of the limbs, brain injury can generally be judged. The child of a middle school teacher went to the hospital for unstable head lifting at the age of 4 months. The doctor took a look and said that he had severe cerebral palsy and might be disabled in the future. After returning to the hospital, the family cried and hugged each other. After two months of treatment, he recovered completely. [Expert Comment] Children within 6 months of birth show mild brain damage and some can recover on their own, so it is not easy to conclude cerebral palsy. The concept of central coordination disorder is a child with mild brain injury, which does not reach the standard of cerebral palsy, but has the possibility of developing into cerebral palsy. Therefore, it is important to diagnose cerebral palsy in several large hospitals and not to listen to the diagnosis of one doctor in one hospital, and to confirm the diagnosis only after a systematic evaluation by experts. 3-year-old Bao was diagnosed with cerebral palsy a year or two ago, and the family asked every day what good drugs and methods were available. Last year, they heard that a certain medicine was effective in treating the disease, so the family pinned all their hopes on this medicine. As a result, the family spent more than 60,000 yuan of their savings on several large boxes of medicine, but Xiao Bao’s disease did not progress. The main treatment for cerebral palsy is comprehensive rehabilitation, which generally focuses on motor rehabilitation, i.e. functional training, massage, together with acupuncture, physical therapy, medicine, language, education and other methods. In foreign countries, cerebral palsy treatment rarely uses drugs, mainly motor rehabilitation. There is no drug that can cure the disease, so never believe that there is any miracle cure. 8-month-old Haohao had been treated in a hospital for more than 3 months, but his head was still tilted back, his hands were held tightly, and his two upper limbs were stretched backward, as if he had wings. His mother casually held him during the consultation, and there was no correction or suppression of his abnormal posture. Expert’s comment】For children with cerebral palsy, the combination of medical rehabilitation, family rehabilitation and social rehabilitation should be especially emphasized. In addition to medical rehabilitation, parents should be instructed to master the knowledge of rehabilitation and correct the abnormal posture of the child in daily life, which is very necessary to promote the child’s motor development. For example, when holding a child like Hao Hao, do not hold the child face to face, but let the child face forward, with the mother’s chest against the child’s head and hold the child with both hands. This can control the child’s head back, the upper limbs back extension.
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