Cerebral palsy is caused by a variety of perinatal etiologies, and the most common causes are birth injuries, hypoxic asphyxia, and intracranial hematoma, among others, as a result of damaging lesions of the upper motor neurons of the central nervous system that develop during infancy. As a result of these etiologies (as shown in Table 4-2), metabolic disorders and damage to the nervous system occur, followed by extensive neuronal degeneration and necrosis, slowing or even stopping the development of the central nervous system, resulting in the gradual development of the corresponding clinical symptoms as the child ages. Table 4-2 Causes of cerebral palsy 1. Clinical manifestations Most of the symptoms begin in infancy, and the clinical symptoms vary depending on the location and degree of brain damage. In the case of damage to the pyramidal system, spastic paralysis occurs, with the lower extremities being more severe than the upper extremities; in the case of damage to the extrapyramidal system and basal ganglia, there may be various involuntary movements, such as tremor, chorea, tardive dyskinesia, and abnormal muscle tension; in the case of damage to the cerebellar system, ataxia and dysarthria, and nystagmus are manifested; in the case of extensive cerebral hemispheric lesions, there are often language, intelligence, visual and hearing impairments, and there may also be physical There may also be physical impairment or seizures. A small number of children often have involuntary crying and laughing, jaw reflex hyperactivity, supranuclear ophthalmoplegia, and central facial palsy. Children usually start to talk later than normal children 6-12 months later, and start to walk later. Foreign statistics show that 65% of patients have an IQ of about 70, and only 45% of patients have an IQ of 90. 2. Auxiliary examinations The histopathological changes in the brain of children with cerebral palsy are mainly based on the cause. According to research, acute and chronic ischemia and hypoxia are most likely to cause damage to the fetal nervous system, resulting in lesions in the cerebral cortex, thalamus, basal ganglia, brainstem, cerebellum, etc. In severe cases, extensive bilateral pathological changes may occur. Through CT or MRI examinations, it is easy to find brain tissue with brain atrophy changes incompatible with the age of the affected child. In addition, the IQ of school-age children with the disease can be measured by the WAIS scale. Treatment and prognosis The treatment of cerebral palsy can be divided into non-surgical treatment and surgical orthopedic surgery. Non-surgical treatment: For children with cerebral palsy, it is best to start with physical therapy, traditional Chinese massage and massage at the age of about 2 years old to gradually reduce the muscle contracture and facilitate toddling. For those with extrapyramidal symptoms, the main goal is to exercise their functions through systematic educational training, and at the same time, according to the type of involuntary movements, different drugs are selected for treatment, such as haloperidol, Antan, clonidine, and Tebretol. In case of seizures, antiepileptic drugs such as sodium phenytoin, phenobarbital, sodium valproate, and carbamazepine are selected for symptomatic treatment. For children with mental retardation, they are trained in a stepwise manner mainly according to the intellectual rehabilitation training program. For hypertonia, it can be addressed with Myona or baclofen. Surgical treatment: The most common surgical treatment for cerebral palsy is aimed at loosening muscle contractures and preventing deformities from occurring. Depending on the type of deformity, different surgical procedures can be chosen, such as horseshoe foot with calf tendon lengthening; horseshoe exostosis can be corrected by filling a bone piece at the lateral talus-heel joint and lengthening the Achilles tendon at the same time (Grice procedure); hip deformity can be solved by releasing the hip joint adductor and flexor muscles; crestal scoliosis can be corrected by brace fixation, etc. After plastic surgery, the deformity of the child can be improved to varying degrees. The prognosis of cerebral palsy is generally good, except for abnormal limb function and low intelligence, children can survive for a long time.