Cerebral palsy is a syndrome resulting from non-progressive brain injury and developmental defects from conception to infancy, mainly manifesting as motor deficits and postural abnormalities.
Etiology.
High-risk factors for cerebral palsy occur mainly in newborns with one or more factors such as hypoxic-ischemic encephalopathy, prematurity, hyperbilirubinemia, and intracranial hemorrhage, some of which may develop into cerebral palsy. There are many causes of cerebral palsy, but the cause may not be found in more than 1/3 of cases. Sometimes multiple factors may also be present in some cases.
Prenatal factors are most common and include genetic and chromosomal disorders, congenital infections, malformations or hypoplasia of brain development, and fetal brain ischemia and hypoxia resulting in periventricular white matter softening or damage to the basal ganglia. Perinatal factors refer to brain injury that occurs between the beginning of labor and one week after birth, including cerebral edema, neonatal shock, intracerebral hemorrhage, sepsis or central nervous system infection, and ischemic-hypoxic encephalopathy. Perinatal factors may be an important cause of cerebral palsy in preterm infants. Late postneonatal factors include various causes of non-progressive brain injury such as central nervous system infections, cerebrovascular disease, cranial trauma, and poisoning that occur between 1 week and 3 or 4 years of age.
Although prematurity and intrauterine growth retardation are not direct causes of cerebral palsy, they are important high-risk factors for cerebral palsy. Intrauterine inflammation of the mother or chorioamnionitis, has received increasing attention as a potential risk factor.
Clinical presentation
1. Clinical typing
(1) The spastic type is dominated by damage to the cone system.
(2) The involuntary movement type is dominated by damage to the extrapyramidal system, with increased involuntary movements. The manifestation is tardive movement, dance-like movement, dystonia, tremor, etc.
(3) Tonicity is mainly due to damage to the extrapyramidal system, with a cogwheel or leadpipe pattern of increased muscle tone.
(4) The ataxia type is dominated by cerebellar damage.
(5) Hypotonia type.
(6) Mixed type: The same child has two or more types of symptoms.
2.Types according to the site of paralysis
(1) Monoplegia with single limb involvement.
(2) Diplegia with involvement of all four limbs, with light upper limbs and heavy lower limbs.
(3) Triple limb palsy with three limbs involved.
(4) Hemiplegia with hemiplegic limb involvement.
(5) Quadriplegia with involvement of all four limbs, with similar involvement of the upper and lower limbs.
Diagnosis
1. The brain injury causing cerebral palsy is non-progressive.
2.The site of the lesion causing the motor disorder is in the brain.
3. The symptoms appear in infancy.
4.Mental retardation, epilepsy, perceptual disorders, communication disorders, behavioral abnormalities and other abnormalities may be combined.
5.Except for central motor disorders caused by progressive diseases and temporary motor retardation in normal children.
Treatment
Early screening, diagnosis and intervention for children at risk of cerebral palsy are the main preventive measures to reduce the disability and improve the quality of survival of the children. For example, play is an infant’s instinct, a form of life movement, and can be trained by using toys, common household items or homemade toys, creating a colorful external environment and stimulating with food, toys and household activities. Toys and household activities, etc. stimulate. Let the child feel the colorful external environment, so that the child becomes agile and adaptable.