Since cerebral palsy is caused by damage to the brain during development, early symptoms may appear during the neonatal period and early infancy (1-6 months), and there are various early symptoms depending on the cause and severity of the damage. The main manifestations are.
1, easy to provoke, no reason to continue to cry, can not be good at nursing; or excessive quiet, weak cry, weak nursing, swallowing difficulties, easy to vomit, poor weight gain.
2.Low muscle tone, reduced spontaneous movement, abnormal posture.
3.Crying and excitement when the body is hard, good jerking, stiff and uncoordinated movements.
4. Slow reaction, no recognition, no laughing, no eye contact and no chasing.
5.Great motor development is obviously lagging behind, can’t lift the head, can’t roll over, can’t sit, can’t grasp the hands with fists.
6. Frequent spastic seizures, which is a red flag and generally has a poor prognosis.
Regardless of any of the above early manifestations, the value alone is small, but the compound presence, that is, the presence of a combination of various manifestations is of great significance. In addition, some milder conditions often have no obvious symptoms in early infancy, but in the second half of infancy (between 6-12 months) there are some symptoms that can also be seen as early manifestations, such as: both lower limbs will not support jumping, both hands will not grasp against the palm, will not grasp standing, will not say goodbye to people and other manifestations.
Main disorders
1, central motor disorders: manifested as backward motor development, such as the child lifting, turning over, sitting, crawling, kneeling, standing, walking and other trunk and limb motor development is backward or stagnant. Difficulty in active movement, inadequate separation movement, stiffness, uncoordinated and asymmetrical movements, various abnormal movement patterns, joint reactions and involuntary movements, ataxia, and slow movement, etc.
2. Postural abnormalities: Due to the presence of abnormal muscle tone, the persistence of primitive reflexes, the appearance of pathological reflexes and the absence of complex motor responses in children with cerebral palsy, the child is unable to complete normal activities, for example, the child’s head and limbs cannot be kept in midline position, the limbs are spastic, presenting coracobrachialis and unable to maintain postural balance.
Combined disorders and secondary disorders
In addition to motor disorders and postural abnormalities, children with cerebral palsy also have one or several other disorders to varying degrees.
1. Mental retardation: About 75% of the children have varying degrees of mental retardation, and a smaller percentage of children with tardive dyskinesia have mental retardation.
2, language disorders: about 30%-70% of children have different degrees of language disorders, and often chewing, swallowing difficulties as a precursor, the manifestation of the form of language development delay and motor dysarthria, so that the child pronunciation, expression difficulties, individual children completely aphasic. The degree of language impairment is generally proportional to the degree of motor dysfunction and the level of intelligence.
Seizures: The literature reports that about 15%-75% of the seizures can occur at different ages, but the general tardive dyskinesia and ataxia are rare.
4. Visual impairment: about 50-60% have different visual impairment. The most common are internal strabismus and amblyopia, a few may have optic nerve atrophy, congenital cataract, nystagmus, hemianopia and total blindness, etc.
5, hearing impairment: about 5-8%, with nuclear jaundice caused by the hands and feet of the more common type of children, a few children combined with congenital deafness.
6.Sensory dysfunction: about 10% of the children may be accompanied by loss of tactile sensation or loss of solid sensation, loss of position sense and other superficial sensory impairment.
7. Cognitive impairment: Children with the disease are often unable to correctly recognize simple geometric figures, cannot distinguish the relationship between the image of an object and its spatial background, cannot recognize various colors, have poor memory and judgment, and other higher brain neurological dysfunctions.
8. Oral and dental dysfunctions: the child has weak sucking, chewing and swallowing difficulties, poor lip closure, poor breathing control, frequent salivation, dental hypoplasia, dental caries, periodontitis, etc.
9. Emotional and behavioral disorders: Due to the impaired brain function and motor and interaction difficulties, most children have emotional abnormalities, such as crying, capriciousness, excitability, emotional instability, strong personality and stubbornness. In addition, it is often accompanied by excitement, hyperactivity, inattention, compulsive actions and self-isolation behavior.
10, secondary disorders: mainly contracture deformation of joints, such as the most common Achilles tendon contracture, can appear pointed foot and foot inversion deformation, shoulder joint, hip joint dislocation, osteoporotic fracture, deformation cervical spondylosis, cervical instability, scoliosis, etc.. The secondary disorders are often seen in older children with cerebral palsy or children with severe cerebral palsy.