There are many causes of pediatric cerebral palsy, which are summarized as follows: parental smoking, alcoholism, drug abuse, maternal mental illness, diabetes mellitus during pregnancy, vaginal bleeding, hypertensive disorders during pregnancy, placenta praevia, pre-eclampsia or taking contraceptive pills for infertility, birth control pills, high birth rate, prematurity, history of miscarriage, twin or multiple births, fetal growth retardation, intrauterine infection, intrauterine distress, placenta abruptio, placental dysfunction, long breech delivery, preterm or premature delivery, low birth weight infants, postnatal asphyxia and aspiration pneumonia, lack of birth control, preterm or premature delivery, lack of birth control, intrauterine distress, intrauterine distress. Placental abruption, placental dysfunction, cord bypass, forceps delivery, long breech delivery, preterm or term delivery, low birth weight infant, postnatal asphyxia aspiration pneumonia, hypoxic ischemic encephalopathy, nuclear jaundice, intracranial hemorrhage, infection, poisoning and malnutrition, etc. Clinical manifestations Sudden rigidity of the child: difficulty in dressing the child in certain positions, such as in the supine position, flexing his body or hugging him. Floppy: The infant’s head and neck are floppy and cannot be lifted. His limbs droop when he is held in a suspended position. The infant rarely moves. Delayed development: The infant learns to hold his head, sit, and use his hands later than children of the same age, and may use one part of his body more than another, e.g., some children use one hand more than both. Poor feeding: Poor sucking and swallowing. The tongue often pushes out milk and food. Difficulty in shutting up. Abnormal behavior: May cry, be irritable, sleep poorly, or be very quiet, sleep too much, or not laugh at 3 months. 1. Early symptoms (1) Newborn or 3-month-old infant is easily startled, cries a lot, is averse to breast milk and has difficulty sleeping. (2) Early feeding, chewing, drinking and swallowing difficulties, as well as salivation and whistling disorders. (3) Low sensory threshold, as evidenced by easy startling to noise or position change, increased cuddle reflex with crying. (4) In normal infants shortly after birth, due to the influence of the stepping reflex, when standing upright, the two feet can be seen interacting with each other in stepping movements. 3 months of age, although it can subside, but by 3 months of age, there is still no indication of standing or stepping, both to suspect pediatric cerebral palsy. (5) Infants who have passed “100 days” are still unable to lift their heads, and their heads are still wobbly when they stand up in April and May. (6) Fist clenching: Generally, infants can clench their fist without opening it within 3 months after birth. If the thumb is still inward and the hand does not open at 4 months, pediatric cerebral palsy should be suspected. (7) Normal infants should be able to reach out and grasp objects when they see them at 3–5 months, if they cannot do so after 5 months, they are suspected of having pediatric cerebral palsy. (8) Generally, the baby will smile 4-6 weeks after birth and recognize people later. Children with spastic type of cerebral palsy have indifferent expressions, and those with tardive dyskinesia often have a sad face. (9) The muscles are flaccid and cannot be turned over, and the movement is sluggish. When touching the inner thighs of the child, or letting the child’s feet on the bed or bouncing up and down, the lower limbs appear to be stretched and crossed. (10) Stiffness, especially when dressing, the upper limbs are difficult to put into the cuffs; when changing diapers and washing, the thighs are not easily abducted; when wiping the palms of the hands, and when bathing, stiffness of the limbs appears. Infants do not like bathing. (11) Premature development: Infants with pediatric cerebral palsy may have premature rolling over, but a sudden reflex rolling over, with the whole body rolling over like a rolling log, rather than conscious segmental rolling over. In infants with spastic diplegia, both lower limbs may appear to be stiff before sitting still, standing on the toes like a ballerina. 2. Main symptoms (1) Poor motor self-control, or in severe cases, hands will not grasp things, feet will not walk, some will not even roll over, sit up, stand, chew and swallow normally. (2) Postural disorders various postural abnormalities, postural stability is poor, 3 months still can not head straight, used to favor the side, or left and right back and forth sway. The child does not like to take a bath, and it is not easy to break the fist when washing hands. (3) Mental retardation accounts for about 1/4 of the children with normal intelligence, about 1/2 of those with mild or moderate intelligence deficiency, and about 1/4 of those with severe intelligence deficiency. (4) Language disorder has difficulty expressing language, slurred pronunciation or stuttering. (5) Visual and auditory disorders are most common with internal strabismus and difficulty in discriminating the rhythm of sound. (6) Growth disorders of dwarfism. (7) Dental development disorders are lax and easily fractured. Oral and facial dysfunction, sometimes spasm or uncoordinated contraction of facial and tongue muscles, difficulty in chewing and swallowing, difficulty in closing the mouth and drooling. (8) Emotional and behavioral disorders are stubborn, capricious, irritable, withdrawn, with high mood swings and sometimes compulsive, self-injurious, and aggressive behavior. (9) Thirty-nine to 50% of children with cerebral palsy have epilepsy induced by fixed lesions in the brain, especially in children with severe mental retardation. III. Diagnosis The manifestations of cerebral palsy are various depending on the etiology and typology, but are mostly seen in the early stages: Early symptoms in infants with cerebral palsy (within 6 months of age) 1. Body tenderness and reduced spontaneous movements This is a symptom of hypotonia and can be seen at one month. If it persists for more than 4 months, it can be diagnosed as severe brain injury, mental retardation or muscular system disorders. This is a symptom of hypertonia and can be seen at one month. If it persists for more than 4 months, it can be diagnosed as cerebral palsy. 3. unresponsiveness and unresponsiveness to name calling This is an early manifestation of mental retardation and is generally considered to be diagnosed as mental retardation at 4 months of age and unresponsiveness to name calling at 6 months of age. 4, abnormal head circumference Head circumference is an objective indicator of the morphological development of the brain, and children with brain injury often have abnormal head circumference. 5, poor weight gain, nursing weakness. 6.Fixed posture Often due to abnormal muscle tone caused by brain injury, such as coracocephaly, frog position, inverted U-shaped posture, etc.. It can be seen in the first month after birth. 7, not smiling If you can’t smile at 2 months and laugh out loud at 4 months, you can be diagnosed with mental retardation. 8.Hand clenched fist If 4 months still can not open, or thumb inward, especially the presence of one side of the upper limb, there is important diagnostic significance. 9.Body torsion 3 – 4 months old infants with body torsion often suggest extra-pituitary damage. 10, head instability Such as 4 months prone can not lift the head or sitting position when the head can not be upright, is often an important sign of brain injury. 11, strabismus 3 – 4 months of age infants with strabismus and poor eye movement, can indicate the presence of brain injury. 12.Inability to reach out and grasp objects If the infant cannot reach out and grasp objects at 4–5 months, it can be diagnosed as mental retardation or cerebral palsy. 13.Gaze at hand If it still exists after 6 months, it can be considered as mental retardation. Some brain injuries are mild and often have no obvious symptoms in early infancy, but in the second half of infancy (6–12 months). 4, differential diagnosis 1, progressive crestal myasthenia This disease starts in infancy, most of the symptoms appear after 3 – 6 months, a few patients have abnormalities after birth, manifested as symmetrical weakness of the upper and lower limbs, muscle weakness is progressively aggravated, muscle atrophy is obvious, tendon reflexes are reduced or disappeared, often due to whistling muscle insufficiency and repeatedly suffer from whistling tract The child’s cry is low, the cough is weak, muscle biopsy can help confirm the diagnosis, the disease is not combined with mental retardation, facial expressions are sensitive, flexible eye movements. Some children’s motor development is slightly more delayed than normal children of the same age, especially premature children. However, they do not have abnormal muscle tone and postural reflexes, abnormal movement patterns, or other abnormal neurological reflexes. The symptoms of motor development lag can disappear within a short period of time as the child grows older and focuses on motor training. 3, congenital muscle flaccid children are born with obvious hypotonia, muscle weakness, low or absent deep tendon reflexes. It is often complicated by whistling tract infections. This disease is sometimes misdiagnosed as hypotonic cerebral palsy, but the latter tendon reflexes can usually be elicited. 4.Low intelligence This disease often has backward motor development, uncoordinated movements, abnormal primitive reflexes, vojta postural reflexes, corrective responses and balance responses, and is easily misdiagnosed as cerebral palsy in early infancy, but its symptoms of mental retardation are more prominent. V. Treatment 1. Comprehensive rehabilitation medical treatment such as motor (sports) therapy, including gross motor, fine motor, balance and coordination training; such as crawling, purposeful pointing (nose, ears, etc.), training to grasp objects, hold objects, sitting up, swaying, holding (back against the wall, facing the wall), in-situ movement (bending over to pick up objects, foot lift training, one-legged independence, jumping in-situ), walking and running; and then physical therapy, including neurological Electrical stimulation therapy, heat therapy, water therapy; there is also occupational therapy, that is, ability training, but the efficacy is general. Modern medical treatment methods are as follows: ① surgery; ② orthopedic devices; ③ water, electricity, light and sound therapy; ④ language and communication therapy; ⑤ treatment of motor function; ⑥ ADL training. 2.Pharmacological therapy Oral or injection of relevant drugs: cerebral neurotrophic drugs, muscle relaxants, blood-activating drugs, etc. Including drugs for constructing and repairing brain tissues (cells), such as lecithin (containing phosphatidylcholine, ceruloplasmin, sphingomyelin, etc.), which can repair brain cell membrane damage caused by trauma, hemorrhage, and hypoxia, protect nerve cells, accelerate neural excitation conduction, and improve learning and memory functions. You can also choose drugs that can promote brain cell DNA synthesis, promote the utilization of oxygen by brain cells, improve brain cell energy metabolism, enhance brain function, supply various amino acids needed for brain tissue repair and regeneration, and regulate brain nerve activity, such as Gullichi (brain enzyme hydrolysis tablets) and spirulina tablets (capsules). Then there is active supplementation of multivitamins, such as 21-golden vitamin. The conditioned hospital’s can alternatively choose the following injectable injections (the same effect as the tablets): brain activator, brain polypeptide, acetyl glutamine, cytidyl phosphorylcholine, etc. 3.Chinese medical treatment includes acupuncture therapy (caution for cerebral palsy with high muscle tone), massage therapy and Chinese herbal medicine. 4.Pediatric cerebral palsy movement therapy Movement therapy for children with cerebral palsy: Movement therapy is based on kinesiology and neurophysiology, using apparatus or the therapist’s unarmed hand technique or using the child’s own strength to restore and treat the whole body and local functions through active and passive movements. (1) Common goals of motor therapy for children with cerebral palsy. (1) Use normal way of movement as much as possible. ②Use both sides of the body. (3) Maintain an extended position while lying, sitting, kneeling and standing. ④Movements and activities related to daily living. ⑤Prevent deformities. (2) Training goals for each type of children with cerebral palsy. ①Spastic type relaxes the stiff muscles, avoids movement in spastic position and prevents deformity. (②Hand and foot tardive type use hand grasping action training to stabilize involuntary movements, and if the abnormal body position is variable, do as the goal of spastic type. ③Ataxia type improve balance in kneeling, standing and walking positions, stand and walk stably, and control unstable shaking, especially in hands.