I. What is cerebral palsy
Pediatric cerebral palsy, referred to as cerebral palsy, is a syndrome caused by non-progressive brain injury from before birth to one month after birth. The main manifestations are central motor deficits and postural abnormalities. It may be accompanied by mental retardation, epilepsy, hearing impairment, visual impairment, and speech impairment. Cerebral palsy is not equal to mental retardation (stupidity), and a significant number of children with cerebral palsy have normal intelligence.
Causes and risk factors of cerebral palsy
There are many risk factors that can trigger cerebral palsy.
The common ones are: prematurity, low birth weight (physical examination below 2500g. It is reported that the risk of cerebral palsy in low weight babies is 40~100 times higher than normal babies), obstructed labor, birth injury, giant babies, double or multiple brachium, abnormal umbilical cord, umbilical cord wrapping around the neck, overgrowth, postnatal asphyxia, mother with preterm abortion, high age of first birth (>35y), gestational hypertension, intrauterine infection, neonatal sepsis, chemobrain, pneumonia, otitis media, delayed resolution of jaundice, etc.
Incidence of cerebral palsy
With the development of perinatal medicine and neonatal intensive care technology, the mortality rate of neonates has been gradually decreasing, but the incidence of cerebral palsy has been increasing among the surviving neonates.
What are the manifestations of cerebral palsy?
(a) Lagging motor development and reduced active movement.
At 3 months of age, normal infants can lift their heads in prone position and leave the bed with their elbows supporting their chests; at 4-5 months of age, they can actively reach for objects with flat support; at 6-7 months of age, they can sit alone; at 8-10 months of age, they can crawl; at 1 year of age, they can stand alone; at 1-1.5 years of age, they can walk alone; children with cerebral palsy cannot reach this level.
(b) Abnormal muscle tone: the child has increased muscle tone, instability or low tone.
(iii)Postural abnormalities: head back, hand clenched fist, thumb inward, pointed foot, double upper limbs internally rotated back, scissor step, etc.
(iv) Reflex abnormalities: including two parts of the content. One is the persistence of the firing that should be lost at a certain age and the reflexes that should appear do not appear; the second is some pathological reflexes (+), and these can only be known through examination at the hospital.
As long as the above four clinical manifestations are present, cerebral palsy can basically be diagnosed.
However, it is a little late for parents and friends to see if there is something wrong with their child before they seek medical attention.
Here I tell parents and friends the five early symptoms of cerebral palsy.
1. Abnormal posture such as head back and body jerking;
2. Abnormal crying, not related to normal physiological needs;
3.Less movement (reduced spontaneous movement);
4. Easy to be frightened;
5. Difficulty in breastfeeding.
Children with the above symptoms and risk factors should be considered to have early cerebral palsy. If you do not have the above symptoms, but have the above high-risk factors, you should also go to the hospital for regular review, usually once a month, and follow up for at least six months.
The relationship between imaging and clinical: From the practice of imaging, it is found that the clinical manifestations of most cases are consistent with imaging, but it is also found that a few cases do have signs of cerebral palsy, but the CT and MRI tests are normal. Therefore, do not think that if the CT and MRI tests are normal, it is not cerebral palsy, and delay the early treatment of cerebral palsy.
V. The significance of early diagnosis and treatment
Early diagnosis generally refers to the diagnosis within 6~9 months after birth. Among them, within 3 months is also called ultra-early diagnosis. Ultra-early diagnosis we generally call as central coordination disorder, which is actually brain injury in early diagnosis. The implication of early diagnosis is that it allows the child to be treated early. In the past, cerebral palsy was thought to be an incurable disease, but in recent years, scholars from various countries have shown that if early diagnosis and early treatment are made, it can be cured or normalized except for very severe cases. The reason why early treatment is effective is that brain tissue is not yet mature in early infancy (0-6 months) and is still in the stage of rapid growth and development, while brain injury is also in the primary stage and abnormal posture and movement have not yet been immobilized. Therefore, the plasticity of the brain is high in this period.