What is encephalopathy: symptoms in newborns and children under one year of age, treatment methods and prognosis for recovery. What does the diagnosis of perinatal encephalopathy mean in a child?

Encephalopathy is a non-inflammatory disease of the brain in which its tissue changes, resulting in disruption of its basic functions. The pathology can be congenital or acquired.

Congenital perinatal encephalopathy in children suggests that they have various pathologies nervous system that arose during their intrauterine development, during childbirth or immediately after birth. The diagnosis is very serious, requiring medical intervention, a sufficiently long course of treatment and vigilant attention from parents.

Since a child acquires perinatal encephalopathy at the very beginning of his life, attentive parents may notice some deviations from the first days of his life. Over time, they will intensify, grow and will distinguish the sick baby from other, healthy babies. The disease covers a fairly wide range of manifestations of nervous disorders and pathologies. Doctors identify from them a number of the most typical, main symptoms of perinatal encephalopathy in children.

In infancy:

weak or very late cry at birth;
problems with heartbeat;
lack of sucking reflexes;
anxiety;
frequent, hysterical crying;
excessive lethargy or increased muscle tone;
inadequate reactions to sound and light;
reflex shudders;
bulging eyes, strabismus;
tilting the head;
frequent regurgitation during meals and after meals (read more about why a child often regurgitates);
sleep disorders.

At an older age, you can note:

disorders of memory and consciousness;
inactivity, lack of initiative, apathy towards everything;
permanent;
depression;
fatigue, absent-mindedness, irritability, tearfulness, general weakness, bad dream, lack of appetite;
dizziness;
vagueness of thought;
narrowed range of interests;
verbosity;
speech disorder.

The problem with perinatal encephalopathy in children is that the disease borders too closely on many other similar diseases of the central nervous system. Parents may miss the first signs due to their ignorance. Even if the child often lags behind mentally and mental development from their peers, parents hope that over time he will catch up with them. But in severe forms of congenital encephalopathy this is almost impossible. If you consult a doctor in a timely manner and make a correct diagnosis, therapy is prescribed depending on the form and severity of the disease.

Types of disease

A child can be diagnosed with various forms of the disease, of which there are quite a few. The classification is based on the genesis (origin) of brain disorders. Most common the following types encephalopathy:

posthypoxic perinatal- caused by a lack of oxygen, fetal hypoxia during intrauterine development or during childbirth;
hypoxic-ischemic- brain damage caused not only by oxygen deficiency, but also by a serious disorder cerebral circulation;
transient- transient disturbances in the blood circulation of the brain, which can manifest themselves in short-term loss of consciousness, temporary deterioration of vision, speech impairment, weakness in different parts body, numbness, tingling muscles.

Each of these types differs not only in its special symptoms, but also requires certain treatment.

Treatment methods

Treatment of perinatal encephalopathy in children is long-term. The doctor tries to take into account the severity and duration of the disease, the age of the child, and concomitant diseases. Therapy is carried out on an outpatient basis or in a hospital setting, according to the doctor’s decision. Usually two or three courses of therapy are required over the course of a year - it all depends on the severity of the encephalopathy. The main methods of treatment are:

drug therapy (analgesics, NSAIDs, hormones);
blockades (injections);
metabolite, antioxidant, vascular therapy;
manual therapy (joint, muscle, radicular technique);
physiotherapy (SMT, UHF);
osteopathy;
therapeutic exercises (well-known exercise therapy);
surgical treatment;
acupuncture (reflexotherapy);
herbal medicine: treatment with herbs minimizes the negative consequences of encephalopathy in children - herbal teas from knotweed, dandelion, plantain, clover, knotweed, mint, sweet clover, lingonberry, St. John's wort, lemon balm, calamus root, thyme, oregano are prescribed - they contribute to a noticeable improvement even with severe or late consequences of encephalopathy (including mental retardation);
aromatherapy also comes to the rescue in such cases: they improve the condition of sick children essential oils ginger, chamomile, geranium, lavender, rosemary;
stem cell treatment.

The indicated therapeutic actions and techniques are used depending on the causes, symptoms and severity of the manifestations of the disease in the child. Constant monitoring by a doctor helps to minimize dangerous consequences for the health of children, which may occur in adulthood.

Consequences of perinatal encephalopathy in adult life

Many adult neurological diseases originate from childhood. Doctors say that their cause is untreated congenital encephalopathy. The consequences can be very diverse:

early osteochondrosis;
severe migraines;
cardiopsychoneurosis;
impotence;
hypertension;
scoliosis;
attention deficit disorder;
hyperactivity;
vision problems;
fine motor disorders.

The disease itself and its severe consequences are a real tragedy for parents. However, such dysfunctions of the brain and central nervous system are not a death sentence; many manifestations are treatable. Moreover, the modern development of medical technologies is rapidly progressing. Medicines and treatments are becoming more advanced. Perhaps a cure for encephalopathy will be found very soon.

Ivan Drozdov 03.07.2017

Perinatal encephalopathy - damage to nerve cells various areas brain, occurring during fetal development, as well as during or immediately after childbirth. This is due to a number of reasons and negative factors, affecting the body of a pregnant woman. In modern medicine, the pathology can be successfully treated, but can lead to a number of adverse consequences.

In ICD-10, pathology does not have a separate code. When making a diagnosis, specialists may classify perinatal encephalopathy as code G93 “other disorders of the nervous system,” as well as code P91 “other disorders of cerebral status in newborns.”

Perinatal encephalopathy: symptoms

In most cases, doctors are able to recognize perinatal encephalopathy by the baby’s behavior in the first hour or day of his life. During this period and the next year of life, the newborn develops the following symptoms:

weak or delayed cry at the time of birth;
the presence of a number of cardiovascular disorders - absence of heartbeat, abnormal heart rate;
shuddering, tremor of limbs;
the baby has reduced or absent basic reflexes - sucking, concentrating, swallowing);
strabismus;
unnatural tilting of the head when lying down;
relaxation or, conversely, tension in muscle tissue;
the child cries frequently and hysterically, and it is almost impossible to calm him down;
profuse and frequent regurgitation;
restlessness during sleep;
signs of low blood pressure and weakness.

In adulthood, perinatal encephalopathy can be expressed in the following symptoms:

apathy to what is happening;
concentration disorder;
difficulty in expressing thoughts and wishes;
lack of appetite;
speech disorder.

Causes of the disease

Unfavorable environmental conditions

The main cause of perinatal encephalopathy in infants is the impact of negative factors on the fetus developing in the womb through the mother’s body, namely:

development of acute infectious or purulent pathologies during pregnancy or exacerbation of existing chronic diseases;
toxicosis regardless of the stage of pregnancy;
a pregnant woman living in unfavorable environmental conditions - near large industrial centers, as well as enterprises that emit radiation and toxic substances;
exposure of future parents to habits that negatively affect the development of the fetus - smoking, drinking alcohol and drugs;
threat of pregnancy failure;
the presence on the parental side of genetic diseases associated with metabolic disorders and blood supply systems;
poor nutrition of pregnant women and women in labor during lactation;
congenital defects, prematurity;
birth injuries caused by incompetence of doctors and poor labor performance.

Advance planning of pregnancy and limiting exposure to the described factors will reduce the risk of perinatal encephalopathy in the newborn.

Diagnostic methods

Doppler ultrasound

Detection of perinatal encephalopathy is possible at the stage of fetal development in the womb. To do this, a late pregnant woman undergoes the following studies:

Ultrasound of the fetus to detect cases of abnormal position or entanglement of the umbilical cord;
Doppler ultrasound to assess the development of the vascular and cardiac systems.

If a newborn exhibits symptoms characteristic of perinatal encephalopathy, children's pediatrician conducts diagnostic studies:

clarifies from parents the presence of factors contributing to the development of pathology;
examines the baby for the presence of disorders of the motor system, central nervous system, nervous excitability, and fontanel conditions;
prescribes video monitoring to detect spontaneous and involuntary movements of the baby.

To assess the functioning of brain structures and possible foci of damage to nerve tissue, the child undergoes instrumental diagnostics using one or more methods:

neurosonography;
electroneuromyography;
dopplerography;
electroencephalogram.

If perinatal encephalopathy is suspected, the child must be seen by an ophthalmologist to assess the condition of the fundus and identify symptoms indicating the course of the disease.

Treatment of perinatal encephalopathy

Timely detection of signs of pathology significantly increases the baby’s chances of a full recovery and further full life. The treatment of perinatal encephalopathy should be approached comprehensively, involving specialists of several profiles in this process - pediatrician, pediatric cardiologist and a neurologist, orthopedist, and rehabilitation specialist.

The course of treatment includes not only drug therapy, but also physiotherapeutic procedures, ensuring a gentle daily regimen and good nutrition, correction of psychomotor and physical development.

The composition of drug therapy depends on the type and severity of brain disorders. The following medications may be prescribed to your child:

diuretics (Diacarb) – to relieve severe hydrocephalic syndrome;
vasodilators (Dibazol) - with decreased muscle tone;
muscle relaxants (Baclofen, Mydocalm) – with increased tone muscles;
anticonvulsants (as indicated by a pediatric neurologist) - if the baby has an epileptic syndrome, confirmed by diagnostic results;
means that improve blood flow to the brain structures and its proper nutrition (Nootropil, Cortexin);
B vitamins, which improve the functioning of nerve cells, are prescribed in injections, tablets or electrophoresis.

In addition to drug treatment, the child is prescribed a number of physiotherapeutic procedures:

electrophoresis;
medicinal baths;
massage;

The described procedures are contraindicated in cases where the baby has confirmed epileptic seizures. In other cases, manipulations are carried out under the supervision of the attending physician in a strictly established manner.

If the symptoms that appear indicate deep damage to the brain structures and significantly aggravate the state of health, the baby may be prescribed a neurosurgical operation. Also, in consultation with the pediatrician, it is advisable for the child to undergo restorative treatment with herbal decoctions.

Consequences of perinatal encephalopathy

Despite the fact that perinatal encephalopathy has a positive prognosis for complete recovery, there is a possibility of developing a number of unpleasant consequences caused by the neglect of the disease, ineffective treatment and characteristics of the body. These include:

Delay in the development of motor skills and psyche. In most cases, with a diagnosed mental retardation, a person is not limited in his abilities and can lead independent life activities.
Psycho-emotional disorders, expressed in attention deficit, increased emotional and physical activity.
Hydrocephalus and the consequences caused by this disease.
Disorders of the autonomic system and basic vital systems caused by changes in blood pressure and metabolic disorders.
Epilepsy attacks.
Neurotic disorders, manifested in the form of sleep disturbances, mood swings, attacks of aggression and tearfulness.

The consequences of perinatal encephalopathy are treatable. If they occur, it is necessary to contact an experienced neurologist and rehabilitation specialist to prescribe step-by-step treatment and a course of rehabilitation.

What is perinatal encephalopathy: a lifelong sentence or a common treatable disease?

Encephalopathy – organic lesion or damage to human brain tissue by various factors.

The perinatal period is the period from the 28th week of pregnancy to the seventh day after birth. The perinatal period consists of three parts: antenatal (from the 28th week of pregnancy to childbirth), intranatal period (the period of childbirth itself) and postnatal (from childbirth to the seventh day of life).

Perinatal encephalopathy in children is severe and very dangerous disease with a huge number of consequences, received by a child during the perinatal period and representing a lesion of the most important organ that forms a person’s personality - the brain.

Why is perinatal encephalopathy dangerous?

The degree of danger of perinatal encephalopathy in newborns depends on the degree and severity of damage to brain tissue, as well as on the specific type of affected area. First of all, a serious lesion can disrupt the physical-motor and rational functions of the body. Consequences of perinatal encephalopathy: impaired vision, hearing, speech (if the speech center is affected), convulsive activity, disorders of memory and consciousness, paralysis - complete or partial, general weakness, frequent dizziness and loss of consciousness, delayed psychomotor development, and much more, i.e. j. the concept of encephalopathy is a very general term huge amount disorders, some of which may not even appear.

Many modern mothers, having heard such a diagnosis, unfortunately, try to terminate a long-awaited pregnancy or abandon their children in the maternity hospital, fearing that they will end up with a severely disabled or mentally handicapped child. But with such a diagnosis often made, most children are able to lead an active, full-fledged lifestyle, if the diagnosis is made on time and treatment is started.

You shouldn’t write your baby off and take the diagnosis as a death sentence. All human organs have increased regeneration at an early age, which is especially pronounced in infants, and the consequences of perinatal encephalopathy in adulthood may not even appear, it is only necessary special treatment, care and proper lifestyle.

Consequences in adulthood

In adult life, the disease suffered at an early age can have residual severe consequences:

Epilepsy.
Mental retardation.
Violation of any body functions.
psychoneurological diseases.
Autonomic-visceral dysfunctions are disruptions in the functioning of any internal organs due to incorrect signals sent by the brain.
Disorders of memory and consciousness.

But with proper care you can minimize possible risks:

Hyperactivity syndrome and attention disorders.
Headaches and tinnitus, dizziness.
Physical weakness, fatigue and increased morbidity.
Lack of activity and lack of initiative.
Narrowed circle of interests.
Absent-mindedness.
Tendency to depression.

With minimal lesions or lesions of not too vital parts of the brain and a timely diagnosis, complete recovery from perinatal encephalopathy in newborns is also possible. Almost all sick children in adulthood are fully functional citizens who can take care of themselves.

Probable causes

Encephalopathy in newborns can be caused by a huge number of factors, which explains its wide prevalence. The intrauterine development of a child and his nervous system is such a fragile process that it is extremely easy to be disrupted by any negative influence. The placental barrier, of course, is a great protective force of nature, but, unfortunately, it cannot protect from everything, and especially from the stupidity of the mother herself. Here is an incomplete list of causes of perinatal encephalopathy in children:

The most common reason for diagnosis is pregnancy pathologies, all kinds of birth injuries received during labor disruption or medical error, shock to the abdominal area, thermal overload during pregnancy, etc.
In second place is toxic encephalopathy in newborns, caused by the penetration of harmful toxins, most often of alcoholic, narcotic, nicotine or medicinal origin, through the placental barrier.
In third place is encephalopathy in infants, caused by fetal hypoxia for various reasons.
An autoimmune conflict caused by a difference in the Rh factors of the blood of the mother and child carries the risk of this disease.
Unsuccessful independent attempts to abort unwanted pregnancy cause not only perinatal encephalopathy in newborns, but also many other serious abnormalities.
Chronic diseases and infectious diseases transferred by the mother during pregnancy can be transmitted to the child and destroy the fragile process of fetal formation. Thus, infection with rubella during pregnancy is a factor in its mandatory medical termination at any stage.
The borderline age of a woman or a man may be the cause of the production of defective germ cells, which as a consequence leads to developmental disorders, including prenatal encephalopathy.
Early age of parents when reproductive system parents are underformed.
Stress during pregnancy does not seem to be a serious risk factor for young mothers, however, excess hormones easily penetrate the placental barrier and are transmitted to the child’s nervous system. Excessive levels of adrenaline and cortisol burn neurons in adults, and an undeveloped children’s brain can be seriously damaged, because during the period of intensive development, every cell counts, from which this or that organ or part of the brain and peripheral nervous system ultimately turns out.

Prematurity of the fetus causes encephalopathy of the brain in newborns, expressed in the underdevelopment of its parts. This syndrome may easily go away during age-related development, or it may, on the contrary, remain if the development of the brain has been stopped or disrupted by some factors.
Malnutrition of the mother is another cause of various developmental abnormalities, which is rarely taken seriously. The fact is that all the organs and cells of the child are formed from substances received by the mother’s body. If the mother is sharply lacking some substance, vitamin or mineral, then the body’s self-defense mechanism turns on, which does not allow the baby to take the last remnants. Lack of necessary building material– this is a disruption of the entire process of constructing a new organism, which results in both deviations in physical development, low quality of immunity and muscular system, weakness and underdevelopment of internal organs, and deviations in the development of the nervous system, including encephalopathy of the newborn. The periodic desires of the expectant mother for ice cream at three in the morning or potato jam are not a whim caused by hormonal mood swings, but the child’s real need for building materials.
A disturbed ecological situation around a pregnant mother can be affected by a whole range of reasons that cause disturbances in its natural course. There is stress, toxin poisoning, hypoxia due to carbon dioxide, and many other factors.

A huge number of traumatic factors surrounding a pregnant mother in modern world, led to the spread of the diagnosis of perinatal encephalopathy in the newborn. In most cases, these are minor disorders that go away by adulthood or do not cause significant symptoms. Many newborns, without undergoing a special examination, suffered this syndrome unnoticed by their parents and doctors. But there are also the opposite cases, when a small deviation does not return to normal over time, but, on the contrary, grows and worsens with development, causing irreparable harm to the child. For timely detection, it is necessary to have an idea of the symptoms of encephalopathy in newborns and promptly consult a doctor at their first manifestations.

Symptoms of perinatal encephalopathy

It is very difficult to identify the symptoms of encephalopathy in an infant in the early stages of development. The fact is that small deviations in the erratic movements and incoherent cooing of a newborn are invisible to an untrained eye and become noticeable only by the age of six months, and mental disorders even later - already in the conscious period.

Perinatal encephalopathy, symptoms in newborns:

Absence or weakness of the sucking and or swallowing reflex.
Deviations in the muscle tone of the newborn.
Too violent a reaction or lack thereof to various stimuli.
Sleep disorders. Restless sleep. Sleepless nights with constant crying.
Sharp, rapid raising of arms and legs.
Frequent regurgitation.
Convulsions and epileptic seizures.
High or low blood pressure.

Perinatal encephalopathy in older children can manifest itself as:

Syndrome of increased excitability.
Convulsive syndrome.
Lethargy, inactivity, apathy, absence of any reflexes, depression of vital functions. Collectively, these symptoms are called “comatose syndrome.”
Increased intracranial pressure caused by a consequence of perinatal encephalopathy - excess fluid in the brain (Hypertension-hydrocephalus).
Hyperactivity.
Impaired motor functions, increased awkwardness and carelessness.
Vegetovascular dysfunction, causing both constant belching, indigestion and stool disorders, as well as various skin symptoms.
Retardation in physical and or mental development.
Depression.
Sleep disorders.
Speech disorders.
Lack of clarity in expressing your thoughts.
Migraines and acute headaches.

Varieties

Perinatal encephalopathy is primarily divided into simply encephalopathy with established cause occurrence and perinatal encephalopathy unspecified.

Perinatal encephalopathy unspecified - perinatal encephalopathy in newborns caused by unspecified factors (the cause of its occurrence is not clear).

Encephalopathy unspecified is a more difficult type of encephalopathy to treat, since treatment is based only on minimizing the consequences without eliminating the causes of its occurrence, which can result in residual encephalopathy at an older age.

Residual encephalopathy is the residual manifestations of the disease or its consequences some time after the disease or brain injury.

Unspecified encephalopathy in children is dangerous due to lack of follow-up treatment and confusion of symptoms with other disorders of the child’s nervous system.

Unconfirmed encephalopathy in newborns is a type of disease in which symptoms of encephalopathy appear that are not caused by brain damage.

There are also subtypes of perinatal encephalopathy:

Posthypoxic perinatal encephalopathy caused by lack of oxygen.

Transient or dyscirculatory - caused by impaired blood circulation in the brain.
Hypoxic-ischemic – arising against the background of hypoxia, complicated by circulatory disorders.
Toxic encephalopathy - caused by the action of toxins.
Radiation encephalopathy – developed under the influence of radiation.
Ischemic encephalopathy - caused by destructive processes (destruction processes) in certain areas of brain tissue.
Encephalopathy of mixed origin, most often related to unconfirmed encephalopathy in newborns.

This is not the entire list of encephalopathic subspecies, subdivided according to the causes of occurrence and area of localization of the disease.

Diagnosis of encephalopathy

Presence of symptoms characteristic of the disease, is not yet a basis for making a final diagnosis. If encephalopathy is suspected, which is quite easily confused with other diseases of the nervous system, a thorough examination is carried out:

General tests that reveal inflammatory processes, including in the brain, and disruption of the body’s systems.
Magnetic resonance imaging.
Electroneuromyography – modern method, testing the sensitivity of peripheral nerve fibers.
An electroencephalogram, which detects epileptic signs by recording the electrical potentials of the brain.
Neurosonography is an ultrasound scan of a child’s brain, which is performed on almost all children as a preventive measure.

Prognosis for children who have had the disease

In most cases, even in the absence of obvious symptoms of encephalopathy, automatic preventive examination is carried out for all risk categories, which now include the majority of the world's population.

With early diagnosis and not too advanced brain lesions, the child most often recovers and has no abnormalities in the future. Such cases are the most common, since the plasticity of the growing child's body very high. Even children who have developmental disabilities can become independent, practically healthy people.

Epilepsy.
Decreased activity.
Neurological disorders, minor psychical deviations etc., which do not overly poison the patient’s life and do not interfere with the people around him.

Severe cases consequently entail more dire consequences:

Paralysis.
Mental disability.
Disability.
Early mortality.
Life restrictions (ban on certain products, mandatory procedures, etc.)

Severe consequences occur quite rarely and mainly in the absence of proper treatment and care, which is most often the fault of parents leading an immoral lifestyle (alcoholics, drug addicts) or in low-income or large families where there is not enough money or time for proper care for the baby, or a cruel decision was made to direct them to normal children, and not to bother with a defective child. With the right efforts, severe injuries can have very moderate consequences.

Treatment of a child

Self-medication of perinatal encephalopathy in children is out of the question.

Treatment takes a lot of effort and is carried out exclusively with medication and physiotherapeutic methods. It is very long-term with constant monitoring by the attending physician.

With mild and moderate symptoms, sick children remain on home treatment, which consists of taking medications, physiotherapeutic procedures and periodic observation.

Severe disorders are treated exclusively in a hospital and may even require surgical intervention, for example, in case of hydroencephalic syndrome or damage caused by various tumors, hematomas or death of too large areas.

Treatment is prescribed in a variety of ways, depending on the type and causes of damage, and consists of several interconnected blocks:

Eliminating the cause of the disease.
Treatment of damaged tissue.
Normalization of the nervous system and stabilization of its signals.
Restoring body functions.
General rehabilitation therapy.
Prevention of resistance.

As a restorative therapy and additional assistance in treatment, they often resort to procedures from traditional medicine, which can only be prescribed by a doctor. By independently interfering with the course of treatment, parents can cause irreparable harm to their child.

Prevention of disease in newborns

The diagnosis of perinatal encephalopathy, of course, in most cases is not a death sentence, however, it is much easier to prevent its development in a baby than to deal with the consequences all his life.

There are cases when the mother is powerless to do anything: an accidental blow or disrupted labor, but often the cause of the disease is simply an incorrect lifestyle or genetic predisposition.

Modern medicine has already discovered many ways to deceive nature at the genetic level and give birth absolutely healthy baby at almost any age and with any genetic pathologies. It is enough to plan your pregnancy correctly and conduct a thorough examination, based on which you can choose the right method of action.

It is also easy to insure against accidents by preparing for pregnancy in advance and preparing for childbirth for all 9 months. In order to avoid all kinds of birth injuries, you do not need to refuse a cesarean section, which has become a very common and fairly easy procedure, if there is even the slightest indication for it, and also choose in advance good hospital where the birth will take place.

Pregnancy lasts only 9 months and many women experience it only once or twice in their lives. This is not such a long period of time in which you can be patient and take care of your child, while at the same time saving yourself from big troubles in the future.

IN last years cases of encephalopathy have increased significantly. Perinatal encephalopathy has extremely serious consequences, as it entails changes in the child’s brain tissue, as well as disruption of its main functions.

Precisely aggravating consequences of perinatal encephalopathy force doctors to recommend that parents closely monitor the child’s condition and behavior, because the disease is much easier to prevent or cure early stage, rather than eliminating all the changes that it brings with it.

This pathology can be either congenital or acquired during growing up.

The congenital form of encephalopathy develops on the basis of various pathologies of the fetal nervous system, which can occur both during development inside the womb and during labor.

Perinatal encephalopathy is an extremely serious diagnosis! The situation requires immediate medical intervention, long-term treatment and constant parental attention.

Main symptoms of the disease

Since this disease manifests itself in the very first months of the child’s birth, very attentive parents may well notice changes and deviations in the behavior and condition of the baby already in the first days.

The symptoms of this disease develop and intensify very quickly, and in short term are able to distinguish a sick child from healthy infants. Encephalopathy covers wide range possible manifestations nervous pathologies and disorders. But there is a list of the main, most typical symptoms of this disease:

Cardiopalmus;

Restless behavior;

Late or weak cry during birth;

Lack of sucking reflex;

hysterical and frequent crying;

Muscles are in increased tone, or excessive lethargy;

Reflexive shudders;

Unnatural tilting of the head;

Not quite adequate reaction to light or sound;

Strabismus or bulging eyes;

Too frequent regurgitation during/after meals;

Sleep disturbance.

Some of the listed symptoms are quite common and completely natural manifestations for a newborn. For example, frequent regurgitation after or during meals. And the reason for this is the peculiarity of the structure of the baby’s digestive system.

Symptoms that appear in older age:

Lack of initiative in everything;

Little or no activity;

Disorders of consciousness and memory;

Frequent depression;

Absent-mindedness;

Tearfulness;

Fast fatiguability;

Irritability;

Sleep disturbance;

General weakness of the body;

Poor appetite or complete absence of it;

Inability to form a thought;

Frequent dizziness;

A small circle of interests or their absence;

Speech impairment;

Verbosity or constant silence.

Types of encephalopathy

This disease has many different forms, which are classified based on the origin (genesis) of brain dysfunction. The most common types of encephalopathy:

Perinatal posthypoxic (lack of oxygen, fetal hypoxia during gestation or during childbirth);

Ischemic hypoxic (serious cerebral circulatory disorders, oxygen deficiency, and, as a result, brain damage);

Transient (impaired cerebral circulation of a transient nature, manifested by: temporary blurred vision, loss of consciousness, weakness in various parts of the body, muscle tingling, anemia, speech impairment).

Consequences of the disease

Despite the fact that the period of illness perinatal, encephalopathy consequences can manifest itself in adult life. Many neurological diseases have their origins in childhood. If encephalopathy is not cured at an early age, complications such as:

Severe and frequent migraines;

Early development of osteochondrosis;

Neurocirculatory dystonia;

Hypertension;

Impotence;

Scoliosis;

Hyperactivity;

Attention deficit syndrome;

Motor impairment;

Vision problems.

Medicine has not stood still for a long time, but is developing at incredible speed. Treatment methods and various medications are becoming more and more improved. Therefore, in the very near future, perhaps salvation will be found from this serious illness.

This is a serious illness and serious consequences can become a real tragedy for parents. But don’t think that dysfunction of the nervous system and brain is a death sentence! Most manifestations of encephalopathy are completely curable.

Perinatal encephalopathy is a clinical syndrome that occurs in children during the perinatal period from the 28th week of pregnancy to 7 days after birth in full-term infants and up to 28 days in premature infants. Sometimes it ends in death. Perinatal encephalopathy is a serious disorder of brain function in infants that can have consequences well into adulthood.

Signs

Symptoms of perinatal encephalopathy (ICD-10 code G93) can be varied:

Convulsive syndrome, weakening of reflexes, muscle tone or their increase.
Strong screams, prolonged hysterical crying.
The baby does not latch on well.
Blueness of the face during an attack of convulsions.
Swallowing problems, regurgitation.
Cardiac disorder.
Late appearance of screaming.
Light sleep, frequent awakenings.
Irritability, increased reaction to sounds, light, or lethargy, lethargy.
Increased head size due to intracranial hypertension.

The earliest symptoms of the pathology are muscle cramps in infants - the first signs of disturbances in the functioning of the central nervous system.

Learn about asymmetry of the ventricles of the brain: features of the course in children and adults.

What is ventriculomegaly in a child: causes and consequences.

Brain damage can cause pseudobulbar and bulbar syndromes. This manifests itself in dysfunction nerve centers, located in the brain stem, the most ancient formation. The baby does not take the breast well, or sucking and grasping reflexes are completely absent.

With less serious disorders, the child may choke on mother's milk, since damage to the centers of the glossopharyngeal nerve, which innervates the soft palate and epiglottis, is possible. Regurgitation may also be present. Defeat of the centers vagus nerve causes cardiac dysfunction: tachycardia, arrhythmia.

Damage to the nuclei of the oculomotor nerves causes increased photosensitivity and a violent reaction even to natural daylight. Difficulty breathing and bluish skin are caused by damage to the vasomotor and respiratory centers of the medulla oblongata.

Headaches and muscle pain can interfere with sleep, frequent awakenings during sleep, and epileptiform seizures with salivation are possible. As the child grows up, the following consequences of perinatal encephalopathy may develop:

Decreased intelligence, memory impairment.
Children's cerebral paralysis.
Muscle dystrophy.
Hyperactivity disorder, attention deficit disorder, problems with speech, writing.
Irritability or lethargy.
Impaired socialization, poor learning ability, inability to concentrate.
Developmental delay.

The consequences of perinatal encephalopathy in adult life are disability, sometimes the inability to care for oneself, and lack of communication skills. But a gradual smoothing of symptoms is also possible if the damage is minor.

Causes of encephalopathy

Perinatal encephalopathy usually results from hypoxia or ischemia of the infant's brain. The main causes of perinatal encephalopathy:

Blood conflict during pregnancy: Rh factor, blood group, presence of antiphospholipid syndrome, increased blood clotting.
Birth injuries, umbilical cord entanglement. Prematurity of pregnancy. Intrauterine infections, as well as antiphospholipid syndrome can cause premature birth.
Late delivery.
Intrauterine infections in the mother.
Hormonal diseases (adrenal insufficiency in women, progesterone deficiency).
Presence of arterial hypertension.
A pregnant woman falls into a coma due to the development of liver and kidney failure.

Damage to an infant's brain is the result of hypoxia (oxygen deprivation) and the death of the infant's neurons. This can occur with Rhesus conflict. A discrepancy between the Rh factor provokes the formation of immune complexes in the blood of the placenta and disruption of microcirculation in it. Antiphospholipid syndrome has similar symptoms. Increased blood clotting often causes fetoplacental insufficiency.

Find out what hypoxia is in newborns: causes, symptoms, diagnosis and treatment.

What a mother should know about in case of perinatal damage to the central nervous system in a child: features of the clinical picture of the pathology.

Do you know about the causes of oligophrenia and the manifestations of the disease at various stages?

Birth injuries lead to hematomas and damage to the brain, including its stem. When the umbilical cord is wrapped around the fetus during pregnancy, it can be signaled by fetal kicking - this is a sign that the fetus is not getting enough oxygen. The umbilical cord is twisted and placental blood does not flow through the umbilical vessels.

In prematurity, the cause of hypoxia at birth is the underdevelopment of the lungs for breathing atmospheric oxygen. At birth, the baby switches from placental to atmospheric breathing. The type of hemoglobin changes, old red blood cells die, but new ones are formed more slowly. Therefore, oxygen transport is impaired. In addition, the cardiovascular system is underdeveloped - the vasomotor and respiratory centers of the bulbus of the brain work under overload. Treatment

To treat the consequences of brain damage, reflexology, massage, physical therapy. Therapy for intracranial hypertension includes the use of diuretics. Convulsive syndrome is corrected with anticonvulsants prescribed by a doctor. To eliminate hypoxia, Mexidol, Actovegin, Trimetazidine are used to support the cardiovascular system.

Prevention is also important: medical supervision during pregnancy, timely treatment of sexually transmitted infections in the mother, correction of increased blood clotting. If there is a lack of progesterone, its synthetic analogue Duphaston is prescribed. If a pregnant woman has a deficiency of adrenal hormones, it is necessary to use GCS (Dexamethasone). This will prevent the development of pulmonary distress syndrome.

Conclusion

Perinatal encephalopathy is a serious pathology. The prognosis of the disease depends on the degree of damage. Necessary regular examination: neurosonography (ultrasound of the fontanel), Dopplerography, electroencephalography, electromyography to assess muscle tone.

One of the most terrible diseases is encephalopathy in children, which can have either a congenital form (perinatal) or acquired during life. The disease itself is a diffuse brain disorder, which in children manifests itself in an accelerated form of development.

Consequences of encephalopathy in children

As it became known only recently, the perinatal form of the disease in newborns can be inherited. However, this information is unspecified. Symptoms in the youngest children are not as pronounced as in adults, and therefore it is rarely possible to diagnose the disease in time and take measures to eliminate it. The most a terrible consequence encephalopathy in newborns is a lack of supply of nutrients to the brain (for example, when the bilirubin form of encephalopathy occurs). As a result, nerve cells acquire signs of dystrophy and die, due to which important departments and functions of the body stop developing.

Treatment should also be aimed at eliminating swelling of the brain. It is the increase in brain size that leads to enlargement of the head in children whose skull has not yet formed to the proper extent. Consequences - hydrocephalus, Down syndrome, cerebral palsy and this is not the entire list; an unspecified cause of the anomaly may occur.

Types of encephalopathy

The childhood form of the disease is no different from the adult form according to the classification - encephalopathy can be congenital hereditary or developed in the womb, so to speak, perinatal and acquired due to the influence of harmful factors on the brain area. The symptoms of both forms of encephalopathy in newborns or adult children are similar.

The disease can be caused not only by non-compliance with the diet during pregnancy, but also by birth trauma - such cases of residual encephalopathy account for about 8-10% of all registered cases.

The children's nervous system is very unstable and delicate, especially when receiving traumatic brain injuries, there is a risk of developing consequences even some time after treatment has been provided. Compare: if a child can get a concussion only from jumping from a great height or sudden braking while running, what could cause a rupture of the vessel?

Discirculatory or toxic

This form of brain disease differs from residual disease in that it can cause organic changes in neurons due to the effects of vascular diseases or the entry of toxins into the blood. This may be due to an unspecified reason, or due to the following factors:

Vascular insufficiency.
Arterial or venous aneurysm.
Blood diseases - toxicoplasmosis, leukemia, bilirubin deficiency or elevated level, etc.
Viruses and infectious diseases - from jaundice (Botkin's disease) to hepatitis, influenza with complications, pneumonia.
Diseases of other organs, etc.

Signs of encephalopathy begin to appear in children with sleep disorders: the child has trouble falling asleep and is capricious. His perception deteriorates, his psyche suffers. All these are symptoms of the so-called pseudoneurasthenic syndrome. It includes dizziness and unsteadiness when walking, problems with blood pressure, and failure of the brain to perform the work of the organs of hearing or vision. Since the children's nervous system is quite fragile, sudden mood swings may occur - tearfulness, increased activity or consequences of epileptic encephalopathy in children.

If treatment is not prescribed on time, perinatal or other encephalopathy that is not specified during the diagnostic process will lead to more harmful abnormalities in the functioning of the brain. Stagnation of consciousness will become permanent; for children it is like being in prostration. Frequent fainting, asymmetry of tendon reflexes, and increased muscle tone in newborns and older children are possible. Finally, symptoms will often manifest as vegetative-vascular dystonia and lability. As for the emotional state, it is accompanied by deterioration of attention and memory in children.

Perinatal

Another form of brain disease is encephalopathy, which appears either in the last 12 weeks of pregnancy or during childbirth. The cause may be either unspecified - stress, trauma, poor nutrition, or specific disease suffered by the expectant mother. For example, anemia or pneumonia.

To prevent encephalopathy in newborns, it is recommended to monitor your diet, walk in the fresh air and completely relieve yourself of stress. You should also be careful with drinking coffee, chocolate, especially alcohol and cigarettes - even passive smoking provokes a disease such as perinatal or a form of residual encephalopathy of the brain in newborns. By the way, even if the disease could not be avoided (birth trauma), treatment in the first weeks of life is quite easy, and the chances of completely getting rid of the consequences by 12 months of life are 90-95%.

Bilirubin

This form of cerebral encephalopathy occurs due to a hemolytic disease, which is caused by incompatibility of blood groups between mothers and children. If bilirubin, which has not been processed by the liver, is elevated in the blood - above 0.1-0.2 grams per 1 liter, then it leads to toxic poisoning, that is, to the entry of dangerous substances into the brain area.

Bilirubin disease encephalopathy can be caused by causes of jaundice:

Sepsis.
Birth injuries or injuries received during the life of children.
Toxoplasmosis.
Propensity for maternal diabetes mellitus.
Heredity in children.
Unfinished treatment of intrauterine jaundice.

Symptoms or what happens as a result of damage to the brain, its subcortical nuclei, and cerebellum: tissue metabolism is disrupted, which leads to an inevitable decline in immunity and failure of body functions, as with later residual encephalopathy in children.

The clinical picture divides symptoms into three phases:

Signs appear food poisoning, such as weakness, nausea, decreased skeletal muscle tone. However, conventional treatment for poisoning does not help: babies continue to regurgitate frequently and may refuse to eat.
Symptoms present in kernicterus appear - bent joints, clenched hands. The neck bends painfully, bilirubin encephalopathy can lead to an increase in body temperature and even respiratory failure.
A false effect occurs, which actually indicates that the treatment does not produce results. Usually, a short-term improvement is replaced by a return of symptoms in an intensified form - to cerebral palsy, a mask-like face, overstrain of the back muscles, and rolling of the iris behind the eyelid.

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Treatment of the disease

Every doctor will advise you to start a complex of preventive and therapeutic measures already when the primary symptoms of encephalopathy appear. So, in addition to medications, it is prescribed special diet, in which you need to eliminate as much as possible the consumption of table salt, polyunsaturated fats, cholesterol, and chocolate. Instead, consume more iodine-containing foods, vitamins and ascorbic acid.

Neurologist, website editor

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According to statistics, every year 4-5% of newborns are diagnosed with perinatal encephalopathy (PEP). This serious illness, but thanks to the development of medicine, it is now treatable. Depending on the type of provoking factor, experts distinguish several types of illness. Each of them can and must be fought. The earlier the problem is identified, the higher the patient’s chances of recovery or a high quality of life. The best prevention pathology is planning pregnancy, its proper management, eliminating the influence of negative external stimuli on the fetus.

Perinatal encephalopathy in children - what is it?

The complex name refers to a whole group of pathological conditions that arise during the period of intrauterine development of a child or the first days of his life.

The diagnosis of perinatal encephalopathy is made when there is brain damage in full-term infants from the 28th week of pregnancy to 7 days after birth, and in premature infants - up to 28 days after birth.

Diseases have different development mechanisms, causes, and consequences. They can manifest themselves in different ways, but often have general signs. An experienced specialist may suspect problems in a baby immediately after it is born.

Probable causes

The influence of negative external factors on the body of a pregnant woman affects the nervous system of the child. In some cases, this even becomes an indication for termination of pregnancy due to too high a risk to the fetus.

Points contributing to the development of PEP:

exacerbation of chronic diseases in a pregnant woman;
acute infectious pathologies in the expectant mother;
woman's age under 18 or after 35 years;
non-compliance with a pregnant or lactating diet, violation of the diet;
early and late toxicosis;
threatened miscarriage, history of interrupted or frozen pregnancy;
prematurity of the baby, the presence of congenital developmental anomalies;
bad habits of parents, especially women (smoking, drinking coffee, alcohol, drugs);
taking potentially dangerous medications during pregnancy and lactation;
injuries or complications during childbirth, weak labor, rapid labor;
the mother has a history of genetic pathologies and metabolic disorders;
unfavorable environmental conditions - the effect on the body of toxins, radiation, industrial chemicals, gases, salts of heavy metals.

The more of these factors affect a woman’s body, the higher the risk of developing perinatal encephalopathy in the baby. Once exposed, it is impossible to reduce the damage caused. Only pregnancy planning will protect you from the development of problems, comprehensive prevention complications.

Symptoms of perinatal encephalopathy

In most cases, signs of PEP become apparent immediately after the baby is born. Having compared them with the patient’s medical history, the doctor immediately makes a preliminary diagnosis and prescribes specialized diagnostics.

Early signs of perinatal encephalopathy are:

the baby is lethargic, has a delayed cry, or has obvious lung weakness;
lack of heartbeat, arrhythmia, increased or slow heart rate;
hypertonicity or pathological muscle weakness;
too violent a reaction to sounds, light or lack of response to external stimuli;
involuntary reflex shudders, muscle twitching;
lack of reflexes that should be present in every newborn;
nervous behavior of the baby, causeless anxiety;
constant crying of a hysterical type, inability to calm the child;
functionality problems oculomotor nerve leading to bulging eyes or strabismus;
when lying on your back, tilt your head back;
dyspeptic disorders not related to digestion - vomiting, frequent or profuse regurgitation;
shallow sleep, leading to frequent awakenings, difficulty falling asleep.

Sometimes the symptoms of encephalopathy do not appear in infancy, but much later. This can be expressed in the form of depression, VSD, speech impairment. Some children have problems expressing their thoughts and do not show interest in what surrounds them. In adulthood, disorders of such mental processes, such as attention, perception, memory. The clinical picture, which appears at an older age, allows one to quickly suspect the diagnosis, but the chances of recovery are lower than when starting to work with a newborn.

Varieties

Experts divide pathology into several groups according to the type of provoking factor. Knowing the cause of the disease, it is easier to choose treatment and methods of restorative therapy.

Perinatal encephalopathy can be:

hypoxic – a consequence of asphyxia of newborns or lack of oxygen in the blood during pregnancy;
traumatic - the result of injuries that the baby may receive during childbirth. This danger occurs when the fetus is in the wrong position, inappropriate environmental conditions, problems with labor, or medical error;
toxic-metabolic – disorders provoke inflammatory or systemic diseases, suffered by a woman during pregnancy, congenital malformations. Expectant mothers who take potentially dangerous drugs during pregnancy;
infectious – the result of an infectious process in the mother’s body that affects the fetus.

This is the basic classification of perinatal encephalopathy. The disease is also divided into three degrees of severity, which help make a prognosis. By mechanism development of PEP There are also several types. The hemorrhagic form occurs as a result of hemorrhage, the ischemic form is a consequence of impaired blood supply, and the dysmetabolic form is associated with failures of metabolic processes.

Why is perinatal encephalopathy dangerous?

The risks associated with AEDs and the consequences of the disease directly depend on the degree of brain damage. The indicator is also influenced by the location of the source of the problem and the mechanism of development of the disease.

IN severe cases pathology threatens disability due to the failure of physiological processes. Intrauterine brain damage can negatively affect the quality of speech, memory, level of intelligence, and perception. Problems associated with delayed psycho-emotional development and decreased functionality of muscle tissue cannot be ruled out.

The following consequences cannot be excluded:

attention deficit, hyperactivity;
interruptions in the functioning of internal organs;
hydrocephalus, ischemia of brain tissue;
epileptic seizures;
reactions of a neurotic type that affect the quality of sleep and the patient’s behavior - often such children require regular monitoring in order to assess the dynamics of the condition;

Fortunately, today the disease in most cases can be cured or at least corrected. The main thing to remember is that such a diagnosis lasts for life. The danger of perinatal encephalopathy is also that its consequences can appear many years after the end of therapy if professional help is refused.

Consequences in adulthood

If you identify the disease in time, carry out the necessary therapy, and adhere to the doctor’s recommendations, then there is a high probability of completely getting rid of the problem. Therapy in this case requires complex and often long-term treatment. It is selected individually, taking into account the specifics of the situation.

List of possible negative consequences of perinatal encephalopathy in adult life:

hypertension;
migraine;
osteochondrosis already at a young age;
decreased libido, impotence;
scoliosis;
decreased quality of vision;
problems with fine motor skills.

Much depends on the severity of the illness and the quality of medical care provided to the child. Some parents are reluctant to admit that there is something wrong with their baby, which can result in valuable time being lost.

Diagnosis of encephalopathy

In the process of making a diagnosis, anamnesis and pregnancy history play an important role. At certain dates, the woman undergoes an ultrasound, which allows us to exclude abnormalities in the development of the child, entanglement in the umbilical cord, and other alarming signals. If a problem is suspected in a newborn, additional research methods such as MRI, EEG, neurosonography, and other hardware approaches are prescribed. It is necessary to examine the child by a pediatrician and neurologist. Specialists check the newborn’s reflexes and rule out the presence of syndromes characteristic of the pathology. Additionally, a fundus examination is performed by an ophthalmologist.

Prognosis for children who have had the disease

Today, PEP is not a sentence. Previously, doctors recommended that women at high risk of developing the disease in their child terminate their pregnancy. Parents abandoned such children; pediatricians did not know how to treat them. Now the situation has changed radically. The statistics of complete cure after identifying a mild form of perinatal encephalopathy is rapidly improving. Even with moderate and severe degrees of pathology, the chances of success are high. At a minimum, such children can count on a full life without restrictions.

Treatment of a child

Combating the diagnosis of perinatal encephalopathy requires an integrated approach. The list of measures is selected in accordance with symptoms, test results, goals, and degree of brain damage. Treatment is aimed at alleviating the child’s condition, preventing complications, and restoring the functionality of the affected organ.

Basic treatment regimen for PEP:

the use of medications - these can be drugs to improve microcirculation, muscle relaxants, anticonvulsants, nootropics, diuretics, vitamins;
herbal medicine – most often to means plant origin resorted to for hydrocephalus;
physiotherapy - electrophoresis facilitates and simplifies the process of administering medications. Massage for encephalopathy in children allows you to cope with muscle tone disorders. Exercise therapy promotes the normal development of the child;
radical measures are rare, but it happens that the patient requires neurosurgery, hemodialysis, ventilation to maintain vital signs at the right level.

An important point is to provide the baby with suitable conditions. Such children should be protected from stress and excessive physical and mental stress. WITH early age shown to kids water procedures, hardening, air baths, massage, gymnastics. It is necessary to monitor the child’s diet, starting from infancy.

Prevention of disease in newborns

Planning a pregnancy, undergoing a medical examination before conception, timely implementation of the gynecologist’s recommendations, and a woman’s attentive attitude to her health are points that reduce the risks of developing PEP to a minimum. Each to the expectant mother It is recommended to treat your chronic diseases in advance, eliminate potential sources of infection, and strengthen your immune system with vitamins.

You should not risk the baby’s life by considering unconventional delivery options. New-fangled methods of giving birth in unsanitary conditions, unnatural positions, without the supervision of professionals threaten with serious complications. It is better to find an experienced doctor in advance who will know about all the nuances of pregnancy and will help you prepare for it.

The development of perinatal encephalopathy in children can complicate life for both the child and his parents. It is much wiser to take care of pathology prevention in advance and reduce all risks to a minimum. Even if such a diagnosis is made, the chances of a positive outcome are high. You just need to contact specialists in a timely manner and strictly follow their recommendations.

The term “encephalopathy” refers to a set of symptoms and syndromes varying degrees severity, indicating disturbances in brain activity. Such disorders, for the most part, occur during the perinatal or neonatal period of a baby’s life. Therefore, encephalopathy in newborns is also called perinatal.

An adjective must be added to the term, which gives an idea of the cause of brain damage and some of the symptoms that accompany it.

Kinds

Depending on the nature and causes of encephalopathy, the following forms are distinguished:

Hypoxic - formed when there is a lack of oxygen supply to the brain. Encephalopathies of the hypoxic type include perinatal, asphyxial, and post-resuscitation.
Toxic - the culprits of its development are poisons in the form of alcohol, drugs or poisoning with various chemicals (lead, carbon monoxide).
Toxic-metabolic. Poisoning also occurs due to toxic substances, but they are only formed internally human body due to metabolic disorders and the impossibility of completely removing poisons from the body. Most shining example- bilirubin encephalopathy, which develops with.
Diabetic - damage to brain structures against the background diabetes mellitus and metabolic disorders associated with the disease.
Post-traumatic. Formed after traumatic brain injury in the near future or months or even years later.
Radiation - formed under the influence of ionizing radiation.
Discirculatory (another name for vascular) - develops due to impaired blood supply to the brain, the cause of which lies in vascular damage. This is mainly a disease of older people, so we will not consider it in detail.

Perinatal hyposkic encephalopathy

Correct, dynamic development of the nervous system and psyche is especially important at the beginning of a baby’s life. Therefore, parents should be wary if their child has the following clinical symptoms:

the baby cries for a long time for no reason (especially in the first days after birth);
he is too sluggish, there is muscle hypotonicity;
restless behavior, muscle hypertonicity;
reacts inappropriately to light or sound;
throws back his head;
often starts spontaneously;
burps violently and frequently;
bulging eyes, Graefe's symptom.

Arching the back and throwing back the head - warning signs. They cannot be ignored

Even when the child is in the delivery room, neurological disorders and brain damage can be suspected by low Apgar scores, bluish skin, poor motor activity, impaired heartbeat, and a weak sucking reflex. Such children often gain weight poorly. In order not to miss the development of pathology, the child requires additional attention and consultation from a neurologist.

Causes

Perinatal encephalopathy occurs for various reasons, but in the vast majority of cases it is associated with hypoxia at different stages of the baby's development. So, brain hypoxia in the prenatal period is provoked by:

threat of miscarriage;
diseases of the expectant mother: chronic (heart defects, diabetes, pyelonephritis) and acquired (rubella, ARVI);
early and late toxicosis;
chronic placental insufficiency;
mother's bad habits.

During childbirth, situations are dangerous when:

the child swallowed amniotic fluid;
there was asphyxia;
premature placental abruption occurred;
the waters have broken, and labor is protracted;
rapid birth.

Encephalopathy is also differentiated depending on its severity:

Mild degree. The baby's behavior is restless, accompanied by prolonged crying and frequent regurgitation. The child does not sleep well, sleep is divided into short intervals. Strabismus develops.
Moderate severity. One or more syndromes indicating neurological dysfunction are present. These include hypertension, hydrocephalic syndromes, and movement disorders. Sucking and swallowing reflexes are impaired, the cry is shrill, the baby screams even in a sleepy state.
Severe degree. There is a pronounced comatose syndrome, clouding of consciousness, brain functions are completely suppressed.

Syndromes inherent in encephalopathy

Hypertensive-hydrocephalic

First of all, the syndrome is recognizable by the rapid growth of head circumference. The cranial sutures are more open, and the fontanelles bulge. Nystagmus, suppression of reflexes and motor activity, strabismus, and asymmetry of facial muscles are observed. With this disease, severe symptoms indicate developing cerebral edema.

Movement disorder syndrome

It is expressed in the disorganization of muscle tone, both in the direction of weakening and increasing it. Along with hyper- or hypotonicity, there is a delay in psychomotor development, since motor functions are not formed in a timely manner. Therefore, you need to pay attention to the late appearance of the first smile, inhibited perception of an auditory or light stimulus, and poor facial expressions.

Hyperexcitability syndrome

The child is overly active, periods of wakefulness are increased, and sleep intervals are reduced. Present, extremities, with an increase in body temperature, febrile convulsions are possible.

Hypotonicity and hypertonicity of muscles must be corrected using massage techniques and physiotherapy

Convulsive

Manifests itself in the form of episodic shudders and twitching of the limbs. Attacks can be expressed in bending of the head with tilts, arms and legs are tense, sucking movements are imitated.

Comatose

The baby's condition is extremely serious, with a maximum of 4 points on the Apgar scale. Hypotension is pronounced, depressed or completely disappears, there is no reaction to light, the pupils are constricted. The breathing rhythm and pulse are irregular, the blood pressure is low, the heart sounds are muffled and barely audible, and convulsive seizures are possible.

Diagnostics

The diagnosis is made on the basis of the collected anamnesis, the clinical picture on this moment and results of brain ultrasound examination. The mother's card is carefully studied: how the pregnancy went, whether pathologies of the fetus were identified during the intrauterine period, whether the mother was treated for infection. The newborn’s Apgar scores, how the delivery went, and whether there were any complications are taken into account.

Repeated examination of the child by a neurologist is mandatory. It is determined whether there is a suspicion of encephalopathy, and an additional consultation with an ophthalmologist is prescribed, where the baby’s fundus is examined.

Neurosonography helps in diagnosing pathology - ultrasonography, carried out through an unovergrown large fontanel. It makes it possible to assess the structure of the brain, the condition of the ventricles and convolutions. Electroencephalography (EEG for short) examines the activity of the cerebral cortex for signs of seizures. If such an examination does not provide an objective picture and it is difficult to make a diagnosis, CT scan brain

Neurosonography is mandatory to determine brain dysfunctions

Treatment

Mild forms of encephalopathy are treated using homeopathic remedies and herbal remedies, as well as physiotherapeutic techniques, physical therapy, and massage.

Treatment of perinatal encephalopathy medium degree severity largely depends on the severity of certain syndromes. For example, diacarb is often prescribed, a drug that promotes normal drainage of cerebrospinal fluid. For muscle hypertonicity, muscle relaxants are prescribed - drugs that relax muscles (mydocalm). Dibazol is used for muscle spasms. And to improve cerebral circulation and form new connections between nerve cells, they practice prescribing Pantogam, Lucetam, Vinpocetine, Nootropil. Treatment is almost always accompanied by taking B vitamins, which have a positive effect on the development of the nervous system.

If expressed convulsive syndrome, the doctor selects anticonvulsants, taking into account the age, body weight and degree of illness of the baby. Antiepileptic drugs must be taken under the supervision of doctors; they cannot be discontinued on their own, otherwise seizures may become more frequent. Massage and physiotherapy are contraindicated for children with epileptic syndrome.

Attention! All the names of drugs listed in the article are serious drugs and can only be prescribed by a doctor. Almost all of them, according to the instructions, are not intended for infancy, so the doctor makes the choice of dosages and the drug itself, based on his experience and clinical cases on their use and treatment of newborns. The names of the drugs are given in the article for informational purposes only. Self-medication in such situations is prohibited.

Toxic encephalopathy

It appears when brain cells are poisoned by poisons and pesticides that come from outside or formed inside the body. Most often occurs against the background of:

hemolytic disease;
taking narcotic substances, antipsychotics, antidepressants or anticonvulsants during pregnancy by the mother;
mother drinking alcohol in large quantities;
household poisoning by vapors of mercury, gasoline or other substances.

A typical example of toxic encephalopathy is bilirubin encephalopathy. Yellowness of the skin, which appears against the background of increased bilirubin levels, often occurs in infants in the first month of life. However, only in 4-5% of all cases the bilirubin content is so high that it is able to penetrate the blood-brain barrier and have a toxic effect on the brain. This condition is characterized by drowsiness, suppression of reflexes, spasms of the neck muscles, and falling into a coma.

Phototherapy is used for hyperbilirubinemia

Intoxication of the body and, in particular, the brain, can occur in different ways. The disease occurs in acute form, when the toxic effect is one-time, but in large doses. The symptoms of oppression of all organs and systems in such situations are clearly expressed.

At chronic intoxication small doses of poisons clinical picture may be somewhat blurred, may be expressed mainly by weakness, nausea, weakening of sensitivity in the upper and lower limbs. In addition to general diagnostics, blood and urine are examined for the presence of a suspected toxic substance.

Treatment

A special feature of the treatment of bilirubin encephalopathy is phototherapy. The baby is placed under blue light lamps, while the baby's body temperature (to avoid overheating) and the newborn's weight (since the baby is losing fluid) are constantly monitored. Up to three times a day, blood is drawn to test bilirubin levels.

Detoxification therapy is required; Ringer's solutions, glucose, nootropic and antioxidant drugs, and vitamins are administered intravenously. In especially severe cases, a replacement transfusion of blood or plasma is offered.

Post-traumatic encephalopathy

This pathology does not always make itself felt immediately. It may take months, or even years, for symptoms to appear:

dizziness with swaying in different directions;
delayed psychomotor development;
seizures;
fainting states.

Such symptoms develop as a result of serious trauma (a mild concussion does not lead to serious consequences), for example, due to fractures of the cranial bones from beatings, falls from a height, complications after an accident.

Treatment

Treatment will largely depend on the injury itself. In severe cases, neurosurgeons perform surgery. In milder cases, they are treated with medication with nootropics and antioxidants.

Possible consequences

The outcome of brain pathologies may end full recovery, however, in severe cases, vegetative-visceral disorders, speech and speech delays are observed. mental development, hyperactivity.

Cerebral palsy is one of the most severe consequences brain disorders

The most severe consequences are those that provoke the development of diseases that affect the child’s social adaptation: cerebral palsy, epilepsy, hydrocephalus.

Prevention

Prevention brain pathologies includes a responsible approach to pregnancy and childbirth on the part of the mother: proper rest, absence of bad habits, timely visits to the doctor, along with passing the necessary tests and conducting the proposed examinations. No less important is competent management of childbirth and paying due attention to the baby in the first weeks of his life.

Today, the diagnosis of perinatal encephalopathy (PEP) is often overused. According to statistics, only 4% of children have serious disorders affecting the nervous system and brain activity. But the reality is that any neurological disorder, such as, for example, a trembling chin, which in the first months can be considered normal, is attributed to brain pathologies.

So, true encephalopathy in newborns is rare and is accompanied by serious syndromes that cannot be ignored. After a certain time, this term is replaced by a specific diagnosis, which requires vigilant monitoring and treatment. Patience to you, dear parents.

This is not an inflammatory disease of the brain; it is associated with impaired blood supply, reduction and destruction of brain cells. It can be an acquired disease, as a result of birth trauma, hypoxia, which leads to serious violations brain, but most often congenital pathology. This disease is diagnosed in approximately 50% of infants. More severe forms of PPCNS occur in only 10% of newborns. More vulnerable: Congenital encephalopathy in infants, complicated during childbirth (birth trauma, placental abruption, abnormal position of the fetus, large head in the child, narrow pelvis in a woman). It can be suspected for the first time immediately after the birth of a child. At birth, the internal organs, including the central nervous system, are not fully developed; the development of all systems requires a period of time. There are several forms of encephalopathy.

Perinatal encephalopathy in newborns.

It is considered from the 28th week of pregnancy to the 8th day of the child’s life. It can occur if (causes of encephalopathy):

The child's mother is too young or old
Abortion
Miscarriages
Infertility treatment
Mom's diabetes
Mom's heart defects
Mom's flu
Smoking, alcohol
Risk of miscarriage
Working in hazardous industries
Taking medications
Fast (less than 6 hours, slow more than 24 hours) labor
C-section
Premature placental abruption
Umbilical cord entanglement, umbilical cord prolapse
Multiple birth

Periods of perinatal encephalopathy in newborns.

The acute period is 7-10 days to a month.
Early recovery period up to 4 – 6 months.
Late recovery period up to 1 – 2 years.

In the acute period observed: lethargy, muscle hypotonia, decreased reflexes (sluggish sucking) or, conversely, hyperexcitability of the nervous system (shallow sleep, trembling of the chin and limbs), throwing the head back.

Early period of perinatal encephalopathy in newborns, when general cerebral symptoms decrease, and focal brain lesions appear. Muscle hypotonicity or hypertonicity appears. Possible paresis and paralysis, hyperkinesis (enlargement of the head, expansion of the venous network on the forehead, temples, enlargement and bulging of the fontanelle. Marbling and pallor of the skin, cold hands and feet, changes in the gastrointestinal tract (constipation, increased gas production), heart rhythm disturbances and breathing.

Late period of perinatal encephalopathy in newborns, muscle tone and other functions gradually normalize. Dynamic development occurs in the central nervous system and psyche of the child. Pre-speech and speech development is being formed. At this age, you can already notice that the child is lagging behind; those reflexes and skills that should be there, or they are not there, or they are very weak, are sharply delayed. There may be persistent spastic syndrome or, conversely, muscle hypotension.

Hypoxic-ischemic damage to the nervous system.

One of the forms of encephalopathy caused by fetal hypoxia ( oxygen starvation brain cells). With chronic intrauterine hypoxia they suffer, the capillaries of the brain grow slowly and become more penetrating. During childbirth, this leads to asphyxia (severe respiratory and circulatory disorders). Therefore, asphyxia of a newborn at birth is a consequence of fetal hypoxia. Several degrees of hypoxic-ischemic form can be distinguished infant encephalopathy:

Depression and excitation of the central nervous system, which lasts up to 7 days after birth.
After 7 days, convulsions, increased intracranial pressure, and disturbances in heart and respiratory rhythm are added.
Severe convulsive condition, high intracranial pressure.

Mixed lesion disease.

In addition to hypoxic-ischemic damage to the central nervous system, intracranial hemorrhages (not traumatic) are added; the severity depends on where the hemorrhage occurred.

Traumatic damage to the central nervous system.

Damage spinal cord during childbirth, this can happen if the fetus is large or incorrectly positioned. When it is easier to remove the head and shoulders, when the head is diligently turned when it is removed, or when it is pulled behind the head, the obstetrician performs these manipulations to reduce the child’s hypoxia. It all depends on the experience of the doctor. Damage can also occur during a caesarean section with a “cosmetic incision” that is not sufficient to remove the child’s head. Artificial ventilation of the lungs in the first 2 days can lead to damage, especially in children and those with low weight.

Metabolic disorders.

Alcohol syndrome, nicotine, drug disorders occur as a result of the cessation of the intake of alcohol, nicotine, and drugs.

Intrauterine infection.

Depends on the type and severity of the disease. Such children are often born in a state of asphyxia, with low weight, an enlarged liver, developmental defects, and there may be a convulsive syndrome.

In the maternity hospital, neonatologists examine newborns and identify perinatal lesion central nervous system and prescribe treatment. But this treatment must be continued at home. What should alert the mother: frequent restlessness of the child, regurgitation, trembling of the chin, arms and legs, freezing of the child in one position, unusual eye movements, rapid head growth of more than 1 cm per week, enlargement of the edges of the fontanel and its bulging.

If your baby has something, you need to consult a neurologist, the sooner the better, and begin treatment to fully restore your baby’s health.

Treatment of encephalopathy in infants.

Treatment is usually complex, it begins after a complete examination of the baby, for this you need to pass tests:

Take examinations:

NSG (neurosonography)
EEG (encephaloelectrography)
MRI (magnetic resonance imaging)
Cerebrospinal fluid
Neurologist
Oculist

With proper treatment and timely diagnosis infant encephalopathy It is well treated, treatment is carried out both at home and in the hospital, it all depends on the severity of the disease, but treatment is carried out over a long period of time and in courses. Drugs are prescribed to restore the structure of the brain, improve blood supply to the brain, B vitamins (Magne B6, Magnelis), sedatives, drugs that treat symptoms: for seizures, anticonvulsants (Konvulex, Finlepsin, Depakine), drugs that relieve muscle hypertonicity, as well as drugs that treat movement disorders. Other drugs can be prescribed intramuscularly and intravenously. Electrophoresis is well used for the treatment of encephalopathy (if there is no history of seizures), neurologists like to prescribe physical therapy, massage, and herbal medicine. One of the important principles of treatment is this.