Good afternoon! My daughter is 3 years old, one leg is thinner than the other and she is lame. The leg is developing poorly. The doctors didn’t really make a diagnosis, they send it back and forth and that’s it, tell me where and how to contact? Thanks!!!

Good afternoon! My daughter is 3 years old, one leg is thinner than the other and she is lame. The doctors did not really diagnose, tell me where and how to apply? Thanks!!!

Elizaveta, please tell me in which clinic you receive and how to get an appointment with you? Thanks in advance for your reply.

I read your article in a magazine. Have you after all and test was on revealing roblem. I like it. It was because of your article that I bought the magazine. Thanks. Very intelligently written.

We were diagnosed with motor delay at 3 months. found a good doctor. a lot of work with the child. did massage. currents. gymnastics every day. the result was not long in coming. sat down at 7 months. at 10 went very confidently. The main thing is to find a doctor from God. thanks for the system. the child is developing very well

Please help us figure out what to do. The child was born by caesarean section due to hypoxia. He was very excited. For the first half of the year he slept 10 hours a day, he cried all the time. When crying with his right hand, he scratched his face and pulled his right hand. the degree of intracranial hyper……..(inaudible). The neuropathologist prescribes drinking a potion with valerian and something else, soothing. The result is zero. , but then she began to notice that it was hard for him to take something with his right. At 4.5 months they went for a massage, and after the massage he began to roll over on his stomach. And the handle was also weak and inept. At 7 months they went to the neurological hospital. that besides the handle, the right leg is also not as active as the left one. After the examination, they said that there is a small intracranial pressure and one ventricle-2.5 with a normal 2.2. Became mute the leg is better, and after the massage. charging, he began to take toys better with a pen, and began to sit. At 9 months, a second course of treatment - exercise, massage, physiotherapy (AMPLIPULS device), pantogam, became a little better, already walks with two handles, but puts his right leg on. It turns out like limping. the left one can normally eat cookies. Since 10 months he walks by himself by one hand, but limps. At 11 m. I really didn’t want to walk myself. At 1 and 1.5 m. he began to walk with a limp, the right handle does not work well. He keeps it with his thumb in his fist. When he rattles the rattle with his left hand, he strains his right hand a lot. And all the time he plays only with his left hand, occasionally shifting toys to his right. dietary supplements - IZ, Joy, Top. It got better, but the difference between the right and left arm and leg is still visible. They drank for 1.5 months. Then the hospital. The examination showed - ECHO encephaloscopy
Sounding was carried out on typical tracks in the ECHO location mode:
signals from brain structures are clear,
Offset M echo m Md55 Ms55
Transmission mode: M echo 55
Width of the III ventricle 5.0
Ventricular ECHO d88 s88
Final complex d115 s115
Ventricular Lifshitz index D2.2 S2.2
Ripple value M echo 60% V echo 70%
The nature of the pulsations is moderately intense
Additional ECHO signals D=S
Ripple front increased
Again massage, exercise, physio and paraffin therapy. Electrophoresis is impossible due to hemangioma. It gets better, but there is still a difference. With the right hand, it often takes not between the thumb and index, but between the index and middle. The doctor says I will diagnose you with cerebral palsy - hemaporesis. And I want to cure and not apply for disability. HELP SOMEONE WITH ADVICE. WHAT SHOULD I DO.
Now we are a year and a half old, sometimes he began to point in a book at something with his right hand or when he wants to start a button with his right hand, but not with his index finger, but with his ring finger, and it’s clear that it’s hard for him to do this! Maybe someone heard about the doctor’s clinic Kozyavkin in Truskavets?

Hello, Doctor! My son is 11 years old. He was diagnosed with dyscirculatory disorders, astheno- neurotic syndrome. 1. vegetative paroxysms are expressed: marbling of the skin, microcirculatory disorders. Expressed anxiety, expansion of reflexogenic zones. Muscle tone is dystonic. 2. Had an episode of diabetes insipidus. Medicines were prescribed: phenibut 0.5 x 2 r. in magne B6 1 x 2 Cavinton 1 x 2 I have a question, is there alternative methods treatment, because the child became worse from phenibut.

I also have a problem with my son, it’s mine. In my opinion, he is not obedient, for the whole day there is not a single time that he would fulfill my request, and when we start discussing this, he involuntarily twitches his shoulders, and just in general there is no moment when his arms and legs were not in motion. He constantly does something, picks, even when he watches a cartoon. the first thing he answers to the request is "no" I will not sit down, or not. I won’t go, and then his options for what he wants to do. He is 3.2 years old.
Trouble from morning to evening.
I was born by caesarean section. In the first month I was under the supervision of a neurologist, in the second month they used drugs, parashocks and injections + massages. They removed spasticity.
What to do, how to find a way? Requests and persuasion do not help.
Whether to address to the doctor?

My daughter Sasha is 2 years and 5 months old, it seems to me that we need expert advice. The fact is that from birth, instead of a pacifier, she sucks her thumb and when she falls asleep she starts stroking a toy or a blanket. I can’t wean her, she starts swearing. and which specialist to contact

My son Alyosha is 1 year and 5 months old.
He has had many neurological problems since birth. The doctors can't offer anything besides prescribing medicines. When Alyosha was 7 months old, I canceled all drugs, including anticonvulsants, at my own peril and risk. We have at least some development: he began to smile, walk. However, his developmental delay is very strong.
I beg you, if anyone can advise a doctor who will not stuff the child exclusively with pills, but can offer something else. Thanks a lot in advance.

Good afternoon!

Tell me what can be done.

The boy is 11 years old, going to the 6th grade.

Inattentive and distracted. Lessons for half an hour
can stretch over 2 weekends.

He only likes to watch TV, on the computer
play and sit in the sandbox.

There is an aggravating circumstance - the grandmother.

Thanks in advance for any advice or hints.

"Endlessly open and close doors, turn on and off the light and water, etc." What age is this about? And what is endless? At what age can a child concentrate for more than 15 minutes? And if he is not interested in this game, why should he concentrate?
It is not clear what age children are in question - about first-graders or after a year? because the norms for these ages are different!

pYUEOSH RTBCHDYCHBS UFBFShS. fBL CHUE Y RTPYUIPDYF ... chTBYU OE IPFSF RPDTPVOP CHOILBFSH CH RTPVMENSCH NBMEOSHLYI RBGYEOFCH. rTPRYUBMY FBVMEFLHY UYUYFBAF, UFP UCHPK DPMZ CHSHCHRPMOYMY.pFUADB OCHETOPE Y CHUE VEDSHCH. zTHUFOP... :-((

The doctor whose visit instills fear in most Russian parents is a neurologist. Moms and dads are afraid that this particular specialist will definitely find some kind of neurological abnormality in their beloved child. And these fears are not so groundless - according to statistics, 90% of babies in our country have one or another neurological diagnosis. Is this diagnosis always reliable and are neurological problems really so common? pediatrician Evgeny Komarovsky.

Features of the children's nervous system

The nervous system of a newborn undergoes the most significant changes in the process of growth. Children are born with an immature nervous system, and it has yet to be formed, strengthened. The most intense changes occur during the neonatal period and the first year of life, and therefore it will not be difficult for any neurologist to find certain neurological symptoms in a baby at 2 months or at 6 months.

During the formation of functions nervous system not everything goes smoothly, says Yevgeny Komarovsky, hence the incomprehensible cry for an incomprehensible reason, spasms and tics, hiccups and regurgitation, which bring so many experiences to parents and rich food for the doctors' activities.

If mothers understand the seriousness of the processes taking place with the child, questions, fears and doubts will become much less.

The brain of a newborn is quite large compared to the body, as the child grows, the proportions change, the structure of the brain becomes more complicated, and additional furrows appear.

The most active changes occur from birth to 5 months.

The spinal cord and spine of the baby grow unevenly, and their growth evens out at its pace only by 5-6 years. The speed of transmission of nerve impulses in the nervous system of a child is different than that of an adult, and in accordance with mother's and father's, it will come only by 6-8 years.

Some of the reflexes that a newborn has, go away with time and by the year there is no trace of them, they are replaced by permanent reflexes. The sense organs in newborns function from the first minutes after birth, but not in the same way as in adults. For example, a baby begins to see clearly at about 1.5-2 months, and he can hear well already on the third day after birth.

neurological problems

When mothers with complaints of a child's trembling chin, shaking hands or regular hiccups come to the doctor, he is well aware that in 99% of cases such symptoms are a variant of the norm, given the intensive process of improving the nervous system. The doctor knows that these little "troubles" will most likely go away on their own, and possibly very soon. But he, according to Komarovsky, does not want to take responsibility for your child, and therefore it is easier for him to say that the shaking chin is a neurological symptom, and prescribe a certain treatment that will not cause harm (massage, swimming in an inflatable circle on the neck, vitamins).

Of course, there are real neurological problems, and they are all very serious without exception, Komarovsky says, but they occur in only 4% of children.

Therefore, most of the neurological diagnoses made to babies by neurologists in the clinic at the next scheduled examination have little in common with real diseases.

Worst of all, if the doctor prescribes medication to the child to eliminate neurological symptoms, which by and large exist only on paper.

Real situations when such pills are needed - no more than 2-3% of all established diagnoses. But they are accepted by everyone to whom they are prescribed.

Komarovsky considers effective drug treatment only for children of the first month of life, if they really have serious violations during childbirth. Then even they are shown only massage and physiotherapy.

When does the problem really exist?

- a diagnosis that is very fond of making children in Russian clinics. When it really is, the child needs urgent hospitalization, and not home treatment with pills, says Komarovsky. If the child is cheerful, cheerful, active, sociable, he does not need to be treated for intracranial pressure, since it is most likely not present at all.

The most common complaint with which parents turn to a pediatric neurologist is the child's op.

With this, in most cases, the search for a disease begins, which, most likely, will be found.

Komarovsky urges mothers to stop looking for diseases in their children and simply understand that a child has a lot of other reasons for crying - hunger, heat, a desire to communicate, a desire to attract attention, an uncomfortable diaper, and so on. All these reasons have nothing to do with neurological diseases.

Very active children are considered to be sick, they are immediately diagnosed with "hyperactivity", calm and slow children are also considered unhealthy, they are stigmatized as "lethargy", they try to explain poor sleep and appetite with neurological problems. You don’t need to do this, says Yevgeny Komarovsky, since real neurological diseases are rare, and they sound menacing, probiotics and gymnastics do not cure them.

These include epilepsy, cerebral palsy, neurosis of varying severity, Parkinson's disease, encephalopathy, pathological involuntary nervous tics and other conditions, many of which are congenital.

There is no need to compare your child with other children and the norms of the development of babies that exist in theory. Your child is a personality that develops in accordance with its internal "settings", they are purely individual.

Today, problems in the field of neurology in newborns are very common. After all, the child is affected by modern ecology, and parental nutrition, stress. The most common neurological disorders in infants are: birth trauma, lack of oxygen during the development of the fetus in the womb in the first months of pregnancy, complications that arose during childbirth, poor heredity. Also, the mother's toxicosis can affect the child if it manifests itself in a severe form.
The health of the baby depends on the heredity that he received, as well as on the social conditions in which he is. At the same time, at an early age, he needs dynamic observation in the first, third, sixth, ninth and twelfth months of life, after birth.
Motor, mental and speech development of a child in the first year of life - dynamics
In the first month after his birth, the baby learns to hold his head, fix his gaze, track the movement of bright objects, and listen to various sounds. At the same time, he unconsciously begins to smile and make sounds with the help of the larynx.
In the third month, the child has already learned to confidently hold his head, rise on his forearms, roll over on his side from his back. Often trying to take objects around him, such as toys, began to respond to the voice and face of his mother, shows a vocal reaction to hunger or discomfort. The facial expressions of the baby come to life when someone's voice sounds, if he feels good, then he smiles or laughs.
At six months, the newborn should already sit on his own, get on all fours, and can swing. At this age, he often tries to crawl away somewhere. He takes objects with one hand, showing interest in them, and has already learned how to manipulate them quite well. The kid is already starting to babble (imitated speech), pronounce his first syllables, he also loves to imitate the intonations of adults.
At the ninth month, the baby is characterized by active crawling, the ability to stand (of course, with support or holding on to the nearest support). He is already good with toys, he has learned to take objects of small sizes. During this period of development, he already distinguishes between relatives and strangers, he can repeat movements, imitating the “interlocutor”, for example, playing “patties” and “magpie-crow”. Also, the child will be able to show a certain part of the body and understand that they are saying “no”, say short words(usually "mom" and "dad"). Now he is already able to complete a simple task and drink from a mug on his own.
At twelve months, children begin to walk independently, understand speech addressed to them, play with dolls or cars, help themselves dress, learn to be neat. Vocabulary at this age is about ten to twelve words.
It is important to know that when forming a child's speech, two options are usually distinguished: 1) the number of words spoken by the child gradually increases; 2) speech develops unevenly (the child starts from the simplest syllables, and at 6-12 months it falls silent, and at 9 months begins the conscious repetition of syllables).
The most common neurology in newborns (nervous system damage) at this age is caused by hypoxia (while carrying a child in the womb or during childbirth) changes in the functioning of the central nervous system. The changes mean: too high excitability, disturbed sleep and eating behavior, disturbances in movements (and muscle tone), disturbance in the regulation of pressure inside the skull, the skin has become marbled, the palms and feet are wet, the limbs are cold, meteorological lability is observed, the possible occurrence of different types convulsions.
Parents must be aware that in the absence of the necessary and proper this case attention to such manifestations, which are pathological, with regard to the state of the child's central nervous system, certain consequences can be reaped. The baby may have delayed psychomotor and speech development, which in turn can lead to behavioral disorders (hyperactivity), lack of attention, he may frolic emotional instability, disrupt the formation of writing, reading and counting skills. In addition, the development of brain functioning will also slow down, i.e. speech, attention and memory in a child will be impaired.
If parents have noticed the following symptoms in a child, it is imperative to go to the appointment of a pediatric neurologist:
- the baby's suckling is too sluggish, he interrupts because he gets tired;
- the baby chokes, milk flows out through the nose;
- there is nasality in the voice, and the cry is weak;
- in a child, regurgitation occurs often, and the whole is added insufficiently;
- the newborn is inactive or too restless, and this condition only intensifies, even if almost nothing changes around him;
- the baby's chin, upper and / or lower limbs tremble, especially when he cries;
- the child has an unreasonable shudder, it is difficult to fall asleep, and the dream itself is superficial and short;
- when lying on his side, he usually throws back his head;
- head circumference grows too fast or too slowly;
- the child is inactive, lethargic, the muscles are in a flabby state (in low tone) or he is constrained in his movements (which indicates a high muscle tone), which makes swaddling him a difficult task.

If the first symptoms are not noticed in time, precious time will be lost, and the consequences of such diseases are very difficult and often simply irreparable: delay in the speech and psychomotor apparatus, serious behavioral disorders, emotional instability. One of the most serious and common diseases of the nervous system is neuralgia in children. This is a disease of the peripheral, and not the central nervous system of the child. The difficulty lies in the fact that neuralgia in infants is difficult to diagnose, since the child cannot talk about the pain that torments him.

Symptoms of childhood neuralgia

How to recognize neuralgia in a newborn, if he can have a large number of reasons to cry? To consider the symptoms of neuralgia in children, attention, care and observation are needed.

• the baby can, with choking crying, constantly reach out with his hands to his face, and the muscles of the face, upon closer examination, can involuntarily twitch - this is the first sign of trigeminal neuralgia facial nerve;
• the child sometimes, when crying, cannot open the jaws, which are cramped - this also indicates a pinched trigeminal nerve;
• the child begins to scream heart-rendingly if they take him in his arms or simply change his body position - this may be a symptom of intercostal neuralgia;
• tearfulness and profuse sweating, not characteristic of newborns;
• the baby involuntarily retracts the head at any touch.

All of the above symptoms may also be accompanied by the following additional phenomena:

The main symptoms by which neuralgia can be recognized are convulsions and severe pain when touching the affected area of ​​the body.

Causes of childhood neuralgia

The main cause of any neuralgia is the pinching of the nerve ending by the vessels, which, due to improper blood circulation, can expand and thereby put pressure on nearby nerve cells.

The expectant mother may well protect her unborn child from this disease, since the causes of neuralgia in newborns lie precisely in the lifestyle of the mother during pregnancy.

• lack of oxygen, which, in turn, can be caused by ordinary anemia, past infection, smoking;
• great physical and psycho-emotional stress during pregnancy;
• birth injury;
• fetal prematurity.

A child can acquire neuralgia due to an oversight of the parents:

• intercostal neuralgia in children can be triggered by the fact that the child was simply picked up incorrectly;
• constant presence in the so-called kangaroo bags can also cause neuralgia;
• drafts and generally any hypothermia;
• spinal diseases.

Treatment of children's neuralgia

Neuralgia in children is a fairly common phenomenon, and modern pediatric neurology has made great strides in the treatment of diseases of the nervous system, so if you find signs of neuralgia in a child, you should not panic. An urgent consultation with a specialist is needed, who will determine the exact diagnosis and prescribe the appropriate methods and drugs for treatment. With neuralgia in children, the following effective methods are used:

• massotherapy;
• swimming;
• daily bathing in the bath;
• physical therapy has a great effect in neurology - a medical sports complex special exercises, which help to improve blood circulation and eliminate the pressure of blood vessels on the nerve endings;
• analgesics for pain relief;
• considering that up to 3 months the child should not be given medicines, homeopathy is a reliable and effective remedy.

To avoid the occurrence of neuralgia in a child, parents should already from the moment of conception think and take care of the health of their baby: mommy should lead healthy lifestyle life and provide the unborn child with everything necessary already in the womb.

Symptoms of neurological diseases in children

Manifestations of symptoms of neurological diseases can be even in infancy. alarm bell for parents should be constant crying. Most often, parents consider this whims. In fact, what is considered a whim is not a whim at all. Small children cry either with improper care, or with physical or mental ailments. Not all children can calmly endure the difficulties they face, and believe me, knowing the world and acquiring basic skills is a very difficult task. Some children react in a difficult situation with hysteria or withdrawal. Over time, such attacks become a system. Most often, a bad character, to which parents tend to ascribe such behavior, is not at all a character, but a real neurosis.

It is believed that the nervousness of the child is normal and it is not necessary to consult a doctor. Often only a doctor can identify a nervous breakdown.

If you do not want to make the mistakes of other parents, then beware if:

Your child is very ahead of his peers mentally. The psyche of a child at a high rate of development has every chance of "overstraining".

He is very passionate about any occupation to the point of fanaticism. It can be some kind of subculture, learning an exotic language, any non-standard hobby for his peers.

A complete escape from reality in a certain game (there are times when a child imagines himself as an animal and all his behavior is subordinated to such behavior).

The child suffers from daydreams - hallucinations. This manifests itself in a conversation with someone invisible, constantly listening and asking if you can’t see or hear anything? The child's lies and fantasies about something he really believes in, such as being abducted by aliens and so on.

Obvious signs of a nervous breakdown are: nervous tics, headaches, obsessive fears, tantrums, tearfulness, desire for loneliness, various phobias, hypochondria, food refusal, stuttering, insomnia, neurotic enuresis. If you notice one symptom or a whole complex, contact your doctor immediately, because the sooner you turn, the easier it will be for the child to get out of this state.

Most often, neurological disorders affect children with low or high self-esteem, individualistic children, as well as timid children, children under strict parental control, anxious by nature, children with increased suggestibility, touchy children, unwanted children.

If you honestly look at your child, evaluate your relationship with him, his predispositions and characteristics, then it will be much easier for you to influence the situation, because most often you need to start with yourself.

Pediatric neurology

The nervous system of a child is one of the most important components of a holistic organism. With the help of the nervous system, not only control over the activity of the whole organism as a whole is carried out, but also the relationship of this organism with the external environment. This relationship is carried out with the help of sensory organs, receptors on the surface of the child's skin.

The nervous system is a very complex formation in the body of a child. Any violation in its well-coordinated activities can lead to the development of quite serious diseases.

The development of the nervous system is uneven. The laying of the brain occurs in the early stages of pregnancy (1st week prenatal development child). But even after childbirth, the process of division and the formation of new nerve cells does not complete. The most intensive period of formation of the child's nervous system falls on the first 4 years of life. It is during this period that the child receives more than 50% of the information that helps him in later life. Adverse environmental influences, infectious diseases, injuries during this period lead to the formation of the greatest number of neurological diseases.

The motor activity of the child, which is also controlled by the nervous system, is also important. Being inside the uterus, the child takes a certain position, which allows him to occupy a smaller volume. After birth, the child can identify various reflexes. The presence of these reflexes, on the one hand, is associated with the immaturity of the nervous system, and on the other hand, they help the child survive in the environment. Gradually, in the process of maturation of the nervous system, many of the reflexes disappear, but some, such as swallowing, remain with us for life.

The sense organs (sight, smell, touch, hearing) are very important in the life of a child. These organs help the child navigate the environment, form an idea about objects and phenomena, communicate and learn about the world. Any violations of these sense organs lead to the fact that it becomes very difficult for a child to perceive the world, to communicate with his peers. Of no small importance for the formation of communication is speech, which will also be controlled by the nervous system. Speech impairment can be both a consequence of brain damage and organic diseases of the organs involved in the formation of speech. It is necessary to identify various speech disorders in time and treat these conditions, since speech is necessary not only for communication, but also for the correct assimilation of the knowledge gained.

In some cases, it is quite difficult to recognize neurological diseases in children in the early stages, as they may be hidden behind the functional immaturity of the nervous system. In this case, only parents are able to provide all possible assistance to medical workers, since they are next to the child almost 24 hours a day, and can immediately determine whether the child's behavior has changed. A feature of neurological disorders in children is also the fact that many of them are wounded, timely, correct, although long-term treatment disappear almost completely.

Having studied the articles collected in this section, you will be able to learn how to identify various conditions in children that may indicate the presence of a pathology of the nervous system in a child and draw the attention of a doctor to this in time.

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For any diseases, especially during pregnancy or in a child, do not diagnose symptoms and treat yourself, you must always consult a specialist doctor.

Symptoms and treatment of childhood neurological lesions

Pediatric neurologist (neuropathologist)

The most common pathologies of the central nervous system in children under one year old include the so-called perinatal encephalopathy. A pediatric neurologist (neuropathologist) is engaged in identifying abnormalities and pathologies of the child's nervous system. The development of perinatal encephalopathy in an infant can provoke an umbilical cord around the neck of the fetus during pregnancy, premature from the placental layer, prolonged or premature birth, general anesthesia during childbirth. Many pathologies of the child's nervous system are associated with cerebral hypoxia, which has arisen due to external or internal adverse factors in the last month of pregnancy - toxicosis, the use of potent drugs, smoking, the development of acute infectious diseases, the threat of miscarriage, etc.

1. The arms and chin are shaking strongly at the slightest excitement, crying, and even sometimes in a calm state;

2. Very superficial, restless sleep in an infant. The baby has difficulty falling asleep and often wakes up;

3. Frequent and profuse regurgitation in an infant;

4. Convulsions (twitching) during an increase in body temperature;

5. When relying on the foot or on the "toes", the fingers are strongly pressed

Here are some of the techniques they use chiropractors and pediatric osteopaths for the treatment of pathologies of the nervous system in children:

1. Visceral manual therapy.

Restoration of mobility and normal functioning of organs.

2. Vertebroneurology (soft technique of pediatric manual therapy).

This technique is based on working with ligaments and muscles at a slow pace with stretching of spasmodic, tense areas.

3. Craniosacral therapy. Normalization, alignment of the work of the bones of the child's skull.

When the movement of the bones of the skull is displaced or disturbed, the movement of the cerebral fluid, blood flow is disturbed and, as a result, the functioning of the brain deteriorates, intracranial pressure increases, the ventricles of the brain expand (hydrocereus), and headaches intensify. This technique is very relevant for young children.

4. Emotional techniques.

Very relevant for behavioral disorders, various neuroses in children. Emotional techniques are associated with the impact on the channel-meridian and stress points, with the emotional state.

5. Work with muscles for their relaxation.

As you know, muscles are associated with internal organs, bones, vertebrae. The technique is aimed at muscular-ligamentous relaxation, post-isometric relaxation (holding a special posture, and then relaxing)

1. Frequent headache

2. Piercing back pain

3. Problems of memory and attention

4. Violations of the functions of the spine on different levels

5. Reduced concentration

6. Panic attacks

7. Delay in the rate of speech development, writing, sound pronunciation

8. Diseases of peripheral nerves (neuropathy, neuralgia)

9. Quick fatigue

At six months

At nine months

After a year - a mandatory annual examination by a neurologist.

There are the following children's neurological lesions:

1. Due to toxic disorders

4. Hypoxic lesions

5. Due to traumatic lesions

6. Epilepsy (post-traumatic and hereditary)

7. Specific syndromes (including combinations of the above lesions of the nervous system)

Neurological diseases in children

On a daily basis, the child interacts with environment, that is, it grows and develops, which is necessarily controlled by the nervous system. This explains the importance of the role assigned to it in the children's body. The smallest disruption in the work of the National Assembly can result in unpleasant diseases neurological nature, which in childhood are very common. The lack of parents' understanding of the symptoms of such disorders contributes to untimely access to a specialist and delayed initiation of therapy, which is unacceptable.

Photo: Violations in the nervous system of the child

Neurological diseases are recognized as a pathology in which there is a violation in the work of the central and peripheral nervous systems.

When can violations be noticed?

The appearance of the first signs of one of the neurological ailments can be noted even in early infancy. Regular crying of the baby should be the first signal for parents to promptly visit a specialist. Instead, most moms and dads prefer to attribute this behavior of the baby to banal capriciousness. But we all know that babies can cry for several reasons: with improper care and malaise.

As the child gets older, tantrums may be a habitual response to difficult situations and difficulties encountered along the way. Parents are again trying to fence themselves off from the problem, blaming the unbearable nature of the child. Of course, in such cases, do not go to the doctor. In fact, it is a mistake to write off all kinds of violations in the behavior of a child of any age on character traits. More often, the problem lies in something more complex, for example, neurosis, which only a qualified specialist can identify.

What are the consequences of delay?

The NS is comparable to a clockwork: it is worth a small part to fail, and full-fledged work will be disrupted. If a child has a neurological problem, and even in running complications may soon appear. The most optimistic of them is a violation in the work of the psychomotor apparatus. If you continue to do nothing, the child can become hyperactive and try on attention deficit disorder, or even become a hostage nervous tick. At the same time, the child's behavior becomes really complicated, in some cases even inadequate.

Reasons for the development of pathology

Predict how the NA will respond to the negative external influence not even experienced doctors can do it. Possible reasons for the violation of the normal psycho-emotional state of the child include:

hereditary factor; brain tumors; disease internal organs chronic nature; low immunity; traumatic brain injury; infections; response to medication.

This is not a complete list. According to some reports, even the ecological situation and gender can affect the state of the nervous system.

Risk group

Doctors distinguish a group of children who are more prone to neurological disorders than others. First of all, these are children with too low or, on the contrary, overestimated self-esteem. Even at a very early age, it is difficult for them to develop normally in society, which is why isolation is manifested. Also in this group include children with signs of individualism, anxious and touchy. Often, neurological diseases overtake children with a high degree of suggestibility and too timid.

Unwanted children can also be attributed to the risk group.

Neurological diseases in children: symptoms

It is sometimes difficult to recognize problems in the work of the child's NS even by an experienced specialist during a clinical examination. To parents far from medicine, such a thing will seem completely impossible. But to observe the behavior of the child from the very first days of his life is their direct duty.

Infants must be examined by a neurologist, which allows you to identify the disease at an early stage and start treatment as soon as possible. It is unacceptable to miss an appointment with the doctor!

Signs of nervous breakdown include:

• nervous tic;
• obsessive states;
• fears;
• speech disorder;
• tearfulness and tantrums;
• loss of appetite or complete refusal of food;
• stuttering;
• enuresis;
• insomnia;
• hypochondria;
• fainting;
• impaired coordination of movements;
• tingling in different parts body.

Parents should pay attention to the condition of the child if he constantly or with noticeable regularity complains of dizziness, tinnitus and problems with swallowing. Increased fatigue for no apparent reason should also alert.

Having noticed one, and in particular several signs in their child, parents should immediately go to an appointment with a pediatric neurologist. Consultation with a specialist is also recommended because often the symptoms presented do not indicate neurological problems at all, but diseases. digestive tract, viral infection or problems with the endocrine system. This is due to the inseparable connection of the nervous system with the entire body.

Photo: Neurological problems in a child

A word about headaches

Chronic malaise, as it is customary to call a headache, is one of the leading places in prevalence among children. In many cases, it is considered a symptom indicating a number of diseases - from banal ophthalmological to brain tumors. The presence of a persistent headache is an alarming signal that may indicate big problems and developing in a child. neurological abnormalities. If the pain is characterized by a gradual increase, localization on both sides of the head and a dull character, while the child's appetite and sleep are disturbed, do not postpone the examination!

In order for the treatment of neurological diseases to be more effective, parents should seek help in time. But first you need to remember about the constant monitoring of the behavior and well-being of the child, which are the main indicator of his condition.

Neurology in children

Neurology is usually called the pathology of the nervous system, although in reality it is a science that studies them. Pathological phenomena of the nervous system should never be ignored by doctors! Neurology in children - especially. Diseases of the nervous system lead to serious consequences, because the most optimistic diagnosis when ignoring the disease is a delay in the development of the speech and psychomotor apparatus. This may be followed by hyperactivity, attention deficit disorder. Such children are on the verge of neurosis, nervous tics and inappropriate behavior.

Symptoms of pathologies of the nervous system

Some signs of neurology in children are quite eloquent, so sleep disturbances, a shaking chin or arms, legs, frequent regurgitation, tucking up the toes in a standing position should alert parents. These symptoms are a reason to contact a pediatric neurologist. However, the symptoms of neurology in children may be blurred, but if it is difficult for parents to notice them, then an experienced neurologist will be able to draw the right conclusions.

Treatment of pathologies and prognosis

Fortunately, neurology in infants in most cases can be corrected and treated. The doctor should carefully analyze the features of the baby's lifestyle, starting with monitoring the mother's pregnancy. If the neurology of premature babies or infants with pathologies has an unclear etymology, then additional studies are assigned. The parents of the child are offered to conduct an examination of the baby's fundus, ultrasound, Doppler, EEG. In extreme cases, an MRI may be required.

The brain in the first months of a baby's life develops very actively, its structures mature, as well as mental and motor functions. It is for this reason that it is very important to diagnose as early as possible and prescribe effective treatment.

As a treatment, combined methods are often used, combining drugs, the clinical effectiveness of which has already been proven, and massages, physiotherapy exercises, physiotherapy. In addition, modern neuropathologists are constantly replenishing their arsenal with new methods of neurological rehabilitation: computer speech programs, methods for improving movement coordination, cerebellar stimulation, etc.

In order to be sure of the health of their child, parents should visit a neurologist every three months until the age of one. Thereafter, the inspection is carried out annually.

Pediatric neurology is a branch of medicine that deals with diseases of the child's nervous system. It arose at the intersection of 2 disciplines - neurology and pediatrics. She is also closely associated with neurosurgery and psychiatry. Neurology in children is one of the most complex disciplines in medicine.

A bit of history

Yakunin Yu.A., Badalyan L.O., Shabalov N.P. made a great contribution to the development of pediatric neurology. and, of course, Ratner A.Yu. They did a lot for the development of perinatal pathology, i. in neonatal neurology.

Also, in order to improve the processes of diagnosis and treatment by pediatric neurologists, in 2015 the third edition of the book “Children’s Neurology in Newborns and Clinical Recommendations” was published, ed. prof. Guzeeva V.I. and co-authors.

Here are all the latest materials on the etiology, definition and therapy of pathologies of the nervous system in childhood; the entire algorithm of the doctor's actions is indicated.

Particularly detailed information is given on the pathology of newborns. Much attention is paid to evidence-based medicine and its achievements.

A neurologist (a more modern name for the specialty of a neuropathologist) specializes in the study, prevention, detection and treatment of diseases with lesions of all parts of the nervous system.

This is especially important in children, because neurological pathologies leave a trace in the future for life. The work of a pediatric neurologist is very responsible, because with his decisions he decides the future fate of the child: his social adaptation, mental and physical health; and even his illnesses in the adult period.

Today in pediatric neurology is open new section diseases: hereditary metabolic diseases. This is done because of the 2.5 thousand nosologies in neurology, 70% of them are hereditary.

Visits to a pediatric neurologist should be scheduled in the first month of life, every 3 months for 1 year of life. Then they are performed annually as needed.

The importance of timely access to a pediatric neurologist

Children's neurology differs markedly from that of adults; The nervous system of children changes with age and is not a copy of an adult in miniature. Children have many diseases atypical course and are quite rare.

The main problem of pediatric neurology is perinatal lesions of the nervous system. The perinatal period begins at 22 weeks of gestation and ends 7 days after delivery. During this very crucial period for the mother and fetus, a variety of factors can influence it.

The last month before childbirth and health are very dependent on external factors: late toxicosis; nicotine; taking drugs; stress; infections - all this is very much for the body of the unborn baby, these are harmful factors. For example, even minor stress in the mother during pregnancy leads to a supersaturation of the baby's bones with calcium.

As birth approaches, the bones of the fetus harden; the result is painful labor for the mother and difficulty for the baby in passing through the birth canal. It is also indisputable that today the number of stresses in a person's life is growing exponentially.

The work of the nervous system can be disturbed even in the prenatal period. Therefore, the neurologist examines the child in the first weeks of life and immediately after childbirth.

If the birth of the mother was pathological and the child was born in asphyxia, there was an imposition of forceps and other obstetric manipulations, this will definitely affect the nervous system. Many researchers in the West consider current childbirth to be non-physiological.

The same was said by the only neurologist who examined newborns during the perinatal period in the book - A.Yu. Ratner Neurology of newborns. This monograph describes the damage that becomes inevitable for an infant during obstetric manipulations.

Also A. Yu. Ratner, all neurologists, osteopaths and massage therapists insist that during childbirth the most vulnerable place in the fetus is the neck and shoulder girdle. They are under the most stress. Here is the boundary between the spinal cord and the brain.

Here are those structures that orient a person in space; responsible for biorhythms, breathing, providing the body with energy. They are laid later than all and continue to mature in the perinatal up to 3 years. They call them the I block of the brain.

That is why it is so important to treat the pathology of the nervous system in the first year of life. If the baby's neck is injured, this will manifest itself muscle spasms in the neck; the neck will be sunk into the shoulders.

Such babies do not like to lie on their stomach - it hurts them; it is hard for them to hold their head, it falls and sticks its nose down. This is because when the head is raised, the neck and shoulders reflexively tighten.

These babies often have sleep disturbances; rickets is more common. At an older age, they will suffer from headaches because the spasticity of the muscles in this area will persist.

Vessels feeding the brain pass through 1 block and this will also be reflected in it. This clearly demonstrates how great importance is attached to neurological disorders in the first 3 years of life, with an emphasis on the first year. Also, the detachment of the child's place, the speed of childbirth in any direction, and anesthesia during childbirth have a negative effect. And you don’t have to hope for a chance if the child screamed immediately during childbirth, was attached to the chest and immediately took the breast, etc. If you ignored the neurologist, the baby may have a ZPR at a minimum, the child will remain disabled. Organic lesions are quite possible.

Children with a lag can also lag behind in society, basic skills, be inadequate, emotionally unstable, etc. According to statistics, a child is disabled in 50% of cases due to neurological diseases.

At the same time, 70% of diagnoses are related to the condition of the pregnant woman for a period of weeks and the health of the baby during the neonatal period.

With an early appeal to a pediatric neurologist, half of these problems can be successfully solved.

This is possible because it is in the first months of a newborn's life that the brain actively develops and matures, it has more opportunities for adaptation, and therefore the treatment will be most tangible in terms of effectiveness. If time is lost, it will be possible to speak only about the meager possibilities of rehabilitation. In other words, everything is good on time.

When is it necessary to contact a neurologist urgently?

The first symptoms of disorders are possible in the first month of life. The main symptoms that should alert parents and which should be paid attention to are the following:

1. During crying, the baby's chin trembles and the hands shake; sometimes it can be noted at rest.
2. The child is easily excitable.
3. The child does not fall asleep well, his sleep is superficial and he easily wakes up from the influence of external factors, for example, from the sound of a voice; constantly naughty. Parents of such children should not try to create ideal ways to improve sleep at home, such as curtained windows, dimming, complete silence, whispering - this is not an option. All this will aggravate the situation and delay the diagnosis.
4. Abundant and frequent regurgitation in infants, even with a small amount of food.
5. The appearance of seizures in a child, even at a low temperature.
6. A supported baby, placed on piles, curls its fingers or stands on tiptoe, like a ballerina.
7. Older children may experience: frequent headaches, they can be prolonged.
8. Fainting states.
9. Pain and shooting in the back.
10. Violations in the performance of normal movements at different levels of the spinal column.
11. Absent-mindedness, inability to attract attention, memory impairment.
12. Apathy, lethargy, fatigue, no interest in the environment.
13. Does not interact with peers.
14. Bad dream.
15. Panic attacks against the background of complete well-being.
16. Neuralgia and signs of damage to peripheral nerves.
17. Twitching of spontaneously different muscles.
18. Enuresis in children 5-6 years old.
19. Hyperactivity.
20. Delay in speech, learning to write, decreased intelligence.

In all these cases, you do not have to wait for a scheduled examination, you should immediately go to the doctor.

1. In children up to a year, an examination every 3 months; in the presence of violations on a monthly basis.
2. Then examination in the pre-preschool period - 4 - 5 years.
3. In the junior school period - 7 years;
4. 13-14 years - puberty.

All professional examinations are necessary for the early detection of pathologies in order not to bring them to serious condition. Also, early detection of psychomotor insufficiency and mental underdevelopment is possible.

How is the examination performed by a pediatric neurologist?

After a traditional examination (visual examination, palpation, manipulations to determine the motor and sensory spheres), a neurologist always clarifies the entire list of diseases from the birth of a child; analyzes all the negative aspects of pregnancy in the mother; the course of childbirth. The transferred diseases in the 3rd trimester of pregnancy are specified.

Diagnostic measures

Of the diagnostic methods for suspicious symptoms, the following are used:

• Ultrasound with dopplerography of cerebral vessels;
• examination of the fundus;
• MRI (in extreme cases).

At the time of admission, the following must be checked:

• visual reflexes;
• muscle tone and strength;
• conditioned and unconditioned reflexes;
• sensitivity and its loss are determined;
• coordination in space;
• cognitive cognitive functions.

TO additional methods studies include assessment of hearing, brain stem, speech apparatus. Since many problems are often of a polyetiological nature, the treatment is carried out together with other specialists.

Treatment methods

How to treat congenital pathologies? At congenital pathologies the main goal is to stop the aggravation of the pathology and help in the adaptation of the child. LS is not used immediately.

For starters apply:

• manual therapy;
• craniosacral technique;
• muscle relaxation;
• emotional technique;
• physio-, reflexo- and binaural therapy;
• massages;
• LFC and others.

Manual therapy - restores the mobility and function of the spine. In children, it is carried out gently, at a slow pace, removing all spasms from tense zones.

Craniosacral technique - its purpose is the manual gradual alignment of the bones of the skull. This restores the blood supply to the brain; reduces ICP. The technique is used in infants.

Emotional techniques - used for behavioral deviations and neuroses.

Muscle relaxation - it consists of relaxing the muscle fibers. This has a positive effect on skeletal system especially on the spine. It also relaxes the internal organs.

Of the new methods, one can note computer speech programs, methods for improving coordination of movements (cerebellar stimulation).

As you can see, when neurological treatment little is acceptable at home.

A neuropathologist does not just prescribe treatment and sends the child home, not remembering him until the next medical examination. He is always in control of the treatment.

In order to stimulate motor skills, mental development, parents can successfully carry out at home after consultation with a doctor simple exercises for the development and improvement of fine motor skills:

1. Pour a little buckwheat groats into a bowl and sorting it out, pour it from palm to palm. You can hide small objects in this cereal and let the child try to grope for them.
2. Pour warm water from a basin into a bucket with a glass;
3. At the first steps of the child, let's run him barefoot more often. Let him feel the surface in stacks; this will enrich his tactile sensations. At the same time, the surface alternates in texture - floor, carpet, rubber mat, fabric, etc.
4. Engage in plasticine modeling with your child, draw with finger paints.

Common pathologies

This article will outline the most common neurological pathologies in children.

1. Brain dysfunction or otherwise attention deficit hyperactivity disorder - first manifested by a reduced concentration of attention, then the child becomes irritable, easily excitable. The muscles are hypotonic, which causes awkwardness of movements, the work of the musculoskeletal system as a whole is disrupted. The posture is broken, flat feet develop, urinary incontinence appears. Children cannot learn the school curriculum, they have vegetative symptoms: increased heart rate, dizziness, headaches.
2. Also, perinatal pathology includes birth injuries, fetal hypoxia, intracranial hemorrhages. At the first examination, there may be complete health, and the manifestation of pathologies will manifest itself in a few months.
3. Hypoxic-ischemic encephalopathy is a consequence of fetal hypoxia. The brain suffers completely: the cortex and subcortex. If left untreated, this will result in a decrease in intelligence, paralysis, convulsive syndrome, cerebral palsy. Violations at an early stage are well manifested on the EEG.
4. Birth trauma is a broad concept that includes a violation of the integrity of tissues in the fetus during childbirth. Among them are spinal cord injuries, paralysis of the facial nerve. Paralysis of the facial nerve gives symptoms: swelling, omission and immobility of the mouth; eyelids do not close tightly; the nasolabial fold is absent. Treatment can lead to complete recovery. Spinal cord injury during childbirth can occur with the breech presentation of the fetus, due to the use of obstetric manipulations. Under such conditions, subluxations of the vertebrae, infringement and spasm of the vertebral artery, hemorrhages in the membranes of the spinal cord easily occur. In spinal cord injuries, contusion and compression are especially common. Neurological disorders in this case are manifested in the form of paralysis, pelvic disorders, urination disorders. Signs of damage are determined by the level of the segment. In these diseases, to treat such disorders, the neck and head of the child are immobilized. Medically relieve swelling of tissues and pain, restore the functioning of damaged brain structures.
5. Intracranial hemorrhages - they have hypoxia, impaired blood clotting, infections during the mother's pregnancy; prematurity. With all of them, the state of the walls of the vessels of the brain is disturbed, and the pathology of childbirth becomes the trigger. Treatment consists in observing a sparing and protective regimen (exclusion of any irritants - light, sound; swaddling is only sparing); medical treatment. If the hemorrhage progresses, it is possible and surgical intervention in the form of removal of blood by suction with ultrasound control.
6. Traumatic Brain Injuries: TBI includes contusion and concussion. In a child, this is manifested by asthenic syndrome; often it is accompanied by vegetative dystonia: increased blood pressure, changes in heart rhythm; disrupted work of the thermoregulation center.
7. Microcephaly. A pronounced decrease in the size of the skull and, accordingly, the brain is characteristic. Mental inferiority will be observable. Speech and motor skills are impaired.
8. Hydrocephalus. Another name is dropsy of the brain. With it, the cavities of the ventricles of the brain are sharply enlarged due to increased secretion of CSF, which accumulates in the brain cavities. Signs of hydrocephalus are formed even inside the womb. As a result, the skull is deformed, the forehead becomes excessively convex, the network of veins on the skull and temples is pronounced. The fontanelles are noticeably dilated, the eyes roll up under the superciliary arches. Often, pathologies in older children are a late result for not recognizing them in the first months of life.

Pediatricians always need knowledge of neurology, because in many childhood diseases, the nervous system suffers in parallel. Practice shows that often professional training There are not enough doctors in neurology, so mistakes and neglected cases in diseases that are easy to diagnose are not uncommon. This needs special attention.

The main variants of neurological pathology in children of the first year of life

To identify diseases of the nervous system, manifested by a specific delay in psychomotor development, it is important to assess the neurological and psychopathological signs associated with developmental delay. The age-related immaturity of the nervous system of a child of the first year of life determines the fragmentation and non-differentiation of the signs observed in him. The body, especially of a newborn and an infant, reacts to various hazards with a limited number of typical reactions, the nature of which primarily depends on the age phase of neuropsychic development. Below are the main options, reflecting mainly the type of neuropsychic response in the first year of life.

General examination of the newborn - what parents should pay attention to

Considering high frequency perinatal pathology of the nervous system and possible difficulties in obtaining a qualified specialized care, there is undoubtedly an urgent need for parents to receive relevant popular science information.

What can we see for ourselves? - general examination of the newborn

The child normally breathes rhythmically, makes automatic movements of the limbs in sufficient volume and symmetrically. The slightest restriction of movement in the arms or legs should be the basis for a focused study - whether movement disorders? The nature and volume of the crying of the child is important. A lot can tell the posture of the newborn. In some cases, the child is lethargic, inactive, sometimes - literally flattened. In other cases, on the contrary, the tone in the limbs is evenly increased - when swaddling, a peculiar stiffness of the limbs immediately attracts attention. It is very important not to miss even small convulsive twitches during examination.

Very much gives an examination of the head of a newborn. A birth tumor is typical for most newborns. How more sizes This tumor, therefore, made the birth of a child more difficult, and such a child should be the subject of a particularly careful examination. In some children, bruises on the face, neck, torso as a result of traumatic childbirth attract attention - in these cases, neurological symptoms are more often detected.

Head deformities (the so-called "configuration") almost always indicate a birth injury of the skull, and among these children, craniocerebral symptoms are much more common, which is quite understandable and easily explained.

IN daily practice cephalohematoma is sometimes underestimated, usually only because it is "common" and "located outside the skull". Indeed, we are talking about a subperiosteal hematoma, sometimes very significant in size. It is really common, but this cannot serve as an argument "against" - this is a trauma, and it is not even the cephalohematoma in itself that is important for the diagnosis, but what it indicates - at the level of such a hematoma in the underlying areas of the brain there are undoubtedly areas of microhemorrhages , which, regardless of the age of the patient, indicate brain contusion. One of important indicators difficulties with delivery is such a sign as finding the bones of the skull on top of each other. This small dislocation usually does not cause damage to the underlying brain tissue, but it certainly indicates that the fetal skull passed along birth canal, experiencing great resistance - in these cases, signs of damage to the nervous system are often detected.

An important role in assessing the condition of the child is played by the condition of the fontanelles: tension, bulging of the fontanelles is a very formidable symptom of increased intracranial pressure. The size of the head of a newborn tells the doctor a lot: signs of hydrocephalus, if they are detected from the first days of life, usually indicate intrauterine pathology of the brain, while gradual development hydrocephalus can often be the result of birth damage to the brain.

Here it should be noted the catastrophic frequency of the unreasonably extended diagnosis of "hypertensive-hydrocephalic syndrome", which in many hospitals and clinics is made with or without reason. The worst thing is that in such cases, massive and prolonged therapy with diacarb immediately begins, which is not only unjustified, but exhausting the child.

In some newborns, the head is smaller than normal, and besides, the brain part of the skull is smaller than the front - sometimes, this indicates intrauterine and genetic pathology (microcephaly) and, unfortunately, has serious consequences. IN Lately more and more often there are children with a very early closure of the fontanel, while the growth rate of the head in such newborns is clearly behind the norm.

The sign of a "short neck" is quite common, and it is usually very demonstrative and conspicuous. It seems that the child's neck is very short (although there is no anatomical defect), the head seems to be located directly on the shoulders. With age, the degree of these manifestations gradually decreases. In these same children, attention is drawn to the severity of the transverse folds on the neck with persistent weeping in the area of ​​these folds. It can be assumed that the symptom of a short neck arises as a result of overstretching of the neck during a difficult birth, followed by a reflex contraction of it according to the "accordion phenomenon" type. Later, it is in these children that another very important sign appears - a sharp protective tension of the cervico-occipital muscles.

Assessment of the condition of the abdominal wall is very important. It is known that in many newborns the abdomen is flabby, flattened, and in these cases it is impossible to exclude a violation of the contractility of the abdominal muscles as a result of birth injuries of the thoracic spinal cord. This is especially demonstrative in case of predominantly one-sided localization of the lesion - the "weak" half of the abdominal wall protrudes slightly, the navel is displaced when crying. With a bilateral lesion, it is more difficult to judge this. Can be useful next test: if such a newborn has a weak cry, then when the doctor’s hand presses on the child’s stomach, the voice becomes much louder.

Equally unfavorable should be considered priapism - a spontaneous erection of the penis in a newborn. Pediatricians often encounter this symptom, but do not know how to interpret it. At the same time, this symptom is well known in adult neurology and indicates a significant spinal pathology.

We tried to consider some possibilities general inspection a newborn to look for signs that make it possible to suspect a particular neurological pathology.

Each of the above signs cannot be considered evidence, but in the aggregate they acquire great diagnostic meaning. In any case, only a doctor specializing in perinatal neurology can resolve your doubts.

Perinatal cerebral depression (nervous hypoexcitability)

Small motor and mental activity of the child, which is always below his motor and intellectual capabilities; high threshold and a long delayed period of occurrence of all reflex and voluntary reactions. Depression is often associated with low muscle tension and reflexes, slow switching of nervous processes, emotional lethargy, low motivation and weakness of volitional efforts.

Hypoexcitability can be expressed to varying degrees and manifest itself either episodically or persistently. The episodic occurrence of the syndrome is characteristic of somatic diseases, especially the pathology of the gastrointestinal tract, accompanied by malnutrition. Sometimes mild but persistent manifestations of the syndrome may be due to the type of higher nervous activity. The predominance of cerebral depression in the first months of life is observed in prematurity, in children who have undergone oxygen starvation, intracranial birth trauma. Severe and persistent depression is often accompanied by a delay in psychomotor development, which acquires some characteristic features.

The delay in psychomotor development in hypodynamic syndrome is characterized by a slow formation of all conditioned reflexes. In the neonatal period and in the first months of life, this manifests itself in the lag in the development of the conditioned reflex at the time of feeding; in the future, the development of all food conditioned reflexes is delayed (a reflex to the position of feeding, the appearance of a breast or a bottle of milk, etc.), the development of food, and then visual and auditory dominant and sensitive local reactions is delayed. Especially characteristic is the delay in the development of chain motor combined reflexes, which most clearly begins to manifest itself from the second half of life! Such a child at the age of 6-8 months does not pat a blanket or a toy with his hand, does not knock an object against an object, by the end of the year does not repeatedly throw out an object, does not put an object into an object. This is also manifested in vocal reactions: the child rarely repeats sounds, syllables, i.e., performing single movements and pronouncing individual sounds, he does not strive to repeat them. As a result of the delay in the formation of conditioned reflexes on the combination of a word with an object or action, both in a specific and in a non-specific situation, the initial understanding of speech and obedience to verbal commands in these children occurs in more late dates. At the same time, a lag is formed in such functions as object-manipulative activity, crawling, babble, speech understanding, and one's own speech.

In the hypoexcitability variant, the formation of positive emotional reactions is noted at a later date. This is manifested both when communicating with an adult, and in the spontaneous behavior of the child. During the neonatal period, when communicating with an adult, such children usually lack oral attention, at the age of 2 months, the reaction of joyful animation at the sight of an adult and an affectionate voice is not expressed or weakly expressed. Often, instead of facial expressions of animation, a child can see only a reaction of concentration. A smile appears later than 8-9 weeks, its occurrence requires a complex of stimuli, including proprioceptive ones, their repetition; the latent period of the appearance of a smile in response to a stimulus is extended.

In the state of wakefulness, the child remains lethargic, passive, orienting reactions occur mainly to strong stimuli. The reaction to novelty is sluggish and in most cases has the character of passive amazement, when a child with wide eyes remains motionless at the sight of a new object, without making active attempts to approach it, to capture it. The longer the period of absence of active wakefulness and orienting-exploratory behavior, the more pronounced the lag in psychomotor development.

The revitalization complex is one of the main manifestations of active forms emotional behavior in a child of the first months of life - with hypoexcitability, it is either absent or manifested in a rudimentary form: a weak mimic reaction without eye gleam and voice reactions or the absence of a motor component, distinct vegetative manifestations. Active negative emotional reactions are also weakly expressed and almost do not affect the general behavior of the child.

Features of the emotional sphere determine the secondary underdevelopment of the intonational expressiveness of voice reactions, as well as the specifics of the formation sensory functions. So, at the second age stage, a hypoexcitable child usually fixes and traces an object well, but movements eyeballs after a moving object, it does not begin immediately, but after a certain latent period, as is typical for a newborn: the eyes, as it were, are constantly catching up with an object moving in the field of vision. These visual responses are erratic and often require special optimal conditions: a certain state of the child, sufficient strength and duration of the stimulus, etc. In the second age period, these reactions most clearly and often occur not in the supine position, but in an upright position on the hands of an adult. A feature of visual perception during hypoexcitability at this age stage is also that the child spontaneously almost does not examine the surrounding objects, he does not actively search for the stimulus. The hypoexcitable child usually turns his head and eyes towards an invisible source of sound after repeated repetition and a long latency period; auditory perception, as well as visual, usually does not acquire a dominant character.

The delay in psychomotor development in the syndrome of hypoexcitability is characterized by a disproportion in development, which manifests itself in all forms of sensory-motor behavior. So, with sufficient development of differentiated emotional reactions to "ours" and "strangers", the child shows active joy in communicating with friends, protests in communicating with strangers, that is, insufficient communication activity remains pronounced at the age stages. Along with the timely development of individual sensory functions, there is a lag in the formation of intersensory connections, especially in the system of the tactile-kinesthetic analyzer, therefore, hypoexcitable children later begin to examine and suck their hands, feel toys, they develop visual-motor coordination with a delay. The lack of active exploratory behavior is expressed in the disproportionate development of visual perception. Therefore, with sufficient development of differentiated visual perception in a child, the automatic nature of tracing an object can be preserved.

With dynamic quantification During the development of age, a child with hypoexcitability syndrome loses 7-9 points in different periods, and the maximum loss is observed at the age of 4-5 months, when the first intersensory connections and active forms of behavior should normally be actively formed.

Perinatal cerebral hyperexcitability

Motor restlessness, emotional instability, sleep disturbance, increased innate reflexes, increased reflex excitability, a tendency to pathological movements, often in combination with a reduced threshold for convulsive readiness. Causally, hyperexcitability is not very specific and can be observed in children with perinatal pathology, some hereditary fermentopathies and other metabolic disorders, congenital childhood nervousness, and with minimal brain dysfunction. There may not be a pronounced lag in psychomotor development in these children, but with a thorough examination, it is usually possible to note some minor deviations.

For violation of psychomotor development in hyperexcitability syndrome, a lag in the formation of voluntary attention, differentiated motor and mental reactions is characteristic, which gives psychomotor development a kind of unevenness. By the end of the first year of life, such children usually have a well-expressed cognitive interest in the environment, active forms of communication, and at the same time, with strong emotions, a general revival complex with diffuse motor reactions may appear.

All motor, sensory and emotional reactions to external stimuli in a hyperexcitable child arise quickly, after a short latent period, and fade away just as quickly. Having mastered certain motor skills, children constantly move, change positions, constantly reach for some objects and capture them. At the same time, manipulative research activity, imitative games and gestures are weakly expressed in them. Usually children show a keen interest in the environment, but increased emotional lability often makes it difficult for them to contact others. Many of them have a long-term fear reaction to communication with unfamiliar adults with active protest reactions. Usually, hyperexcitability syndrome is combined with increased mental exhaustion. When evaluating the age development of a hyperexcitable child, they are usually referred not to the delay group, but to the "risk group" if hyperexcitability is not combined with other neurological disorders.

Postpartum disorder of intracranial pressure regulation

An increase and instability of intracranial pressure in young children is often combined with hydrocephalic manifestations, which are characterized by the expansion of certain intracerebral spaces as a result of the accumulation of an excess amount of cerebrospinal fluid. An increase in intracranial pressure in newborns and infants can be transient or permanent, hydrocephalus - compensated or subcompensated, which, along with the anatomical and physiological characteristics of early age, determines a wide range of clinical manifestations.

In most cases, with hypertension-hydrocephalic syndrome, there is an increase in the size of the head, which is determined by dynamic measurement of its circumference and comparison with the dynamics of growth and body weight. An increase in head circumference is considered pathological if it exceeds the normal by more than 2 sigma deviations. As the head circumference increases, a disproportion between the brain and facial skull is revealed. Skull enlargement may be asymmetrical due to a unilateral pathological process or a defect in child care.

An increase in intracranial pressure in infants is also accompanied by a divergence of the cranial sutures, which can be determined by palpation and X-ray examination. The divergence of the sutures occurs quickly with progressive hydrocephalus and more slowly when the intracranial pressure is increased mildly or stabilized. On percussion of the skull, the sound of a "cracked pot" is noted.

Another sign of increased intracranial pressure is the bulging and enlargement of the large fontanel. With severe hydrocephalic syndrome, small and lateral fontanelles can be opened. However, it should be borne in mind that changes in the cranial sutures and fontanelles are detected only at a certain stage in the development of the pathological process, so their absence during a single examination cannot be regarded as evidence against the presence of hypertensive-hydrocephalic syndrome.

With an increase in intracranial pressure in newborns and infants, the venous network of the scalp expands and the skin at the temples becomes thinner.

Neurological symptoms in hypertensive-hydrocephalic syndrome depend both on the severity of the syndrome and its progression, and on those changes in the brain that caused it. First of all, the behavior of children changes. They become easily excitable, irritable, cry - sharp, piercing, sleep - superficial, children often wake up. Such a complex of signs is more typical for the predominance of hypertension syndrome. With hydrocephalic syndrome, on the contrary, children in most cases are drowsy. Decreased appetite, regurgitation, vomiting lead to a decrease in body weight. Defeat cranial nerves manifested by a symptom of the "setting sun", converging strabismus, horizontal nystagmus.

Muscle tone varies depending on the severity of intracranial hypertension and the course of the disease. In the first months of life, with an increase in intracranial pressure, especially if it is accompanied by hyperexcitability and the volume of the skull is not increased, muscle tone is often increased, tendon reflexes are high, with an expanded zone, stop clonuses are sometimes observed. In hydrocephalic syndrome with moderately severe intracranial hypertension, muscular hypotension is first observed. If hydrocephalus progresses, in the future, an increase in muscle tone can be noted, earlier in the legs. This is due to the stretching of the pyramidal fibers of the parasagittal region due to an increase in the ventricles of the brain.

In newborns and infants with hypertensive-hydrocephalic syndrome, hand tremor is often pronounced. It can be frequent, small-scale or rare, large-scale type of hemibalism. Convulsions are observed much less frequently, they usually occur with a rapid increase in intracranial hypertension.

Changes in the fundus in young children do not necessarily develop due to the possibility of an increase in the volume of the skull due to the divergence of the cranial sutures. However, in some cases it is possible to detect varicose veins, blurring of the borders of the nipple optic nerve, and later, with the progression of hydrocephalus, its edema and atrophy.

Important for the diagnosis of hypertension syndrome is the determination of the pressure of the cerebrospinal fluid during lumbar puncture, which normally in newborns is mm of water. Art., in chest waters. Art. With hypertension syndrome, cerebrospinal fluid pressure in infants can rise to 200-3Q mm of water. Art. and higher. The composition of the cerebrospinal fluid in hypertensive-hydrocephalic syndrome depends on the characteristics of the pathological process as a result of which it arose, the nature of the course of the syndrome, and the stage of its development. Seen more often normal composition cerebrospinal fluid, but there may be protein-cell or cell-protein dissociation.

Along with clinical, ophthalmological and liquorological data for the diagnosis of hypertensive-hydrocephalic syndrome, the following are important: transillumination of the skull, EchoEG, craniography, computed tomography.

The transillumination method is safe, it can be carried out repeatedly and in outpatient settings. The principle of the method is the propagation of light rays in a space filled with liquid. Normally, in newborn infants around the tube with a light source there is a ring of luminescence with a width of 0.5 to 3 cm, depending on the density of the bones of the skull. The most intense glow is observed in the frontal regions (up to 3 cm), the smallest in the occipital region (0.5-1 cm). An increase in the boundaries of the glow occurs when the subarachnoid space expands to 0.5 cm. Translucence of the cavities of the intracerebral tissue or ventricles is possible only with a thickness of the brain tissue less than 1 cm.

In children with external and internal hydrocephalus, a symmetrical glow is detected. Asymmetric luminescence occurs with unilateral expansion of the ventricle and suoarachnoid space.

On EchoEG in hydrocephalus, an increase in the number of reflected echo signals, ventricular index (normal 1.9) and amplitude of echo pulsations is recorded. In the case of asymmetric expansion of the ventricular system, the m-exo is displaced in the direction opposite to the enlarged ventricle.

In children infancy with a slight increase in intracranial pressure without divergence of cranial sutures, craniography does not provide sufficient information for diagnosis. At the same time, it is the craniogram that can provide objective evidence of an increase in intracranial pressure. With the progression of hydrocephalus, craniograms show a divergence of the cranial sutures, more often the coronal and sagittal ones, already after 2-3 weeks. Asymmetric expansion of the cranial sutures indicates the localization of the lesion. Thinning of the bones of the cranial vault and pronounced digital impressions in children of the first year of life indicate the relative age of the process that led to the limitation of the intracranial space.

CT scan- a safe and painless method of x-ray examination of the skull and brain structures, the radiation exposure at which is minimal (0.3 load when receiving a conventional x-ray of the skull). For young children, the significance of these benefits is very large. In addition, it can be performed on an outpatient basis. Computed tomography gives a clear idea of ​​the size of the brain ventricles in hydrocephalus, as well as the presence and localization of lesions.

The depth and nature of the delay in psychomotor development in hydrocephalus and hypertension syndrome vary widely, depending on the primary changes in the nervous system that caused hydrocephalus, and on the secondary ones caused by increasing hypertension. If the destructive changes in the brain that caused hydrocephalus were pronounced, even if hydrocephalus is compensated by conservative or surgical measures, the development of the child is significantly delayed. At the same time, the addition and progression of the hypertensive-hydrocephalic syndrome in any pathology makes the developmental delay even more pronounced and peculiar, despite the compensation of the primary process. Finally, with timely effective compensation of both the primary process and hydrocephalus, a slight developmental delay, more often partial, is quickly eliminated.

Pediatric neurologist (neuropathologist)

The most common pathologies of the central nervous system in children under one year old include the so-called perinatal encephalopathy. The identification of deviations and pathologies of the nervous system of the child is engaged in pediatric neurologist (neurologist). The development of perinatal encephalopathy in an infant can provoke an umbilical cord around the neck of the fetus during pregnancy, premature from the placental layer, prolonged or premature birth, general anesthesia during childbirth. Many pathologies of the child's nervous system are associated with cerebral hypoxia, which has arisen due to external or internal adverse factors in the last month of pregnancy - toxicosis, the use of potent drugs, smoking, the development of acute infectious diseases, the threat of miscarriage, etc.

Various pathologies of the central and peripheral nervous system of the child must be taken seriously. Timely contacting to a pediatric neurologist at the slightest sign of a violation of the nervous system in a child, severe consequences in development can be avoided. If pediatric neurologist does not diagnose and prescribe a course of treatment for a child with certain disorders of the nervous system in time, then inaction can lead at least to a delay in the speech and psychomotor apparatus. Pathologies of the nervous system can also lead to deficiency syndrome. attention to violations behavior, emotional instability, to a violation of the formation of reading, writing, counting skills.

Pediatric neurologist must necessarily examine the child at the first signs of pathology nervous system, to which include the following symptoms (may appear immediately after birth or several months later):
1. The arms and chin are shaking strongly at the slightest excitement, crying, and even sometimes in a calm state;
2. Very superficial, restless sleep in an infant. The baby has difficulty falling asleep and often wakes up;
3. Frequent and profuse regurgitation in an infant;
4. Convulsions (twitching) during an increase in body temperature;
5. When relying on the foot or on the "toes", the fingers are strongly pressed

As noted pediatric neuropathologists, severe lesions of the nervous system are easily diagnosed and are much less common than the lungs (especially in the first year after the birth of a child). Small pathologies of the nervous system are much more difficult to diagnose, but it is the early detection of disorders of the central or peripheral nervous system and the subsequent complex of treatment that make it possible to avoid dangerous consequences. perinatal lesion child's brain. It is extremely important that during the first few weeks after birth, the child is examined by a specialist - pediatric neurologist.

According to recent statistics, more than 50% of childhood disability is associated precisely with pathologies of the nervous system, 70% of which appear during pregnancy and in the first month after the birth of a child (perinatal period). Pathologies of the nervous system in the perinatal period cause the development of perinatal encephalopathy, a syndrome of minimal brain dysfunction (more recently referred to as ADHD). Untimely treatment of these disorders of the nervous system can lead to excessive irritability, impulsiveness of the child, poor school performance. Later, lesions of the central and peripheral nervous system can lead to various diseases musculoskeletal system, motor awkwardness, severe headaches, autonomic dysfunction syndrome.

During the inspection, pediatric neurologist collects the developmental features and past illnesses of the child from the moment of birth. The specialist also analyzes information about how the last weeks of pregnancy went, how the birth went, what diseases the mother suffered in the last month of pregnancy. If any signs and symptoms of a disorder of the nervous system in a child are detected, the pediatric neuropathologist prescribes additional studies - ultrasound (NSG), fundus examination, EEG, ultrasound (Doppler), stem auditory evoked potentials technique, MRI (in rare cases). After analyzing the results of the studies, the neuropathologist prescribes and controls a specific treatment.

In the first month of a child's life, intensive maturation and development of brain structures, mental and motor functions takes place. The sooner the pathology of the nervous system is detected and the appropriate course of treatment is prescribed, the higher the likelihood of avoiding dangerous consequences for the child's health. Today in the arsenal pediatric neurologist there are many various methods treatment of both severe and mild pathologies of the nervous system. These are both physical methods of influence (physiotherapy exercises for children, massage, physiotherapy), and drugs with a studied clinical efficacy, and the latest methods of neurological rehabilitation (specialized computer speech programs, methods for improving cerebellar stimulation).

Many modern medical centers are equipped with the latest equipment for diagnosing diseases of the nervous system, develop and apply effective techniques of manual and emotional therapy in order to avoid the use of chemotherapy drugs that have side effects as much as possible.
Here are some techniques that manual therapists and pediatric osteopaths use to treat pathologies of the nervous system in children:
1. Visceral manual therapy.
Restoration of mobility and normal functioning of organs.
2. Vertebroneurology (soft technique of pediatric manual therapy).
This technique is based on working with ligaments and muscles at a slow pace with stretching of spasmodic, tense areas.
3. Craniosacral therapy. Normalization, alignment of the work of the bones of the child's skull.
When the movement of the bones of the skull is displaced or disturbed, the movement of the cerebral fluid, blood flow is disturbed and, as a result, the functioning of the brain deteriorates, intracranial pressure increases, the ventricles of the brain expand (hydrocereus), and headaches intensify. This technique is very relevant for young children.
4. Emotional techniques.
Very relevant for behavioral disorders, various neuroses in children. Emotional techniques are associated with the impact on the channel-meridian and stress points, with the emotional state.
5. Work with muscles for their relaxation.
As you know, muscles are associated with internal organs, bones, vertebrae. The technique is aimed at muscular-ligamentous relaxation, post-isometric relaxation (holding a special posture, and then relaxing)

Pediatric neurologist also deals with the diagnosis and treatment of traumatic and infectious lesions of the nervous system, tumors, cerebral palsy, diseases of the autonomic nervous system, convulsive conditions (for example, epilepsy in children), chromosomal and hereditary diseases of the nervous system, related to nervous diseases (endocrinological, orthopedic, psychiatric disease).

At an older age to a pediatric neurologist should be treated for the following symptoms:
1. Frequent headache
2. Piercing back pain
3. Problems of memory and attention
4. Violations of the functions of the spine at different levels
5. Reduced concentration
6. Panic attacks
7. Delay in the rate of speech development, writing, sound pronunciation
8. Diseases of peripheral nerves (neuropathy, neuralgia)
9. Quick fatigue

Scheduled examination of the child at a pediatric neurologist:
At three months
At six months
At nine months
At 1 year old
After a year - mandatory annual examination by a neurologist.

There are the following children's neurological lesions:
1. Due to toxic disorders
2. Hereditary, genetic
3. Infectious
4. Hypoxic lesions
5. Due to traumatic lesions
6. Epilepsy (post-traumatic and hereditary)
7. Specific syndromes (including combinations of the above lesions of the nervous system)