Perinatal lesions of the central nervous system(PPCNS) of a child occurs at the most crucial stage of development, namely from the 7th month to the first week of a newborn's life.
This pathology occurs in the womb, during childbirth or in the first days of a baby's life.
What is PPNS
There are many varieties, each of which has a fairly extensive characteristic, but in this case we are faced with the task of understanding what it is - PCNS in newborns and how terrible such a diagnosis is. 
First of all, it should be understood that this is not a specific, but a collective term. It implies a variety of deviations in the functioning of the nervous system that have arisen due to intrauterine and birth pathologies and leading to perinatal encephalopathy.
We can talk about PCNS if the baby has a history of deviations in mental, physical and speech development before he reaches the age of one.
For a long time it was believed that in this disease, changes in nervous system already remain constant, but modern medicine focuses on the fact that the brain small child has a huge compensatory potential and can successfully restore its functions even with moderate currents.
Important! Pathology in severe form threatens the life of the child, since without treatment it causes irreversible damage to the central nervous system.
Often, perinatal CNS damage occurs in premature infants for the reason that the work of the nervous system directly depends on body weight. 
How often can babies
According to statistics, immediately after birth, the diagnosis of PCNS is made from 5 to 55% of babies. Often the disease proceeds in a mild and even barely noticeable form, and therefore such a difference is recorded.
Among children who were born on time, about 10% have a severe degree of pathology, and in children who rush to appear, the disease is detected in 70% of cases.
Severity
There are three degrees of severity of the course of the disease, each of which differs in its manifestations and further prognosis:
- A mild degree is accompanied by a twitching of the baby's chin, he has a weak manifestation of reflexes. Muscle tone can be either slightly increased or decreased. The work of the nervous system can range from inhibition of nervous processes to their excitation.
- Medium degree: inhibition of the processes of the nervous system dominates over their excitation. The child is restless, anxious, with convulsive activity. The functioning of the heart, kidneys and digestive tract insufficient and problematic;
- Severe: the child is practically unviable and requires resuscitation. Him serious violations in the work of the heart and lungs.
Causes and risk groups
All causes of this disease can be roughly divided into four categories.
CNS damage due to hypoxia (oxygen starvation) of the fetus. This is the most common category. The reasons are various diseases expectant mother in the perinatal period, oligohydramnios or polyhydramnios, multiple pregnancy.
Acute hypoxia can also occur during childbirth, due to premature detachment of the placenta, which causes disturbances in the uteroplacental circulation. In some cases, this option is explained by squeezing the baby's head during its passage through the birth canal.
Naturally, the severity of CNS damage directly depends on the duration of oxygen starvation. If the lack of oxygen has chronic form, the capillaries in the brain stop growing in the baby, and their permeability increases.
Did you know? During fetal development, the number of cellsin the fetusevery minute increases by 250 thousand. And by 9 months, a baby's brain already has more than 10 million cells.
During childbirth, asphyxia occurs due to severe disorders in the work of the cardiovascular and respiratory systems.
The second category is injuries caused by trauma. Trauma to the nervous system occurs mechanically and possibly both during childbirth and within the first few hours after birth.
Such lesions can occur when obstetricians use special instruments during childbirth to help expand or protect the perineum from ruptures, withdraw the head or rotate it.
Too long stay in birth canal and strong compression during attempts also injure the head and spinal cord baby.
The third category includes violations in the metabolism of the baby. Usually they occur in the womb and are directly dependent on the mother and what she consumes. The child may develop nicotine, alcohol and drug syndromes.
Hypoxia is also caused by toxins that appear in the mother's body during illness or as a result of taking medications. 
The fourth category is the infection of the fetus. The central nervous system infects the virus and causes a disruption in the functioning of the nervous system. How the damage occurs and what its consequences depend on the type of virus and the overall severity of the disease.
The risk group for PPTSNS, first of all, includes newborns whose mothers are younger than 18 and older than 30, their activities are associated with harmful production, they have bad habits and genetic diseases.
pregnant women with kidney failure, heart defects, hypertension, endocrine disorders, extragenital diseases and anemia are also at risk. They also include pregnant women who have been diagnosed with frequent medical and spontaneous or infertility.
How does it manifest and develop?
During the course of the disease, three periods are distinguished: acute (from the prenatal period to the first month after birth), recovery (from the second month to a year, and in premature babies up to two years) and the outcome of the disease. Each of the periods has its own specific symptoms. 
In the acute period, the baby may experience:
- Hydrocephalus (dropsy of the brain), due to which the baby's head is enlarged, and the fontanel pulsates and protrudes above the surface of the skull;
- Convulsions of both the limbs and the whole body.
- Vegetative-visceral syndrome due to impaired vascular tone;
- Inhibition of the nervous processes of the central nervous system, due to which the main reflexes and motor activity are significantly reduced;
- Muscular dystonia, there can be both depression and excitation of the central nervous system (the baby often cries for no reason, his chin trembles nervously, sleep is intermittent and inconsistent). This condition is observed with a mild degree of the disease;
- A coma is when an infant goes into a coma. The most severe form of the disease. The activity of the central nervous system is extremely depressed. The child is in intensive care.
But it escalates very quickly. The child has delays in psycho-speech development, which is natural with such a disease. He later masters various motor skills, for example, holding his head, crawling, sitting, walking. He also begins to speak later than his peers. The outcome of the disease becomes clear by the time the child is one year old.
Even if the treatment was successful, the baby may have a developmental delay, hyperactivity and cerebroasthenic syndrome, due to which the baby becomes weather dependent, hysterical, gets tired quickly, sleeps poorly and is often anxious.Did you know? Since birth, a baby's brain has tripled in size every year compared to the previous year. But in old age, the picture is reversed: every year the weight of the brain decreases by one gram.
Diagnostics
Signs of PCNS can be seen even in the hospital, when examined by a neonatologist. Based on the clinical picture, the doctor suggests a diagnosis. 
Further, after the baby leaves the maternity hospital, a neurologist will monitor his condition, who can prescribe the following diagnostic methods:
- Ultrasound of the brain (neurosonography) can only be performed in the first year of life. The bones of the skull are too dense and ultrasonic radiation cannot penetrate through them, therefore, in infants, the procedure is performed through a still open fontanel. This diagnostic method is simple and safe for the child.
- CT ( CT scan) and MRI (magnetic resonance imaging) is the most informative way to look into the baby's brain. It is resorted to if the ultrasound turned out to be uninformative, and the symptoms have an average and severe degree of manifestation. Tomography gives very detailed information. However, for the procedure to be successful, the child needs to lie still in the scanner, and since this is not possible in the case of an infant, special preparations may be administered to him.
- EEG (electroencephalography) allows you to assess the functionality and condition of the vessels of the brain, but the procedure must be carried out several times (for comparison);
- Doppler ultrasound allows you to assess the blood flow in the vessels of the brain.
Treatment and rehabilitation measures
If PCNS is detected immediately after birth, then the baby is immediately rehabilitated. In the acute period, doctors relieve cerebral edema, eliminate and prevent convulsions.
With help special vitamins reduce the permeability of the vascular walls, give drugs to improve myocardial contractions, even out the metabolism of nerve tissues and create a gentle lifestyle for the baby.
In the recovery period, treatment depends on the symptoms of PCNS present in the newborn.
IN common child stimulating therapy is provided, which provokes the growth of brain capillaries, improves nutrition and restoration of damaged areas. 
Forecast
Even if the treatment of the baby was carried out correctly and on time, perinatal damage to the central nervous system will leave its traces forever. With a mild degree of illness, such consequences will be some developmental delay and impulsiveness of the baby on the one hand, as well as lethargy, apathy, anxiety and sleep disorders on the other.
A severe form of the course of PTCNS in newborns has the same consequences: the child may experience hydrocephalus (hydrocephalus) of the brain, cerebral palsy and epilepsy.
In general, approximately 30% of children make a full recovery, 40% of children have impairments in the functionality of the nervous system, and another 30% have organic disorders. Sometimes death occurs.
Important! To prevent the appearance of such a serious disease in crumbs, a pregnant woman must undergo all routine examinations, avoid stress, infections, and eliminate bad habits from her life.
Prevention measures
Primary prevention is available in the form of a healthy lifestyle for the expectant mother. 
In addition, competent assistance in delivery should be provided by doctors.
Secondary prevention consists in caring for the newborn baby and preventing perinatal lesion CNS. He should be regularly observed by a doctor, take tests. With mother's milk, the baby should receive all the substances necessary for growth.
PCNS is a severe pathology of intrauterine development of a child, which affects the dysfunction of the central nervous system. Often the disease has consequences, even with successful treatment.
Therefore, the best thing you can do for your baby is to lead a healthy lifestyle in order to prevent the occurrence of perinatal CNS damage.
From this article you will learn the main symptoms and signs of damage to the nervous system in a child, how the treatment of lesions of the central nervous system in a child is carried out and what causes perinatal damage to the nervous system in a newborn.
Treatment of damage to the nervous system in a child
Some children on the eve of exo amens are so worried that they get sick in the truest sense of the word.
Preparations for the treatment of the nervous system
Anacardium (Anacardium) - a drug for the treatment of the nervous system.
- As soon as the child sits down written work He loses all self-confidence and remembers absolutely nothing.
Argentum nitricum (Argentum nitricum) - a drug for the treatment of the nervous system.
- On the eve of the exam, the child is hurried, excited, irritable and nervous.
- Diarrhea before the exam.
- The child may ask for sweets.
Gelsemium (Gelsemium) - a drug for the treatment of the nervous system.
- Weakness and trembling on the eve of a responsible event or exam.
- Possible diarrhea.
Pikrik acid (Picric acid) - a drug for the treatment of the nervous system.
- For good students who have studied hard but can no longer continue to teach - they would even like to throw away their textbooks.
- The child is afraid that he will forget everything on the exam.
- The child is very tired from studying.
Potential and number of doses:
One dose of 30C the evening before the exam, one in the morning and one just before the exam.
Symptoms of damage to the nervous system in a child
Most diseases of the nervous system in early age accompanied by a delay in psychomotor development. In their diagnosis, the assessment of the presence of neurological syndromes, as well as the identification of lesions of the nervous system, is of primary importance.
Hypoexcitability syndrome - a symptom of damage to the nervous system
The syndrome of hypoexcitability is characterized by low motor and mental activity of the child, a long latent period for the occurrence of all reflexes (including congenital ones), hyporeflexia, and hypotension. The syndrome occurs mainly with dysfunction of the diencephalic-limbic parts of the brain, which is accompanied by vegetative-visceral disorders.
Hypoexcitability syndrome develops with perinatal brain damage, some hereditary and congenital diseases(Down's disease, phenylketonuria, etc.), metabolic disorders (hypoglycemia, metabolic acidosis, hypermagnesemia, etc.), as well as in many severe somatic diseases.
Hyperexcitability syndrome - a symptom of damage to the nervous system
The syndrome of hyperexcitability is characterized by motor restlessness, emotional lability, sleep disturbance, increased innate reflexes, and a decrease in the threshold for convulsive readiness. It is often combined with increased muscle tone, rapid neuropsychic exhaustion. Hyperexcitability syndrome can develop in children with perinatal pathology of the central nervous system, some hereditary fermentopathies, and metabolic disorders.
Syndrome intracranial hypertension- a symptom of damage to the nervous system
The syndrome is characterized by increased intracranial pressure, often combined with the expansion of the ventricles of the brain and subarachnoid spaces. In most cases, there is an increase in the size of the head, divergence of cranial sutures in infants, bulging and enlargement of the large fontanelle, disproportion between the brain and facial departments skull (hypertension-hydrocephalic syndrome).
The cry of such children is piercing, painful, "brain". Older children often complain of such a symptom as headache, although this complaint is not specific to this syndrome. Defeat VI pair cranial nerves, a symptom of the "setting sun" (the appearance of a distinct strip of sclera between upper eyelid and the iris, which gives the impression of "falling" eyeball down), spastic tendon reflexes - late symptoms persistent intracranial hypertension.
Percussion of the skull sometimes reveals a "cracked pot" sound. Sometimes there is a horizontal, vertical or rotatory nystagmus.
Perinatal damage to the nervous system
Perinatal damage to the nervous system - group pathological conditions, due to the impact on the fetus (newborn) of adverse factors in the antenatal period, during childbirth and in the first days after birth.
There is no single terminology for perinatal lesions of the nervous system. The terms "perinatal encephalopathy", "impaired cerebral circulation", "cerebral dysfunction", "hypoxic-ischemic encephalopathy", etc. are commonly used.
The lack of a unified terminology is associated with the uniformity of the clinical picture in various mechanisms of brain damage, which is due to the immaturity of the nervous tissue of the newborn and its tendency to generalized reactions in the form of edematous-hemorrhagic and ischemic phenomena, manifested by symptoms of cerebral disorders.
Classification of perinatal lesions of the nervous system
The classification provides for the allocation of the period of action of a harmful factor that dominates etiological factor, the period of the disease [acute (7-10 days, sometimes up to 1 month in very preterm infants), early recovery (up to 4-6 months), late recovery (up to 1-2 years), residual effects], severity (for acute period- light, medium, heavy) and basic clinical syndromes.
Causes of perinatal lesions of the nervous system in children
The main cause of brain damage in the fetus and newborn is hypoxia, which develops during an unfavorable course of pregnancy, asphyxia, as well as accompanying birth injuries, tension-type headache, infectious and other diseases of the fetus and newborn. Hemodynamic and metabolic disorders arising from hypoxia lead to the development of hypoxic-ischemic lesions of the brain substance and intracranial hemorrhages. In recent years, IUI has received much attention in the etiology of perinatal CNS lesions. The mechanical factor in perinatal brain damage is less important.
The main reason for the defeat spinal cord- traumatic obstetric aids with a large fetal weight, incorrect insertion of the head, breech presentation, excessive rotation of the head during its removal, traction by the head, etc.
Signs of perinatal lesions of the nervous system
Clinical picture perinatal brain lesions depends on the period of the disease and the severity (table).
In the acute period, the CNS depression syndrome develops more often (the following symptoms appear: lethargy, hypodynamia, hyporeflexia, diffuse muscle hypotension, etc.), less often the CNS hyperexcitability syndrome (increased spontaneous muscle activity, superficial restless sleep, chin and limb tremor, etc.). d.).
In the early recovery period, the severity of cerebral symptoms decreases, and signs of focal brain damage become apparent.
The main syndromes of the early recovery period are as follows:
- Syndrome movement disorders manifested by muscular hypo, hyper dystonia, paresis and paralysis, hyperkinesis.
- Hydrocephalic syndrome is manifested by an increase in head circumference, divergence of sutures, enlargement and bulging of fontanelles, expansion of the venous network on the forehead, temples, scalp, predominance of the size of the brain skull over the size of the facial one.
- Vegetovisceral syndrome is characterized by microcirculation disorders (marbling and pallor skin, transient acrocyanosis, cold hands and feet), thermoregulation disorders, gastrointestinal dyskinesias, lability of the cardiovascular and respiratory systems, etc.
In the late recovery period, the normalization of muscle tone and static functions gradually occurs. The completeness of recovery depends on the degree of CNS damage in the perinatal period.
Children in the period of residual effects can be divided into two groups: the first - with obvious neuropsychiatric disorders (about 20%), the second - with normalization neurological changes(about 80%). Nevertheless, the normalization of the neurological status cannot be equivalent to recovery.
Increased neuroreflex excitability, moderate increase or decrease in muscle tone and reflexes. Horizontal nystagmus, convergent strabismus. Sometimes, after 7-10 days, the symptoms of mild CNS depression are replaced by excitation with tremor of the hands, chin, and motor restlessness.
Usually, symptoms of CNS depression, muscle hypotonia, hyporeflexia, appear first, followed by muscle hypertonicity after a few days. Sometimes there are short-term convulsions, anxiety, hyperesthesia, oculomotor disorders (Grefe's symptom, "setting sun" symptom, horizontal and vertical nystagmus, etc.). Often there are vegetative-visceral disorders Pronounced cerebral (sharp depression of the central nervous system, convulsions) and somatic (respiratory, cardiac, renal, intestinal paresis, adrenal hypofunction) disorders The clinical picture of spinal cord injury depends on the location and extent of the lesion. With massive hemorrhages and ruptures of the spinal cord, spinal shock develops (lethargy, adynamia, severe muscle hypotension, severe inhibition or absence of reflexes, etc.). If the child remains alive, then the local symptoms of the lesion become clearer - paresis and paralysis, disorders of the sphincter function, loss of sensitivity. In children of the first years of life, it is sometimes very difficult to determine the exact level of damage due to the difficulties in identifying the border of sensitive disorders and the difficulties of differentiating central and peripheral paresis.
Diagnosis of perinatal lesions of the nervous system
The diagnosis is based on anamnestic (social and biological factors, the state of health of the mother, her obstetric and gynecological history, the course of pregnancy and childbirth) and clinical data and is confirmed by instrumental studies. Neurosonography is widely used. Help in diagnosis x-ray studies skull, spine, if necessary - CT and MRI. So, in 25-50% of newborns with cephalohematoma, a skull fracture is found, with birth injuries of the spinal cord - dislocation or fracture of the vertebrae.
Perinatal lesions of the nervous system in children are differentiated from birth defects development, hereditary disorders metabolism, more often amino acids (manifest only a few months after birth), rickets [a rapid increase in head circumference in the first months of life, muscle hypotension, autonomic disorders (sweating, marbling, anxiety) are more often associated not with the onset of rickets, but with hypertensive-hydrocephalic syndrome and vegetative-visceral disorders in perinatal encephalopathy].
Treatment of perinatal lesions of the nervous system in children
Treatment of damage to the nervous system in the acute period.
Basic principles of treatment for cerebrovascular accidents in the acute period (after resuscitation) are the following.
- Elimination of cerebral edema. For this purpose, dehydration therapy is carried out (mannitol, GHB, albumin, plasma, lasix, dexamethasone, etc.).
- Elimination or prevention convulsive syndrome(seduxen, phenobarbital, difenin).
- Decreased vascular wall permeability (vitamin C, rutin, calcium gluconate).
- Improvement of myocardial contractility (carnitine chloride, magnesium preparations, panangin).
- Normalization of the metabolism of the nervous tissue and increasing its resistance to hypoxia (glucose, dibazol, alphatocopherol, actovegin).
- Creation of a gentle regime.
Treatment of damage to the nervous system in the recovery period.
In the recovery period, in addition to post-syndromic therapy, treatment is carried out aimed at stimulating the growth of brain capillaries and improving the trophism of damaged tissues.
- Stimulating therapy (vitamins B, B 6, cerebrolysin, ATP, aloe extract).
- Nootropics (piracetam, phenibut, pantogam, encephabol, cogitum, glycine, limontar, biotredin, aminalon, etc.).
- To improve cerebral circulation, angioprotectors are prescribed (cavinton, cinnarizine, trental, tanakan, sermion, instenon).
- With increased excitability and convulsive readiness, sedative therapy(seduxen, phenobarbital, radedorm).
- Physiotherapy, massage and physiotherapy exercises (LFK).
Children with perinatal CNS lesions should be under the supervision of a neurologist. Periodic courses of treatment are required (23 months twice a year for several years).
Prevention of perinatal lesions of the nervous system
Prevention consists primarily in the prevention of intrauterine fetal hypoxia, starting from the first months of pregnancy. This requires the timely elimination of adverse socio-biological factors and chronic diseases of women, the identification early signs pathological course of pregnancy. Great importance also have measures to reduce birth trauma.
Treatment prognosis
The prognosis for perinatal lesions of the central nervous system depends on the severity and nature of the damage to the central nervous system, the completeness and timeliness of therapeutic measures.
severe asphyxia and intracerebral hemorrhages often end in death. Severe consequences as gross violations psychomotor development are rarely formed (in 35% of full-term and in 10-20% of very premature babies). However, in almost all children with perinatal brain damage, even mild degree, signs of minimal brain dysfunction persist for a long time - headaches, speech disorders, tics, incoordination of fine movements. They are characterized by increased neuropsychic exhaustion, " school maladaptation".
The consequences of spinal cord injury during childbirth depend on the severity of the injury. With massive hemorrhages, newborns die in the first days of life. In survivors of the acute period, there is a gradual recovery of motor functions.
When a baby is born, its internal organs and body systems are not yet fully formed. This also applies to the central nervous system, which is responsible for the normal social life of a person. For the formation process to be completed, a certain time period is required.
In recent years, the number of pathologies of the central nervous system in infants has increased significantly. They can develop even in the prenatal period, and also appear during childbirth or immediately after them. Such lesions, which adversely affect the functioning of the nervous system, can cause serious complications and even disability.
What is perinatal CNS damage?
Perinatal damage to the central nervous system, abbreviated as PPNS, is a number of pathologies that are related to malfunctions in the functioning of the brain and developmental anomalies in its structure. Similar deviations from the norm are observed in children in the perinatal period, the time frame of which is between the 24th week of pregnancy and up to the first 7 days of life after birth, inclusive.
At the moment, PCNS in newborns is a fairly common phenomenon. Such a diagnosis is established in 5-55% of babies. A strong scatter of indicators is due to the fact that often CNS lesions of this kind pass easily and quickly. Cases of severe forms of perinatal damage occur in 1-10% of children who were born at the appointed time. Premature babies are more susceptible to the disease.
Disease classification
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IN modern medicine accepted to classify deviations in normal functioning CNS in accordance with what causes caused this or that pathology. In this regard, each violation has its own forms and symptoms. There are 4 main pathological types of CNS lesions:
- traumatic;
- dismetabolic;
- infectious;
- hypoxic origin.
Perinatal injury in the newborn
Perinatal lesions of the central nervous system are those that develop in the perinatal period, most of which occurs in fetal time. The risks of CNS depression in a child increase if, during pregnancy, a woman suffered:
- cytomegalovirus infection (we recommend reading:);
- toxoplasmosis;
- rubella;
- herpetic infection;
- syphilis.
The child may receive intracranial injury and trauma to the spinal cord or peripheral nervous system during childbirth, which can also cause perinatal lesions. Toxic effects on the fetus can disrupt metabolic processes and adversely affect brain activity.
Hypoxic-ischemic damage to the nervous system
Hypoxic-ischemic damage to the nervous system is one of the forms of perinatal pathology, which is caused by fetal hypoxia, that is, insufficient oxygen supply to the cells.
A manifestation of the hypoxic-ischemic form is cerebral ischemia, which has three degrees of severity of the course:
- First. Accompanied by depression or excitation of the central nervous system, which lasts up to a week after birth.
- Second. To depression / excitation of the central nervous system, lasting more than 7 days, convulsions are added, increased intracranial pressure and vegetative-visceral disorders.
- Third. She is characterized by a severe convulsive condition, impaired functions of the brain stem, high intracranial pressure.
Mixed disease
In addition to ischemic genesis, hypoxic lesions of the central nervous system can be caused by hemorrhages of non-traumatic origin (hemorrhagic). These include hemorrhages:
- intraventricular type 1, 2 and 3 degrees;
- subarachnoid primary type;
- into the substance of the brain.
The combination of ischemic and hemorrhagic forms is called mixed. Its symptoms depend solely on the location of the hemorrhage and the severity.
Features of the diagnosis of PCNS
After giving birth in without fail examined by a neonatologist, assessing the degree of hypoxia. It is he who can suspect a perinatal lesion by changes in the condition of the newborn. The conclusion about the presence of pathology is confirmed or refuted in the first 1-2 months. During all this time, the baby is under the supervision of doctors, namely a neurologist, a pediatrician and an additional narrow specialist (if required). Deviations in the work of the nervous system require special attention in order to be able to correct them in time.
Forms and symptoms of the course of the disease
Perinatal damage to the central nervous system of a newborn can occur in 3 different forms, which are characterized by their own symptoms:
- light;
- middle;
- severe.
Knowing the symptoms, which speaks of the oppression of the central nervous system, it is possible to establish a diagnosis in the early stages and treat the disease in a timely manner. The table below describes the symptoms that accompany the course of the disease for each of its forms:
| PPCN form | Characteristic symptoms |
| Light |
|
| Medium |
|
| heavy |
|
Reasons for development
Very often, the cause of the development of PCNS is fetal hypoxia during the prenatal period. Among the reasons leading to perinatal damage to the central nervous system in an infant, four main ones are worth noting:
- Hypoxia of the fetus in the prenatal period. This deviation is associated with a lack of oxygen entering the baby's blood from the mother's body. The contributing factors are harmful conditions work of a pregnant woman, addictions such as smoking, past infectious diseases and previous abortions.
- Injury caused during childbirth. If a woman is weak generic activity, or the baby lingered in the pelvis.
- Violation of metabolic processes. They can be caused by toxic components that enter the body of a pregnant woman along with cigarettes, alcoholic drinks, narcotic substances and potent drugs.
- Viral and bacterial infections that entered the mother's body during pregnancy, abbreviated VUI - intrauterine infections.
Consequences of the disease
In most cases, by the time the child is one year old, almost all the symptoms that accompany damage to the nervous system disappear. Unfortunately, this does not mean at all that the disease has receded. Usually after such an illness there are always complications and unpleasant consequences.
Parents may experience hyperactivity in their child after undergoing PCNS Among them note:
- Hyperactivity. This syndrome is characterized by aggressiveness, tantrums, learning difficulties, and memory problems.
- developmental delay. This applies to both physical and speech, mental development.
- Cerebroasthenic syndrome. He is characterized by the dependence of the child on weather conditions, mood swings, restless sleep.
The most serious consequences of the oppression of the central nervous system, which lead to the disability of the baby, are:
- epilepsy;
- cerebral palsy;
- hydrocephalus (we recommend reading:).
Risk group
The prevalence of the diagnosis of perinatal lesions of the nervous system in a newborn is due to many factors and conditions that affect the intrauterine development of the fetus and the birth of a baby.
In pregnant women who led a healthy lifestyle and the child was born at term, the probability of PCNS is sharply reduced to 1.5-10%.
To the group increased risk, which is 50%, babies get:
- with breech presentation;
- premature or, conversely, overdue;
- with a high birth weight exceeding 4 kg.
The hereditary factor is also significant. However, it is difficult to predict exactly what can cause CNS depression in a child and depends more on the situation as a whole.
Diagnostics
Any disturbance of brain activity is difficult to diagnose on early stage. Babies are diagnosed with perinatal lesions of the central nervous system during the first months of life, starting from the presence of problems with the motor and speech apparatus, as well as taking into account violations mental functions. Closer to the year, the specialist should already specify the type of disease or refute the conclusion made earlier.
Disorders in the work of the nervous system are serious danger for the health and development of the child, so it is important to diagnose the problem in time in order to carry out proper treatment. If a newborn baby behaves uncharacteristically, and he has the first symptoms of an illness, parents must definitely show him to the doctor. First, he inspects, but for accurate diagnosis one such procedure may not be enough. Only A complex approach will reveal the disease.
At the slightest suspicion of the development of PCNS, the child should be immediately shown to the doctor For this reason, the following clinical and laboratory tests are usually additionally prescribed:
- neurosonography (we recommend reading:);
- CT - computed tomography or MRI - magnetic resonance imaging of the brain;
- ultrasound - ultrasound diagnostics;
- x-ray examination;
- echoencephalography (EchoES), rheoencephalography (REG) or electroencephalography (EEG) - methods of functional diagnostics (we recommend reading:);
- examination of a consultative nature by an ophthalmologist, speech therapist and psychologist.
Treatment methods depending on the symptoms
Treatment of any pathologies of the central nervous system in newborns should be carried out in the first months of life, since at this stage almost all processes are reversible, and it is possible to completely restore impaired brain functions.
In the first months of life, PCNS is easily treatable. For this, appropriate drug therapy is carried out, which allows:
- improve the nutrition of nerve cells;
- stimulate blood circulation;
- normalize muscle tone;
- normalize metabolic processes;
- save the baby from convulsions;
- stop swelling of the brain and lungs;
- increase or decrease intracranial pressure.
When the child's condition stabilizes, in combination with medications perform physiotherapy or osteopathy. Therapeutic and rehabilitation course are developed individually for each case.
intracranial hypertension
The syndrome of intracranial hypertension manifests itself as an increase compared to the norm, swelling of a large fontanelle and divergence of the sutures of the skull (we recommend reading:). Also, the child is nervous and quickly excitable. When similar symptoms the baby is prescribed diuretic drugs, conducting dehydration therapy. In order to reduce the likelihood of hemorrhages, it is recommended to drink a course of Lidaza.
Plus crumbs make special gymnastic exercises which help reduce intracranial pressure. Sometimes they resort to acupuncture and manual therapy to correct fluid flow.
General strengthening gymnastic exercises are necessarily included in the complex treatment of PCNS Movement disorders
When diagnosing a syndrome of motor disorders, treatment is a series of measures aimed at eliminating the problem:
- Medical therapy. Prescribed drugs such as Galantamine, Dibazol, Alizin, Prozerin.
- Massage and physiotherapy. For children under one year old, a minimum of 4 courses of such procedures are required, each of which consists of approximately 20 sessions with specially selected exercises. They are selected depending on what is prone to deviations: walking, sitting or crawling. Massage and exercise therapy is carried out using ointments.
- Osteopathy. Includes massage internal organs and impact on the desired points of the body.
- Reflexology. Has established itself as the most effective method. Its help is resorted to in cases where SOS leads to a delay in the maturation and development of the nervous system.
Increased neuro-reflex excitability
One of possible manifestations perinatal lesions in the acute phase is increased neuro-reflex excitability.
Relating to mild form the course of the pathology, it is typical for it:
- decrease or increase in muscle tone;
- extinction of reflexes;
- superficial sleep;
- unreasonable trembling of the chin.
Massage with electrophoresis helps to restore muscle tone. In addition, drug therapy is carried out, and treatment with the help of pulsed currents and special baths can be prescribed.
epileptic syndrome
The epileptic syndrome is characterized by periodic epileptic seizures, which are accompanied by convulsions, which are shudders and twitches of the upper and lower extremities and heads. The main task of therapy in this case is to get rid of the convulsive state.
The central nervous system (CNS) is the main part of the human nervous system, which consists of an accumulation of nerve cells. In humans, it is represented by the spinal cord and brain. Departments of the central nervous system regulate the activities individual bodies and body systems, and as a whole ensure the unity of its activity. With lesions of the central nervous system, this function is impaired.
Damage to the central nervous system can occur in a child both during fetal development (perinatally) and during childbirth (intranatally). If harmful factors affected the child at the embryonic stage of intrauterine development, then severe defects incompatible with life may occur. After eight weeks of pregnancy, damaging influences no longer cause gross violations, but sometimes slight deviations appear in the formation of the child. After 28 weeks of intrauterine development, damaging effects will not lead to malformations, but a normally formed child may develop some kind of disease.
Perinatal damage to the central nervous system (PP CNS)
This pathology is most recorded in children of the first year of life. This diagnosis implies a violation of the function or structure of the brain of various origins. PP CNS occurs in the perinatal period. It includes antenatal (from 28 weeks of fetal development to the onset birth act), intranatal (the act of childbirth itself) and early neonatal (the first week of a child's life) periods.
The symptoms of PP CNS include an increase in neuro-reflex excitability; decreased muscle tone and reflexes, short-term convulsions and anxiety; muscle hypotension, hyporeflexia; respiratory, cardiac, renal disorders; paresis and paralysis, etc.
The occurrence of perinatal CNS damage is influenced by the following reasons: somatic diseases mother, malnutrition and immaturity of a pregnant woman, acute infectious diseases during pregnancy, hereditary diseases, metabolic disorders, pathological course of pregnancy, as well as unfavorable environmental conditions.
According to their origin, all perinatal lesions of the central nervous system can be divided into:
- Hypoxic-ischemic damage to the central nervous system. Hypoxic-ischemic damage to the central nervous system occurs due to a lack of oxygen supply to the fetus or its utilization during pregnancy or childbirth;
- Traumatic damage to the central nervous system. Traumatic damage to the central nervous system is caused by traumatic damage to the fetal head at the time of delivery;
- Hypoxic-traumatic lesion of the central nervous system. Hypoxic-traumatic lesion of the central nervous system is characterized by a combination of hypoxia and damage cervical the spine and the spinal cord located in it;
- Hypoxic-hemorrhagic lesion of the central nervous system. Hypoxic-hemorrhagic damage to the central nervous system occurs during birth trauma and is accompanied by impaired cerebral circulation up to hemorrhages.
In recent years, the diagnostic capabilities of children medical institutions improved significantly. After one month of a child's life, a neurologist can determine the exact nature and extent of CNS damage, as well as predict the further course of the disease, or completely remove the suspicion of a brain disease. The diagnosis can be characterized by complete recovery or the development of minimal CNS disorders, as well as severe diseases that require mandatory treatment and regular follow-up with a neurologist.
Treatment of the acute period of perinatal lesions of the central nervous system is carried out in a hospital. Drug therapy, massage, physiotherapy and physiotherapy, acupuncture, as well as elements of pedagogical correction are used as the main treatment for the disease.
Organic lesion of the central nervous system
This diagnosis means that the human brain is defective to a certain extent. Pathological changes occur in the substance of the brain. Light degree organic damage The central nervous system is inherent in almost all people and does not require medical interventions. But here the average and severe degree of this disease is already a violation of the activity of the nervous system. Symptoms include freezing spells, sleep disturbance, irritability, rapid distractibility, repetition of phrases, daytime enuresis. Vision and hearing may deteriorate, coordination of movements may be disturbed. Human immunity decreases, various colds occur.
The causes of organic lesions of the central nervous system are divided into congenital and acquired. The former include cases when, during pregnancy, the child's mother had an infection (ARI, influenza, tonsillitis), took certain medications, smoked and drank alcohol. During periods of psychological stress of the mother one system blood supply can transfer stress hormones to the body of the fetus. The influence is exerted by sudden changes in temperature and pressure, exposure to radioactive and toxic substances contained in the air, dissolved in water, food, etc.
Diagnosing an organic lesion of the central nervous system is quite simple. An experienced psychiatrist can determine the presence or absence of organics by the child's face. However, the types of disorders in the brain determines laboratory diagnostics, which is based on a series of procedures that are harmless to the body and informative for the doctor: ultrasound diagnostics of the brain, electroencephalograms, rheoencephalograms.
Organic treatment is a very long process. It is mainly medicinal. For the treatment of organic lesions of the central nervous system, medications. For example, nootropic drugs can improve brain function. Vascular preparations are used.
Often, children are diagnosed with "residual lesion of the HNS." Residual organic lesions of the central nervous system are present in children mainly as residual effects of birth trauma and brain disorders. Manifested as a disorder associative thinking, and in more severe cases neurological disorders. Treatment is prescribed by a doctor. Various elements of pedagogical correction are used, exercises for concentration of attention, classes with a psychologist and a speech therapist are useful.
The consequences of damage to the central nervous system depend primarily on the degree of the disease. Perhaps as full recovery, and delayed mental, motor or speech development in a child, various neurological reactions, etc. It is important that during the first year of life the child receives a full rehabilitation.
Help children with central nervous system disease
At the moment, there are no children with this diagnosis in the care of our foundation. However, you can help sick children with other diagnoses!
A newborn child is not yet a fully completed creation of nature. Although the baby has arms and legs, and the eyes seem to look at the mother consciously, in fact, in order to complete the maturation of many body systems, it takes time. The digestive system, vision, nervous system continue to develop after the baby is born. The central nervous system of a newborn is one of the most important systems, since it regulates the development of a little man and affects how harmoniously he will feel in a new world for him. Unfortunately, at present, lesions of the central nervous system of newborns are not uncommon. The consequences of damage to the central nervous system of newborns can forever turn a baby into a disabled person.
Features of the central nervous system of a newborn
The CNS of newborns has a number of features. A newborn baby is different enough large mass brain, it is 10% of body weight. For comparison, in an adult, the brain weighs 2.5% of body weight. At the same time, large convolutions and furrows of the brain have a less pronounced depth than in an adult. At the time of birth, the baby has not yet fully completed the differentiation of the right and left hemispheres, while there are unconditional reflex reactions.
During the first 2-3 days, there is an increase in the level of non-opiate peptides, which are involved in the regulation of certain hormones responsible for the functions of the gastrointestinal tract. There is also an active development of auditory and visual analyzers promoted by close contact with the mother. A newborn child has a very developed taste and olfactory analyzer, and the taste threshold is much higher than that of an adult.
CNS damage in newborns
CNS lesions in newborns may be mild, moderate, or severe form. The Apgar score is used to assess the child's condition. CNS lesions in newborns mild are displayed as 6-7 points and are quite easy to correct with the help of primary resuscitation.
The average degree of damage to the central nervous system of newborns is marked by Apgar scores of 4-5. The child has increased intracranial pressure, a decrease, or vice versa, an increase in muscle tone. For several days, the baby may completely lack spontaneous movements, and there is also oppression of the main congenital reflexes. If treatment is started on time, then on the 6-7th day of life, the baby's condition will stabilize.
In the case of severe CNS damage, the newborn is born in a state of hypoxemic shock. There is a lack of breathing, impaired heart rate, muscle atony and inhibition of reflexes. With such a lesion of the central nervous system of a newborn, cardiac and respiratory resuscitation, as well as the restoration of metabolism, will be needed to restore the functioning of important systems. The child has cardiovascular and brain disorders. With severe damage to the central nervous system, the newborn is shown intensive therapy, but the prognosis remains unfavorable.
Reasons for the development of perinatal lesions of the central nervous system in newborns
The main cause of the development of perinatal CNS lesions in newborns is oxygen starvation, which the child experiences in the womb or during childbirth. The degree of perinatal damage to the central nervous system in the newborn also depends on the duration of oxygen starvation suffered by the baby.
In addition to hypoxia, intrauterine infections, birth trauma, malformations of the spinal cord and brain, as well as hereditary factors that cause metabolic disorders can lead to the development of damage to the central nervous system of a newborn.
Hypoxic - ischemic damage to the central nervous system in newborns
Since hypoxia most often causes damage to the central nervous system of newborns, every expectant mother should know what causes fetal hypoxia and how to avoid it. The severity of hypoxia - ischemic injury The central nervous system in newborns depends on the duration of hypoxia in a child in utero. If hypoxia is short-term, then the resulting disorders are not as serious as if the fetus experiences oxygen starvation for a long period, or hypoxia occurs frequently.
In this case, there may be functional disorders brain or even nerve cell death. To prevent hypoxic-ischemic damage to the central nervous system in newborns, a pregnant woman should be attentive to her health. Conditions such as early and late toxicosis, uterine tone, some chronic diseases provoke the occurrence of fetal hypoxia, therefore, at the slightest suspicion, you need to undergo treatment prescribed by a specialist.
Symptoms of ischemic damage to the central nervous system of newborns
Damage to the nervous system can be manifested by several symptoms, one of which is CNS depression in newborns. With depression of the central nervous system in newborns, a decrease in muscle tone is observed and, as a result, motor activity. In addition, with CNS depression in newborns, the child sucks poorly and swallows poorly. Sometimes facial asymmetry and strabismus can be observed.
The syndrome of increased neuro-reflex excitability is also a consequence of damage to the central nervous system of the newborn. The kid constantly shudders, becomes restless, there is a tremor of the chin and limbs.
The hydrocephalic symptom also indicates damage to the central nervous system of the newborn. It manifests itself in the fact that the newborn has a disproportionately enlarged head and fontanel, which is due to a large accumulation of fluid.
How to treat CNS lesions?
Treatment of CNS lesions in newborns can take long time, but at the same time, if the damage is not too severe, there is a possibility of almost full recovery CNS functions. An important role in the treatment of CNS lesions in newborns is played by proper child care. In addition to drugs prescribed by a doctor that improve cerebral circulation, massage and physiotherapy exercises are necessarily included. Treatment of CNS lesions in newborns is carried out in accordance with the symptoms.
The main problem is the fact that the true degree of damage to the central nervous system of a newborn becomes apparent only after 4-6 months. Therefore, it is very important to make every effort to improve the functions of the central nervous system of the newborn, regardless of the severity of hypoxia.
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