Cerebral palsy groups

Children's cerebral paralysis traditionally divided into three main groups.

The first group is true cerebral palsy. This is the most complex form of the disease, which is characterized by the presence of hereditary factors and genetic disorders in the embryonic development of the fetus.

A fetus with such lesions is underdeveloped, its cerebral convolutions are weakly expressed, the cerebral cortex is also underdeveloped, and there is no clear differentiation of the gray and white matter of the brain. At the time of birth, such a fetus turns out to be intellectually and biologically defective; it has a number of other quite serious anatomical and functional lesions of the brain.

Reasons for the development of primary infantile paralysis It turns out there are several, these include genetic disorders and the impact of various unfavorable factors on the fetal brain. In most of these cases, the severity of brain damage is incompatible with life. If such a child can be saved, restored normal functioning his head and spinal cord turns out to be impossible. According to official statistics, children with such a severe diagnosis account for no more than 10% of total number patients with cerebral palsy.

The second group of cerebral palsy. This group includes cases of acquired true cerebral palsy. There are also several reasons for the development of this serious disease:

Severe birth injuries with cerebral hemorrhage;
- the traumatic effect of toxic substances on the fetal brain, including the effect of anesthesia;
- severe infection of the brain later pregnancy or during childbirth.

All these conditions can have a traumatic effect on brain cells, cause their death and form a severe picture of the disease.

Main hallmark Cerebral palsy of the second type from the first group is the absence of a hereditary nature of the lesion. With active rehabilitation therapy, such patients can be more or less adapted to life in society, so that adult life serve yourself independently and move independently. Statistics show that the number of patients with this form of cerebral palsy also does not exceed 10%.

The third group of the disease is non-acquired, non-true cerebral palsy. In most cases, this disease can be considered a secondary cerebral palsy syndrome. This group is the most numerous - about 80% of patients suffer from this particular form of cerebral palsy. Such children at the time of birth have a fully formed, intellectually and biologically complete brain. The cause of various dysfunctions in the functioning of parts of the brain is birth trauma, which leads to disruption of individual functions.

The main difference between these children and the first two groups is that they retain their intelligence and have good opportunities to restore impaired functions. The main causes of the development of cerebral palsy of the third group are oxygen deprivation of the fetal brain during the period of perinatal development, exposure to toxic substances or incorrect delivery techniques.

More information about the disease and its treatment

Causes of cerebral palsy
Cerebral palsy groups
Forms of cerebral palsy
Cerebral palsy statistics
Exercise therapy for cerebral palsy
Symptoms and signs of cerebral palsy in children
Treatment methods for cerebral palsy
Rehabilitation of children with cerebral palsy
Features of development of children with cerebral palsy
Mental development of children with cerebral palsy
Speech development of children with cerebral palsy
Mental development of children with cerebral palsy
Physical development of children with cerebral palsy
Massage for cerebral palsy
Exercises for children with cerebral palsy
Treatment of cerebral palsy in China
Treatment of cerebral palsy in Israel
Treatment of cerebral palsy in Hungary
Treatment of cerebral palsy in Germany
Treatment of cerebral palsy in the Czech Republic

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Quite clear images from a dream make an indelible impression on the awakened person. If after some time the events in a dream come true in reality, then people are convinced that this dream was prophetic. Prophetic dreams are different from regular topics that they, with rare exceptions, have direct meaning. A prophetic dream is always vivid and memorable...

I have been diagnosed with cerebral palsy (cerebral palsy) since birth. More precisely, from the age of one (about then the doctors finally determined the name of what was happening to me). I graduated from a special school for children with cerebral palsy, and 11 years later I came to work there. 20 years have passed since then... According to the most conservative estimates, I know, more or less close, more than half a thousand people with cerebral palsy. I think this is enough to dispel the myths that those who are faced with this diagnosis for the first time tend to believe.

Myth one: Cerebral palsy is a serious illness

It is no secret that many parents, upon hearing this diagnosis from a doctor, experience shock. Especially in recent years, when the media are increasingly talking about people with severe cerebral palsy - wheelchair users with damage to their arms and legs, slurred speech and constant violent movements (hyperkinesis). They don’t even know that many people with cerebral palsy speak normally and walk confidently, and with mild forms they do not stand out among healthy people at all. Where does this myth come from?

Like many other diseases, cerebral palsy ranges from mild to severe. In fact, it’s not even a disease, but common cause a range of disorders. Its essence is that during pregnancy or childbirth, certain areas of the cerebral cortex are affected in the baby, mainly those responsible for motor functions and coordination of movements. This is what causes cerebral palsy - disruption of the correct functioning of individual muscles, up to the complete inability to control them. Doctors count more than 1000 factors that can trigger this process. It's obvious that various factors cause different consequences.

Traditionally, there are 5 main forms of cerebral palsy, plus mixed forms:

Spastic tetraplegia– the most severe form, when the patient, due to excessive muscle tension, is unable to control either his arms or legs and often experiences severe pain. Only 2% of people with cerebral palsy suffer from it (hereinafter statistics are taken from the Internet), but they are the ones most often talked about in the media.

Spastic diplegia– a form in which either the upper or lower extremities are severely affected. The legs are more often affected - a person walks with bent knees. Little's disease, on the contrary, is characterized by severe damage to the hands and speech with relatively healthy legs. Consequences of spastic diplegia occur in 40% of cerebral palsy patients.

At hemiplegic form motor functions of the arms and legs on one side of the body are affected. 32% have signs of it.

In 10% of people with cerebral palsy, the main form is dyskinetic or hyperkinetic. It is characterized by strong involuntary movements - hyperkinesis - in all extremities, as well as in the muscles of the face and neck. Hyperkinesis often occurs in other forms of cerebral palsy.

For ataxic form characterized by decreased muscle tone, sluggish slow movements, severe imbalance. It is observed in 15% of patients.

So, the baby was born with one of the forms of cerebral palsy. And then other factors are included - factors of life, which, as you know, is different for everyone. Therefore, what happens to him after a year is more correctly called the consequences of cerebral palsy. They can be completely different even within the same form. I know a man with spastic diplegia of the legs and quite strong hyperkinesis, who graduated from the Faculty of Mechanics and Mathematics of Moscow State University, teaches at the institute and goes on hikes with healthy people.

According to various sources, 3-8 babies out of 1000 are born with cerebral palsy. The majority (up to 85%) have mild and moderate severity diseases. This means that many people simply do not associate the peculiarities of their gait or speech with the “terrible” diagnosis and believe that there are no cerebral palsy in their environment. That's why the only source of information for them comes from publications in the media, which do not at all strive for objectivity...

Myth two: Cerebral palsy is curable

For most parents of children with cerebral palsy, this myth is extremely attractive. Without thinking about the fact that disorders in the functioning of the brain today cannot be corrected by any means, they neglect the “ineffective” advice of ordinary doctors, spending all their savings and collecting huge sums with the help of charitable foundations to pay for an expensive course at the next popular center. Meanwhile, the secret to alleviating the consequences of cerebral palsy is not so much in fashionable procedures, but in constant work with the baby, starting from the first weeks of life. Baths, regular massages, games with straightening the legs and arms, turning the head and developing precision of movements, communication - this is the basis that in most cases helps the child’s body partially compensate for the disturbances. After all, the main task early treatment consequences of cerebral palsy - not correcting the defect itself, but preventing improper development of muscles and joints. And this can only be achieved through daily work.

Myth three: Cerebral palsy does not progress

This is how those who are faced with mild consequences of the disease console themselves. Formally, this is true - the state of the brain does not really change. However, even light form hemiplegia, practically invisible to others, by the age of 18 inevitably causes curvature of the spine, which, if not addressed, is a direct path to early osteochondrosis or intervertebral hernias. And this means severe pain and limited mobility, up to the inability to walk. Each form of cerebral palsy has similar typical consequences. The only trouble is that in Russia this data is practically not generalized, and therefore no one warns growing children with cerebral palsy and their relatives about the dangers that await them in the future.

Parents know much better that the affected areas of the brain become sensitive to the general condition of the body. A temporary increase in spasticity or hyperkinesis can be caused even by a common flu or a surge in blood pressure. In rare cases, nervous shock or serious illness cause a sharp long-term increase in all the consequences of cerebral palsy and even the appearance of new ones.

Of course, this does not mean that people with cerebral palsy should be kept in greenhouse conditions. On the contrary: the stronger the human body, the more easily it adapts to unfavorable factors. However, if the procedure or physical exercise regularly cause, for example, increased spasticity, they should be abandoned. Under no circumstances should you do anything through “I can’t”!

Parents should pay special attention to the condition of the child from 12 to 18 years of age. At this time, even healthy children experience serious overload due to the peculiarities of the body's restructuring. (One of the problems of this age is skeletal growth, which outstrips the development of muscle tissue.) I know several cases when walking children, due to problems with the knees and hip joints at this age they sat in a wheelchair, and forever. This is why Western doctors do not recommend putting cerebral palsy children aged 12-18 years on their feet if they have not walked before.

Myth four: everything comes from cerebral palsy

The consequences of cerebral palsy are very different, and yet their list is limited. However, relatives of people with this diagnosis sometimes consider cerebral palsy to be the cause of not only a disorder motor functions, as well as vision and hearing, but also such phenomena as autism or hyperactivity syndrome. And most importantly, they believe that if cerebral palsy is cured, all other problems will be solved on their own. Meanwhile, even if the cause of the disease is indeed cerebral palsy, it is necessary to treat not only it, but also the specific disease.

During the birth process, Sylvester Stallone's facial nerve endings were partially damaged - part of the actor's cheeks, lips and tongue remained paralyzed, however, slurred speech, a grin and large sad eyes later became his calling card.

The phrase “You have cerebral palsy, what do you want!” is especially funny! sounds in the mouths of doctors. I heard it more than once or twice from doctors of different specialties. In this case, I have to patiently and persistently explain that I want the same thing as any other person - relief from my own condition. As a rule, the doctor gives in and prescribes the procedures that I need. IN as a last resort, going to the manager helps. But in any case, when faced with a particular disease, a person with cerebral palsy has to be especially attentive to himself and sometimes tell doctors necessary treatment to minimize negative impact procedures.

Myth five: people with cerebral palsy don’t get hired anywhere

It is extremely difficult to say anything based on statistics here, because there is simply no reliable data. However, judging by the graduates of the mass classes of special boarding school No. 17 in Moscow, where I work, only a few remain at home after school. About half go to specialized colleges or departments of universities, a third go to regular universities and colleges, and some go straight to work. At least half of the graduates are subsequently employed. Sometimes girls quickly get married after finishing school and begin to “work” as a mother. With graduates of classes for children with mental retardation the situation is more complicated, however, even there, about half of the graduates continue their studies in specialized colleges.

This myth is spread mainly by those who are unable to soberly assess their abilities and want to study or work where they are unlikely to meet the requirements. Having received a refusal, such people and their parents often turn to the media, trying to force their way. If a person knows how to balance desires with possibilities, he finds his way without showdowns and scandals.

A good example is our graduate Ekaterina K., a girl with a severe form of Little’s disease. Katya walks, but can work on a computer with just one finger of her left hand, and her speech is understood only by very close people. The first attempt to enroll in a university as a psychologist failed - after looking at the unusual applicant, several teachers declared that they refused to teach her. A year later, the girl entered the Academy of Printing in the editorial department, where there was a distance learning option. Her studies went so well that Katya began earning extra money by taking tests for her classmates. Get a job after graduation permanent job she failed (one of the reasons was the lack of an ITU labor recommendation). However, from time to time she works as a moderator of educational websites in a number of universities in the capital ( employment contract is registered to another person). And in free time writes poetry and prose, posting works on his own website.

Dry residue

What can I advise parents who find out that their baby has cerebral palsy?

First of all, calm down and try to give him as much attention as possible, surrounding him (especially in early age!) only positive emotions. At the same time, try to live as if an ordinary child is growing up in your family - walk with him in the yard, dig in the sandbox, helping your baby establish contact with peers. No need once again remind him of the illness - the child himself must come to an understanding of his characteristics.

Secondly, do not rely on the fact that sooner or later your child will be healthy. Accept him for who he is. One should not think that in the first years of life all efforts should be devoted to treatment, leaving the development of intelligence “for later.” The development of mind, soul and body are interconnected. Much in overcoming the consequences of cerebral palsy depends on the child’s desire to overcome them, and without the development of intelligence it simply will not arise. If the baby does not understand why he needs to endure the discomfort and difficulties associated with treatment, there will be little benefit from such procedures.

Third, be lenient with those who ask tactless questions and give “stupid” advice. Remember: recently you yourself knew no more about cerebral palsy than they did. Try to calmly conduct such conversations, because their attitude towards your child depends on how you communicate with others.

And most importantly, believe: your child will be fine if he grows up to be an open and friendly person.

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Anastasia

I read the article. My theme:)
32 years old, right-sided hemiparesis (mild form of cerebral palsy). Regular kindergarten regular school, university, independent search for a job (in fact, that’s where I’m at now), travel, friends, ordinary life….
And I went through the “lame-footed” one, and through the “club-footed” one, and through God knows what. And there will be much more, I'm sure!
BUT! The main thing is a positive attitude and strength of character, optimism!!

Nana

Should we really expect things to get worse with age? U I'm easy degree, spasticity in the legs

Angela

But people’s attitude and unfavorable living conditions broke me. At 36 years old, I have no education, no job, no family, although it is a mild form (right-sided hemiparesis).

Natasha

After vaccinations, a lot of “cerebral palsy” appeared. Although the children do not have cerebral palsy at all. There is nothing congenital or intrauterine there. But they attribute it to cerebral palsy and, accordingly, incorrectly “heal” it. As a result, they actually get a type of paralysis.
Often the cause of “congenital” cerebral palsy is not trauma at all, but an intrauterine infection.

Elena

A wonderful article that raises a huge problem - how to live “with it”. It has been well shown that it is equally bad not to take into account the presence of limitations associated with the disease and to attach excessive importance to them. You shouldn't focus on what you can't do, but rather focus on what you can.
And it is indeed very important to pay attention to intellectual development. We even injected Cerebrocurin, it gave us a huge boost in development, after all, embryonic neuropeptides really help to use the existing capabilities of the brain. My opinion is that you shouldn’t wait for a miracle, but you shouldn’t give up either. The author is right: “this can only be achieved through the daily work” of the parents themselves, and the sooner they do this, the more productive it will be. It’s too late to start “preventing improper development of muscles and joints” after one and a half years of age - “the locomotive has left.” I know on personal experience and from the experiences of other parents.
Ekaterina, all the best to you.

* Kinesthesia (ancient Greek κινέω - “move, touch” + αἴσθησις - “feeling, sensation”) - the so-called “muscular feeling”, a sense of position and movement of both individual members and the entire human body. (Wikipedia)

Olga

I completely disagree with the author. firstly, why didn’t they say anything about double hemiplegia when considering the forms of cerebral palsy? it differs from ordinary hemiplegia and from spastic tetraparesis. secondly, cerebral palsy is truly curable. if we mean the development of compensatory capabilities of the brain and improvement of the patient’s condition. thirdly, the author has seen heavy children in the eyes??? those that are out of the question to bear playing in the sandbox. when you look at a child almost in the wrong way and he shakes with convulsions. and the screaming doesn't stop. and he arches in such a way that there are bruises on mom’s arms when she tries to hold him. when the child cannot only sit or lie down. fourthly. form of cerebral palsy- it’s not about anything at all. the main thing is the severity of the disease. I saw spastic diplegia in two children - one is almost no different from his peers, the other is all crooked and with convulsions, of course, he cannot even sit upright in a stroller. but there is only one diagnosis.

Elena

I don’t quite agree with the article as a mother of a child with cerebral palsy - spastic diplegia, medium degree gravity. As a mother, it’s easier for me to live and fight thinking that if this is incurable, then it’s fixable—it’s possible to bring the child as close as possible to “norms.” social life. For 5 years we have heard enough that it is better to send our son to a boarding school and give birth to a healthy one ourselves... and this is from two different orthopedic doctors! It was said in front of a child whose intellect was preserved and he heard everything... of course he closed himself off, began to avoid strangers... but we have a huge leap - our son walks on his own, although he has poor balance and his knees are bent... but we are fighting. We started quite late - from 10 months , other consequences were treated before premature birth and the doctors don’t care...

Cerebral palsy - this abbreviation scares all parents and often sounds like a death sentence. However, upon receiving such a diagnosis, the child’s parents should not give up, but simply must sound the alarm. This terrible diagnosis should be questioned and the true causes leading to impaired motor functions of the child should be identified. The fact is that pediatric neurologists tend to make this diagnosis, which is familiar to them, from the first year of a child’s life - when the first signs of paralysis and paresis appear. However, after in-depth scientific and practical research, it turned out that the diagnosis of “cerebral palsy” is a very conditional and imprecise diagnosis. As noted by Anatoly Petrovich Efimov, traumatologist-orthopedist-neurorehabilitation specialist, doctor medical sciences, Professor, CEO Interregional Center for Rehabilitation Medicine and Rehabilitation in Nizhny Novgorod, “Cerebral palsy is not a death sentence, since in 80% of cases it can be cured until the child fully recovers. If this is done in a timely manner, as my medical practice shows, children under 5 years of age are cured in 90% of cases and go to school along with ordinary children.”

Cerebral palsy does not exist without a cause. If there is any talk from doctors about the threat of cerebral palsy or about cerebral palsy, parents should do the following.
Firstly, parents need to find out the causes of cerebral palsy together with the doctor if the doctor insists on this diagnosis. But these reasons are few, and in any hospital they can be identified in one or two weeks. There are only six causes that lead to cerebral palsy.

First reason These are hereditary genetic factors. All disorders that exist in the genetic apparatus of the parents can actually manifest themselves in the form of cerebral palsy in the child.

The second reason– this is ischemia (impaired blood supply) or hypoxia (lack of oxygen) of the fetal brain. This is the oxygen factor, a lack of oxygen to the child’s brain. Both can occur during pregnancy or during childbirth as a result of various vascular disorders and hemorrhages.

Third reason– this is an infectious factor, that is, microbial. The presence in the child in the first days and first weeks or months of life of such diseases as meningitis, encephalitis, meningoencephalitis, arachnoiditis, occurring with high temperature, severe general condition of the child, with poor blood tests or cerebrospinal fluid, with the detection of specific microbes that cause infectious diseases.

Fourth reason– these are the effects of toxic (poisonous) factors, poisonous drugs on the body of the future person. This is most often when a woman takes potent medicines during pregnancy, the work of a pregnant woman in hazardous working conditions, in chemical production, in contact with radiation or chemical substances.

Fifth reason– physical factor. Exposure of the fetus to high-frequency electromagnetic fields. Exposure, including x-rays, radiation and other physical hazards.

Sixth reason– this is a mechanical factor - birth trauma, trauma before childbirth or shortly after it.

In each clinic, in one or two weeks it is possible to fully assess the root causes of paralysis of brain functions. Practice shows that pediatric neurologists are keen on diagnosing and searching only for infectious or ischemic causes of brain damage in a child. A diagnosis of viral or infectious brain damage is often made. Doctors also pay attention to the lack of oxygen due to vascular disorders, although most vascular disorders and hemorrhages are traumatic, because young blood vessels in newborns cannot burst on their own, like in old people 80-90 years old, so a typical stroke does not occur in children. Vessels in newborns and children are soft, elastic, pliable, adaptive, therefore it is deeply wrong to explain the causes of cerebral palsy by vascular disorders. Most often they are behind traumatic causes. The importance of identifying the root cause of the disease is that the entire program of further treatment and the life prognosis for the child depend on it.

There are three groups of cerebral palsy.

First group– Cerebral palsy is true, not acquired. The disease is hereditary, congenital, primary, when at the time of birth a child’s brain is truly deeply affected by genetic disorders or disorders of embryonic development. It is underdeveloped, smaller in size and volume, the convolutions of the brain are less pronounced, the cerebral cortex is underdeveloped, there is no clear differentiation of gray and white matter, and there are a number of other anatomical and functional disorders of the brain. This is primary, i.e. true cerebral palsy. The brain at the time of birth is biologically and intellectually defective and paralyzed.

Primary cerebral palsy is formed due to:
1) hereditary reasons;
2) the effects of various unfavorable factors during the embryonic (intrauterine) development of a child;
3) severe birth injury, often incompatible with life.
But if such a child is miraculously revived and saved, a state of the brain or spinal cord remains incompatible with normal development.
There are about 10% of such children.

Second group– Cerebral palsy is true, but acquired. There are also about 10% of children with this diagnosis. These are children with acquired disorders. Among the reasons are severe birth trauma, for example, deep hemorrhage during childbirth with the death of parts of the brain, or the traumatic effects of toxic substances, especially anesthesia, as well as severe infectious damage to the brain with purulent meningoencephalitis, etc. such serious causes, affecting the brain and nervous system of the child, form a severe picture of cerebral palsy, but they are no longer hereditary and embryonic in nature, unlike the first group of patients with cerebral palsy, but acquired. Despite the severity of the lesion, children can be adapted to independent movement and independent walking so that they can subsequently take care of themselves. It is possible for them to be rehabilitated at home so that they can move independently, so that they do not need to be carried in their arms, since this is impossible for aging parents to do, and a child’s body grows to the considerable weight of a man or woman.

Third group– Cerebral palsy is not true acquired. This is false, pseudo-cerebral palsy, or secondary, acquired cerebral palsy syndrome, a much larger group. At the time of birth in in this case The children's brain was biologically and intellectually complete, but as a result of, first of all, birth injuries, disturbances appeared in various parts of the brain, leading to subsequent paralysis of individual functions. 80% of children suffer from acquired cerebral palsy. Outwardly, such children differ little from children with true cerebral palsy, except for one thing - their intelligence is preserved. Therefore, it can be argued that all children with a smart head, with intact intelligence, are never children with true cerebral palsy. That is why all these children are very promising for recovery, since the cause of cerebral palsy-like syndrome in them was mainly birth trauma - severe or moderate.
In addition to birth injuries, the cause of secondary (acquired) cerebral palsy is oxygen deprivation of the brain during pregnancy, mild hemorrhages in the brain, exposure to toxic substances, and physical adverse factors.

In addition to the diagnosis of cerebral palsy, it is worth dwelling on the diagnosis of “threat of cerebral palsy.” It is placed mainly in the first year of a child’s life. It is necessary to take into account: the main causes of paralysis have not yet been identified nervous system, musculoskeletal system, until a modern comprehensive examination of the child has been carried out and until normal, natural periods for the appearance of walking have arrived, it is impossible to prematurely make a diagnosis of “threat of cerebral palsy”. For such children under one year of age, it is necessary to take a lot of trouble, first of all, for parents, to consult them in the best centers, with the most the best doctors in order to finally understand the prospects for the development of such a disease in a child.

An important and large group of patients diagnosed with cerebral palsy are children with so-called secondary cerebral palsy, that is, initially at the time of birth these children had no reason to be diagnosed with cerebral palsy. Nature does not create such diseases. Where do they come from? It turns out that all these children only have cerebral palsy-like diseases, with consequences of birth injuries or exposure to other pathological factors. But due to improper treatment by the age of 7-10 they become children with secondary cerebral palsy - absolutely unpromising, with irreversible functional disorders, with medical and biological consequences, that is, profound disabilities. This group of children is entirely the responsibility of the doctors. By virtue of various reasons they were treated with a treatment regimen for cerebral palsy for years without finding out true reasons development of movement disorders and other disorders. As for treatment of cerebral palsy, used potent drugs that affect the brain, prescribed inadequate physical procedures, primarily electrical procedures, used manual therapy without justification, prescribed active massage to those parts of the body where it is undesirable, used needle methods, as in the treatment of true cerebral palsy, methods of electrical stimulation, prescribed drugs hormonal nature, etc. Thus, improper treatment carried out for years (5, 7, 10 years) forms a large group of disabled people with secondary infantile paralysis. This group children is a great sin of modern medicine. First of all, child neurology. Parents need to know about this in order to prevent the formation in our society of such a group of patients as children with cerebral palsy of a false, acquired, secondary nature. With correct modern diagnostics and proper rehabilitation treatment, all these children can recover to a normal state, i.e. they can master a certain working specialty depending on their age and the date of commencement of adequate rehabilitation.

How should the parents of a child behave when diagnosed with “threat of cerebral palsy” or “cerebral palsy”?

First of all, don't give up. They should know that in addition to traditional neurological treatment regimens for cerebral palsy, in Russia it has become possible to accurately diagnose the true causes of cerebral palsy. And also to distinguish true cerebral palsy from acquired, the true causes leading to brain paralysis from causes that temporarily paralyze, i.e. so that paralyzing disorders are reversible. Particularly effective is the group of children who have developed cerebral palsy as a result of birth injuries, since many of the consequences of injuries are reversible. And reversibility means treatability. Therefore, cerebral palsy caused by birth trauma is treated in such a way that the child has prospects for recovery at any age. Although it should be noted that the earlier treatment is started, the more effective it is. The best cure rate is observed in children under 5 years of age - in 90% of cases, up to 10 years of age - about 60%. After 10 years, due to the fact that children are neglected, that is, by this time many physiological disorders appear in their body, and not only in the brain, but also in bones, joints, muscles and other organs, they are already recovering worse. But they must be restored to the level of independent movement and self-service. These patients should apply and actively engage in all methods of family rehabilitation at home until positive results appear. final result. Of course, the older the child is, the longer it takes to recover. But in any case, you cannot stop and to achieve the necessary results you need to practice at home. All ages are susceptible to rehabilitation.

Ekaterina SERGEEVA

Disability for cerebral palsy is given not on the basis of an existing diagnosis, but if the disease is accompanied by limitations in life activity. In this case, it means limited ability to move, speak, self-care, and learn. It has different degrees severity, but in many cases it leads to disability. This disease is not considered genetic, but is congenital. This is what makes it special.

For what reasons does a child develop cerebral palsy?

The main cause of this serious disease is considered to be damage to the parts of the brain responsible for the functioning of the entire body. Damage to a child’s brain can begin in the womb, from the first days of life, or during childbirth.

The following factors can increase the likelihood of developing cerebral palsy:

intrauterine infections;
low hemoglobin in pregnant women;
infection of the nervous system in an infant;
difficult childbirth;
asphyxia during childbirth.

In addition, alcohol abuse by a woman during pregnancy significantly increases the likelihood of developing cerebral palsy. It is quite difficult to determine whether a child has this disease at an early age. The fact is that the baby’s physical activity is limited, and he sleeps for a long part of the day. Only the most severe forms of the disease can be detected at this early stage. As the baby develops, some abnormalities may occur, usually 2 months after birth.

To identify cerebral palsy in a child, a neurologist prescribes a list of medical examinations that can be used to make a correct diagnosis. In infants, neurosonography is used for this (examination of parts of the brain through the fontanel). For older children, the procedure of electroencephalography and electroneuromyography is used to determine muscle performance. If the diagnosis is confirmed, the child with cerebral palsy is assigned a disability group.

How can you visually identify this disease?

Initially, you should observe how the child’s arms and legs function correctly. Cerebral palsy can cause spasms of motor activity of both the upper and lower limbs. In addition to that muscle fibers are under great tension, so that they are difficult to bend or straighten. Symptoms of lethargy are also likely, in which there are difficulties in moving the arms and legs.

The other is hyperkinesis. With it, involuntary movements are observed in the muscle structures. If the described symptoms are detected, the child must be seen immediately by a doctor. These signs can lead to severe disability.

During the life of the child, other manifestations or complications may be noticeable. These include impaired speech abilities due to spasm of the speech apparatus. This leads to the child starting to stutter or speaking slowly. In addition, cerebral palsy can be accompanied by a mental disorder from the simplest to the most severe form. The final stage of this disorder is oligophrenia.

Today, modern equipment is used to detect cerebral palsy in a timely manner. Wherein rehabilitation period works best for children. In order to make a diagnosis, prescribe various examinations depending on age.

Only an institution can recognize a child as disabled civil service medical and social examination. At this point, the health status and degree of activity limitation of the disabled person is assessed.

What benefits does disability give to a child?

The main reason for calling for disability registration for a child with cerebral palsy is pension payments carried out by the state. These are funds intended for the purchase of necessary medications and various means for caring for a disabled child.

In addition to pension accruals, a disabled child has the right to the following benefits:

free travel in the city public transport(except taxi);
benefits for travel by rail, air and river transport;
free treatment in a sanatorium;
providing disabled people with necessary medical equipment;
free receipt of medicines at a pharmacy according to a prescription prescribed by a doctor.

These rights are granted not only to disabled children, but also to their mothers. This is a benefit when calculating tax payments on income received, the right to a reduced work schedule, additional leave, as well as immediate retirement. Receipt of benefits will depend on what disability group the child is given.

Group 1 is considered the most dangerous and is assigned to a child who does not have the ability to carry out independent care without anyone’s help (move, eat, dress, etc.). At the same time, a disabled person does not have the opportunity to fully communicate with people around him, and therefore needs regular supervision.

Disability group 2 implies some restrictions in the above manipulations.

Also, a child who received group 2 does not have the ability to learn.

However, it is possible to obtain knowledge in institutions designated for these purposes for disabled children with disabilities.

Group 3 is assigned to a disabled person who is able to individually carry out movements, communicate, and learn. But at the same time, children have a delayed reaction, and therefore require additional monitoring due to their health status.

Disability in cerebral palsy

As mentioned above, children receive disability when diagnosed with cerebral palsy. Mandatory assistance The doctor at the site must assist in documenting the disability. In addition, he must give direction for passing medical commission. At the next stage, a medical and sanitary examination (MSE) is carried out, with the help of which the diagnosis is confirmed. When preparing for its passage, it is necessary to clarify the severity of motor disorders, the degree of damage to the hand, the degree of impairment of support, speech, mental disorder and other factors.

Parents must prepare the required documents in order to register a disability group for a child with cerebral palsy. The kit includes: a referral received at the clinic, with the results of the studies performed, a birth certificate, a passport of one of the parents, an application, a certificate of registration from the housing office, photocopies of all necessary documents. In addition to this, other documents may be required to confirm general condition health (result of examination or hospital extracts).

Within about a month, parents should be given a certificate on the basis of which a certain disability group will be assigned. This document should be submitted to the Pension Fund to process pension payments.

Thus, childhood illnesses can be quite serious, as in the case of cerebral palsy. If the child has this pathology, him in mandatory must be assigned a disability group by a higher authority. Disabled children have the right to free medical care and life-sustaining medications.

Besides medical care children with cerebral palsy also need pedagogical assistance. To do this, parents, together with teachers, must draw up a comprehensive plan for influencing a disabled child. It should include classes on teaching correct movements, therapeutic exercises, massage, and work on exercise machines. the main role assigned to early speech therapy activities.

The result of physiotherapeutic and speech therapy effects increases due to treatment medicines.

However, it is completely impossible. But with timely measures and correct behavior of parents and teachers, a disabled child can achieve enormous success in independent care and acquiring skills.

Effective rehabilitation of children with cerebral palsy includes a set of measures. Attention is paid not only to the physical, but also to the mental development of the child, the acquisition of skills of independence and social adaptation. For children with disabilities, free observation, vouchers for treatment in sanatoriums, and provision of medicines and means of technical rehabilitation.

Causes of the disease and risk factors

The causes of cerebral palsy are divided into intrauterine provoking factors and postpartum ones. The first type includes:

difficult pregnancy;
unhealthy lifestyle of the mother;
hereditary predisposition;
difficult childbirth, during which fetal asphyxia occurred;
spicy or some chronic diseases mothers;
children born ahead of schedule and with low weight;
infectious processes occurring in a latent form in the mother’s body;
toxic poisoning of the child’s brain due to incompatibility of mother and fetus in blood type and Rh factor or liver failure of the child.

Postpartum triggers include:

baby weight up to 1 kg at birth;
the birth of twins or triplets;
head injuries at an early age.

In every third case, however, to identify specific reason pathology fails. And as a rule, rehabilitation of children with cerebral palsy does not depend on the causes of the disease. can be reconsidered only in the case of premature and low birth weight babies - such patients often require more careful care and medical supervision.

Main phases of the disease

Rehabilitation of children with cerebral palsy depends on the phase of the disease, the severity of the disease and the age of the patient. There are three phases of the course of the disease:

Early (up to 5 months). Cerebral palsy is manifested by developmental delay and preservation of unconditioned reflexes.
Primary (up to 3 years). The child often chokes on food, does not try to speak, asymmetry, hypertonicity or excessive muscle relaxation are noticeable.
Late (over three years). It manifests itself as shortening of one limb compared to the other, disturbances in swallowing, hearing, vision, speech, convulsions, disturbances in urination and defecation, and mental retardation.

Early signs of cerebral palsy

Early signs of cerebral palsy include the following deviations:

delayed physical development: head control, rolling over, sitting without support, crawling or walking;
preservation of “childish” reflexes upon reaching 3-6 months of age;
one hand dominance by 18 months;
any symptoms that indicate hypertonicity or excessive relaxation (weakness) of the muscles.

Clinical manifestations of the disease can be either pronounced or almost invisible - it all depends on the degree of damage to the central nervous system and brain. Contact for medical care should if:

the child’s movements are unnatural;
the child has seizures;
muscles look excessively relaxed or tense;
the baby does not blink in response to loud noise in one month;
at 4 months the child does not turn his head towards a loud sound;
at 7 months does not sit without support;
at 12 months does not speak individual words;
the baby does not walk or walks unnaturally;
The child has strabismus.

Comprehensive rehabilitation of children with cerebral palsy gives the best results if it begins at an early age. At severe forms illness, untimely recovery physical activity or late development of social skills, the child may remain completely unadapted to life.

Is it possible to cure the disease?

Cerebral palsy is a disease that is almost impossible to cure completely. However, comprehensive and timely rehabilitation allows children with this diagnosis to undergo education on an equal basis with healthy children and lead a full life. Significant progress can be considered if the child retains a few symptoms of the disease.

Modern methods of treating cerebral palsy

The main task for children with paralysis is the gradual development of skills and abilities, physical and social adaptation. Methods that are developed individually for each child gradually correct motor defects, improve motor activity, develop the patient emotionally, personally and socially, and develop independence skills in life. Everyday life. As a result of systematic rehabilitation, the child can integrate into society and adapt to later life on one's own.

The rehabilitation program for children with cerebral palsy includes the following approaches:

treatment water treatments: swimming, balneo- or hydrotherapy;
PET therapy, or treatment with animals: hippotherapy, psychophysical rehabilitation in the process of communicating with dolphins and swimming;
application orthopedic devices, exercise equipment, gymnastic balls, ladders;
raising bioelectrical activity muscles;
massotherapy allowing to reduce the degree of lethargy and muscle spasms;
drug treatment: Botox, botulinum toxin, Xeomin, Dysport are used;
Vojta therapy, which allows you to restore natural behavior patterns;
physiotherapeutic treatment: myoton, ultrasound, magnetic therapy, darsonvalization;
Montessori therapy, which allows you to develop the ability to concentrate and develop independence;
sessions with a psychologist;
speech therapy classes that correct speech disorders (the Logorhythmics program);
special pedagogy;
shiatsu therapy - massage of biologically active points;
classes using the Bobat method - special gymnastics using certain equipment;
laser exposure to reflexogenic zones, the tip of the nose, joints, reflex segmental zones, the area of paretic muscles;
art therapy aimed at preparing the child for learning;
Peto's technique - dividing movements into separate acts and learning them;
surgical orthopedic interventions;
Spa treatment;
alternative treatment methods: osteopathy, manual therapy, catgut therapy, vacuum therapy, electroreflexotherapy.

Of course, not all methods of rehabilitation of children with cerebral palsy are listed above. There are many ready-made programs developed and currently being developed by rehabilitation centers, alternative approaches and techniques.

Physical rehabilitation of children with cerebral palsy

Physical recovery of a sick child should begin as early as possible. Leading experts in the world have recognized that the rehabilitation of a disabled child (CP) brings the best results up to three years of age, but in Russia many centers refuse to accept children under one or three years of age, and doctors are in no hurry to establish a diagnosis and register disability. But still physical rehabilitation - the most important stage adaptation of a special child to future life, and you should start working with a young patient immediately after the diagnosis of cerebral palsy is established.

Rehabilitation of children with cerebral palsy is necessary to prevent weakening and atrophy of muscles, to avoid the development of complications, and is also used to promote the child’s motor development. Therapeutic massage, physical education and exercises on special simulators are used. In general, any physical activity is useful, and the supervision of a specialist will help to form motor stereotypes, properly develop physical fitness and prevent addiction to pathological positions.

Rehabilitation Bobath therapy

The most common form of rehabilitation is Bobath therapy in combination with other equally effective techniques. The essence of the therapy is to give the limb a position opposite to that which it, due to hypertonicity, tends to assume. Classes should be conducted in a calm environment, three times a day or a week, each movement is repeated 3 to 5 times. The movements themselves are carried out slowly, because the main goal of treatment is muscle relaxation. Exercise sets are developed individually. Treatment using the Bobath therapy method can also be carried out at home - a parent or guardian is trained to perform the techniques with the help of a specialist in a rehabilitation center.

Means of technical rehabilitation

When physically restoring the motor activity of a child with cerebral palsy, means of technical rehabilitation of children are also used. Severe cerebral palsy requires devices for the mobility (walkers, wheelchairs), development (exercise bikes, special tables and chairs) and hygiene (bath seats, toilet chairs) of the child. Also, rehabilitation means for children with cerebral palsy involve the use of orthopedic devices and exercise equipment. For example, the Adele suit is used, which redistributes the load and develops motor skills, the “Veloton”, which stimulates the muscles, the “Spiral” suit, which allows the formation of new stereotypes of movements, and so on.

Social rehabilitation of disabled children with cerebral palsy

Closer to school age More attention is paid to the child’s social adaptation. Efforts are aimed at developing independence skills, mental development, preparing the child for collective learning and communication. In addition, the patient is taught to dress independently, take care of himself, perform hygiene, move around, and so on. All this will reduce the burden on those caring for a disabled child, and the youngest patient will be able to adapt to life.

Psychologists, speech therapists and teachers work with special children. The role of parents or guardians who will work with the child at home is extremely important. Social rehabilitation of children (CP) pursues the following goals:

extension vocabulary and outlook;
development of memory, attention and thinking;
developing personal hygiene skills;
developing self-service skills;
development of speech, formation of culture.

Children with this diagnosis can study in experimental classes, which are often formed in private schools, but if there are significant restrictions, it is better to think about boarding or homeschooling. In a boarding school, a child can communicate with peers, gain special skills and participate in career guidance activities. Homeschooling requires more parental involvement and daily medical supervision.

In many cases further work activity a person diagnosed with cerebral palsy. Such people can master the professions of mental work (teachers, but not elementary school teachers, economists, architects, junior medical staff), work at home as programmers, freelancers, and even (if their hand movements are preserved) as seamstresses. Employment is impossible only in severe cases.

Disability due to cerebral palsy

It has several forms and degrees of severity. Disability for cerebral palsy is registered if the disease is accompanied by restrictions in relation to normal life, training, self-care, speech contact. Registration of disability is possible only after medical examination. Mother and child will have to see a neurologist, surgeon, psychiatrist, pediatrician, orthopedist, ophthalmologist and ENT specialist. The “adventures” do not end there. Followed by:

draw up a final conclusion from the head of the medical institution;
go through the document verification procedure in an adult clinic;
submit the package of documents to the collection point for medical and social examination.

Depending on the period of establishment of disability, carry out medical and social examination(and therefore, to go through all the doctors again) must be repeated after a certain period of time. You also need to obtain conclusions again if the completed individual program rehabilitation undergoes changes - for example, if a child, as prescribed by a specialist, requires a new means of rehabilitation.

Benefits for disabled children with cerebral palsy

Registration of disability for some families is a vital issue, because it makes it possible to receive cash payments for rehabilitation and benefits.

Thus, families with disabled children with cerebral palsy are entitled to the following benefits:

free rehabilitation in federal and regional centers and sanatoriums;
a discount of at least 50% on payment for municipal or public housing, as well as housing and communal services;
the right to priority receipt of land plots for individual construction, gardening and housekeeping;
provision of medicines (as prescribed by a doctor), medical nutrition products;
free travel to and from the place of sanatorium-resort treatment, as well as on public transport (benefits are given to a disabled child and one accompanying person);
compensation for the services of a psychologist, teacher and speech therapist, determined by the individual rehabilitation program (in the amount of no more than 11.2 thousand rubles per year);
exemption from fees in kindergartens;
compensation payments to unemployed persons caring for a disabled child (a parent, adoptive parent or guardian can receive 5.5 thousand rubles, another person - 1.2 thousand rubles);
pension for a disabled child and additional payments (in total 14.6 thousand rubles as of 2017);
the period of caring for a child with a disability is counted as part of the mother’s work experience;
the mother of a disabled child with cerebral palsy has a number of benefits labor legislation: cannot be involved in overtime work, business trips, has the right to work part-time, retire early, and so on;
a single mother raising a disabled child cannot be fired, except in cases of complete liquidation of the enterprise.

Rehabilitation centers in Russia

In special centers, rehabilitation of children with cerebral palsy is carried out comprehensively and under the supervision of relevant specialists. As a rule, systematic classes, an individual program and professional medical support for both children and parents make it possible to achieve significant results in a relatively short period of time. Of course, to consolidate the results, you need to continue studying according to the proposed program at home.

Russian Scientific and Practical Center for Physical Rehabilitation and Sports (Grossko Center)

There are several rehabilitation centers in Russia. The Grossko Center in Moscow operates according to a comprehensive program: upon admission, diagnostics are carried out, then specialist instructors in physical rehabilitation work with a special child. Physical rehabilitation of children with cerebral palsy at the Grossko Center includes physical therapy classes, swimming, exercises with special simulators that allow them to develop coordination of movements and consolidate motor stereotypes, exercises on a treadmill, and roller skating. Based on the results of pedagogical testing, programs are adjusted so that the rehabilitation meets the needs and condition of a particular small patient.

The cost of rehabilitation of a child (cerebral palsy) at the Grossko Center is, of course, not small. For example, you will have to pay 1,700 rubles for the initial appointment, and the cost of 10 physical therapy sessions (45-50 minutes each) is 30 thousand rubles. One session with a speech therapist (lasting 30 minutes), as well as a massage session (30-40 minutes according to the doctor’s indications) will cost 1000 rubles. However, there really are results from the classes, and the Grossko Center itself is a prominent institution.

Russian Research Institute of Traumatology and Orthopedics named after. R. R. Vredena

The Rehabilitation Center for Children with Cerebral Palsy named after R.R. Vreden (RNIITO - Russian Research Institute of Traumatology and Orthopedics) in St. Petersburg provides its clients with a full range of services: from diagnosis to surgical intervention, including, of course, treatment and recovery. Highly professional specialists of the center with many years of experience are at their disposal. practical experience more than twenty fully equipped departments.

Moscow Scientific and Practical Center for Rehabilitation of Persons with Disabilities Due to Cerebral Palsy

The Moscow Scientific and Practical Center for the rehabilitation of people with disabilities due to cerebral palsy is considered one of the most accessible and well-known. The center’s doctors work on the basis of several dozen rehabilitation programs, use all modern domestic developments and find an individual approach to each patient. The center accepts children from three years old. In addition to directly physical recovery, speech pathologists, speech therapists, professional massage therapists and conductologists - teachers who work with children and adults who have disorders of the central nervous system - work with young patients.

Institute of Conductive Pedagogy and Regenerative Movement Therapy in Budapest, Hungary

Rehabilitation of a disabled child (cerebral palsy) at the Institute named after. A. Petyo in Budapest, the capital of Hungary, is a center where hundreds of families strive to get to. The institution is famous for its excellent specialists, the use of the most modern developments in the treatment of young patients, as well as the visible results achieved by children with cerebral palsy who have completed a rehabilitation course.

There are many other rehabilitation centers and sanatoriums that accept children with cerebral palsy for rehabilitation. Only in Moscow, for example, there are the “Movement” Rehabilitation Center for Children with Cerebral Palsy, the “Ogonyok” Rehabilitation Center, the “Overcoming” Rehabilitation Center and others. Some institutions also offer free rehabilitation for children with cerebral palsy. Families with disabled children are also provided with support charitable organizations and social centers.

What is due to a child with cerebral palsy? Cerebral palsy (CP) Cerebral palsy in a child what disability group