Central nervous system disorders, symptoms, treatment. The development of the central nervous system and signs of pathology

The nervous system is the leading physiological system of the body.

Neuropsychic development (CPD) is an improvement, a qualitative change in the intellectual and motor skills of a child. At the time of birth, the nervous system of children has this characteristic:

By the time of birth, a healthy full-term newborn baby has a well-developed spinal cord, medulla oblongata, trunk, and hypothalamus. Life support centers are associated with these formations. They provide vital functions, the survival of the newborn, and the processes of adaptation to the environment.

At birth, the brain is the most developed organ. In a newborn, the brain mass is 1 / 8-1 / 9 of the body weight, by the end of the first year of life it increases 2 times and is equal to 1/11 and 1/12 of the body weight, at 5 years it is 1 / 13-1 / 14, in 18-20 years old - 1/40 of body weight. The large grooves and convolutions are very well expressed, but shallow. There are few small furrows; they appear only in the first years of life. The size of the frontal lobe is relatively smaller, and the occipital lobe is larger than that of an adult. The lateral ventricles are relatively large and stretched. Length spinal cord increases somewhat more slowly than the growth of the spine, so the lower end of the spinal cord moves upward with age. The cervical and dorsal enlargements begin to contour after 3 years of life.

The child's brain tissue is characterized by significant vascularization, especially gray matter... At the same time, the outflow of blood from the brain tissue is weak, so toxic substances accumulate in it more often. The brain tissue is richer in protein substances. With age, the amount of protein decreases from 46% to 27%. By birth, the number of mature neurocytes, which will then become part of the cerebral cortex, is 25% of the total cells. Simultaneously, there is histological immaturity nerve cells to the birth of a child: they are oval in shape, with one axon, there is granularity in the nuclei, there are no dendrites.

By the time of birth, the cerebral cortex is relatively immature, subcortical motor centers are differentiated to varying degrees (with a sufficiently mature thalamo-pallidary system, the striated nucleus is poorly developed), myelination of the pyramidal pathways is not complete. The cerebellum is poorly developed, characterized by small thickness, small hemispheres and superficial furrows.

Underdevelopment of the cortex and the prevailing influence of the subcortex affects the child's behavior. Underdevelopment of the cortex, striated nucleus, pyramidal pathways makes voluntary movements, auditory, visual concentration impossible. The dominant influence of the thalamo-pallidary system explains the nature of the movements of the newborn. In a newborn, involuntary slow movements are of a massive generalized nature with general muscle rigidity, which is manifested by physiological hypertension of the limb flexors. The movements of the newborn are limited, chaotic, erratic, athetosis-like. Tremor and physiological muscle hypertonia gradually fade away after the first month of life.

The prevailing activity of subcortical centers with a weak influence of the cortex is manifested by a complex of congenital unconditioned reflexes(VBR) of a newborn, which are based on three: food, defensive, indicative. These reflexes of oral and spinal automatism reflect maturity nervous system newborn baby.

The formation of conditioned reflexes occurs after birth and is associated with the food dominant.

The development of the nervous system continues after birth until puberty... The most intensive growth and development of the brain is observed in the first two years of life.
In the first half of the year, the differentiation of the striated nucleus and pyramidal pathways ends. In this regard, muscle rigidity disappears, spontaneous movements are replaced by voluntary ones. The cerebellum grows and develops intensively in the second half of the year, its development ends by two years. With the development of the cerebellum, coordination of movements is formed.

The first criterion for a child's CPD is the development of voluntary coordinated movements.

The levels of organization of movements according to N.A. Bernstein.

    Spinal level - at the 7th week of intrauterine development, the formation of reflex arcs begins at the level of 1 segment of the spinal cord. It is manifested by muscle contraction in response to skin irritation.

    Rubrospinal level - in reflex arcs the red core turns on, due to which the regulation of muscle tone and trunk motility is ensured.

    Thalamopallidal level - from the second half of pregnancy, a number of subcortical structures of the motor analyzer are formed, integrating the activity of the extrapyramidal system. This level characterizes the child's motor arsenal during the first 3-5 months of life. It includes vestigial reflexes, emerging posotonic reflexes and chaotic movements of a newborn child.

    The pyramidal striatal level is determined by the inclusion in the regulation of the striatum with its various connections, including with the cerebral cortex. The movements of this level are the main large voluntary movements that are formed in 1–2 years of life.

    Cortical, parietal - premotor level - development of fine movements from 10-11 months, improvement of motor skills throughout a person's life.

The growth of the cortex is carried out mainly due to the development of the frontal, parietal, and temporal regions. The proliferation of neurons lasts up to a year. The most intensive development of neurons is observed at 2-3 months. This determines the psychoemotional, sensory development of the child (smile, laughter, crying with tears, revitalization complex, humming, recognizing friends and foes).

The second criterion for CPD is psychoemotional and sensory development.

Different areas and fields of the cortex finish development at different times. The centers of movement, hearing, vision mature by 4-7 years. The frontal and parietal regions finally mature by the age of 12. Completion of myelination of the pathways is achieved only by 3-5 years of postnatal development. The incompleteness of the process of myelination of nerve fibers determines the relatively low rate of conduction of excitation through them. The final maturation of conduction is achieved at 10-12 years.

Development of the sensory sphere. Pain sensitivity - pain sensitivity receptors appear at 3 months of intrauterine life, however, the pain threshold of sensitivity in newborns is much higher than in adults and older children. The child's reactions to a painful stimulus are at first a general generalized character, and only after a few months do local reactions occur.

Tactile sensitivity - occurs at 5-6 weeks of intrauterine development exclusively in the perioral region and by 11-12 weeks extends to the entire surface of the fetal skin.

Thermoreception of a newborn child is morphologically and functionally mature. There are almost 10 times more cold receptors than heat receptors. The receptors are unevenly located. The child's sensitivity to cooling is significantly higher than to overheating.

The eyes of a newborn child are relatively large, their ratio to body weight in a newborn is 3.5 times greater than that of an adult. As the eye grows, refraction changes. In the first days after birth, the child opens his eyes to a short time, but at the time of birth he did not have a system of synchronous opening of both eyes. There is no reflex eyelid closure when an object is approached to the eye. Asymmetry of eye movement disappears in the third week of a child's life.

In the first hours and days of life, children are characterized by hyperopia (farsightedness), over the years its degree decreases. Also, a newborn child is characterized by moderate photophobia, physiological nystagmus. The pupillary reaction in the newborn is both direct and friendly, that is, when one eye is illuminated, the pupils of both eyes narrow. From 2 weeks, the secretion of the lacrimal glands appears, and from 12 weeks the lacrimal apparatus is involved in the emotional reaction. At 2 weeks, a transient fixation of the gaze occurs, usually monocular, it gradually develops and at 3 months the child stably fixes stationary objects with a binocular gaze and traces the moving ones. By the age of 6 months, visual acuity increases, the child sees well not only large, but also small objects.

At the eighth week of postnatal development, a blinking reaction to the approach of an object and to sound stimulation appears, which indicates the formation of protective conditioned reflexes. The formation of peripheral visual fields is completed only by the 5th month of life. From 6 to 9 months the ability of stereoscopic perception of space is established.

When a child is born, he perceives the surrounding objects as many color spots, and sounds as noise. It takes the first two years of his life to learn to recognize images, or connect sounds into something meaningful. The infant's reaction to bright light and sound is defensive. In order for the baby to learn from the foggy spots reflected in his eyes to highlight the mother's face (first of all) and then other people close to him, conditioned connections must be developed in the occipital cortex of his brain, and then stereotypes representing complex systems such connections. So, for example, the child's perception of space consists of the friendly work of many analyzers, primarily visual, auditory and skin. Moreover, the connections in the cerebral cortex, which are responsible for the complex structures that provide an idea of ​​the child's own being in a confined space, are formed rather late. Therefore, a child of the first years of life, being in a confined space, does not fix his gaze on individual objects and often simply does not notice them.

The presented facts are largely explained by the relatively late development of the macular region of the eye in the child. So the development of the macula is largely completed 16 to 18 weeks after the birth of the baby. A differentiated approach to color perception in a child begins only at 5-6 months of age. Only by 2 - 3 years old children can correctly assess the color of the object. But by this time the morphological "maturation" of the retina does not end. The expansion of all its layers continues up to 10 - 12 years, and therefore, only by this age the color perception is finally formed.

The formation of the auditory system begins in the prenatal period at 4 weeks. By the 7th week, the first coil of the snail is formed. At 9-10 weeks of intrauterine development, the snail has 2.5 turns, that is, its structure approaches that of an adult. The snail reaches the form characteristic of an adult at the 5th month of fetal development.

The ability to respond to sound appears in the fetus during the prenatal age. A newborn child hears, but is able to differentiate the strength of sound only about 12 decibels (he distinguishes sounds by one octave in pitch), by the age of 7 months he begins to distinguish sounds that differ from each other by only 0.5 tones.

At the age of 1 to 2 years, the auditory field of the cortex (41 fields according to Brodmann) of the brain is formed. However, its final "ripening" occurs at about 7 years. Consequently, even at this age, the child's auditory system is not functionally mature. Sensitivity to sound reaches its maximum only by adolescence.

With the development of the cortex, most of the congenital unconditioned reflexes gradually fade away during the first year. Conditioned reflexes are formed under the influence of external stimuli.

Speech develops on the basis of conditioned reflexes - the third criterion for CPD. Up to 6 months passes preparatory stage speech - the child communicates with others only with the help of emotions: a smile, a complex of revitalization when addressing him, humming, differentiation of intonation. Gulenie - pronunciation of the first sounds (a, gu-y, uh-uh, etc.).

Speech directly develops after 6 months: the ability to understand a word (sensory speech) and speak (motor speech). Babble - pronunciation of individual syllables (ba-ba-ba, ma-ma-ma, etc.).

By the end of 1 year of life, there are already 8-12 words in the child's vocabulary, the meaning of which he understands (give, mom, dad, etc.). Among them there are onomatopoeics (am-am - to eat, av-av - dog, tick - tock - clock, etc.). In 2 years, the vocabulary reaches 300, short sentences appear.

Due to the fact that sensory systems are actively functioning in a newborn child, he develops the simplest type of memory - a short-term sensory fingerprint. This type of memory is based on the property of the sensory system to preserve and lengthen the effect of the stimulus (there is no object, but the person sees it, the sound has stopped, but we hear it). In an adult, this reaction lasts about 500 MSK, in a child, due to insufficient myelination of nerve fibers and a lower speed of nerve impulse conduction, it takes a little longer.

In a newborn child, the functions of short-term and long-term memory are primarily associated with the activity of auditory and sensory systems, and at a later date - with locomotor function. From the second month of a child's life, other parts of the cortex are also involved in the formation of memory. At the same time, the rate of formation of a temporary connection is individual and already at this age depends on the type of higher nervous activity.

In a newborn, due to the immaturity of the cerebral cortex, attention is carried out through simple forms of orientational reactions (to sound, light). More complex (integrated) mechanisms of the attention process appear at the age of 3-4 months. During this period, the occipital -rhythm periodically begins to form on the electroencephalogram, but in the projection zones of the cortex it is unstable, which indicates that the child does not have conscious reactions in the sphere of sensory modalities.

The child's CPD depends on environmental factors, upbringing, which can either stimulate the development of certain skills, or inhibit.

Due to the peculiarities of the nervous system, the child cannot quickly switch from one type of activity to another, he quickly gets tired. A child from an adult is distinguished by high emotionality, imitative activity.

CPD assessment is carried out on decreed (epicrisis) terms according to age-appropriate criteria

Unconditioned reflexes of the newborn

The main form of activity of the nervous system is reflex. All reflexes are usually divided into unconditioned and conditioned.

Unconditioned reflexes- these are innate, genetically programmed reactions of the body, characteristic of all animals and humans.

Conditioned reflexes- individual, acquired reactions of higher animals and humans, developed as a result of learning (experience).

A newborn child is characterized by unconditioned reflexes: food, defensive and orientational.

Conditioned reflexes are formed after birth.

The main unconditioned reflexes of a newborn and an infant are divided into two groups: segmental motor automatisms, provided by segments brain stem(oral automatisms) and spinal cord (spinal automatisms).

FBG of a newborn baby

    Reflexes in the child's supine position: Kussmaul-Genzler's search reflex, sucking reflex, Babkin's palmar-mouth reflex, grasping or hugging reflex (Moro), asymmetric cervico-tonic reflex, grasping reflex (Robinson's), plantar reflex, Babinsky reflex.

    Reflexes in an upright position: the child is taken from the back by the armpits, the doctor's thumbs support the head. Reflex of support or straightening; automatic gait or step reflex.

    Reflexes in the prone position: defensive reflex, labyrinth tonic reflex, crawling reflex (Bauer), Galant reflex, Perez reflex.

Oral segmental automatisms

Sucking reflex

When the index finger is inserted into the mouth 3-4 cm, the child makes rhythmic sucking movements. The reflex is absent in pareserial nerves, profound mental retardation, in severe somatic conditions.

Search reflex (Kussmaul reflex)

Proboscis reflex

A quick swipe of the finger to the lips causes the lips to be pulled forward. This reflex lasts up to 2-3 months.

Palmar-oral reflex (Babkin's reflex)

When pressed thumb on the area of ​​the palm of the newborn (both palms at the same time), closer to the tenar, the mouth is opened and the head is bent. The reflex is pronounced in normal newborns. The lethargy of the reflex, rapid exhaustion or absence indicate damage to the central nervous system. The reflex may be absent on the affected side with peripheral parezerocy. After 2 months. it fades away and by 3 months. disappears

Spinal motor automatisms

Protective reflex of the newborn

If the newborn is put on its stomach, then a reflexive turn of the head to the side occurs.

Stance reflex and automatic newborn gait

The newborn has no readiness to stand, but it is capable of supporting reaction. If you hold the child upright in weight, then he bends his legs at all joints. The child placed on a support straightens the torso and stands on bent legs on a full foot. Positive support reaction lower limbs is a preparation for stepping movements. If the newborn is slightly tilted forward, then he makes step movements (automatic gait of newborns). Sometimes, when walking, newborns cross their legs at the level of the lower third of the legs and feet. This is caused by a stronger contraction of adductors, which is physiological for this age and outwardly resembles the gait in infantile cerebral palsy.

Crawling reflex (Bauer) and spontaneous crawling

The newborn is placed on its stomach (head in the midline). In this position, he makes crawling movements - spontaneous crawling. If you put a palm to the soles, then the child reflexively pushes off from it with his feet and crawling increases. In the position on the side and on the back, these movements do not occur. In this case, coordination of the movements of the arms and legs is not observed. Crawling movements in newborns become pronounced on the 3rd - 4th day of life. The reflex is physiological up to 4 months of life, then it fades away. Self-crawling is the forerunner of future locomotive acts. The reflex is depressed or absent in children born in asphyxia, as well as in intracranial hemorrhages, spinal cord injuries. Attention should be paid to the asymmetry of the reflex. In diseases of the central nervous system, crawling movements persist for up to 6 - 12 months, like other unconditioned reflexes.

Grasp reflex

Appears in a newborn when pressed on his palm. Sometimes a newborn wraps his fingers so tightly that he can be lifted up ( Robinson reflex). This reflex is phylogenetically ancient. Newborn monkeys are held on the hairline of the mother by gripping the brushes. With paresis, the reflex is weakened or absent, in retarded children - the reaction is weakened, in excitable ones - it is enhanced. The reflex is physiological up to 3 - 4 months, then, on the basis of the grasping reflex, an arbitrary grasping of the object is gradually formed. The presence of a reflex after 4 - 5 months indicates damage to the nervous system.

The same grasping reflex can be triggered from the lower extremities. Thumb pressure on the ball of the foot induces plantar flexion of the toes. If, on the other hand, stroke irritation is applied to the sole of the foot with a finger, then dorsiflexion of the foot and fan-shaped divergence of the fingers occur (physiological Babinsky reflex).

Reflex Galant

When the skin of the back is irritated paravertebrally along the spine, the newborn bends the back, an arc is formed, open towards the stimulus. The leg on the corresponding side is often extended at the hip and knee joints... This reflex is well evoked from the 5th - 6th day of life. In children with damage to the nervous system, it may be weakened or completely absent within 1 month of life. When the spinal cord is damaged, the reflex is absent for a long time. The reflex is physiological up to the 3rd - 4th month of life. With damage to the nervous system, this reaction can be observed in the second half of the year and later.

Reflex Perez

If you run your fingers, lightly pressing, along the spinous processes of the spine from the tailbone to the neck, the child screams, raises his head, unbends the torso, bends the upper and lower limbs. This reflex causes a negative emotional reaction in the newborn. The reflex is physiological up to the 3rd - 4th month of life. Inhibition of the reflex during the neonatal period and a delay in its reverse development is observed in children with damage to the central nervous system.

Reflex Moro

Called by different and not various techniques: hitting the surface on which the child lies, at a distance of 15 cm from his head, raising the extended legs and pelvis above the bed, sudden passive extension of the lower limbs. The newborn moves his arms to the sides and opens his fists - phase 1 of the Moro reflex. After a few seconds, the hands return to their original position - phase II of the Moro reflex. The reflex is expressed immediately after birth, it can be observed during the manipulation of the obstetrician. In children with intracranial injury reflex in the first days of life may be absent. With hemiparesis, as well as with obstetric parasitic surgery, an asymmetry of the Moro reflex is observed.

Assessment of the degree of maturity of the nervous system of a newborn child

The criteria for assessing CPD are:

    motor skills (this is a purposeful, manipulative activity of a child.);

    statics (this is fixing and holding certain parts of the body in the required position.);

    conditioned reflex activity (1 signaling system);

    speech (2 signaling system);

    higher nervous activity.

The neuropsychic development of a child depends on biological and social factors, the conditions of the regime of life, upbringing and care, as well as the state of health of the child.

The delay in the pace of mental development may be due to the unfavorable course of the prenatal period, because at the same time, brain lesions associated with hypoxia are often noted, the rates of maturation of individual complex structures are disrupted. Immaturity of certain parts of the brain in the postnatal period often leads to various disorders neuropsychic development... To unfavorable biological factors include toxicosis of pregnancy, the threat of miscarriage, asphyxia, diseases of the mother during pregnancy, prematurity, etc. The harmful habits of the parents (smoking, alcohol abuse) are important.

Among the unfavorable social factors are the unfavorable family climate, single-parent families, and the low educational level of parents.

The rate of development of the child decreases due to frequent acute diseases... Proper upbringing plays an important role in the development of a young child. It is necessary to have frequent systematic communication with him, the gradual formation of various skills and abilities in the child, and the development of speech.

The child develops heterochronously, i.e. uneven. When assessing CPD, the doctor looks at the epicrisis period for those lines (indicators) that by this moment are developing most intensively, i.e. leading lines.

Leading lines of the child's CPD at various epicrisis periods

FOR - visual analyzer

CA - auditory analyzer

E, SP - emotions and social behavior

DO - general movements

DP - movements with objects

PR - understandable speech

AR - active speech

H - skills

DR - hand movements

SR - sensory development

Fine art - visual activity

G - grammar

B - questions

CPD for children of the first year



There are 4 main groups of teaching staff:

I group includes 4 subgroups:

— normal development when all indicators are age appropriate;

- accelerated, when there is a lead of 1 ES;

- high, when there is a lead of 2 ES;

- upper harmonious, when some of the indicators are ahead of 1 ES, and some are 2 and higher.

II group - these are children who have a delay in the CPD of 1 e.s. It includes 2 subgroups with a uniform delay of 1 ES. along one or more lines:

a) 1-2 lines - 1 degree

b) 3-4 lines - 2 degree

inharmonious - with uneven development, when some of the indicators have a delay of 1 ES, and some are ahead.

III group - these are children who have a delay in CPD by 2 e.s. It includes 2 subgroups with a uniform delay of 2 E.s. along one or more lines:

a) 1-2 lines - 1 degree

b) 3-4 lines - 2 degree

c) 5 or more lines - 3 degree

lower harmonious - with uneven development, when some of the indicators lag behind (or ahead) by 2 ES, and some by 1 ES.

IV group- these are children who have a delay in CPD by 3 e.s. It includes 2 subgroups with a uniform delay of 3 e.s. along one or more lines:

a) 1-2 lines - 1 degree

b) 3-4 lines - 2 degree

c) 5 or more lines - 3 degree

lower harmonious - with uneven development, when some of the indicators lag behind (or ahead) by 3 ES, and some by 1 or 2 ES.

A delay of 3 or more epicrisis periods indicates the presence of a borderline state or pathology. These children need advice and treatment from specialist doctors.

Damage to the nervous system in newborns can occur both intrauterine (prenatally) and during childbirth (intrapartum). If harmful factors acted on the child at the embryonic stage of intrauterine development, severe, often life-incompatible defects occur. Damaging influences after 8 weeks of pregnancy can no longer cause gross deformities, but sometimes they are manifested by small deviations in the formation of the child - stigmas of dysembryogenesis.

If the damaging effect was exerted on the child after 28 weeks of intrauterine development, then the child will not have any defects, but some kind of disease may occur in a normally formed child. It is very difficult to isolate the impact harmful factor separately in each of these periods. Therefore, they often talk about the impact of a harmful factor in general in the perinatal period. And the pathology of the nervous system of this period is called perinatal damage to the central nervous system.

Various acute or chronic diseases mothers, work in hazardous chemical industries or work associated with various radiation, as well as harmful habits of parents - smoking, alcoholism, drug addiction.

A child growing in the womb can be adversely affected by severe toxicosis of pregnancy, pathology of the child's place - the placenta, and the penetration of infection into the uterus.

Childbirth is a very important event for a baby. Especially great trials fall on the share of an infant if childbirth occurs prematurely (prematurity) or rapidly, if there is birth weakness, breaks early fetal bladder and water flows out when the baby is very large and they help him to be born with special techniques, forceps or a vacuum extractor.

The main causes of damage to the central nervous system (CNS) are most often - hypoxia, oxygen starvation of various nature and intracranial birth trauma, less often intrauterine infections, hemolytic disease newborns, malformations of the brain and spinal cord, hereditary metabolic disorders, chromosomal pathology.

Hypoxia ranks first among the causes of damage to the central nervous system, in such cases, doctors talk about hypoxic-ischemic damage to the central nervous system in newborns.

Hypoxia of the fetus and newborn is a complex pathological process in which the access of oxygen to the child's body decreases or completely stops (asphyxia). Asphyxia can be single or repeated, varying in duration, as a result of which carbon dioxide and other under-oxidized metabolic products accumulate in the body, damaging primarily the central nervous system.

With short-term hypoxia, only minor disturbances occur in the nervous system of the fetus and newborn cerebral circulation with the development of functional, reversible disorders. Long-term and repeated occurrence of hypoxic conditions can lead to severe disorders of cerebral circulation and even to the death of nerve cells.

Such damage to the neonatal nervous system is confirmed not only clinically, but also with the help of ultrasound Doppler examination of cerebral blood flow (USDG), ultrasound examination of the brain - neurosonography (NSG), computed tomography and nuclear magnetic resonance (NMR).

In second place among the causes of damage to the central nervous system in the fetus and newborn is birth trauma. The true meaning, the meaning of birth trauma is damage to a newborn baby caused by mechanical impact directly on the fetus during childbirth.

Among the variety of birth injuries during the birth of an infant, the baby's neck experiences the greatest stress, resulting in various injuries. cervical spine, especially the intervertebral joints and the junction of the first cervical vertebra and the occipital bone (atlanto-occipital joint).

There may be dislocations (dislocations), subluxations and dislocations in the joints. This disrupts blood flow in important arteries that supply blood to the spinal cord and brain.

The functioning of the brain is highly dependent on the state of the cerebral blood supply.

Weakness is often the root cause of these injuries. generic activity a woman. In such cases, forcedly applied rhodostimulation changes the mechanism of passage of the fetus through birth canal... With such stimulated childbirth, the child is born not gradually, adapting to the birth canal, but quickly, which creates conditions for displacement of the vertebrae, stretching and rupture of ligaments, dislocations, and cerebral blood flow is disturbed.

Traumatic damage to the central nervous system during childbirth most often occurs when the size of the child does not correspond to the size of the mother's pelvis, when the fetus is in the wrong position, during delivery in the breech presentation, when premature, low birth weight babies are born and, conversely, children with large mass bodies, large in size, since in these cases various manual obstetric techniques are used.

Discussing the causes of traumatic lesions of the central nervous system, one should separately dwell on childbirth using the imposition of obstetric forceps. The fact is that even with the impeccable application of the forceps to the head, intense traction for the head follows, especially when trying to help the birth of the shoulders and torso. In this case, all the force with which the head is stretched is transmitted to the body through the neck. For the neck, such a huge load is unusually high, which is why when removing the baby with forceps, along with the pathology of the brain, damage to the cervical spinal cord occurs.

Particular attention should be paid to the issue of damage to the child that occurs during a caesarean section. Why is this happening? Indeed, it is not difficult to understand the trauma of a child as a result of his passage through the birth canal. Why does the caesarean section operation, designed to bypass these paths and minimize the possibility of birth trauma, ends up in birth trauma? Where do these injuries come from during a cesarean section? The fact is that a transverse incision for a cesarean section in the lower segment of the uterus should theoretically correspond to the largest diameter of the head and shoulders. However, the circumference obtained with such an incision is 24-26 cm, while the circumference of the middle child's head is 34-35 cm.Therefore, removing the head and especially the child's shoulders by pulling the head with an insufficient incision of the uterus inevitably leads to injury to the cervical spine. That is why the most common cause of birth injuries is a combination of hypoxia and damage to the cervical spine and the spinal cord located in it.

In such cases, they talk about hypoxic-traumatic damage to the central nervous system in newborns.

With birth trauma, cerebral circulation disorders often occur, up to hemorrhages. More often these are small intracerebral hemorrhage in the cavity of the ventricles of the brain or intracranial hemorrhages between the meninges (epidural, subdural, subarachnoid). In these situations, the doctor diagnoses hypoxic-hemorrhagic lesions of the central nervous system in newborns.

When a baby is born with CNS damage, the condition can be severe. This is an acute period of the disease (up to 1 month), followed by an early recovery period (up to 4 months) and then a late recovery period.

Important for the appointment of the most effective treatment pathology of the central nervous system in newborns has the definition of the leading complex of symptoms of the disease - neurological syndrome. Let's consider the main syndromes of CNS pathology.

The main syndromes of CNS pathology

Hypertensive-hydrocephalic syndrome

When examining a sick baby, the expansion of the ventricular system of the brain is determined, detected by ultrasound of the brain, and an increase in intracranial pressure is recorded (given by echo-encephalography). Outwardly, in severe cases with this syndrome, there is a disproportionate increase in the size of the cerebral part of the skull, sometimes asymmetry of the head in the case of a unilateral pathological process, divergence of the cranial sutures (more than 5 mm), expansion and strengthening of the venous pattern on the scalp, thinning of the skin on the temples.

In hypertensive-hydrocephalic syndrome, either hydrocephalus, manifested by the expansion of the ventricular system of the brain, or hypertensive syndrome with an increase in intracranial pressure may prevail. With the predominance of increased intracranial pressure, the child is restless, easily excitable, irritable, often screams loudly, sleep is light, the child often wakes up. With the predominance of hydrocephalic syndrome, children are inactive, lethargy and drowsiness are noted, sometimes developmental delay.

Often, with an increase in intracranial pressure, children goggle, the Gref symptom periodically appears (a white strip between the pupil and upper eyelid), and in severe cases, there may be a symptom of the "setting sun", when the iris of the eye, like the setting sun, is half submerged under the lower eyelid; sometimes a convergent squint appears, the baby often throws his head back. Muscle tone can be either decreased or increased, especially in the muscles of the legs, which is manifested by the fact that he stands on his "tiptoe" when leaning on, and when he tries to walk, he crosses his legs.

The progression of hydrocephalic syndrome is manifested by an increase in muscle tone, especially in the legs, while the reflexes of support, automatic walking and crawling are reduced.

In cases of severe, progressive hydrocephalus, seizures may occur.

Syndrome movement disorders

The syndrome of movement disorders is diagnosed in most children with perinatal pathology of the central nervous system. Movement disorders associated with a violation of the nervous regulation of muscles in combination with an increase or decrease in muscle tone. It all depends on the degree (severity) and level of damage to the nervous system.

When making a diagnosis, the doctor must solve several very important questions, the main one of which is: what is it - a pathology of the brain or a pathology of the spinal cord? This is fundamentally important because the approach to treating these conditions is different.

Secondly, the assessment of muscle tone in different muscle groups is very important. The doctor uses special techniques to detect a decrease or increase in muscle tone in order to choose the right treatment.

Violations of increased tone in various groups leads to a delay in the emergence of new motor skills in the child.

With an increase in muscle tone in the hands, the development of the grasping ability of the hands is delayed. This is manifested by the fact that the child takes the toy late and grabs it with the whole brush, fine finger movements are formed slowly and require additional training sessions with the child.

With an increase in muscle tone in the lower extremities, the child later stands on his legs, while resting mainly on the front parts of the feet, as if "standing on tiptoe"; in severe cases, the lower extremities cross at the level of the shins, which prevents the formation of walking. In most children, over time and thanks to treatment, it is possible to achieve a decrease in muscle tone in the legs, and the child begins to walk well. As a memory of increased muscle tone, a high arch of the foot may remain, which makes it difficult to select shoes.

Autonomic-visceral dysfunction syndrome

This syndrome manifests itself as follows: marbling of the skin due to blood vessels, violation of thermoregulation with a tendency to an unreasonable decrease or increase in body temperature, gastrointestinal disorders - regurgitation, less often vomiting, a tendency to constipation or unstable stools, insufficient weight gain. All these symptoms are most often combined with hypertensive-hydrocephalic syndrome and are associated with impaired blood supply to the posterior parts of the brain, in which all the main centers of the autonomic nervous system are located, which provides guidance for the most important life-supporting systems - cardiovascular, digestive, thermoregulatory, etc.

Convulsive syndrome

The tendency to convulsive reactions during the neonatal period and in the first months of a child's life is due to the immaturity of the brain. Convulsions occur only in cases of spread or development of a painful process in the cerebral cortex and have many of the most different reasons that the doctor should identify. This often requires instrumental research work of the brain (EEG), its blood circulation (Doppler) and anatomical structures (ultrasound of the brain, computed tomography, NMR, NSG), biochemical studies.

Convulsions in a child can manifest themselves in different ways: they can be generalized, seizing the whole body, and localized - only in a certain muscle group.

Convulsions are also different in nature: they can be tonic, when the child seems to be stretched out and freezes for a short time in a certain position, as well as clonic, in which the limbs and sometimes the entire body are twitching, so that the child can get injured during the seizures ...

There are many options for the manifestations of seizures, which are identified by a neuropathologist from the story and description of the child's behavior by attentive parents.

lami. The correct diagnosis, that is, determining the cause of the child's seizure, is extremely important, since the timely appointment of effective treatment depends on it.

It is necessary to know and understand that convulsions in a child during the neonatal period, if serious attention is not paid to them in time, can become the onset of epilepsy in the future.

Symptoms to be referred to a pediatric neurologist

Summarizing all that has been said, we will briefly list the main deviations in the state of health of children, with which you need to contact a pediatric neurologist:

if the baby sluggishly sucks the breast, takes breaks, gets tired at the same time. Choking, milk flowing through the nose is noted;
if the child has a weak cry, and the voice has a nasal tone;
if the newborn often spits up, does not gain enough weight;
if the child is inactive, lethargic or, on the contrary, too restless and this anxiety increases even with minor changes in the environment;
if the child has chin trembling, as well as upper or lower limbs, especially when crying;
if the child often shudders for no reason, has difficulty falling asleep, while sleep is superficial, short in time;
if the child constantly throws his head back while lying on his side;
if there is too fast or, conversely, slow growth of head circumference;
if the child's motor activity is reduced, if he is very sluggish, and the muscles are flabby (low muscle tone), or, conversely, the child is, as it were, constrained in movements (high muscle tone), so that swaddling is even difficult;
if one of the limbs (arm or leg) is less active in movements or is in an unusual position (clubfoot);
if the child squints or goggles, a white stripe of the sclera is periodically visible;
if the baby constantly tries to turn his head in one direction only (torticollis);
if thighs are restricted, or, conversely, the child lies in the frog position with the hips apart 180 degrees;
if the child was born by cesarean section or in breech presentation, if obstetric forceps were used during childbirth, if the baby was born prematurely or with a large weight, if the cord was entangled, if the child had convulsions in the maternity home. Accurate diagnosis and timely and correctly prescribed treatment of the pathology of the nervous system is extremely important. Damage to the nervous system can be expressed to varying degrees: in some children, they are very pronounced from birth, in others, even severe disorders gradually decrease, but they do not disappear completely, and on long years non-coarse manifestations remain - these are the so-called residual phenomena.

Late manifestations of birth trauma

There are also cases when at birth the child had minimal disturbances, or no one noticed them at all, but after a while, sometimes years, under the influence of certain loads: physical, mental, emotional - these neurological disorders manifest themselves with varying degrees of severity. These are the so-called late, or delayed, manifestations of birth trauma. Pediatric neurologists in daily practice deal most often with such patients.

What are the signs of these consequences?

Most children with late manifestations show a marked decrease in muscle tone. Such children are credited with "innate flexibility", which is often used in sports, gymnastics, and even encouraged. However, to the disappointment of many, it should be said that extraordinary flexibility is not the norm, but, unfortunately, a pathology. These children easily fold their legs into the "frog" position, do the splits without difficulty. Often, such children are happily accepted in the rhythmic or artistic gymnastics section, in choreographic circles. But most of them cannot stand heavy workloads and are eventually deducted. However, these exercises are enough to form a pathology of the spine - scoliosis. Such children are not difficult to recognize: they often clearly show a protective tension of the cervico-occipital muscles, often have a slight torticollis, the shoulder blades stick out like wings, the so-called "pterygoid scapula", they can stand at different levels, like the shoulders. In profile, it can be seen that the child has a sluggish posture, stooped back.

By the age of 10-15, some children with signs of trauma of the cervical spine during the neonatal period develop typical signs of early cervical osteochondrosis, the most characteristic feature which children have headaches. The peculiarity of headaches with osteochondrosis in children is that, despite their different intensity, pains are localized in the cervico-occipital region. As they grow older, the pain often becomes more pronounced on one side and, starting in the occipital region, spreads to the forehead and temples, sometimes radiates to the eye or ear, increases with head turns, so that a short-term loss of consciousness may even occur.

Headaches in a child are sometimes so intense that they can deprive him of the opportunity to exercise, do something around the house, force him to go to bed and take analgesics. At the same time, some children with headaches have a decrease in visual acuity - myopia.

Treatment for headaches, which aims to improve blood supply and nutrition to the brain, not only relieves headaches, but it also improves vision.

The consequences of the pathology of the nervous system in the neonatal period can be torticollis, certain forms of scoliotic deformities, neurogenic clubfoot, flat feet.

In some children, bedwetting - urinary incontinence - can also be due to birth trauma - just like epilepsy and other convulsive conditions in children.

As a result of hypoxic trauma to the fetus in the perinatal period, the brain first of all suffers, the normal maturation of the functional systems of the brain is disrupted, which provide the formation of such complex processes and functions of the nervous system as stereotypes of complex movements, behavior, speech, attention, memory, perception. Many of these children show signs of immaturity or violations of certain higher mental functions... The most common manifestations are the so-called attention deficit hyperactivity disorder and hyperactive behavior syndrome. Such children are extremely active, disinhibited, uncontrollable, they have no attention, they cannot concentrate on anything, are constantly distracted, cannot sit still for several minutes.

They say about a hyperactive child: this is a child “without brakes”. In the first year of life, they give the impression of very developed children, as they are ahead of their peers in the development - they begin to sit, crawl, and walk earlier. It is impossible to restrain a child, he certainly wants to see, touch everything. Increased physical activity is accompanied by emotional instability. At school, such children have many problems and difficulties in learning due to the inability to concentrate, organize, and impulsive behavior. Due to low efficiency, the child does his homework until the evening, goes to bed late and, as a result, does not get enough sleep. The movements of such children are awkward, awkward, and often poor handwriting is noted. They are characterized by hearing and speech memory disorders, children poorly absorb material from hearing, while visual memory impairments are less common. They often have Bad mood, thoughtfulness, lethargy. It is difficult to involve them in the pedagogical process. The consequence of all this is a negative attitude towards learning and even refusal to attend school.

Such a child is difficult for both parents and teachers. Behavioral and school problems are snowballing. In adolescence, these children significantly increase the risk of persistent behavioral disorders, aggressiveness, difficulties in relationships in the family and school, and deterioration in school performance.

Functional disorders of cerebral blood flow especially make themselves felt during periods accelerated growth- in the first year, at 3-4 years old, 7-10 years old, 12-14 years old.

It is very important to notice the first signs as early as possible, take action and carry out treatment early childhood, when the developmental processes are not yet completed, while the plasticity and reserve capabilities of the central nervous system are high.

Back in 1945, the domestic obstetrician Professor M. D. Guetner rightly called birth damage to the central nervous system "the most common national disease."

V last years it became clear that many diseases of older children and even adults have their origins in childhood and are often a late payback for unrecognized and untreated pathology of the neonatal period.

There is only one conclusion to be made - to be attentive to the baby's health from the moment of its conception, to eliminate all harmful effects on his health as soon as possible, and even better, to prevent them altogether. If such a misfortune occurs and the child has a pathology of the nervous system at birth, it is necessary to contact a pediatric neurologist in time and do everything possible so that the baby recovers completely.

It happens that in the maternity hospital or a little later, at the pediatrician's appointment, a newborn child is given complex diagnoses concerning the state of the central nervous system (CNS). What is hidden behind the words "hypertensive-hydrocephalic syndrome" or "autonomic-visceral dysfunction syndrome" and how can these conditions affect the health and development of the child? Is it possible to treat CNS lesions? Natalia Pykhtina, a specialist in children's rehabilitation, head of the clinic of the same name, reports.

The doctor receives the first information about the state of the central nervous system in the first minutes and hours after the baby is born, even in the delivery room. Everyone has heard of the Apgar scale, according to which a child's vitality is assessed by five main visible signs - heartbeat, skin color, breathing, reflex excitability and muscle tone.

Why is it important to correctly assess the infant's motor activity? Because it provides information about the state of the spinal cord and brain, their functionality, which helps to recognize both minor deviations and serious pathologies in time.

So, the greatest attention is paid to the degree of symmetry of the movements of the limbs: their pace and volume should be the same on both sides, that is, for the left arm and left leg and the right arm and leg, respectively. Also a doctor performing initial inspection newborn, takes into account the clarity and severity of unconditioned reflexes. So the pediatrician receives information about the activity of the baby's central nervous system and finds out if it is functioning within the normal range.

Damage to the central nervous system in a child occurs in two ways - in utero or during childbirth. If developmental abnormalities occur in the fetus during the embryonic stage of intrauterine development, then they often turn into defects that are incompatible with life, or extremely difficult and not amenable to treatment and correction.

If the damaging effect was on the fetus after, this will not affect the child in the form of a gross deformity, but it may well cause small deviations that will have to be treated after birth. Negative effects on the fetus at a later date - after- it will not manifest itself in the form of vices at all, but it can become a catalyst in the event of diseases in a normally formed child.

It is very difficult to predict which specific negative factor and at what stage of pregnancy will cause irreparable damage to the fetus. Therefore, the expectant mother needs to be extremely careful and monitor her health even before the moment of conception. Preparing for pregnancy - important stage family planning, because the child's health can be affected by both the mother's bad habits and her chronic diseases, hard work and an unhealthy psychological state.

It is important for the future life of a child and how exactly he will be born. It is at the time of childbirth that there is a risk of injury by the second pathway - intrapartum. Any improper intervention or, conversely, the lack of timely assistance is highly likely to negatively affect the baby. At risk are premature births, as well as childbirth as scheduled, but rapid or, conversely, protracted.

The main causes of CNS damage in newborns are oxygen starvation, which leads to hypoxia, and birth trauma. Less commonly, there are less obvious and diagnosable causes: intrauterine infections, hemolytic disease of the newborn, malformations of the brain and spinal cord, hereditary metabolic disorders or chromosomal pathology.

Doctors distinguish several syndromes of CNS pathology in newborns.

Hypertensive-hydrocephalic syndrome is excessive congestion cerebrospinal fluid in the ventricles and under the membranes of the brain. To identify this syndrome in an infant, an ultrasound of the brain is performed and data on an increase in intracranial pressure are recorded (according to echoencephalography - EEG).

In pronounced severe cases with this syndrome, the size of the cerebral part of the skull increases disproportionately. As you know, children are born with movable bones of the skull, which grow together during development, therefore, with unilateral pathological process this syndrome will be observed divergence of cranial sutures, thinning of the skin in temporal lobe and increased venous pattern on the scalp.

If the child has increased intracranial pressure, he will be restless, irritable, easily excitable and whiny. Also, the baby will sleep poorly, goggle and throw his head back. The manifestation of the Grefe symptom (a white strip between the pupil and the upper eyelid) is possible. In more severe cases there may also be a symptom of the so-called "setting sun", in which the iris of the eye, like the sun at sunset, is half submerged under the lower eyelid. Also converging sometimes appears.

With reduced intracranial pressure, on the contrary, the child will be inactive, lethargic and drowsy. Muscle tone in this case unpredictable - it can be either increased or decreased. The baby can stand on tiptoe when supporting, and when trying to walk, cross his legs, while the reflexes of support, crawling and walking in the baby will be reduced. Convulsions are also common.


Muscle tone disorders

Movement Disorders Syndrome- pathology motor activity- is diagnosed in almost all children with intrauterine abnormalities in the development of the central nervous system. Only the severity and level of the lesion differs.

When making a diagnosis, the pediatrician must understand what the zone and localization of the lesion is, whether there is a problem in the functioning of the brain or spinal cord. This is a fundamentally important question, since the methods of treatment differ radically depending on the established pathology. Also of great importance for the diagnosis is the correct assessment of the tone of various muscle groups.

Violation of tone in various muscle groups leads to a delay in the appearance of motor skills in the infant: for example, the child later begins to take objects with the whole hand, finger movements are formed slowly and require additional exercises, the child later stands on his legs, and the cross of the lower limbs prevents the formation of correct walking.

Fortunately, this syndrome is curable - in most children, due to proper treatment, muscle tone in the legs decreases, and the child begins to walk well. Only the high arch of the foot can remain in memory of the disease. This does not interfere with normal life, and the only difficulty is the choice of comfortable and well-fitting shoes.

Autonomic-visceral dysfunction syndrome characterized by a violation of thermoregulation in a child (body temperature rises or falls for no apparent reason), exceptional whiteness of the skin associated with a malfunction of blood vessels, and gastrointestinal disorders (regurgitation, vomiting, a tendency to constipation, insufficient weight gain in comparison with the indicators taken for the norm).

All these symptoms are most often combined with hypertensive-hydrocephalic syndrome and are directly related to disturbances in the blood supply to the posterior parts of the brain, where all the main centers of the autonomic nervous system are located, which governs the life-supporting systems of the body - the digestive, thermoregulatory and cardiovascular.

Convulsive syndrome

The tendency to seizures in the first months of a child's life is due to the immaturity of the brain. Seizures occur only when the spread or development of a painful process in the cerebral cortex occurs, and have many different causes.

In each case, the cause of the occurrence convulsive syndrome must be identified by a doctor. An effective assessment often requires a number of studies and manipulations: an instrumental study of the brain (EEG), cerebral circulation (Doppler) and anatomical structures (brain ultrasound, computed tomography, NMR, NSG), as well as biochemical blood tests.

From the point of view of localization, seizures are not the same - they are generalized, that is, covering the entire body, and localized, which are associated with individual muscle groups.

Convulsions are also different in nature: tonic, when the child seems to stretch out and freeze for a short time in a certain fixed position, and clonic, in which the limbs, and sometimes the entire body, are twitching.

Parents should carefully observe the child in the first months of life, because convulsions in children can be the beginning if you do not immediately contact a specialist and do not carry out competent treatment. Careful observation and detailed description arising seizures on the part of the parents will greatly facilitate the doctor's diagnosis and speed up the selection of treatment.

Treatment of a child with central nervous system damage

Accurate diagnosis and timely correct treatment of CNS pathology is extremely important. Children's organism very susceptible to external influence at the initial stage of development, and the procedures received on time can radically change the further life of the child and his parents, allowing at the earliest stages to get rid of problems with relative ease, which at a later age can become very significant.

As a rule, children with pathologies of an early age are prescribed drug therapy in combination with physical rehabilitation. Physiotherapy (exercise therapy) is one of the most effective non-drug methods of rehabilitation of children with central nervous system lesions. Correctly selected course of exercise therapy helps to restore motor functions child, using the adaptive and compensatory capabilities of the child's body.

Comment on the article "Lesions of the central nervous system in children: what are they?"

organic defeat of the central nervous system - in all my children. Everyone develops differently. IMHO, taking a child from DD means being ready for behavioral disturbances, poor schooling, theft, damage and loss of things, tantrums ...

Discussion

organic defeat of the central nervous system - in all my children. Everyone develops differently. IMHO, to take a child from DD means to be ready for behavioral disturbances, poor studies, theft, damage and loss of things, tantrums ..... I do not know if you can find healthy in the DD in the full sense of the word. They get there either because of their health, or because of health (both physical and psychotic) bio .... Defeat to defeat strikes, sees, hears, understands ... that's not bad. What lends itself to education, is brought up, what does not give in - fall in love) how difficult? - exactly as much as you are ready, as far as you can accept (or not accept) it by anyone

03.10.2017 21:46:24, the same

My child has an organic lesion of the central nervous system. Expressed in light form of cerebral palsy and some learning difficulties. And my child had an organic lesion of the central nervous system, paraparesis, from one and a half years old disability. The disability was removed at the age of 6, and this spring the neurologist removed it from ...

Discussion

Well, it seems like tomorrow we are doing an MRI. And on Friday, a psychiatrist and a neurologist. The DD gave me a lot of guilt - why do you need to do this, what kind of checks are such, etc., etc. I stupidly - on my own. Thank you from the bottom of my heart, girls. I myself did not expect such support and was very touched. I will write how and what as soon as something new.

I'm not a medic. At all. Therefore, my reasoning is completely philistine. So: in my opinion, a residual organic lesion is a very general diagnosis. Manifestations should depend on the degree and location of the lesion. And it can be from "understands nothing, drooling" (sorry for the incorrectness), to "nothing is noticeable at all." The girl is clearly not in danger of the first option. The child is adequate, obedient, reads poetry, plays role-playing games ... So, I think, everything that could have happened - has already manifested itself in this "bad student". Is this critical for you? If it’s hard to learn? If you don't go to university? If in the very last resort will study in correction?
This is, in principle, real perspective for many adopted children. Not a fact, a child taken in more younger age you won't get the same problems at school.
In general, since my child is practically like that (he studies with difficulty, after the 1st grade he could not do anything), but wonderful and beloved, I feel sorry for the girl. Somehow in the discussion they almost gave up on it. : (Good girl. Although, of course, it's up to you to decide.

Discussion

depends on the background, and even more on the perspective. any child, whether healthy or ill, in a supportive psycho-social environment has a much better chance of growing up to be a good person than under poor baseline conditions. Children with health problems bring no less, and maybe even more, joy than healthy children. unless, of course, you completely dissolve in worries, problems and the search for the best solutions.

Just like on the Internet - from nothing terrible to vagrancy, suicidal tendencies, etc. Look at the children. If something is alarming, contact a specialist. Sorry for the diagnosis on the Internet, but, in my opinion, your children look good.

damage to the central nervous system. Medicine / children. Adoption. Discussion of issues of adoption, forms of placing children in families, upbringing Please tell me what is the defeat of the central nervous system without affecting the psyche. found in the internet only about perinatal lesions of the central nervous system. this one and ...

Discussion

look at a specific child, if necessary, do an MRI to determine whether you are able to raise this child or not. Or maybe defeat is only on paper. Anything can happen.

I have a child from special DR. There was PEP, there was an organic lesion of the central nervous system. There are problems, but almost the norm :) In general, with good care, treatment and, naturally, at home, all this can be nullified.

Lesions of the central nervous system in children: what are they? Is it possible to treat CNS lesions? Natalya, a specialist in children's rehabilitation, says And my child was diagnosed with an organic lesion of the central nervous system, paraparesis, and from one and a half years old he was disabled.

Damage to the central nervous system, ZPR. Medicine / children. Adoption. Discussion of issues of adoption, forms of placing children in families, upbringing of foster children, interaction with guardianship Regarding the differentiation of DPD and mental retardation, use the Veksler children's test and the drawing test.

Discussion

Such diagnoses are found in 90% of pre-Rebenko children.
How serious they are in a particular child - only a doctor can tell. Quite often, this is some kind of reinsurance, it can be written for some additional payments for the maintenance of children, for the placement of the child in the appropriate hospital (you have to put the abandoned child somewhere). In the same way, one should not immediately be intimidated by names like "DR for children with CNS lesions", etc.
First of all, you need to talk with the DR doctor - quite often the information is quite objective.
You can also visit a child in the DR with a "friend" - a neuropathologist who will be able to say something by looking at the child and reading his card.
If you cannot take a doctor with you - you can copy some pages from the child's card (if allowed) (for this purpose it is good to have a digital camera with you, because most likely there is no copier there) - and go to the pediatric neurologist herself, show a copy of the card and talk how serious it is.

Discussion

There is an institute of the brain, which teaches according to the Bronnikov method. I'm not a specialist at all, my friend studied there, she told me about the miraculous results. I can ask if it is worth contacting there in case of your problems. Or maybe you already know about them?

Well, we can assume that we also have an organic lesion, after a cerebral hemorrhage and subsequent hydrocephalus, hypoplasia takes place corpus callosum, diffuse lesion of white matter, etc. I don’t know how to others, but official medicine could not offer us anything except standard vascular therapy and light nootropics in the hope that the remnants of the affected areas would “sort out themselves”, redistribute functions, etc. This process was somewhat stimulated by the treatment of Koreans on the street. ac. Pilyugin, by the way, I saw children with them who also have problems with the cerebellum, there was some progress, but this is all individual. What city do you live?

damage to the central nervous system. My friend was born with placental abruption premature baby(32nd week); suffered severe hypoxia, they even say that some lobules in the brain (I do not understand what is meant) have died.

Perinatal damage to the central nervous system includes all diseases of the brain and spinal cord.

They occur during intrauterine development, during the birth process and in the first days after the birth of a newborn.

The course of perinatal lesions of the central nervous system in a child

The disease occurs in three periods:

1. Acute period. It occurs in the first thirty days after the birth of a child,

2. The recovery period. Early, from thirty to sixty days of a baby's life. And late, from four months to one year, in children born after three trimesters of pregnancy, and up to twenty-four months in early childbirth.

3. The initial period of the disease.

In some periods, various clinical manifestations of perinatal CNS damage occur in a child, accompanied by syndromes. In one baby, several syndromes of the disease may appear at once. Their combination helps to determine the severity of the course of the disease and to prescribe qualified treatment.

Features of syndromes in the acute period of the disease

In the acute period, the child experiences depression of the central nervous system, coma, increased excitability, manifestation of seizures of various etiologies.

In a mild form, with a slight perinatal lesion of the central nervous system in a child, an increase in the excitability of nervous reflexes is noticed. They are accompanied by shuddering in silence, muscle hypertonicity, and may also be accompanied by muscle hypotonia. Children have chin tremors, tremors of the upper and lower extremities. The child behaves capriciously, does not sleep well, cries for no reason.

With perinatal damage to the central nervous system in a child of average shape, he is not very active after birth. The baby does not take the breast well. He has reduced milk swallowing reflexes. After living for thirty days, the symptoms disappear. Excessive excitability changes them. With an average form of damage to the central nervous system, the baby has skin pigmentation. It looks like marble. The vessels have a different tone, the work of the cardiovascular system is impaired. Breathing is uneven.

In this form, the child's gastrointestinal tract is disrupted, the stool is rare, the child spits up hard-eaten milk, swelling occurs in the tummy, which is well heard by the mother's ear. In rare cases, the baby's legs, arms and head flinch with convulsive seizures.

An ultrasound examination shows that in children with perinatal lesions of the central nervous system, the accumulation of fluid in the compartments of the brain. The accumulated water contains cerebrospinal fluid, which provokes intracranial pressure in children. With this pathology, the baby's head increases by one centimeter every week, this can be noticed by the mother by quickly growing out of the caps and appearance your child. Also, due to the liquid, the small fontanelle bulges on the child's head. The baby often spits up, behaves restlessly and capriciously due to constant pain in the head. Can roll the eyes behind the upper eyelid. A child may exhibit nystagmus, in the form of jerking of the eyeball when the pupils are placed in different directions.

During a sharp depression of the central nervous system, the child may fall into a coma. It is accompanied by absence or confusion, impairment of the functional properties of the brain. In such a serious condition, the child should be under constant supervision. medical staff in the intensive care unit.

Features of syndromes in the recovery period

To syndromes recovery period with perinatal damage to the central nervous system in a child, a number of symptomatic features are distinguished: increased nervous reflexes, epileptic seizures, disruption of the musculoskeletal system. Also, in children, psychomotor developmental delays caused by hypertonicity and muscle hypotonia are noted. With prolonged flow, they cause involuntary movement. facial nerve, as well as the nerve endings of the trunk and all four limbs. Muscle tone interferes with normal physical development. Does not allow the child to perform natural movements.

With a delay in psycho-motor development, the child later begins to hold his head, sit down, crawl and walk. The baby has an apathetic daily state. He does not smile, does not make grimaces peculiar to children. He is not interested in educational toys and in general what is happening around him. There is a lag in speech. The kid later begins to pronounce "gu - gu", cries softly, does not utter clear sounds.

Closer to the first year of life with the constant supervision of a qualified specialist, appointment correct treatment and depending on the shape initial disease central nervous system, symptoms and signs of the disease may decrease or disappear altogether. The disease has consequences that persist at the age of one:

1. Slows down psycho-motor development,

2. The child starts talking later,

3. Swings in mood,

4. Bad dream,

5. Increased meteorological dependence, especially the child's condition worsens in strong winds,

6. Some children are characterized by hyperactivity, which is expressed by bouts of aggression. They do not concentrate on one subject, study hard, and have a weak memory.

Serious complications lesions of the central nervous system can become epileptic seizures and cerebral palsy.

Diagnostics of the perinatal CNS lesion in a child

For staging accurate diagnosis and the appointment of qualified treatment, diagnostic methods are carried out: ultrasound with dopplerography, neurosonography, CT and MRI.

Ultrasound of the brain is one of the most popular in the diagnosis of the brain of newborns. It is done through the fontanelle on the head, which is not strong with bones. Ultrasound examination does not harm the health of the child, it can be performed often, as needed to control the disease. Diagnostics can be done for young patients who are inpatients at the ARC. This study helps to determine the severity of the pathology of the central nervous system, to determine the amount of cerebrospinal fluid and to identify the cause of its formation.

Computed tomography and magnetic resonance imaging will help to identify problems with the vascular network and disorders of the brain in a small patient.

Doppler ultrasound will check the blood flow. Its deviations from the norm lead to perinatal damage to the central nervous system in the child.

Causes of perinatal CNS damage in a child

The main reasons are:

1. Fetal hypoxia during intrauterine development, caused by a limited supply of oxygen,

2. Injuries sustained during birth. Often occur with slow labor and the delay of the child in the small pelvis of the mother,

3. Diseases of the central nervous system of the fetus can be caused by toxic drugs used by the expectant mother. Often these are drugs, alcohol, cigarettes, drugs,

4. Pathology is caused by viruses and bacteria when intrauterine development.

Treatment for perinatal CNS damage in a child

If a child has problems with the central nervous system, it is necessary to contact a qualified neurologist to make recommendations. Immediately after birth, it is possible to restore the baby's health by ripening dead brain cells instead of those lost during hypoxia.

First of all, the child is provided with emergency care in the maternity hospital, aimed at maintaining the functioning of the main organs and respiration. Medications are prescribed and intensive therapy, including mechanical ventilation. The treatment of perinatal CNS lesions in a child is continued, depending on the severity of the pathology at home or in the pediatric neurological department.

The next stage is aimed at the full development of the child. It includes constant monitoring by a pediatrician at the site and a neurologist. Drug therapy, massage with electrophoresis to relieve muscle tone. Also, treatment with impulse currents, therapeutic baths is prescribed. A mother should devote a lot of time to the development of her child, massage at home, walking on fresh air, fighting lessons, follow proper nutrition baby and fully introduce complementary foods.

Price: from 1200

An experienced neurologist of the SanMedExpert clinic provides qualified assistance in the treatment of diseases of the central nervous system, of which there are many. The human nervous system is a very complex structure that ensures the interaction of the body with the external and internal world. In fact, this is a link that connects all the elements of the body into a single whole. It is the nervous system that regulates functions internal organs, mental activity and physical activity.

If we talk about the central nervous system, then it consists of the brain and spinal cord. These organs, in turn, have in their composition a huge number of nerve cells that can be excited and conduct all kinds of signals through themselves to the spinal cord and then to the brain. The received information is processed by the central nervous system, after which it is transmitted to the motor fibers. This is how reflex movements arise in our body: dilation and constriction of the pupils, muscle contraction, etc.

An experienced doctor will analyze the patient's complaints and perform a detailed examination; Will advise on vascular, infectious and demyelinating diseases of the brain; We use the most modern diagnostic equipment allowing high-precision research.

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Any disorder or disease of the central nervous system causes disruptions in its activity and causes a number of symptomatic signs. The specialists of our clinic have everything necessary to accurately identify the disease and prescribe an effective treatment.

Classification of diseases of the central nervous system

Diseases of the central nervous system can be classified as follows:

  • Vascular. Chronic brain failure, which often occurs in conjunction with cardiovascular pathologies and hypertension. Also, this group of diseases of the central nervous system includes acute disorders circulation in the brain (strokes), which occur most often in adulthood and old age.
  • Diseases of the brain. The most common CNS diseases affecting the brain include Alzheimer's disease, Norman-Roberts syndrome, sleep paralysis, hypersomnia, insomnia, etc.
  • Infectious. The course, as a rule, is very difficult and pose a serious threat to life. Infectious lesions of the central nervous system include meningitis (inflammation of the membranes of the spinal cord and brain), encephalitis (an inflammatory disease of the brain of a viral nature), poliomyelitis (a serious disease characterized by damage to all brain structures), neurosyphilis (develops when infected with treponema pallidum).
  • Demyelinating. One of the most common demyelinating diseases of the central nervous system is multiple sclerosis, which gradually leads to the destruction of the nervous system. This group also includes epilepsy, disseminated encephalomyelitis, myasthenia gravis and polyneuropathy.

The presented classification is not complete, since among diseases of the central nervous system, degenerative, neuromuscular, neuroses, etc. are also distinguished.

Diseases of the central nervous system have wide range symptomatic manifestations. These include:

  • movement disorders (paresis, paralysis, akinesia or chorea, impaired coordination of movements, tremors, etc.);
  • violations of tactile sensitivity;
  • impairment of smell, hearing, vision and other types of sensitivity;
  • hysterical and epileptic seizures;
  • disturbances of consciousness ( fainting, coma);
  • mental and emotional disorders.

Diagnostics and treatment in our clinic

An experienced neurologist at our clinic will analyze the patient's complaints and perform a detailed examination. Diagnosis of diseases of the central nervous system necessarily includes an assessment of the patient's consciousness, his reflexes, intelligence, etc.

Some diseases are easy to identify by their symptomatic manifestations, but, as a rule, an accurate diagnosis is possible only based on the results of additional studies. In our practice, we use the most modern diagnostic equipment, which allows us to carry out such high-precision studies as:

  • computed tomography of the brain;
  • angiography;
  • electroencephalography;
  • radiography;
  • electromyography;
  • lumbar puncture, etc.

The treatment of each disorder of the central nervous system requires a strictly individual and attentive approach. The therapy is selected by the doctor, but it should be understood that some disorders are not reversible, so the treatment can be purely supportive and symptomatic.

The main method of treating diseases of the central nervous system is medication, but physiotherapeutic procedures, therapeutic exercises and massage also have a good effect. Surgical treatment can be indicated when cysts, tumor neoplasms are detected. As a rule, all operations are performed using modern microsurgical techniques.

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