What disease is DSP?

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What disease is pediatric cerebral palsy (DSP)?

Pediatric cerebral palsy (DSP) is a general term associated with movement disorders that result from changes in various structures of the brain during the perinatal period. Cerebral palsy in children is characterized by mono-, hemi-, para-, tetraparalich and paresis, pathologies of muscle tone, hyperkinesia, speech defects, motor coordination disorders, motor and mental retardation. Mental retardation, psychological changes in BSF (DSP) , epilepsy, changes in hearing and vision may also develop. The disease is diagnosed based on anamnesis and clinical signs. Children with DSP will need to be treated in rehabilitation centers for the rest of their lives, receive medical treatment, and, if necessary, undergo surgery.
Globally, DSP affects 1000-1,7 out of every 7 children. In premature infants, this figure is 10 times higher. Recent studies have shown that this pathology is observed in 40-50% of premature infants. In the field of pediatrics, cerebral palsy is one of the leading problems. This is due to the deterioration of the environment, the development of neonatology, the survival of premature babies (even babies born at 500 g) are widespread and a topical issue.

Contents [Close]

• Causes of cerebral palsy in children
• DSP classification in children
• Symptoms of cerebral palsy in children
• DSP diagnostics
• Rehabilitation treatment of cerebral palsy in children
• Drug and surgical treatment
• Physiotherapeutic treatment and animal therapy
• DSP is the social adaptation of children
• Consequences and prevention of cerebral palsy in children

Causes of cerebral palsy in childrenAt present, the development of DSP can be caused by damage to the brain due to various factors, abnormal formation or death of nerve cells in certain areas of the brain. Exposure to these factors during the perinatal period or shortly after birth (up to 4 weeks) increases the likelihood of developing the disease. The most important factor in the development of DSP is hypoxia. Under the influence of hypoxia, the centers of the brain that are responsible for movement and coordination are the first to be damaged. As a result, children develop symptoms of DSP - pathology of muscle tone, paresis and paralysis.Factors leading to the development of DSP during pregnancy include:

• Fetoplacental insufficiency;
• Early migration of the satellite;
• Pregnancy nephropathy;
• Pregnancy infections (cytomegalovirus, measles, toxoplasmosis, herpes, syphilis);
• Rhesus conflict;
• Somatic diseases of pregnant women (diabetes, hypothyroidism, congenital and acquired heart defects, arterial hypertension);
• Various traumas of a woman during pregnancy.

Factors contributing to the development of DSP in the child at birth:

• The arrival of the fetus with the pelvis;
• Premature birth;
• Strong birth process;
• Discoordinated childbirth.

Factors leading to the development of DSP in the child after birth:

• Infantile asphyxia (as a result of aspiration);
• Hemolytic disease;
• Congenital malformations of the lungs;
• Toxic brain poisoning as a result of incompatibility of maternal and child blood.

DSP classification in childrenThere are 5 types of DSP in pediatric neurology, depending on the area of ​​damage to the brain structure. The most common of these is spastic diplegia. This is the case for 40-80% of all DSPs.

The movement centers of the brain are damaged, resulting in paresis in the legs. When damage occurs to only one hemisphere of the brain, the movement disorder occurs on the opposite side of the body. In most cases of cerebral palsy in children, there is a hyperkinetic form associated with the destruction of the subcortical centers. In the clinic of the disease, involuntary movements - hyperkinesis - are manifested, and this condition is manifested when the child is excited and scared. Atonic-astatic children develop cerebral palsy as a result of brain damage. Symptoms appear in the form of statics and coordination, muscle atony. The most severe form of DSP is bilateral hemiplegia. This causes bilateral damage to the cerebral hemispheres. Children find it difficult to not only walk, stand up straight, but even hold their heads independently due to muscle stiffness.
Photo: Doc.bySymptoms of cerebral palsy in childrenCerebral palsy in children can take many forms and vary in severity. The clinical manifestations of the disease depend on the extent and depth of the lesion. Sometimes the symptoms of cerebral palsy in children appear at birth. The disease is usually diagnosed by a pediatrician a few months later with a child's developmental delay. The main clinical sign of DSP is the inability of children to perform new movements and learn new skills. A child with cerebral palsy cannot hold his head for a long time, he is not interested in toys, he cannot turn his head, he cannot move his arms and legs freely, he cannot hold toys. When a child is held and his feet are on the ground, he does not stand fully on the soles of his feet, only the tip of his feet touches the ground. DSP can be manifested by unilateral or bilateral paresis. If the speech center is damaged, the child may have symptoms of dysarthria. Dysphagia occurs when the centers that control swallowing and choking are damaged. In all forms of DSP, muscle tone is increased. Movement in the limbs is limited, movement in the joints is lost, resulting in atrophy of the muscles of the limbs, which become disproportionate to the body. Patients with cerebral palsy in children develop specific body deformities (scoliosis, thoracic deformities). Motor disorders and skeletal deformities cause chronic pain syndrome in children. Pain occurs in the neck, shoulders, waist. In children with hyperkinetic form, cerebral palsy is characterized by sudden onset of symptoms: recurrent head rotation, facial dislocation, tremors, repetition of the same movement. Atonic-astatic DSP during walking In addition to the above symptoms in children, cerebral palsy may include pathologies such as dizziness, changes in the gastrointestinal tract, respiratory problems, and urinary incontinence. Approximately 20-40% of DSPs are associated with epilepsy. About 60% of children with DSP have vision problems. Deafness or hearing loss also occurs in some patients. Mental retardation, acceptance and concentration, learning disabilities, and behavioral abnormalities may also be evident in children.

Although DSP is chronic, the disease does not worsen, but gradually decreases as the child grows. Patients may suffer from secondary diseases, such as epilepsy, stroke, cerebral hemorrhage, or severe somatic disease.DSP diagnosticsThere are no clear criteria for diagnosing cerebral palsy in children. However, with the birth of a child, some indicators suggest that the child is more likely to develop DSP, including low scores on the scale, range of motion abnormalities, impaired muscle tone, and physical and mental retardation. If such conditions are found in a child, a pediatric neurologist will be required to perform a series of examinations. Inspections include:

• Electroencephalography (EEG);
• Electrotomography;
• Electroneurography;
• Transcranial magnetic stimulation.

In addition to the above symptoms, cerebral palsy in children may be accompanied by pathologies such as nausea, changes in the gastrointestinal tract, respiratory problems, and inability to urinate. Approximately 20-40% of DSPs are associated with epilepsy. About 60% of children with DSP have vision problems. Deafness or hearing loss also occurs in some patients. Mental retardation, acceptance and concentration, reading deficits, and behavioral abnormalities may also be evident in children. Although DPP is chronic, the disease does not worsen, but gradually decreases as the child grows. Patients may suffer from secondary diseases, such as epilepsy, stroke, cerebral hemorrhage, or very severe somatic disease. Fredreich's ataxia, Louis-Bar syndrome, etc.). Pediatric ophthalmologists, otolaryngologists, epileptologists, orthopedists, speech therapists and psychiatrists are required to diagnose cerebral palsy.Rehabilitation treatment of cerebral palsy in childrenUnfortunately, cerebral palsy is one of the most untreatable diseases in children today. However, with timely treatment, children can reach their peers, both mentally and physically. Rehabilitation treatments can help children achieve skeletal deformities, joint mobility, and self-control. It is advisable that all treatments be performed before the child reaches 8 years of age. The DSP treatment program is tailored to each child. This takes into account the degree of damage to the brain, the area, additional symptoms in the child, his vision, hearing, and mental state. Deafness and blindness are common problems in the treatment of children with DSP.

They will have to be trained by specialists. In addition, therapies such as brain stimulation require caution when working with children with epileptic seizures. The main rehabilitation treatments for cerebral palsy in children are exercise therapy and massage. All parents are required to learn how to massage and treat their children with DSP. To achieve effective results, children receive treatment at specialized DSP centers once a year. Today, in such centers, modern equipment is used to treat children with DSP, for example, with the help of pneumocombines, muscles are fixed and joints are held firmly. Special clothing can be used to restore coordination in the child's movements. Speech therapists often treat children with DSP-induced dysarthria.Drug and surgical treatmentIn the treatment of cerebral palsy in children, drug treatment is used only to relieve some of the symptoms. For example, anticonvulsants are prescribed for epilepsy, muscle relaxants for increased muscle tone, and antispasmodics and analgesics for pain relief. In addition, children are given nootropics, metabolites (ATF, amino acids, glycine), neostigmines, antidepressants, tranquilizers, neuroleptics, drugs that strengthen the walls of blood vessels. At the same time, tenatomy is performed to create a "column" in the paralyzed part of the body. If the spastic process is severe and this causes asymmetries in the child's body, spinal rhizotomy may also be performed on the nerve fiber that innervates the area.Physiotherapeutic treatment and animal therapyThe following physiotherapeutic treatments are performed in the treatment of DSP:

• Oxygen therapy;
• Electrostimulation;
• Mud treatment;
• Water treatments;

In modern medicine, DSP has developed animal therapy classes to help children regain their vital skills. At the same time, children "make friends" with animals, which stimulates the child's emotional and spiritual development. The most common of such treatments is the restoration of contact in children with horses and dolphins.DSP is the social adaptation of childrenIn children with cerebral palsy, it is possible for children to adapt to social life, even if there are deficiencies in movement. The role of their parents and relatives is great in this. Rehabilitators, psychologists and educators play an important role in shaping social adaptation in children. Children suffering from this disease increase their adaptability to life in special kindergartens and schools.Consequences and prevention of cerebral palsy in childrenThe outcome of cerebral palsy in children is directly related to the severity, form, and timeliness of treatment. In some cases, DSP can lead to disability. However, with proper treatment, deformities, muscle problems, and range of motion defects in children are reduced, albeit partially, and children are able to control their own lives. DSP prevention is the prevention of various pathologies in women during pregnancy, especially those that lead to fetal hypoxia. .

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