mixed cerebral palsy
Introduction
Introduction to mixed cerebral palsy Cerebral palsy refers to a syndrome characterized by various motor dysfunctions due to non-progressive brain injury from the immature stage of brain development within one month after birth. Cerebral palsy, also known as cerebral palsy in children, is a common central nervous system disorder in childhood. The lesion is in the brain, involving the limbs, often accompanied by mental retardation, epilepsy, behavioral abnormalities, mental disorders, and visual, auditory, and speech disorders. . Several types of cerebral palsy symptoms of mixed cerebral palsy are mixed together, and several types are embodied in one child. That is to say, two or more cerebral palsy symptoms can be called in a child. For mixed cerebral palsy. Children are younger, but they can also be treated psychologically. Children have emotional disorders, abnormal behavior, and cognitive impairment. For the psychological barriers of children with cerebral palsy, respect patients in comprehensive treatment, listen carefully and understand, comfort, and encourage children, while correcting physical dysfunction, stimulate the active participation of children, improve the effect of treatment and training is also a treatment of cerebral palsy To improve the health education of children's psychological state, actively communicate with children, gradually overcome the children's paranoia, rely on psychology, establish independent, confident, strong, upward confidence, cultivate their self-care ability, adapt to society. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: Dysphagia, children stuttering
Cause
Mixed cerebral palsy
1. Genetic factors: It is believed that cerebral palsy can be traced back to a familial genetic history.
2, prenatal factors: the cause of pregnancy within six months: congenital malformations, hereditary defects, intrauterine infection, cerebral hypoxia caused by threatened abortion, rubella infection, poison contact, radioactive material radiation.
3, the cause of late pregnancy: pregnancy toxemia, abnormal placenta or umbilical cord, prenatal bleeding, blood group incompatibility, maternal trauma, infection or multiple pregnancy.
4, postpartum factors: nuclear jaundice, neonatal shock, craniocerebral injury and seizures, immature respiratory obstruction, ventilatory dysfunction caused by cerebral hypoxia, which is one of the causes of cerebral palsy in children.
5, the factors of birth: fetal hypoxia during childbirth, dystocia, neonatal asphyxia, giant children, respiratory failure after birth, premature and immature children, birth injury, low birth weight infants.
Prevention
Mixed cerebral palsy prevention
1. Before the child is born:
(1) Pregnant women should actively carry out early prenatal examinations, do a good job in perinatal care, and prevent congenital diseases in the fetus.
(2) should quit bad hobbies, such as smoking, drinking, can not abuse drugs such as anesthetics, sedatives.
(3) Prevent influenza, rubella and other viral infections, and do not touch cats and dogs.
(4) Avoid contact with harmful and toxic substances such as radiation and frequent B-ultrasound inspection.
2. When the fetus is born:
During childbirth. Fetal asphyxia and intracranial hemorrhage caused by childbirth are an important cause of cerebral palsy in children. Premature birth and dystocia should be prevented. Medical staff should carefully handle all aspects of childbirth and do a good job in the treatment of dystocia.
3, within one month after the birth of the fetus to strengthen nursing, reasonable feeding, prevention of intracranial infections, brain trauma and so on .
4. Pregnant women who have the following conditions should do prenatal checkup as soon as possible:
(1) Older pregnant women (over 35 years old) or men over 50 years old.
(2) Close relatives get married.
(3) There are unexplained abortions, premature births, stillbirths, and neonatal deaths.
(4) Pregnant women with low intelligence or close relatives have epilepsy, cerebral palsy and other genetic history. If a fetal abnormality is found early in pregnancy, the pregnancy should be terminated as soon as possible.
Complication
Mixed cerebral palsy complications Complications, children with dysphagia stuttering
The main hazards of mixed cerebral palsy are as follows:
Motor dysfunction
The exercise self-control ability is poor. In severe cases, the hands will not catch things, the feet will not walk, and some will not even turn over, sit up, will not stand, and will not chew and swallow normally.
Posture disorder
Various postures are abnormal, and the stability of the posture is poor. If you can't stand your head vertically for 3 months, you are used to leaning to one side, or shaking left and right. It is not easy to open your fist when washing your hands.
Mental retardation
About 1/4 of children with normal intelligence, 1/2 of those with mild and moderate intelligence, and about 1/4 of severe mental retardation.
language disability
Difficulties in language expression, unclear pronunciation or stuttering.
Visual and hearing impairment
It is most common to distinguish between strabismus and the rhythm of the sound.
Tooth development disorder
The tooth texture is loose, easy to fold, dysfunction of the mouth, facial muscles and tongue muscles sometimes squat or inconsistent contraction, difficulty in chewing and swallowing, difficulty in closing the mouth, and drooling.
Symptom
Mixed cerebral palsy symptoms Common symptoms Responsive mental disorder mental retardation reduced daily living ability... Limb stiffness, limb movement, uncoordinated hearing impairment, sensory disturbance, ataxia, reflex absorption disappear
1. Unresponsiveness and no response. This is an early manifestation of mental retardation. It is generally considered to be unresponsive at 4 months and no response at 6 months. It can be diagnosed as mental retardation.
2, the body is hard, this is the symptoms of hypertonic muscle, can be seen in a month. If it lasts for more than 4 months, it can be diagnosed as cerebral palsy. This is also one of the symptoms of neonatal cerebral palsy.
3, the body is weak and spontaneous exercise is reduced, this is a symptom of low muscle tone, can be seen in a month. If it lasts for more than 4 months, it can be diagnosed as severe brain injury, mental retardation or muscle system disease. This is a symptom of neonatal cerebral palsy.
4, head circumference abnormalities are also common symptoms of neonatal cerebral palsy. Head circumference is an objective indicator of the morphological development of the brain. Brain-injured children often have abnormal head circumference.
5, breastfeeding difficulties, do not suck after birth, sucking weakness or refusal to suck, tired and weak after sucking, often cough, spit milk phenomenon, mouth can not be closed very well, poor weight gain.
6, sports development is backward, active movement is reduced: cerebral palsy shows varying degrees of motor development, such as head-up, sitting, climbing, standing, walking and other large movements are slower than normal children; grasping things, fine movements of fingers Also behind the normal children.
7, active exercise reduction: decreased performance during the neonatal period, sucking ability and foraging response are poor. At 3 months, the kicking of the lower extremities was significantly reduced or the legs were kicked at the same time. Hemiplegic cerebral palsy often shows a decrease in side activity. The limbs of sick children rarely move, especially the lower limbs are more obvious, often manifested as hemiplegia, bilateral paralysis, quadriplegia and so on. Due to the difficulty of autonomous movement, the movement is stiff and uncoordinated, and abnormal movement patterns often occur. The low muscle tone type is sputum, soft, and too quiet.
Examine
Hybrid cerebral palsy
1. Neonatal routine hematuria examination, biochemical electrolyte examination.
2. Mother and newborn blood type examination, bilirubin qualitative test, serum total bilirubin quantification.
3. Elderly maternal prenatal amniotic fluid gene, chromosome, immunological examination.
4. Brain CT: It is mainly used to determine whether there are organic lesions and lesions. Common abnormalities include extensive brain atrophy, brain softening, and white matter dysplasia. For some cases can be used to suggest the cause, such as congenital brain developmental malformations, intrauterine infections.
5. EEG: Because children with cerebral palsy have more epilepsy, EEG should be routinely performed to rule out the complication. Common abnormalities include slowing of background activity, limited slow wave foci or epileptic seizure discharge.
6. IQ measurement: evaluate the intelligence and social adaptation, and determine whether the child has a mental retardation.
7. Evoked potential: Children with suspected visual and auditory dysfunction can be made visual and auditory evoked potentials to detect abnormalities early and intervene in time.
Diagnosis
Diagnosis and diagnosis of mixed cerebral palsy
1. Soft body and reduced spontaneous movement: This is a symptom of low muscle tone, which can be seen in one month. If it lasts for more than 4 months, it can be diagnosed as severe brain injury, mental retardation or muscle system disease.
2. The body is hard: This is a symptom of hypertonic muscle, which can be seen in one month. If it lasts for more than 4 months, it can be diagnosed as cerebral palsy.
3. Unresponsiveness and no response, this is an early manifestation of mental retardation. It is generally considered to be unresponsive at 4 months and no response at 6 months. It can be diagnosed as mental retardation.
4. Head circumference abnormality: head circumference is an objective indicator of brain shape development, and brain injury children often have head circumference abnormalities.
5. Poor weight gain and breastfeeding weakness.
6. Fixed posture: It is often caused by abnormal brain muscles due to brain damage, such as angular arch reversal, frog position, inverted U-shaped posture and so on. It can be seen in one month after birth.
7. Do not laugh: If you can't smile for 2 months, you can't laugh out loud for 4 months, you can diagnose it as mental retardation.
8. Hand fist: If you can't open it in 4 months, or the thumb is inward, especially the presence of one side of the upper limb, it has important diagnostic significance.
9. Body twist: If the baby is 3-4 months old, it often indicates extrapyramidal injury.
10. Head instability: If you can't raise your head or sit in a position for 4 months, you can't stand upright, which is often an important sign of brain damage.
11. Strabismus: 3-4 months of babies with strabismus and poor eye movements may indicate the presence of brain damage.
12. Can not reach out and grasp the object: If you can't reach out and grab the object in 4-5 months, you can diagnose it as mental retardation or cerebral palsy.
13. Gazing at the hand: It still exists after 6 months, and can be considered as mental retardation. Some brain damage is mild, and there are often no obvious symptoms in the early stages of the baby, but in the second half of the baby (6-12 months).
