When a baby is born, its internal organs and body systems are not fully formed yet. This also applies to the central nervous system, which is responsible for the normal social activity of a person. For the formation process to be completed, a certain time period is necessary.
In recent years, the number of pathologies of the central nervous system in infants has increased significantly. They can develop in the prenatal period, and also appear in the process of childbirth or immediately after them. Such lesions, adversely affecting the work of the nervous system, can cause serious complications and even disability.
What is perinatal CNS damage?
Perinatal damage to the central nervous system, abbreviated PCPSN, is a series of pathologies that are related to malfunctions in the functioning of the brain and developmental abnormalities in its structure. There are similar abnormalities in children in the perinatal period, the time frame of which is in the interval from 24 weeks of gestation to the first 7 days of life after birth, inclusive.
At the moment, PCV in newborns is quite common. Such a diagnosis is set in 5-55% of babies. The strong variation of the indicators is due to the fact that often CNS lesions of this kind pass easily and quickly. Cases of severe forms of perinatal lesions occur in 1-10% of children who were born at the appointed time. Premature babies are more affected.
In modern medicine, it is customary to classify abnormalities in the normal functioning of the central nervous system in accordance with what causes one or another pathology. In this regard, each violation has its own forms and symptoms. There are 4 main pathological types of CNS damage:
- hypoxic genesis.
Perinatal damage in the newborn
Perinatal lesions of the central nervous system are those that develop in the perinatal period, most of which occur in the prenatal period. The risks of the child’s depression of the central nervous system increase if a woman has suffered during pregnancy:
- cytomegalovirus infection (we recommend reading: symptoms and effects of cytomegalovirus infection in children);
- herpes infection;
The child can get intracranial trauma and injuries of the spinal cord or peripheral nervous system during labor, which can also cause perinatal lesions. Toxic effects on the fetus can disrupt metabolic processes and adversely affect brain activity.
Hypoxic-ischemic damage to the nervous system
Hypoxic-ischemic damage to the nervous system is a form of perinatal pathology, which is caused by fetal hypoxia, that is, insufficient oxygen supply to the cells.
A manifestation of the hypoxic-ischemic form is cerebral ischemia, which has three degrees of severity:
- The first. Accompanied by the oppression or excitation of the central nervous system, which lasts up to a week after birth.
- The second. To the oppression / arousal of the central nervous system, lasting more than 7 days, the convulsions, increased intracranial pressure and autonomic-visceral disorders are added.
- Third. She is characterized by a severe convulsive state, dysfunctions of the brain stem sections, high intracranial pressure.
In addition to ischemic genesis, hypoxic lesions of the central nervous system may be due to hemorrhages of non-traumatic origin (hemorrhagic). These include hemorrhages:
- intraventricular type 1, 2 and 3 degrees;
- subarachnoid primary type;
- into the substance of the brain.
Features of the diagnosis of PPNS
After childbirth, a neonatologist is required to examine children, conducting an assessment of the degree of hypoxia. It is he who can suspect perinatal damage by changes in the condition of the newborn. The conclusion about the presence of pathology is confirmed or refuted in the first 1-2 months. During all this time, the crumb is under the supervision of doctors, namely a neurologist, pediatrician and additional specialist narrow focus (if required). Deviations in the work of the nervous system require special attention in order to be able to correct them in time.
Forms and symptoms of the disease
Perinatal damage to the central nervous system of a newborn can occur in 3 different forms, which are characterized by its own symptoms:
Knowing the symptoms, which speaks of the oppression of the work of the central nervous system, it is possible at the early stages to establish the diagnosis and to start treating the disease in a timely manner. The table below describes the symptoms that accompany the course of the disease for each of its forms:
- high excitability of nerve reflexes;
- weak muscle tone;
- gliding squint;
- trembling of the chin, arms and legs;
- wandering movements of the eyeballs;
- nerve movements.
- lack of emotion;
- weak muscle tone;
- spontaneous physical activity of the eyes.
- renal failure;
- malfunction of the intestines;
- problems with the cardiovascular system;
- impaired functioning of the respiratory system.
Causes of development
Among the reasons leading to perinatal CNS damage in an infant, four main ones are worth noting:
- Hypoxia of the fetus during the prenatal period. This deviation is associated with a lack of oxygen entering the baby’s blood from the mother’s body. Aggravating factors are harmful working conditions for pregnant women, harmful habits such as smoking, past infectious diseases, and previous abortions.
- Injuries caused during childbirth. If the woman has a weak labor activity, or the baby is delayed in the pelvis.
- Violation of metabolic processes. They can cause toxic components that enter the body of a pregnant woman along with cigarettes, alcoholic beverages, narcotic substances and potent drugs.
- Viral and bacterial infections that got into the mother during pregnancy, abbreviated IUI – intrauterine infections.
Consequences of the disease
In most cases, by the time a child is one year old, almost all of the symptoms accompanying damage to the nervous system are gone. Unfortunately, this does not mean that the disease has receded. Usually after such a disease there are always complications and unpleasant consequences.
Among them note:
- Hyperactivity This syndrome is characterized by aggressiveness, attacks of hysteria, learning difficulties and memory problems.
- Delayed development. This applies to both physical and verbal, mental development.
- Cerebroasthenic syndrome. He has a child’s dependence on weather conditions, mood swings, restless sleep.
The most serious consequences of the oppression of the work of the central nervous system, which lead to disability of the baby, are:
The prevalence of a diagnosis of perinatal damage to the nervous system in a newborn is caused by many factors and conditions affecting the intrauterine development of the fetus and the birth of a baby.
The group of increased risk, which is 50%, kids fall:
- with pelvic presentation;
- premature or, on the contrary, postponed;
- with greater birth weight in excess of 4 kg.
Also significant is the hereditary factor. However, it is difficult to foresee exactly what can cause depression of the central nervous system in a child and depends more on the situation as a whole.
Any disruption of brain activity is difficult to diagnose at an early stage. The babies are diagnosed with perinatal CNS lesions during the first months of life, starting from the presence of problems with the motor and speech apparatus, and also taking into account violations of mental functions. Closer to the year, the specialist must already specify the type of the disease or refute the earlier conclusion.
Disorders of the nervous system pose a serious danger to the health and development of the child, so it is important to diagnose the problem on time in order to conduct proper treatment. If a newborn baby behaves uncharacteristically, and the first symptoms of the disease appear, parents must show it to the doctor. Initially, he carries out an inspection, but for an accurate diagnosis of one such procedure may not be enough. Only an integrated approach will identify the disease.
At the slightest suspicion of the development of PPSTSN child must immediately show the doctor
For this reason, the following clinical and laboratory tests are usually additionally prescribed:
- neurosonography (we recommend to read: what does neurosonography of the brain of newborns show?);
- CT scan – computed tomography or MRI – magnetic resonance imaging of the brain;
- Ultrasound – ultrasound diagnostics;
- X-ray examination;
- Echoencephalography (EchoES), rheoencephalography (REG) or electroencephalography (EEG) – methods of functional diagnostics (we recommend reading: how do brain EEGs for children?);
- Consultative examination by an ophthalmologist, a speech therapist and a psychologist.
Symptoms of treatment depending on the symptoms
Treatment of any pathologies of the central nervous system in newborns must be carried out in the first months of life, since at this stage almost all processes are reversible, and impaired brain functions can be fully restored.
In the first months of life, PCVS is easily treatable.
To do this, carried out the appropriate drug therapy, which allows you to:
- improve the power of nerve cells;
- stimulate blood circulation;
- normalize muscle tone;
- normalize metabolic processes;
- rid the baby from cramps;
- arrest swelling of the brain and lungs;
- increase or decrease intracranial pressure.
When the child’s condition is stabilized, physiotherapy or osteopathy is carried out in combination with medication. Therapeutic and rehabilitation course are developed individually for each case.
Intracranial hypertension syndrome manifests itself as an increase in the circumference of the head of a newborn child compared to the norm, swelling of a large fontanelle and discrepancy of the sutures of the skull (we recommend reading: what does Komarovsky say that the newborn has a small fontanel?). Also, the child is nervous and quickly excite. When these symptoms appear, the baby is prescribed diuretic drugs by conducting dehydration therapy. In order to reduce the likelihood of hemorrhage, it is recommended to drink Lidaz.
Plus, crumbs make special gymnastic exercises that help reduce intracranial pressure. Sometimes they use acupuncture and manual therapy to correct the outflow of fluid.
Fortifying gymnastic exercises are necessarily included in the complex treatment of PCVS.
When diagnosing the syndrome of motor disorders, treatment is a series of measures aimed at eliminating the problem:
- Drug therapy. Such drugs as Galantamine, Dibazol, Alizin, Prozerin are prescribed.
- Massage and physical therapy. For children under one year, at least 4 courses of such procedures are required, each of which consists of approximately 20 sessions with specially selected exercises. They are selected depending on what is subject to deviations: walking, sitting or crawling. Massage and exercise therapy is carried out using ointments.
- Osteopathy. It consists in conducting a massage of internal organs and the impact on the desired points of the body.
- Reflexology. Has established itself as the most effective method. Her help is resorted to in cases where VOS leads to a delay in the maturation and development of the nervous system.
Increased neuro-reflex excitability
Referring to the mild form of the pathology, it is peculiar to her:
- lowering or increasing muscle tone;
- dying of reflexes;
- superficial sleep;
- causeless jitter.
Massage with electrophoresis helps to restore muscle tone. In addition, medication therapy is carried out, and treatment with impulse currents and special baths can be prescribed.
Epileptic syndrome is characterized by recurrent epileptic seizures, which are accompanied by convulsions, which represent flinching and twitching of the upper and lower extremities and head. The main task of therapy in this case is to get rid of the convulsive state.
Finlepsin is prescribed if the child has convulsive syndrome
The course of the following medication is usually prescribed:
Minimal brain dysfunction
Minimal cerebral dysfunction, better known as hyperactivity or attention deficit syndrome, is a low-symptom form of neurological disorders. Treatment with drugs is mainly aimed at eliminating specific manifestations, while methods of physical exposure, namely, massage or physical education, are able to more effectively correct the pathological condition of the child.
An important role in the full recovery of the baby is the recovery period.
- electrophoresis with medicines;
- therapeutic ultrasound;
- physiotherapy and gymnastics;
- swimming lessons;
- impulse currents;
- thermal procedures;
- pedagogical correction methods;
- therapy with music.
In addition, parents should create certain living conditions for a child with PCD:
- Comfortable temperature. It should not overheat and not cool children.
- The exclusion of sound stimuli. You must not talk too loud next to the crumbs, do not listen to music or watch TV at high volume.
- Minimizing the likelihood of infection. For this you need to reduce visits to friends and relatives.
- Proper nutrition. It is advisable to continue to breastfeed the newborn, because mother’s milk is a source of vitamins, hormones and biologically active substances that help the nervous system to develop and recover normally.
- Use educational rugs, books and toys. In such occupations it is important to observe moderation so that the crumb will not overwork.