How to determine cerebral palsy in premature infants
Release time : 01/18/2025 18:13:27
Premature infantile cerebral palsy refers to a syndrome caused by non-progressive brain damage in the fetus, neonate, or infant period.
How to judge preterm infantile cerebral palsy? How to judge preterm infantile cerebral palsy in the first place? How to judge preterm infantile cerebral palsy? The early diagnosis of cerebral palsy is crucial for effective treatment.
When parents notice any abnormal behavior in their children, they should pay attention. Especially during pregnancy and childbirth, when there are high-risk factors, it is crucial to seek professional medical examinations as soon as possible, so as not to miss the optimal treatment window.
How to identify preterm infant cerebral palsy? 1. Early symptoms: (1) Neonates or infants less than three months old are easily startled, cry continuously, have aversion to breastfeeding, and have difficulty sleeping.
(2) Early feeding, swallowing difficulties, drooling, and respiratory disturbances.
(3) Sensory threshold is low, manifesting as sensitivity to noise or changes in body position, easily startled, and increased hugging reflex accompanied by crying.
(4) Normal newborns, due to the influence of stepping reflex, when standing, can be seen with two steps interchanged at each time.
At 3 months of age, although there may be a temporary remission, if the child does not show signs of standing or walking by 3 months, it is important to suspect cerebral palsy.
The baby who has passed the "hundred days" can't lift his head, and he still keeps his head in an unstable state when he stretches his waist from 4 to 5 months.
(6) Hand Gesture: Generally, infants under 3 months old can close their fists without opening them. If a baby still has thumb adduction and the hand is not open at 4 months, suspicion of cerebral palsy should be considered.
(7) Normal infants should be able to reach out and grasp objects by the age of 3 to 5 months. If they are not able to do so by the age of 5, it is suspected that they have a developmental disorder such as cerebral palsy.
(8) Generally, children smile around the age of 4 to 6 weeks and begin recognizing people.
In children with spastic cerebral palsy, patients with the expressional type often display a somber and troubled expression.
Muscles are soft, unable to turn over, and movements are slow.
Upon touching the inner thigh of a child, or having the child's feet touch the bed or move up and down, a phenomenon of quadriceps retraction and adduction occurs.
(10) The limbs are stiff, especially when dressing, making it difficult to insert the arms into sleeve holes.
When changing diapers, the thighs are difficult to abduct.
During the process of wiping the palms or bathing, limb stiffness occurs.
Infant doesn't like taking a bath.
(11) Premature Development: Children with cerebral palsy may exhibit premature rolling over, but this is a sudden, reflexive roll, where the entire body turns over like a log, rather than a conscious, segmental roll.
Infants with spastic diplegia may exhibit stiffening of both lower limbs before they can sit steadily, standing on their toes like a ballet dancer.
2. Main Symptoms (1) Motor Disorders: Defective self-control of movement, with severe cases resulting in the inability to grasp objects with both hands, walk with both feet, or even turn over on their own. They may not be able to sit up, stand, eat and swallow normally.
(2) Postural disturbances with abnormal postures, poor posture stability, and persisting inability to maintain upright for 3 months. The head is habitually tilted to one side or oscillates in any direction.
The child is reluctant to bathe and struggles to open their fists when washing hands.
(3) Intelligence Deficiency: About one-fourth of the children have normal intelligence, about one-half have mild or moderately deficient intelligence, and about one-fourth have severe intellectual deficiency.
(4) Language barriers, difficulties in verbal communication, unclear pronunciation or stuttering.
(5) Visual and auditory impairments, particularly strabismus (inward deviation of the eyes) and difficulties in rhythm perception of sound, are most frequently observed.
(6) Growth and Development Disorders: Short Stature.
(7) Dental developmental disorders with loose texture and susceptibility to breakage.
Orofacial dysfunction, characterized by occasional spasms or uncoordinated contractions of the facial and lingual muscles, resulting in difficulties with chewing, swallowing, and mouth closure, as well as drooling.
(8) Emotional and behavioral disorders: stubbornness, willfulness, irritability, social withdrawal, significant mood swings, and occasional compulsive, self-injurious, or aggressive behaviors.
(9) Between 39% to 50% of children with cerebral palsy develop epilepsy due to fixed lesions in the brain, particularly those with severe intellectual disabilities.
The treatment of cerebral palsy in premature infants is most effective when started early. The earlier the intervention, the greater the likelihood of a cure. Parents must take this seriously and seek treatment at a reputable hospital as soon as a diagnosis is confirmed.
1. Comprehensive rehabilitation medicine, such as physical therapy, including gross motor, fine motor, balance and coordination training.
Such as crawling, purposeful pointing (nose, ear, etc.), training to grasp objects, holding objects, sitting up, swinging, walking with support (back against a wall, facing the wall), and movement in place (crawling to pick up an object, lifting a foot, single-legged standing, jumping from place to place).
For example, physiotherapy encompasses neurostimulation therapy, thermotherapy, hydrotherapy.
There is also the treatment of homework therapy, which involves skill training, but its efficacy is generally modest.
The modern medical treatment methods are as follows: ① Surgery.
② Orthotics.
Water, electricity, light, sound therapy.
④ Language and communication therapy.
⑤ Treatment of motor function.
⑥ ADL Training.
2. Medication therapy: Oral or intravenous administration of relevant medications, such as cerebral nerve nutrition drugs, muscle relaxants, blood circulation drugs, etc.
Medications that include the construction and repair of brain tissue (cells), such as phosphatidylcholine (which includes phospholipids like phosphatidylcholine, sphingomyelin, and cephalin), can repair damage to brain cell membranes caused by trauma, bleeding, or hypoxia. They protect neuronal cells, accelerate nerve excitation transmission, and improve learning and memory functions.
Drugs that can promote the synthesis of brain cell DNA, enhance the utilization rate of oxygen in brain cells, improve energy metabolism in brain cells, and enhance brain function, as well as supply various amino acids needed for repair and regeneration of brain tissue, and regulate neuronal activities, such as Gulixi (brain enzyme hydrolyzed tablets) and Spirulina capsules.
Moreover, actively supplement various vitamins, such as 21-Golden Vitamin.
Conditional hospitals can alternately choose the following injections: cerebral activator, cerebral polypeptide, acetylglucamine, choline biphosphate.
3. Traditional Chinese medicine treatments include acupuncture therapy (should be used with caution in patients with hypertonia of the cerebral palsy), massage therapy, and traditional Chinese medicine.
4. Pediatric Cerebral Palsy Exercise Therapy: Pediatric cerebral palsy exercise therapy is based on the principles of kinesiology and neurophysiology. It uses devices or manual techniques by the therapist or utilizes the child's own strength to achieve active and passive movements, thereby restoring and treating the body's and local functions.
(1) The common goal of pediatric cerebral palsy motor therapy: to utilize normal movements as much as possible.
Using both sides of the body.
Keep in straight position when lying, sitting, kneeling and standing.
Actions and activities related to daily life.
Prevention of deformity.
(2) Training Goals for Different Types of Cerebral Palsy in Children.
① Spastic Type: Relax stiff muscles, avoid movements that induce spastic postures, and prevent deformities.
② Athetoid Type: Perform grasping exercises with the hands to stabilize involuntary movements. If abnormal postural changes are inconsistent, follow the goals for the spastic type.
Ataxia Type: Improve balance ability in kneeling, standing, and walking positions, stabilize standing and walking, and control unsteady tremors, especially in the hands.
Care for Premature Infants with Cerebral Palsy: In recent years, the incidence of cerebral palsy in children has been gradually increasing in China, affecting the physical and mental health of many children.
Experts point out that there are many causes of cerebral palsy in children, and premature birth is one of the significant factors.
Here is the English translation of the provided text: So, what are the key points to pay attention to in the care of premature infants with cerebral palsy? 1. **Dietary Care**: For premature infants with cerebral palsy, it is important to focus on dietary care. Their diet should include high-calorie, high-protein, and vitamin-rich foods that are easy to digest.
For children who have difficulty eating independently, dietary training should be conducted. When feeding, never forcefully remove the spoon while the child's teeth are clenched, as this may cause damage to their teeth.
Expert guidance suggests that during feeding, the child's head should be kept in the midline position. Tilting the child's head backward while eating can lead to aspiration of foreign objects.
To enable children to learn to eat, we should strive to remove them from the situation of being fed by others as early as possible.
2. In daily life care for preterm infants with cerebral palsy, attention should also be paid to daily life care.
To ensure the cleanliness and hygiene of patients with cerebral palsy, bathing should be carried out regularly, along with the timely change of clothes, sheets, and bedding.
To keep the air fresh indoors, ensure there is plenty of sunlight, good ventilation, and a suitable temperature.
Regularly use ultraviolet radiation for disinfection, and frequently clean the floor with disinfectant to ensure the cleanliness and sanitation of the room in which cerebral palsy patients reside.
Expert guidance: Pediatric patients with cerebral palsy are delayed in various motor development compared to healthy children of the same age, resulting in difficulties in movement.
Therefore, it is necessary to have dedicated personnel on guard, pay attention to safety, and avoid causing accidents.
3. Functional Training: In the care of preterm infants with cerebral palsy, functional training is also important.
Experts point out that the brain lesions in paralytic children are stationary, but the neurological defects caused by them do not remain permanently fixed.
If not treated in an early appropriate manner, abnormal postures and movement patterns will become fixed. It may also result in tendon contractures, skeletal and joint deformities, and further exacerbate intellectual disabilities.
Expert guidance: The paralyzed limb should be maintained in its functional position, and passive or active movements should be performed to promote muscle and joint activity and improve muscle tone.
Particularly, the first six years of life are critical for language acquisition. It is essential to provide children with ample opportunities to engage in language through various activities, encourage them to vocalize and correct any abnormalities in their speech, and persistently engage in language training to enhance their ability to adapt to social life.
Premature infant cerebral palsy rehabilitation training. In the symptoms of cerebral palsy, often accompanied by limb motor dysfunction, it brings many inconveniences to patients and a significant burden to the entire family. Therefore, for cerebral palsy, early intervention and improvement of limb function is crucial.
What are the content of early postnatal cerebral palsy rehabilitation training? 1. Head control training: The ability to raise the head is a major premise for learning other activities in infant development.
During the training, one should hold the child's head at both sides to stabilize it in an upright central position.
During most of the time in the seated position, the child's head is accustomed to maintaining correct posture. This can teach the child to control his or her head and maintain a stable position.
2. The training of upper limb and hand functions should be conducted under a stable posture, with a focus on correcting the spastic patterns in cerebral palsy patients' upper limbs.
One hand can grasp the outer side of the child's elbow, and the other hand can hold the child's hand. Raise and extend the child's arm upwards and outwards.
Lift the shoulder outwardly, extend the elbow straight, and palm up.
Encourage the child to bring their hands to their chest, play with fingers, and grasp toys of various shapes and colors.
3. Lower-body exercises: a. Walk barefoot in front of the gymnastics mirror or on two parallel lines on the ground.
B. Squats, jumping exercises, single-leg standing exercises, knee flexion and extension exercises, and foot dorsiflexion exercises.
C. Balances on a beam and walks.
Certain types of patients require assistance from family members or the use of prosthetic limbs for exercise.
D. Individuals with drooling exercises swallowing movements daily for 100 times; those with speech difficulties begin with the simplest sentences and pay special attention to singing under the music's accompanying effect to improve language and intelligence.
4. Feeding training should encourage the child to eat independently, which is very beneficial for improving the child's dexterity and upper limb motor ability.
The child with good swallowing function should have the feeding training performed in a sitting position.
Children with poor hand grasping ability can use assistive devices to eat.
5. Dressing and Undressing Training: This training is designed to enable the child to gradually learn to dress and undress themselves, thereby enhancing their ability to manage daily life independently.
6. Balance and Coordination Training: The ability to balance and coordinate is the prerequisite for stable movement in sports.
Balance boards, balls, and rollers can be utilized for training.
Training can prompt the child to adjust their posture in a timely manner, enhance their reaction capabilities, and improve their ability to control the head, neck, trunk, and balance and coordination movements.
When conducting rehabilitation training for children, parents must be patient; the children should be earnest in their cooperation; doctors must have determination; with undivided focus on the child's recovery, we can look forward to a bright future.
Parents should use language to guide, because the information feedback of cerebral palsy patients is slow. It has been proved that parents who train and stimulate with language can improve both the intelligence and language skills.
Prevention of Preterm Infant Cerebral Palsy - Infants with cerebral palsy can suffer from various neurological disorders, bone and muscle abnormalities, and even epilepsy. This can have a serious impact on their life.
Among preterm infants, the incidence of cerebral palsy is extremely high, with one out of every three preterm infants being affected by it.
As the saying goes, "Prevention is better than cure," so it's important to focus on preventing cerebral palsy in premature infants to ensure their healthy growth.
1. Pregnancy should prevent rubella virus infection.
2. Regular health checkups during pregnancy: It is important to rule out factors that may lead to difficult labor, and if there are high blood pressure or diabetes, active treatment should be pursued.
Ensure nutritional intake to prevent premature birth.
Avoid unnecessary medication.
Choose a maternity hospital based on the estimated due date, and prepare for safe childbirth.
3. At birth, the infants of immature children should be protected, and the infants with asphyxia and severe jaundice should be treated appropriately.
Such as oxygen inhalation, warming the incubator, etc.
Children with brain injuries should be registered and followed up, with regular screenings.
4. Encourage breastfeeding for the infant and administer the first, second, and third-dose vaccines for measles, polio, rubella, or tuberculosis.
5. Recognize the early symptoms of meningitis, such as fever, neck stiffness, and drowsiness, and seek timely treatment upon diagnosis.
6. In cases of fever, the child should be removed from clothing, ice water applied to the body, sufficient fluids consumed, and timely treatment administered.
7. Pay attention to hydrating children with diarrhea; if the diarrhea is severe, seek medical attention promptly.
8. Attention should be paid to the possibility of cerebral lesions in cases of motor developmental delays, abnormal postures, poor sucking, screaming and refusing to sleep, as well as overly soft or stiff muscles.
The medical information provided in this text is for reference only.
Should you experience discomfort, it is advised to seek medical attention immediately. The diagnosis and treatment of illnesses should be based on the examinations conducted by a physician in person.