Glad to see you again, my dears! Today I want to raise a difficult topic. Mainly, it will be difficult and painful for those in whose family a “special” child is growing up. I'm talking about children with cerebral palsy. This disease affects children more and more often and sometimes amazes with its cruelty towards them. Unfortunately, sometimes parents abandon such children while still in the orphanage, knowing that they will be doomed to lifelong torment with a “defective” child who will always need help and support, as well as treatment.
Fortunately, such parents are a minority; the majority still decide to fight the diagnosis-sentence, treat, nurse, and, most importantly, love their child no matter what, believing in the power of parental love as the main and most effective medicine. And, you know, miracles sometimes happen! To the question of whether it is possible to cure cerebral palsy in a child, which many mothers ask, we will try to find the answer today.
Curable or not?
The symptoms of cerebral palsy are very diverse, and parents often experience a feeling of doom upon learning of such a diagnosis. Can cerebral palsy be cured? And in general, is it curable or not? These are the questions that concern parents in the first place.
Modern medicine does not give a clear answer to this question. Pathologies that affect the brain, in most cases, cannot be completely cured. However, there are many examples where a paralyzed person, despite disappointing forecasts, achieved unexpected and impressive results.
One thing is certain: the earlier treatment for cerebral palsy begins, the greater the chances of minimizing possible complications of the disease. Moreover, when therapy is started in a timely manner, most young patients make significant progress, and some recover completely.
the main task
When talking about whether cerebral palsy is treated (how and with what), you should not get hung up on the word “therapy”. After all, the main task with such a diagnosis is adaptation to life. This is especially true when it comes to the most severe degree of the disease.
Thus, even if cerebral palsy is not completely cured, this disease can definitely be successfully compensated with the help of a well-chosen rehabilitation program. And it’s not without reason that doctors claim that the phrase “cannot be cured” is not a synonym for “cannot be helped.” If you act correctly and believe in yourself, sooner or later the result will be noticeable.
Principles of treatment
The greatest success can be achieved if intensive therapy is carried out in a child under the age of 8 years. It is during this period that the brain actively develops, cognitive processes occur, new skills are acquired, and most future skills and abilities are formed.
It has been proven that it is easier to teach any child aged 3–4 years something than a 7–8 year old child. Therefore, the use of developmental techniques is most effective during brain growth.
A comprehensive rehabilitation program is selected individually, since much depends on the location and severity of brain damage, as well as concomitant visual and hearing impairments. The treatment process becomes somewhat more complicated in the presence of epileptic seizures: in this case, rehabilitation measures should be carried out using gentle, “soft” methods.
Specific therapy for cerebral palsy is complemented by symptomatic therapy, but the main ways to influence the disease are therapeutic exercises and massage. An important component of treatment is medications that normalize muscle tone. These include Mydocalm, Baclofen and Dysport.
Surgery
Is cerebral palsy treated surgically? Surgery is one of many ways to treat this disease. The main goal of surgery is to give the child the opportunity to move. If patients do not have such a prospect, then operations can reduce pain, improve skills during hygiene procedures, help sit down, etc.
As a rule, during surgery for cerebral palsy, doctors perform tendon transfer or removal. The specialist is also able to correct scoliosis, change the incorrect position of the limbs, correct the location of the hip joints, and relieve imbalance of spastic muscles.
Today, methods of functional neurosurgery are actively used for cerebral palsy, namely:
Drug therapy
Taking medications is indicated in the acute phase of the disease, when brain disorders are especially noticeable, that is, in the first six months of a child’s life. Most often, convulsive syndrome is observed - uncontrolled muscle contractions. Anticonvulsants and benzodiazepines are used to combat this syndrome.
Anticonvulsants are taken in courses over a long period. Benzodiazepines are indicated in emergency situations when it is necessary to quickly eliminate an epileptic seizure. The most effective drug from the group of benzodiazepines is Diazepam.
Caution: Anticonvulsant medications may cause negative side effects, including skin rashes. In addition, their effects on the nervous system are not fully understood.
It should be noted that in Russia drugs with unproven effectiveness for cerebral palsy are still often used. These are, first of all, drugs for improving cerebral circulation - Cerebrolysin, Actovegin, Cortexin, Glycine, Cavinton, Cinnarizine, etc.
Diazepam is one of the few drugs whose effectiveness has been proven in the treatment of cerebral palsy.
Many doctors also prescribe nootropics (Piracetam, Phenibut, Pantogam, Mexidol), various dietary supplements, vascular and homeopathic remedies. Some clinics may even recommend stem cell treatment.
The healing effect of the listed drugs is very doubtful, since the dead areas of the brain can no longer be restored.
Therapy for cerebral palsy has 3 main goals:
- the child’s acquisition of self-care skills;
- reducing the risk of contractures that limit movement in the joints and skeletal deformities (curvature of the spine);
- compensation of neurological deficits and provision of conditions for the development of speech and intellectual abilities.
To solve these problems, physical therapy, massage, physical and mechanical therapy, pneumatic and stress suits, Bobath therapy, as well as various auxiliary devices are used - walkers, special chairs, exercise equipment, bicycles and standers.
Orthopedic methods
Is cerebral palsy treated with orthopedics? According to doctors, orthopedic methods of therapy must necessarily be included in the complex therapy of this disease. The essence of this method is the use of special devices that were made specifically for the patient. These include the following: splints, orthoses, braces, special shoes, etc.
Thanks to such simple but effective devices, cerebral palsy therapy can be carried out even at home. By the way, such devices are very often used for spastic diplegia in order to improve the child’s gait and prevent the development of muscle contracture.
Physiotherapy
When performing exercises, the brain “learns” the correct movements of the muscles of the body and limbs, which ultimately forces it to establish regulation of this process. Thanks to regular exercises, primitive reflexes are reduced and the ability to support the body in space is re-formed. In addition, motor strength increases and rhythmic movements are realized.
By normalizing blood circulation and metabolism, metabolic and neurovascular disorders are completely or partially eliminated; the formation of adhesions between the nerve sheaths and surrounding tissues is prevented. Physical activity also helps develop coordination, strengthen weak muscle groups, and improve flexibility and mobility of the spine.
You can start classes only if intracranial pressure is normal and there is no convulsive syndrome. Training is carried out daily under the supervision of a rehabilitation doctor, the complexity of the exercises increases smoothly and gradually.
The gymnastic complex includes exercises for stretching and relaxing muscles, walking on an inclined surface. The training program necessarily includes positional therapy, when the child’s limbs are fixed with special splints or splints.
To stretch the muscles, the baby's arms and legs are swung in all joints, gradually increasing the amplitude. For muscle relaxation, the lower and upper limbs are alternately fixed in a stationary position - thus reducing the frequency of involuntary movements and hypertonicity.
It is very important to normalize the interaction of agonist and antagonist muscles, for which flexion-extension exercises of the joints of the arms and legs are used.
Therapeutic gymnastics is not only about performing mechanical movements, but also about instilling in a child faith in his own strength and confidence in the success of therapy.
While climbing an inclined surface, the abdominal and leg muscles are strengthened. In addition, this is how the child learns to maintain balance.
Aerobic endurance exercises are an integral part of exercise therapy, which ends every workout.
It should be noted that the technique of performing exercises differs depending on the type of disease. In the asthenic form of cerebral palsy, the motor mode should be intermittent, that is, with a minimum of repetitions and frequent breaks. In the atonic form, it is necessary to focus on exercises to maintain balance.
Does character change as you get older?
Infantile paralysis does not progress and remains at the same level as it was at birth, however, with age there are two options for the development of this deviation:
Some patients find it increasingly difficult to move their growing, heavier bodies. As a result, they again end up in a wheelchair. And some have been engaged in the necessary therapy since childhood and learn to live in the world around them.
For many reasons, children endure this disease much easier, especially thanks to the help and support of loved ones. In the Middle Ages, few children with this diagnosis even survived into adolescence, but now they normally live into old age thanks to their adaptation to the world around them and the adaptation of society to them.
Breathing and facial expression training
Classes with the child are not limited to training the body muscles and include exercises for facial muscles and breathing correction. To improve the breathing process, children are recommended to inflate balloons and inflatable toys, blow soap bubbles, sing, play the harmonica or pipe, and whistle.
Children with cerebral palsy need to be taught to recognize the emotions of other people. Thanks to this, the child will adequately respond to the negative emotions of others and gain mental comfort. For this purpose, facial muscles are trained. During the lesson, the child is asked to imagine situations in which he will feel anger, shame, joy, fear, etc.
For example, a child is asked to show how angry the parents are (anger), or how the baby is crying (suffering). For him to portray joy, it is enough to remember Santa Claus carrying a bag of gifts.
How is the diagnosis carried out?
The effectiveness of treatment is directly proportional to the time of diagnosis. Therefore, it is important to examine the baby while still in the maternity ward. Increased attention to children at risk:
- Born premature.
- Children with low weight.
- Children with congenital pathologies and defects.
- Infected from the mother during fetal development.
- If a vacuum extractor or forceps was used during delivery.
- Children who are on mechanical ventilation.
- Children with minimal Apgar scores.
- Children who have had jaundice.
How is cerebral palsy treated?
The doctor must examine all children at risk in detail and identify muscle tone and reflex reactions. If there is a suspicion of damage to a part of the brain, the child is sent for special examinations:
- Ultrasound;
- EEG;
- MRI.
After confirming the severity of the pathology, the doctor determines the necessary instructions for the child, which will help restore motor functions, as well as avoid complicating consequences.
Hydrotherapy
For the physical recovery of children with cerebral palsy, classes are also conducted in water. Water procedures promote relaxation and normalize muscle tone, give energy and improve mood.
By doing exercises in the pool, you can minimize stress and cope with depression. This method is called hydrokinesitherapy, which includes not only therapeutic exercises, but also group water games and underwater massage.
A relatively new method of treating cerebral palsy is animal-assisted therapy. When communicating with animals, in particular horses or dolphins, brain structures are stimulated through vivid tactile sensations. As a result, speech and motor skills gradually expand.
The positive effect of animal therapy is always guaranteed, since both a favorable emotional atmosphere and special contact between the patient and the animal have healing powers. And when visiting the dolphinarium, the ultrasonic waves emanating from the dolphins provide a powerful effect. The power of such ultrasound on a person is hundreds of times greater than the capabilities of any medical device!
One of the options for animal-assisted therapy is communication with dogs. These animals serve as a powerful motivator for the development of fine motor skills, concentration, attention, memory and muscle strengthening.
In addition to hippo and dolphin therapy, canistherapy and feline therapy are used to treat children - treatment with dogs and cats. For children with cerebral palsy, communication with dogs significantly improves the course of the disease.
Traditional methods
Treatment of cerebral palsy with the help of folk remedies is auxiliary. Before such therapy, you should definitely consult your doctor.
The most popular alternative medicine for cerebral palsy are the following:
Massage
Massage sessions are prescribed for children from one and a half years old. There are many techniques, each of which helps to relax tense muscles and restore certain brain functions. To relax the muscles, a downward massage is used; during the procedure, peach or sunflower oil, lanolin or Anestezin are rubbed into the baby’s skin.
To achieve a decrease in muscle tone, you can use an electric vibrator or sound massage - simultaneously massaging the abdominal area and pronouncing hissing/growling sounds like “sh-sh-sh” or “r-r-r”. Muscle tone decreases if you put the child on a fitball (gymnastic ball) and roll him slightly. The baby can lie on the ball either on his back or on his stomach.
Depending on the form and severity of the disease, several types of massage can be used. Classic massage helps improve nutrition and oxygen saturation of muscle fibers, normalizes the functioning of the nervous system and muscle tone.
With the help of massage, you can also improve respiratory function, since in children with cerebral palsy the work of the diaphragmatic, intercostal, pectoralis major and minor muscles is impaired. To stimulate the development of the skeleton, the areas where the tubular bones are located are massaged, which allows for reflex irritation of the nerve endings and vessels responsible for trophism and growth of bone tissue. Particular attention is paid to the heels: the impact on this reflex zone specifically affects the entire musculoskeletal system.
With segmental massage, individual areas of the body are worked out. In this case, the back is massaged in the spine area, but the healing effect extends to the nerve tissue of the brain. Thanks to segmental massage, blood circulation and metabolic processes in the spinal cord improve.
Massage according to the Manakov system is active vibration pressure applied by the end phalanges of two or four fingers where nerve bundles, large vessels and soft tissues are located. The main objective of this massage is to stretch muscles, soft tissues and especially nerves - motor, sensory and sympathetic. It is equally important to reduce existing pathological compactions - fibrous adhesions and scars.
In the treatment of cerebral palsy, acupressure and cryomassage with liquid nitrogen are used, as well as speech therapy massage, which affects the facial muscles.
Standing machines for children with cerebral palsy
Therapeutic massage is indicated for those children who have:
- increased muscle tone;
- slow muscle growth;
- violation of lymph and blood flow;
- skeletal deformities – scoliosis, kyphosis, flat feet, clubfoot, etc.;
- hip dysplasia;
- torticollis;
- unsatisfactory general condition.
Causes
The formation of cerebral palsy is based on a hypoxic process, leading to disruption of the functioning of cells of the central nervous system. The human brain is one of the most sensitive structures to insufficient oxygen content in the blood serum. As a result of prolonged mild hypoxia or an acute short-term lack of oxygen, damage to the cortex and vital structures occurs. The causes leading to hypoxia are:
- Infectious process in the placenta and the fetus. The infection can enter through the mother's blood or from the cervix. The most common pathogens are any of the sexually transmitted infections; opportunistic flora are less commonly identified. The risk group includes women with inflammatory processes in the vagina, as well as pathologies of the urinary system.
- Intrauterine disruption of the formation of the cerebral cortex. Changes in the formation of the nervous system occur as a result of placental insufficiency, late toxicosis, and severe maternal anemia. Birth trauma. During the birth process, you can encounter the development of hypoxia with an increase in its duration, weakness of the pushing period, the formation of a clinically narrow pelvis, and the use of a vacuum extractor or obstetric forceps.
- Pathology on the mother's side. In this case, the most common pathologies are anemia, diabetes, and arterial hypertension.
- Fetal complications caused by Rhesus conflict. This may be long-term persistent jaundice with encephalopathy.
- Fetal intoxication, which can be caused by maternal alcohol or tobacco abuse, as well as drug use.
- Prematurity of the child. Premature birth is a powerful stressor on the fetus; cortical cells may not be sufficiently formed; in addition, a high probability of obstetric trauma is a pathogenic factor.
These options are relevant for the congenital variant of cerebral palsy. Acquired forms develop after an infection, accompanied by inflammation of the brain.
Treatment of cerebral palsy in adults
Many adult patients suffering from cerebral palsy are convinced that treatment is useless and believe that nothing will help them. However, this is not the case, and it is necessary to undergo rehabilitation courses. Yes, recovery is impossible, but with such a severe neurological pathology as cerebral palsy, it is very important to maintain the functions of the nervous system and preserve the skills and abilities that a person possesses.
Thanks to therapeutic measures, an adult can maintain working capacity and a decent quality of life for a long time.
Drug therapy for cerebral palsy in adults includes drugs such as Diazepam and Lioresal. Diazepam is prescribed for frequent seizures. Taking Diazepam and Lioresal together blocks the signals sent by the brain to contract muscles. Dantrolene helps strengthen control over voluntary muscle contractions.
Adult patients are also prescribed dehydrating drugs that increase diuresis and reduce the volume of metabolic products of cerebrospinal fluid (CSF). To improve cerebral circulation and rheological properties of blood, doctors prescribe Emoxipin. You can consolidate the achieved results with the help of physiotherapy, exercise therapy and massage procedures.
Myth 3: “Children with cerebral palsy cannot communicate”
In some cases, cerebral palsy is accompanied by speech and hearing impairments, but many patients do not have such problems - it is believed that 3/4 of people with this diagnosis can speak well. Those who have such difficulties can partially or completely overcome them with the help of a speech therapist.
In case of serious speech disorders, a specialist in alternative and complementary communication (ADC) will be able to select and teach different communication strategies using gestures, cards, computer programs, etc. We have such a specialist in our center, and each of his consultations is a real discovery for many parents .
Paralyzed and unable to speak: an i-tracker will help!
Myth 5: “Cerebral palsy affects everyone the same way”
Cerebral palsy is a collective term for a group of neurological diseases with a wide variety of symptoms. There are four main types of cerebral palsy:
- Spastic (pyramidal) - 70-80%
- Athetoid (extrapyramidal or dyskinetic) - 6%
- Ataxic - 6%
- Mixed
In this case, lesions can affect different parts of the body:
- Quadriplegia - all four limbs are affected. The muscles of the body's core, face and mouth may also be affected.
- Diplegia - both legs are affected, sometimes the arms are also affected, but to a much lesser extent
- Hemiplegia - one side of the body is affected (right or left)
One child with the spastic form may have impaired function in one limb, while another child with the same form of paralysis may have quadriplegia, affecting all four limbs.
Each child's needs and challenges are unique.
