Perinatal encephalopathy is a brain lesion having various causes and manifestations. This is a huge variety of symptoms and syndromes, manifestations and peculiarities: children with severe perinatal encephalopathy require special attention and obligatory observation of the doctor. Perinatal damages of this nature make up about half of the pathologies of the nervous system in children and often become the causes of epilepsy, cerebral palsy, brain dysfunction.
Perinatal posthypoxic encephalopathy
PPE( transient neonatal encephalopathy) implies the appearance of brain disorders of the child that originated before childbirth or in their process. The most important factors contributing to the emergence of PPE are birth trauma, neuroinfections, fetal intoxication and oxygen starvation.
Symptoms are also found in large newborns, premature infants and in case the baby was born with a cord. The diagnosis is indicated by high indexes of fetal weakness on the Apgar scale, the absence of a sucking reflex in children, a violation of the rhythm of the heart and constant nervous excitement.
The diagnosis "hypoxic-ischemic perinatal encephalopathy" is when there are multiple violations in the prenatal period. This leads to a pathology of supplying the fetal tissues with oxygen, but the brain is primarily affected.
Insomnia during pregnancy can adversely affect the mental state of the mother and, as a consequence, the development of the unborn child.
Also can remind of itself and cervicothoracic osteochondrosis and obd. Read more about this.
Perinatal encephalopathy in newborns
Immediately after childbirth, a child with brain damage attracts attention with restless behavior, frequent spontaneous flinching and regurgitation, excessive lethargy and stiffness, increased reactions to sound and light.
Head torsion with unrestrained crying, poor thermoregulation, disturbed sleep often pass during the first week of life. The syndrome of CNS depression in newborns is manifested in the form of lethargy, inhibition, often there is a different muscle tone, leading to asymmetry of the body and facial features.
Types of encephalopathy in children
- Residual form of of brain damage is diagnosed if, in the presence of previously acquired birth injuries, the child suffers infections, inflammation, as well as with poor blood supply to the brain. Such children suffer from a headache, there are often problems with the psyche, a decrease in intelligence, difficulties with learning.
- Discirculatory encephalopathy - damage to brain tissue caused by blood flow disorders. The causes are osteochondrosis, hypertension, increased intracranial pressure, dystonia.
- Ischemic encephalopathy is expressed in poor blood supply to the brain and destructive processes occurring in certain foci of tissues. To this diagnosis lead to excessive smoking, stress and alcohol abuse.
- Toxic encephalopathy is the result of poisoning of the brain with poisonous substances in infections, poisoning with chemicals and alcohol. Severe poisoning of the brain tissue leads to the appearance of epileptic seizures.
- Radiation encephalopathy appears as a result of exposure to ionizing radiation on the brain of patients.
- The mixed genesis of is characterized by the presence of extensive complaints and symptoms, it is only the doctor who can diagnose correctly on the basis of analyzes and brain studies.
Degrees of gravity
During PE it is customary to allocate several periods.
Acute is the period after birth and before the 1st month of life. Up to a year or two the recovery period lasts. Then follows the outcome of the disease.
Each period is characterized by a special course and the presence of various syndromes, sometimes a combination of manifestations is noted.
Even mild manifestations of brain disorders should be carefully monitored - untreated disorders are fraught with developmental delays and unfavorable outcomes. When the severity of brain damage is severe or medium severe, qualified inpatient treatment is necessary.
Mild disorders can be treated on an outpatient basis under the supervision of a neurologist.
Video on which Dr. Komarovsky speaks about the difference between perinatal encephalopathy and normal physiological reflexes of newborns:
Causes of perinatal encephalopathy
Risk factors of that contribute to the emergence of this group of brain lesions:
- Presence of chronic diseases of the mother;
- Power failure;
- Admission by the mother of alcohol and smoking;
- Autoimmune conflict;
- Postponed infectious diseases during pregnancy;
- Borderline age of the mother in childbirth;
- Stress;
- Pathology in pregnancy and childbirth( toxicosis, rapid delivery, trauma at birth);
- Fetal prematurity;
- Unfavorable ecological situation.
Symptoms of the disease
- Continuous crying;
- Frequent regurgitation;
- Exposure of limbs;
- Restless sleep at night and a brief sleep during the day;
- Lethargy or hyperactivity;
- Inadequate response to light and sound stimuli;
- Absence of sucking reflexes;
- Violations of muscle tone.
These and many other symptoms need careful study by the attending physician.
At a later age, the child is often in a bad mood, absent-minded, sensitive to weather changes, the difficulty of getting used to children's institutions.
In combination with perinatal encephalopathy, neonatal tremors can also be diagnosed. This article will help to understand whether it is dangerous.
Sometimes the cause of encephalopathy may be dropsy of the brain in the fetus, you can read about it here.
Cervical osteochondrosis can cause dizziness and nausea. For more information, see the link http: //gidmed.com/ bolezni-nevrologii /golovokruzhenie/ golovokruzhenie-pri-osteohondroze.html.
The main syndromes of perinatal encephalopathy
- Hypertension-hydrocephalic syndrome is manifested by the presence of an excess amount of fluid inside the brain, this leads to a change in intracranial pressure. The diagnosis is based on observation of the size of the head and the condition of the large fontanel. Also, the manifestations of the syndrome - restless sleep, monotonous crying, increased pulsation of the fontanel.
- Syndrome of increased excitability more often makes itself felt increased motor activity, problems with falling asleep and sleeping, frequent crying, lowering the threshold of convulsive readiness, increased muscle tone.
- The convulsive syndrome is known as epileptic and is characterized by a variety of forms. It is paroxysmal movements of the body, trembling, twitching and cramping of limbs.
- Comatose syndrome manifests itself as pronounced lethargy, decreased motor activity, suppression of vital functions, lack of suction and swallowing reflexes.
- The syndrome of vegetative-visceral dysfunction is expressed by increased nervous excitability, frequent regurgitation, digestive disorders, enteritis, stool disorder, abnormal skin condition.
- The movement disorder syndrome manifests itself in the direction of reducing or increasing the muscle tone, which is often combined with developmental disorders, making it difficult to master speech.
- Children's cerebral palsy has a complex structure: it is a violation of fine motor skills, lesions of the limbs, speech dysfunction, visual impairment, mental retardation and reduced ability to learn and social adaptation.
- The hyperactivity syndrome is expressed in reduced ability of children to concentrate and attention disorders.
Diagnosis
The diagnosis is based on clinical data and information about the course of pregnancy and childbirth. The following modern and effective methods are used for diagnosis.
- Neurosonography reveals intracranial brain damage.
- Dopplerography studies the magnitude of blood flow in the brain tissues.
- Electroencephalogram, recording the electrical potentials of the brain, allows you to determine the presence of epilepsy, delay in age development at different stages.
- Video monitoring helps to assess the characteristics of the motor activity of children based on video recording.
- Electroneuromyography makes it possible to study the sensitivity of peripheral nerve fibers.
- Use available types of tomography to assess structural changes in the brain.
Most often, objective information about the disease is obtained with neurosonography and electroencephalography. Sometimes appoint an examination of the oculist, which examines the fundus and the state of the optic nerves, reveals genetic diseases.
Treatment of encephalopathy in children
If symptoms are mild or moderate, doctors leave the child at home for treatment, give advice to parents on maintaining the condition.
But severe lesions of the nervous system and acute period require in-patient treatment. In any case, it is necessary to choose an individual regimen, massage, exercise therapy, methods of phytotherapy and the intake of homeopathic remedies.
Medication treatment
When prescribing treatment, the severity of the diagnosis is taken into account. To improve the blood supply to the brain, the newborn is prescribed piracetam, actovegin, vinpocentin.
- With pronounced motor dysfunctions, the emphasis is on dibazole and galantamine preparations, with increased tone prescribed baclofen or midocals. For the introduction of drugs, various variants of oral administration and the method of electrophoresis are used. Also shown are massages, physiotherapy, daily exercises with the child with special exercises.
- When epileptic syndrome shows the reception of anticonvulsants in doses recommended by a doctor. Anticonvulsants are prescribed for serious indications and severe epilepsy. Methods of physiotherapy for children with such a syndrome are contraindicated.
- In cases of psychomotor development disorders, drugs prescribed to stimulate brain activity and improve cerebral blood flow are prescribed: nootropil, actovegin, cortexin, pantogam, vinpocetine and others.
- In hypertensive-hydrocephalic syndromes, based on the severity of symptoms, appropriate medication is prescribed. In mild cases, the reception of phytopreparations( decoctions of bearberry and horsetail) is shown, in more complicated cases diakarb is used, increasing the outflow of the lycor.
For particularly severe patients, the rational use of methods of neurosurgical therapy. Also used hemodialysis, reflexology, lung ventilation, parenteral nutrition. Children with PEP syndromes are often prescribed vitamins of group "B".
You should definitely consult a doctor if intracranial pressure is found in the baby. It must be treated.
Because subsequently it can signal a disease such as cerebral encephalitis. More information about the features of the disease can be found here.
Treatment at home
Children with perinatal encephalopathy are important from the first days of life to pay increased attention. Parents should be attuned to the need to introduce hardening, massage, swimming, air baths.
Therapeutic massage and special gymnastics improve the tone of the body, develop the motor functions of the hands, train and strengthen the health of the baby. If a child is diagnosed with asymmetry of muscle tone, therapeutic massage is irreplaceable.
It is necessary to take vitamin complexes , you should allocate enough time for walking outdoors, classes and exercises. We also need a balanced diet and a calm, balanced environment in the house, a lack of stress and a sharp change in the regime of the day.
The more quality a child is treated, the more attention is paid to such children from birth and in the first years of life - the less is the risk of severe consequences of brain damage.
Consequences and possible predictions of
The most common consequences of perinatal encephalopathy can be: delayed child development, brain dysfunction( expressed in the absence of attention, poor learning ability), various internal organs dysfunction, epilepsy and hydrocephalus. There can be a vegeto-vascular dystonia.
Completely recuperating about a third of children.
Observance of a woman's day regimen, rules of behavior during pregnancy and personal hygiene, abstention from smoking and alcohol can reduce the risk of brain damage in newborns.
Adequately conducted labor, qualified medical care and supervision of a neurologist, timely diagnosis and treatment reduce the risk of the occurrence of the effects of perinatal encephalopathy.
Perinatal encephalopathy and whether it can be cured: