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ICP: forewarned is forearmed

Date of publication: 23 December 2019
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The diagnosis of infantile cerebral paralysis for all parents sounds like a verdict: they don't want to believe it. However, with the right attitude to the disease, it is possible to prevent many consequences and help the child maintain the same lifestyle as everyone else.
Infantile cerebral paralysis is a lesion of the areas of the brain responsible for controlling the motor functions of muscles. Most often complaints are as follows: the child does not hold his head, does not sit, does not turn over, does not stand, does not speak according to the age.

Causes of ICP

In the development of cerebral paralysis, the leading role is played by harmful factors affecting the child’s brain during intrauterine development, in the process and after childbirth. The statistics are as follows: out of 100 cases of infantile cerebral paralysis, 30 cases occur prenatally, 60 - occur during childbirth, and 10 occur after childbirth.
 

Embryofoetal development
 

The main negative factors that cause the pathological development of the fetal brain in utero:
 
- Infectious diseases of the mother: rubella, cytomegaly, toxoplasmosis and other viral infections.
 
-  Cardiovascular and endocrine disorders in the mother.
- Toxicosis of pregnancy.
 
-  Immunological incompatibility of maternal and fetal blood.
 
- Emotional shock in the period of pregnancy.
 
- Administration of certain medicines by the mother.
 
- Premature birth.

As a rule, ICP occurs as a result of an impact of a complex of several harmful factors acting at different stages of fetal development.

At the early stages of embryofetal development, the brain reacts differently to harmful factors than the brain in the formed fetus. Depending on the phase of development at which the brain was affected by the pathological process, various abnormalities and defects may appear.
 

Causes of ICP development in the process of childbirth:

- Hypoxia - oxygen deficit of the fetus in childbirth.
 
-  Incorrectly chosen method of labor and obstetric aid.
 
-  Birth injuries and dangerous interventions in the delivery process: puncturing of the fetal bladder, stimulation of contractions, mechanical pulling of the fetus or forcing the fetus away. These manipulations are resorted to strictly according to indications being a forced measure and often lead to the development of complications.
 

ICP after childbirth

In the first months of life, it is not always possible to notice ICP in a child. For this purpose, there is a patronage of infants up to 1 year of life and a consultation of pediatric specialists.
 
The main symptoms of the risk of ICP in the 1st 6 months of life:
 
- High or low muscle tone.

-  Delayed development of statics and motor skills.

-  Long-term preservation of spinal automatism reflexes. For example, the grasping reflex should gradually fade by 6-7 months.
 
- The presence of reflex-forbidding positions and tonic stem reflexes. In the position on the stomach - the head is pressed against the chest, the arms and legs are bent at all joints, the arms are pressed against the chest, the legs are pulled up to the stomach, the pelvis is raised. Such a position slows down the development of motor skills, the child cannot raise his head, lean on his hands, bend his back.



It is easier to recognize ICP in children after 1 year of life. Nevertheless, the earlier the disease is diagnosed and treatment is started, the more effective the results are.
 
The diagnosis can be recognized by the following symptoms:
 
- Spasticity - uncontrolled muscle tone.

-  Hyperkinesis - pathological sudden involuntary movements in one muscle or in an entire muscle group at the wrong command of the brain.

-  Ataxia - a disruption in the coordination of movements of various muscles.

-  Pathological postures – these can be manifested in the form of throwing back the head, squeezing the hands into fists, crossing the legs, equinus - walking on tiptoes stepping only on the toes, and not on the entire foot.

-  Mental retardation is frequently observed.

Depending on the severity of motor disorders, 5 types of ICP are singled out. 

Types of ICP:

Spastic tetraplegia is the most severe form when excessive muscle strain does not allow the patient to control either his arms or legs. Involuntary efforts often cause discomfort and severe pain.

Spastic diplegia is a form in which the upper or lower extremities are severely affected. A person walks with bent knees. The defect of the upper extremities and speech is called Little’s disease, in this case the legs are not affected. The consequences of spastic diplegia are observed in 40% of patients with ICP.

Hemiplegic form is a polar disorder, in this form the motor functions of the limbs are impaired only on the left or only on the right side of the body. In 32% of patients its signs are observed.
 
Dyskinetic or hyperkinetic form. It is manifested in strong involuntary movements - hyperkinesis - in all limbs, facial and neck muscles. Hyperkinesis is often found in other forms of ICP.

The ataxic form is characterized by reduced muscle tone, sluggish slow movements, and severe imbalance. It is observed in 15% of patients.

How to arrange the life of the child with ICP

Fortunately, at present there are all conditions for the development and socialization of children with ICP. They study in special schools, can get higher education, find jobs and start families. Of course, this is a great merit of the parents, who did not despair on learning the diagnosis, but daily trained the child with the help of specialists.
 
The disease is incurable, but certain defects can be corrected and the condition can be relieved, especially in the period between 12 and 18 years, when muscles and joints do not keep up with the rapid development of the skeleton and changes in the body.

 
Massage, therapy, exercise therapy aimed at straightening the legs and arms, turning the head, development of coordination of movements, will help prevent defects in muscle development.
 
It is important not to forget about the spiritual aspect. Developed intelligence will facilitate the socialization of the child. There are many examples in the world when people with ICP led an active social life, functioned in society no worse than healthy people, and maybe even better.
 
If the patient himself does not focus on his diagnosis, then others perceive him as a healthy person. This idea, according to psychologists working with parents of such children, should be instilled in a special child since childhood, not allowing feelings of pity, but surrounding the child with attention, care and love.
 

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