What is cerebral palsy? The main causes of cerebral palsy and its classification
1. What is cerebral palsy?
Due to damage to one or more parts of the brain, the patient cannot move the muscles normally. In addition to affecting movement, many cases of children with cerebral palsy are accompanied by other disabling conditions that need to be treated such as: mental retardation, learning disorders, epilepsy, behavioral changes. , vision, hearing, and language problems. The rate of cerebral palsy is about 2/1000 newborns, the disease has a higher incidence in boys than girls (1.35/1).
2. Causes of cerebral palsy
There are many causes of cerebral palsy in children, divided into 3 main groups as follows:
2.1 Prenatal causes
2.1.1 Infections during pregnancy
2.1.2 Lack of oxygen in the fetal brain
2.1.3 Other causes and abnormalities
Children with structural abnormalities of the nervous system also have an increased risk of developing cerebral palsy.
Mother's disease: Thyroid disease, gestational diabetes, pregnancy toxicity, pre-eclampsia ....
Heredity: Family factors.
Using drugs without consulting a doctor during pregnancy, exposed to harmful chemicals during pregnancy.
2.2 Causes during childbirth
2.2.1 Premature birth, low birth weight
Preterm birth is a baby born before 37 weeks of gestation from the first day of the last menstrual period before pregnancy. Babies born prematurely, especially before 32 weeks and especially before 28 weeks of gestation, have a very high risk of cerebral palsy. The reason is that premature babies are at very high risk of cerebral hemorrhage, cerebral edema causing damage to the developing delicate tissues of the brain or causing brain damage in the form of periventricular leukoplakia. Low birth weight: One study found that premature babies with a birth weight less than 1,500 grams were 30 times more likely to have cerebral palsy than full-term babies.
2.2.2 Asphyxiation during labor and birth
2.2.3 Obstetric Trauma
2.3 Causes after giving birth
2.3.1 Brain hemorrhage
Cerebral hemorrhage in newborns and brain hemorrhages in young children due to vitamin K deficiency are common diseases in developing countries like Vietnam, if not treated well, can cause sequelae of cerebral palsy. Other blood diseases leading to clotting disorders are also contributing factors to the increased risk of cerebral hemorrhage in children, leading to cerebral palsy.
2.3.2 Yellow skin
When blood bilirubin levels are high, the liver is not able to metabolize and excrete due to immature liver function in newborns, which will cause pathological jaundice. In this case, the elevated bilirubin in the blood can cross the vascular-brain barrier and settle mainly in the basal nuclei of the brain (hence the name nuclear jaundice) and damage the structures of the brain. This causes cerebral palsy.
Children with pathological jaundice are common in children with mother-child blood group incompatibility (blood group ABO, Rh, and subgroup...). Manifestations in children are dark yellow skin and whole body, yellow sclera of the eyes. If not monitored and treated promptly, the baby may appear to stop sucking, cyanosis and extensor limb stiffness (signs of brain damage).
2.3.3 Postpartum hypoglycemia
2.3.4 Acquired cerebral palsy
3. Classification of cerebral palsy according to clinical type
3.1 Spastic cerebral palsy
Spasticity of the lower extremities The child has obvious spasticity in the lower extremities. In this form, due to the contraction of the adductor thigh muscles, the child's legs are always pulled inward, causing the child to have a very characteristic cross-legged gait.
Spastic hemiparesis Often manifests as spastic paralysis on one side (right or left). Often the upper extremities are more severely affected than the lower extremities.
Spastic quadriplegia Patients in this group present with spastic paralysis of both upper and lower extremities along with the trunk axial muscles. Even the muscles of the face are affected, making the child very disabled.
3.2 Cerebral palsy with dance or agitation
3.3 Cerebral palsy ataxia
Ataxia accounts for about 6%. In this form, postural balance and coordination are affected, the child has difficulty controlling the wobbly gait, the lumbar region, or swinging. Poor motor coordination makes it difficult for children to perform movements that require rhythm, such as clapping their hands to the beat or writing letters.
3.4 Combined cerebral palsy
Mild cerebral palsy Moderate severe Cerebral palsy Severe cerebral palsy
4. Early detection signs of children with cerebral palsy
When born, do not cry immediately or cry weakly. After giving birth, they are usually soft and do not move. Head drooping, unable to lift.
Difficulty holding, bathing, changing clothes for children because young people are stiff Convulsions: unconsciousness, foaming at the mouth Slow to hold head and neck, slow to roll, sit, crawl... Has a disability in using a table Inner hand grasps and performs activities Doesn't recognize mother or loved ones, slows early communication skills Doesn't turn head to respond to sounds, colored toys, doesn't look mother, loved ones Don't know listens to conversation, shows affection, does not turn head to sound Does not show facial expressions, does not use eyes to show pleasure Sucking, sucking difficulty, or choking on milk Or drooling, wheezing, increased nasopharyngeal secretions. .. There are superficial sensory disturbances such as heat, cold, pain Other manifestations: Cross-eyed, drooping eyelids, decrease, loss of vision, hearing loss, mouth distortion... Cerebral palsy is a complex disease, Due to many causes, diverse disease forms, treatment is still difficult. Understanding the causes of diseases helps us to take proactive preventive measures, and at the same time, early detection and timely intervention.
Vinmec Times City International General Hospital has applied stem cell method to successfully treat many cases of cerebral palsy that seemed to have lost all hope. The whole process of stem cell transplantation for cerebral palsy at Vinmec is performed very closely, ensuring safety in accordance with international standards. All surgeries are performed by leading experts and doctors with modern machinery and medical equipment.
In addition, Vinmec has also developed a standard transplant procedure so that it can share experiences with colleagues, creating more opportunities for treatment for children with cerebral palsy across the country.
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