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In cerebral palsy, rehabilitation started before the child is 6 months old brings the best results. The problem, however, is that the visible symptoms of the disease are only visible in a six-month-old toddler. So, neurologists recommend that parents be extremely vigilant. Early rehabilitation may protect against disability.
– Parents should be as vigilant as doctors – believes prof. Sergiusz Jóźwiak, national consultant in the field of pediatric neurology, head of the neurology clinic at the Children’s Memorial Health Institute. – Often it is up to mum and dad to decide whether the child’s disease is diagnosed early, and this is a condition for its cure – she adds.
Cerebral hypoxia
The cause of cerebral palsy (CP) is hypoxia in the child’s brain in utero or during or immediately after delivery. It may be caused by diseases of the mother, fetus, and injuries during pregnancy. It can also be caused by meningitis early in a child’s life. As a result of brain hypoxia, it is damaged, which may result in limb paresis, lack of motor coordination, mental retardation, difficulties with speaking, seeing or hearing. Cerebral Palsy is diagnosed in two infants out of a thousand.
Rehabilitation in cerebral palsy
Many pediatricians believe that you should not rush to diagnose a newborn baby because it is easy to make a mistake at such an early age. And such a mistake can be a tremendous drama for parents.
Prof. Jóźwiak is of a different opinion. He believes that early rehabilitation will not hurt, but may protect the child from disability. – A rehabilitation lasting several dozen days, started in the third month of a child’s life, will bring better results than a several-month rehabilitation started in the 3th month of life – explains the neurologist. – If a small patient with CP does not undergo rehabilitation and lies still until the age of 9 months, he may never start to walk. On the other hand, early rehabilitation may prevent a six-month-old child from having any visible signs of a motor disability, he explains. She adds that delayed physical rehabilitation affects the cognitive development of an infant. The child learns the world through observation and touch. If he lies still, his mind does not develop.
Diagnosing cerebral palsy
If the baby has a low AGPAR score of less than 7 at birth, it should be consulted by a neurologist after leaving the hospital. It happens, however, that despite a good score, a child shows features of PP. – Then the observation by parents is the best diagnostic tool – says prof. Sergiusz Jóźwiak. If, after the first five days of life, it is difficult for your baby to wake up to feeding, you should be vigilant. Any movement asymmetry, tilting to one side, tilting the head back, no sucking reflex, or restless sleep – should worry parents. A neurological consultation is also required for all the time clenching fists and keeping the thumb inside the hand, lasting longer than 4 months. – If in the fourth month the baby’s legs are still straightened and turned inwards, and the toes of the feet are taut and shrunken, you need to tell the doctor about it – advises prof. Jóźwiak.
Magnetic resonance imaging
To evaluate the changes caused by hypoxia in the brain, a neurologist may do a transthiaema ultrasound. – Sometimes, however, the problem is that as a result of taking vitamin D by pregnant women, and also by children immediately after birth, the crown grows faster, even as early as 3 months of age. Without vitamin support, it happens between 6 and 18 months of age. And if the crowns become overgrown, the ultrasound will show nothing – explains Prof. Jóźwiak. Cerebral palsy is also diagnosed by examining the child’s brain using magnetic resonance imaging. – The difficulty is that the child must be put down for such an examination. Moreover, it is an expensive examination.
Rehabilitation exercises
If a neurologist orders rehabilitation, parents must seek the help of a physical therapist who will teach them appropriate exercises. You have to do them every day, preferably three times a day for half an hour. Often, sausage venom can help in rehabilitation. Botulinum toxin eliminates contractures of a child’s hands or legs. Injected into the appropriate part of the muscle, the child can move the previously contracted and immobile limbs. Since botulinum toxin only works temporarily, it does not solve the problem. However, it allows for intensive physical rehabilitation of a previously immobilized child.
Sometimes, brain hypoxia causes so much brain damage that a child will remain disabled for the rest of his life. Then rehabilitation is carried out throughout life.
Text: Halina Pilonis
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