What Is Spastic Diplegia Cerebral Palsy?

Spastic cerebral palsy (hereinafter referred to as cerebral palsy) is cerebral palsy, which refers to movement and posture disturbances caused by non-progressive damage caused by immature brain development under various causes. Its incidence increases with the improvement of prenatal care, socioeconomic conditions, the environment, and obstetric and pediatric care received by mothers and babies.

Causes of Spastic Cerebral Palsy

Cerebral palsy can be caused by various causes before, during, and after childbirth. Prenatal refers to the period from pregnancy to childbirth, perinatal refers to the period from the beginning of childbirth to the delivery of the baby, and postnatal refers to the period from childbirth to 2.5 to 3 years after childbirth. Some babies have fully developed brains and myelin sheath formation can reach the age of 8 years. The vast majority of cerebral palsy occurs in labor.

Spastic cerebral palsy typing

1. Classification by clinical manifestations

(1) Spastic cerebral palsy is the most common. The Brodman IV and VI regions of the brain are the origins of the pyramidal tract. The lesions in these two regions are commonly known as the pyramidal tract disease and usually cause spasms. Spasticity is a condition in which muscle tension increases when the muscle is passively stretched. This is due to the strengthening of normal muscle stretch reflexes. In enhanced stretch reflexes, resistance can be felt when muscles are suddenly and passively moved, and then muscles relax to a certain extent. When muscles are stretched, an increase in the state of spasticity will cause excessive contraction of the muscles. Hypertonic reflexes in spastic muscles can present with myoclonus, suggesting an increased response to drafting.

(2) Hand- foot movement type Hand - foot movement type is the most common form of dyskinesia. The damage caused by dyskinesia is in the base of the brain or in the midbrain, which often affects the entire body, and rarely sees a limb's movement disorder. Patients are often accompanied by facial and muscle-controlling muscle lesions, which are manifested by persistent painful facial expressions, drooling, and difficulty speaking, leading people to mistakenly think that these people are unresponsive, and in fact many patients have normal intelligence.

(3) Stiff type A manifestation of extensive brain damage in stiff cerebral palsy. The clinical manifestation of stiff type of cerebral palsy is loss of muscle elasticity. When attempting to stretch the muscles, the examiner noticed that the patient's muscles were stiff from the beginning to the end of the passive movement of the joint. The passive movement of the joint can increase the stretch reflex. In the stiff type of cerebral palsy, the patient's muscle rigidity can be intermittent or persistent. Due to diffuse damage to brain tissue, the incidence of mental disorders is quite high.

(4) Ataxia type Ataxia type is a clinical manifestation of cerebellar injury. Most of the damage caused by cerebellar lesions is congenital, and occasionally due to bleeding during childbirth. Ataxia is caused by impaired sense of movement and spatial positioning, and it is impossible to distinguish afferent impulses. Ataxia is mainly a loss of sense of position, posture, and balance, and children may have the habit of incomplete fixation with the hand. Typical patients with ataxia have a better prognosis than patients with other types of cerebral palsy, and their symptoms tend to improve spontaneously over time.

(5) Mixed type Damage from several areas of the brain exists simultaneously, but not diffusely. Patients show mixed symptoms of several types, such as a mixture of spastic and ataxia.

2. Typing by disease site

(1) Monoplegia No matter the upper limb or the lower limb, only one limb is affected, which is a rare type. Before making a diagnosis, the examiner must carefully assess the condition of the other limbs.

(2) Hemiplegia Ipsilateral limb involvement. These patients are usually spastic and the upper limbs are usually more severe than the lower limbs.

(3) Paraplegia is often accompanied by premature delivery. Paraplegia is mostly spastic and manifests as scissors gait or cross gait.

(4) Triplegia Three of the four limbs are involved. The most common is spastic paralysis, which is a relatively rare movement disorder. Before determining the three limbs to be paralyzed, one of the uninvolved limbs needs to be carefully evaluated.

(5) Tetraplegia. Brain damage and invasion of limbs. Limbs can show spasticity, dyskinesias, or mixed types.

3. Classified by muscle tension level and severity

Cerebral palsy can be classified according to its muscle tone and severity of damage. Muscle tension can be high, low, or normal. Muscle tone is variable and can change over time. Cerebral palsy children with hand, foot, and movement syndromes are born with low tension, but gradually become high tension with age. On the other hand, ataxia children are born with low tension and remain unchanged.

The severity of the damage can be mild, moderate or severe. Mildly affected patients can get up and walk, and can perform daily activities independently. Some patients do not require any surgical treatment. Conservative treatments such as fine movement training, vocational training, special education and speech training are necessary. Moderate damage accounts for half, and help is needed to get up and walk and daily life. Severely impaired patients are completely incapacitated, usually bedridden or dependent on a wheelchair. Because it is impossible to improve the patient's mobility, the purpose of treatment is to improve their mobility, not to get up and walk.

Clinical manifestations of spastic cerebral palsy

1. Reduced limb flexibility and joint stiffness.

2. Insufficient muscle strength.

3. Hypertension of the tendon.

4. Strong resistance when muscles are stretched.

5. Frequently too strong flexor reflexes.

Spastic muscles are active muscles and antagonist muscles that contract too strongly at the same time, or antagonistic muscles with high muscle tone that inhibit active muscles from functioning. Spastic cerebral palsy is divided into quadriplegia, triplegia, paraplegia, hemiplegia, uniplegia, double paralysis, bilateral hemiplegia and other types according to the physical obstacle. The quadriplegic type obviously cannot develop normally with age from infancy, and sits up and relaxes. Hemiplegia type invasion and upper and lower limbs, sometimes the upper limbs are heavier than the lower limbs. Paraplegic type invades both lower limbs. If the adductor spasm is severe, it is manifested as a cross-shaped deformity of the lower limbs of the patient who lifts up, and scissors gait in the walkable patient. Achilles tendon contracture will appear pointed foot deformity, combined with posterior tibial muscle contracture will be manifested as horseshoe eversion foot deformity, the heel can not land when walking or standing.

Spastic cerebral palsy

No related auxiliary inspection.

Diagnosis of spastic cerebral palsy

The diagnosis of spastic cerebral palsy is as follows:

1. Hypertension reflex, increased muscle tone, hypertenon reflex, positive ankle clonus, positive Pap syndrome, restricted limb movement.

2. Sagging and varus of both feet, toes touching the ground, can not step on the soles of the feet, walking in a scissors-like gait, the pace is small, walking with the toes, can not run.

3. The upper limbs are flexed and adducted by the elbow, the elbows and wrists are flexed, the thumb and thumb are adducted, and they are firmly clasped in the palm. Both upper limbs were awkward, stiff, and uncoordinated. Both lower limbs are stiff, the adduction is cross-shaped, the hip is rotated internally, and the ankle is plantar flexion. When helping the station.

Diagnosis of spastic cerebral palsy

The diagnosis of spastic cerebral palsy is as follows:

1. Hypertension reflex, increased muscle tone, hypertenon reflex, positive ankle clonus, positive Pap syndrome, restricted limb movement.

2. Sagging and varus of both feet, toes touching the ground, can not step on the soles of the feet, walking in a scissors-like gait, the pace is small, walking with the toes, can not run.

Diagnosis of spastic cerebral palsy

The diagnosis of spastic cerebral palsy is as follows:

1. Hypertension reflex, increased muscle tone, hypertenon reflex, positive ankle clonus, positive Pap syndrome, restricted limb movement.

2. Sagging and varus of both feet, toes touching the ground, can not step on the soles of the feet, walking in a scissors-like gait, the pace is small, walking with the toes, can not run.

Spastic Cerebral Palsy Treatment

Drug therapy

Brain neurotrophic drugs, muscle relaxants, blood circulation drugs, etc. Including drugs that build and repair brain tissues (cells), such as lecithin (including phosphatidylcholine, cerebral phospholipid, sphingomyelin, etc.), can repair brain cell membrane damage caused by trauma, bleeding, and hypoxia, protect nerve cells, and accelerate Nerve excitation conduction, improve learning and memory function.

2. Comprehensive rehabilitation medicine

Such as sports (sports) therapy, including coarse exercise, fine exercise, balance and coordination training; such as crawling, purposeful identification (nose, ear, etc.), training grips, holding objects, sitting up, swinging, walking (back Leaning against the wall, facing the wall), in-situ exercise (bend over to pick up objects, train your feet, stand on one foot, take off in place), walk, run; physical therapy, including electrical nerve stimulation therapy, thermotherapy, hydrotherapy There is also occupational therapy, that is, ability training. Now this kind of specialized hospital or clinic is also available in the city. Families with good economic conditions can choose, but the effect is average.

3.BC-Brain Cell Interventional Repair Therapy

The development of "BC-Brain Cell Interventional Repair Therapy" is based on molecular genetics, cytopathology, nanopharmacology, biophysics, molecular immunology, medical psychology, and other disciplines to comprehensively treat the basics of cerebral palsy. , Is a central nerve regeneration therapy.

Prognosis of spastic cerebral palsy

Postoperatively, the patient's limbs are weak and muscle exercises are needed. The bad gait that has been formed in patients with cerebral palsy for a long time needs to be gradually corrected. Mildly contracted tendons can be improved by passive exercise combined with active exercises. Those who have the condition after surgery should still be treated with acupuncture and massage to further improve the treatment effect. Patients should be followed up every 0.5 to 1 year after surgery to provide rehabilitation guidance.

1. Training purpose of spastic cerebral palsy

For children with this type of cerebral palsy, the purpose of exercise training is to promote muscle and joint activity, stretch contracture tendons and ligaments, relax muscle spasms, prevent muscle atrophy, reduce muscle tension, improve body rotation ability, and promote children's hip extension and external limbs The emergence of exhibition and external rotation postures, the emergence of separation movements and interactive movements, the improvement of supporting movements and the improvement of balance and coordination.

2. Cerebral Palsy Rehabilitation Training

(1) Head control can use the prone position to train the ability to raise your head. Method: Let the child lie on his back, take a toy and park it at a level as high as his eyes. In order for the child to look up at it, raise it little by little. . Prone at least 30 minutes a day, about 10 minutes after a meal is most suitable.

(2) Turn over and crawl Let the child lie on the floor, pull his clothes from behind to help him turn his shoulders to turn over; let him lie on his back, put a bath towel on his chest, lift the two ends of the anti-bath towel, and keep only his hands With your knees on the ground, you encourage him while walking slowly along the floor with him; one person helps him move his arms, and the other person helps him move his feet alternately, helping him climb hard towards a certain target.

(3) Support the back to maintain a sitting position Sit up under the support of one's arm, put its favorite items in front of the attention, so as to maintain a longer sitting position, gradually reduce support, and finally sit alone.

(4) Pulling up, the adult can pull one hand of the cerebral palsy to induce him to move from the sitting position to his legs in a kneeling position, and then let him stand up. When the child grabs the crib railing, the parent stands with his hands under his arm support and gradually reduces the help to keep him balanced.

(5) The key to walking with cerebral palsy children is to learn to move the body's center of gravity, start to pull their hands forward, gradually pull one hand over, and finally reach their own alone; also use a toddler sling.

(6) Ascending and descending the stairs began to let the child hold the railing in one hand and the adult hand to maintain balance, and gradually let him out of the support of the adult, relying on the strength of his arms and legs, two steps and one step up and down the stairs. Older children need to encourage him to step up and down the stairs step by step, so that he can practice with music.

(7) Jump Jump is an important item for training the lower thigh muscles. Practice squats to prepare for jumping. Children often pull their hands off the steps to prepare for the explosive power of self-jumping. Hang some bright gauze and small toys indoors (based on the above two trainings) to let several children jump together to touch and pat. .

(8) Balance and coordination training Select an obstacle-free field or room, and under the protection of adults, let the children close their eyes and walk straight, take footprints, go straight, ride a rocking horse, swing, ride a tricycle, pat the ball, catch the ball, Rolling on the ground is a great way to practise balance and coordination.

(9) Fine motion training is mainly to train the coordination ability of the hand and the brain to improve the children's ability to operate and the flexibility of the hand. The training methods mainly include grasping, pinching, grasping objects or toys. To choose objects suitable for children to play, gradually change from square, rectangular to circular. At the age of five or six, patients were taught to learn how to screw bottle caps, wind toys, build blocks, hold pens, write pictures, etc., and lay the foundation for future school readings and improved living skills.

Spastic Cerebral Palsy Prevention

1. Before the child is born

(1) Pregnant women should actively carry out early prenatal check-ups and do perinatal care to prevent fetal congenital diseases;

(2) quit bad habits, such as smoking and drinking, and do not abuse drugs such as narcotics and sedatives;

(3) Prevention of viral infections such as influenza and rubella, without contact with cats and dogs;

(4) Avoid contact with harmful and toxic substances such as radiation and frequent B-ultrasound.

2. When the fetus is born, that is, during childbirth.

Fetal asphyxia and intracranial hemorrhage caused by childbirth are an important cause of cerebral palsy in children. Premature and dystocia should be prevented. Medical personnel should carefully and carefully handle all aspects of childbirth, and do a good job of handling difficult fetuses.

3. Within one month after birth

It is necessary to strengthen nursing, rational feeding, and prevent intracranial infection and brain trauma.

4 Pregnant women who:

(1) Older pregnant women (over 35 years old) or man over 50 years old;

(2) Close relatives get married;

(3) History of miscarriages, premature births, stillbirths and neonatal deaths for unknown reasons;

(4) Pregnant women with mental retardation or close relatives of both parties have a history of epilepsy, cerebral palsy and other genetic diseases. If a fetal abnormality is detected early in pregnancy, the pregnancy should be terminated as soon as possible.