Consequences of organic lesions of the central nervous system in the perinatal period. What is perinatal CNS damage? Methods of laboratory diagnostics of perinatal lesions of the nervous system in children

Recently, more and more newborns are diagnosed with "perinatal lesions of the central nervous system". What are these pathologies and how dangerous are they?

Malysheva Oksana Nikolaevna, a pediatric neurologist-reflexotherapist, head of the Children's Department of Neurology and Reflexology at the Reacenter Izhevsk, answers questions from readers.

Future parents should take care of the health of their children long before they are born. One of the most important periods of a child's development is the perinatal period. Perinatal lesions of the central nervous system (CNS PP) are recorded in 40-60% of infants. They are "indicators" of the state of health of the child, not only in the first year of life, but also in other age periods. In 86.0% of cases, CNS PP lead to neuropsychiatric disorders, and in 36.0% to motor disorders of varying severity. Brain lesions in the perinatal period are the main cause of disability and maladaptation in children.

What does the term "perinatal CNS damage" mean?

This diagnosis unites a large group of lesions of the brain and spinal cord that are different in cause and origin, occurring during pregnancy, childbirth and in the first days of a baby’s life. The perinatal period is the period of individual development of the body from the 28th week of pregnancy to the 7th day of life child.

There are several groups of perinatal CNS lesions:

hypoxic damage (damaging factor-lack of oxygen);
traumatic injury (mechanical damage to the tissues of the National Assembly);
toxicometabolic (metabolic disorders, intoxication);
infections (most often viral).

How do perinatal CNS lesions manifest themselves?

Even in the maternity hospital, a neonatologist, when examining a newborn, should suspect or identify the pathology of the National Assembly and prescribe appropriate treatment. Unfortunately, clinical manifestations can persist and intensify after discharge from the maternity hospital, so parents should be very attentive to the baby and, if necessary, not be afraid to contact a pediatric neurologist.

What should parents be concerned about?

At the initial stage, the characteristic signs of the pathology of the central nervous system: frequent anxiety and crying or unreasonable lethargy, trembling of the chin, arms, legs, frequent regurgitation, startling, sleep disturbance, fading.

The reason for this behavior may be increased intracranial pressure, hydrocephalus, vegetative-visceral disorders, pathological increase or decrease in muscle tone, convulsions. If parents have even the slightest suspicion, you should immediately contact a specialist. The earlier treatment is started or its correction is carried out, the higher the probability of restoration of impaired functions!

What problems can babies have in the future?

If parents think that everything will pass by itself, then they take a big risk. By the age of 3-5, such children, as a rule, already have major health problems (headaches, enuresis, hyperactivity, etc.). Children may already noticeably lag behind in motor (the risk of developing cerebral palsy), speech or mental development. Consequently, the kindergarten and, subsequently, the school will be correctional, which will affect both education and the possibility of choosing a profession, as well as further adult life and the life of subsequent generations .... And in most cases, all this might not be.

What will help to more accurately diagnose perinatal CNS damage?

In order to diagnose and confirm perinatal CNS damage in children, in addition to a clinical examination, additional instrumental studies of the nervous system are carried out, such as neurosonography, dopplerography, computed and magnetic resonance imaging, electroencephalography, electropuncture diagnostics, etc.

How to treat children with perinatal CNS damage?

In connection with the possibilities of early diagnosis of perinatal lesions of the central nervous system, the treatment and rehabilitation of these conditions should be carried out as early as possible, so that therapeutic effects occur in the first months of a baby's life, when the disorders are still reversible. It should be said that the ability of the child's brain to restore disturbed functions, as well as the capabilities of the whole organism as a whole, are very high precisely during this period of life. It is in the first months of life that the maturation of the nerve cells of the brain to replace those that died after hypoxia is still possible, the formation of new connections between them, due to which the normal development of the organism as a whole will be determined in the future. It should be noted that even minimal manifestations of perinatal CNS lesions require appropriate treatment to prevent adverse outcomes of the disease.

Good results in the treatment of CNS PP give microcurrent reflexology method. Unlike acupuncture, the method of microcurrent reflexology is painless, non-invasive, with constant computer control of the therapeutic effect and the patient's condition. The treatment consists in applying ultra-small electrical signals to a combination of biologically active points to restore the normal functioning of the child's brain and spinal cord. Treatment is easily tolerated even by infants.

In the process of treatment, the work of the central nervous system is restored, sleep is normalized, muscle tone is stabilized, the assimilation of new motor skills improves, pre-speech and speech development is activated. At an older age, memory and attention improve, excitability and aggression decrease, headaches and nosebleeds are eliminated.

What do parents need to do on their own to restore the health of their baby?

Above all, just love your baby! Pay attention to proper nutrition. Breastfeeding in itself is a powerful healing factor. In addition, gentle maternal touches during breastfeeding are an important emotional stimulant that helps reduce stress, and therefore, a more complete perception of the world around children.

Massage and gymnastics create favorable conditions for the overall development of the child, accelerate the development of motor functions (mastering such skills as raising and holding the head, turning on the side, stomach, back, sitting, crawling, walking independently).

Among the water procedures with therapeutic effects, therapeutic baths can be used for children with perinatal lesions of the central nervous system. Due to the peculiarities of the skin in children (high permeability, rich vascular network, an abundance of nerve endings - receptors), therapeutic baths are especially effective. Under the action of salts dissolved in water, blood circulation and metabolism in the skin, muscles and the whole body are enhanced. Parents can carry out these procedures on their own at home, having received the recommendations of a doctor.

With the onset of the recovery period of the disease, it is necessary to gradually expand auditory, visual, emotional contacts with the baby, as they are a kind of non-drug "nootropics" - stimulants for the developing brain. However, it should be remembered that excessive workload and enthusiasm for early development programs can lead to fatigue and disruption of the baby's not yet fully strengthened nervous system. Therefore, show moderation and patience in everything, and even better - do not forget to discuss all undertakings with your doctor.

Remember - the health of your child is in your hands! So do not spare the time, effort and love to restore the injured baby. I wish you success!

In recent years, more and more newborns have been diagnosed with a perinatal lesion in a child of the central nervous system. The diagnosis of such a plan unites an extensive group of deviations of the brain and spinal cord, different in cause and origin. Pathology can occur during pregnancy, in childbirth and in the first day of a baby's life. About what these dangerous pathologies are, and will be discussed below.

Doctors distinguish three main periods in the development of the disease. This is an acute period (1st month), recovery (from the 2nd month to 1 year in full-term babies and up to 2 years in premature babies) and the final outcome of the disease. In any of the periods, perinatal injuries differ in different clinical manifestations. Sometimes a child has a combination of several syndromes at once. According to their severity, the severity of damage to the nervous system is determined, treatment is prescribed and forecasts for the future are made.

The main types of CNS lesions

In hypoxic lesions of the central nervous system, the main damaging factor is considered to be an acute lack of oxygen. In traumatic lesions, the damaging factor is mechanical damage to the main tissues of the central system (spinal cord and brain) during childbirth and during the first minutes and hours of a child's life. In dysmetabolic and toxic-metabolic perinatal lesions, the main factor is a metabolic disorder in a child in the primary prenatal period. With lesions of the central nervous system in infectious diseases, the virus has a detrimental effect. Often doctors have to deal with a combination of several factors at once.

Symptoms and manifestations in the acute period

With mild damage to the central nervous system in newborns, a syndrome of high neuroreflex excitability is most often noted. It is manifested by shivering, hypertonicity or, conversely, hypotension of muscle tone. There is also a tremor (trembling) of the chin and all limbs, restless superficial sleep, causeless crying.

With an average lesion of the central nervous system in the first days in children, motor activity and muscle tone are reduced, the reflex of newborns is weakened, including reflexes of sucking and swallowing. At the end of the 1st month, CNS depression begins to gradually disappear or be replaced by increased arousal. The average degree of damage to the central nervous system is characterized by impaired functioning of internal organs and major systems. Also, the child has uneven skin coloration, the rhythm of breathing and heart contractions is disturbed, frequent constipation, regurgitation, and.

In children at the acute stage of the disease, the main signs of perinatal hypertensive-hydrocephalic syndrome appear. It is characterized by excessive accumulations of fluid in the brain containing cerebrospinal fluid, which causes an increase in intracranial pressure. The main symptoms that parents may notice are a rapid increase in the circumference of the baby's head (more than 1 cm per week), a large size and bulging of the fontanel, a visible divergence of cranial sutures, general anxiety of the child, regurgitation, trembling of the eyeballs.

Symptoms and manifestations in the recovery period

A prolonged violation of muscle tone leads to the appearance of a delay in psychomotor development in a child. With a developmental delay, the child begins to hold his head, sit, and walk much later. Poor facial expressions, the late appearance of a smile on the face, reduced interest in toys, objects of its environment, a weak monotonous cry, the late appearance of cooing and babbling - this is what should alert the baby's parents.

Disease outcomes

In most children, by the age of one year, the manifestations of perinatal CNS abnormalities gradually disappear, sometimes only their minor manifestations persist. The most common consequences of perinatal lesions are delays in mental, motor or speech development, visible cerebroasthenic syndrome (manifested in mood swings, motor restlessness, anxious sleep, meteorological dependence).

Hyperactivity disorder and attention deficit disorder may develop. This is such a violation of the central nervous system, which is manifested by aggressiveness, excessive impulsivity, problems with concentration and maintenance of attention, the inability to learn normally and remember information. The most unfavorable outcomes can be: epilepsy, cerebral palsy, hydrocephalus.

The perinatal period is the period of a child's life from the 28th week of pregnancy to the 7th day after birth. It is during this period that the nervous system of the child develops intensively, and most often it is at this time that the child may develop CNS diseases if he has a disposition.

Of course, if doctors find such a disease, then parents begin to be interested in what methods of rehabilitation of perinatal CNS damage are and in general information about this problem. A very important place is occupied by the causes of the lesions of this plan.

Signs of perinatal CNS damage

The manifestation of perinatal CNS damage will depend entirely on the severity of the disease that caused this pathology. If a child has a mild form of damage, then we can talk about a decrease in muscle tone and congenital reflexes, the appearance of a tremor (the chin and, in some cases, the limbs shake) and motor restlessness. As a rule, symptoms appear gradually over 5-7 days after the birth of the child.

If there is an average form of severity of CNS damage, then depression occurs for more than 7 days in the form of muscle hypotension and a strong decrease in congenital reflexes. In some cases, you may notice the appearance of seizures and impaired sensitivity. Recently, more and more often you can find cases of an average form of damage to the nervous system, which are accompanied by vegetative-visceral disorders, dyskinesia of the gastrointestinal tract and unstable stools, regurgitation, flatulence and impaired functioning of the respiratory and cardiovascular systems.

If a newborn child has a severe form of perinatal CNS damage, then one can note a long and very pronounced depression of the nervous system, convulsions, and severe problems that regularly occur with the respiratory, cardiovascular and digestive systems.

It is worth noting that any damage to the nervous system of a newborn child should be detected by a neonatologist even during the baby's stay with his mother in the maternity hospital. He must also prescribe the necessary and appropriate treatment in a particular case. Clinical manifestations of pathology may appear for some time after discharge from the hospital, and in some cases even intensify. If this happens, then any deviations from the norm and problems with the nervous system of the child should and may well be noticed even by the mother, being outside the walls of the maternity hospital. If a child has similar problems, then he may experience the following symptoms:

restlessness or constant lethargy and drowsiness, which cannot be explained by anything;

regular regurgitation that occurs both after feeding and in between;

unusual eye movement of the child;

trembling of the chin or limbs, convulsions.

Quite often, in the presence of pathologies of the central nervous system, hypertensive-hydrocephalic syndrome can occur and the following symptoms: increased intracranial pressure, head circumference increases very quickly (more than 1 cm per week), cranial sutures open, fontanelles increase in size several times.
To date, doctors distinguish four groups of perinatal lesions of the central nervous system in a newborn child, namely:

hypoxic lesions due to lack of oxygen;

traumatic lesions due to damage to the tissues of the nervous system and brain during childbirth or during the first minutes of a child's life;

dysmetabolic due to metabolic disorders in the child's body that occur during pregnancy;

infectious, which occurs during the illness of infectious diseases during the perinatal period.

It is worth noting that in most cases, the child has several types of damage at the same time, and this division occurs only conditionally.

Group 1 perinatal CNS lesions

This type of injury is the most common. The causes of hypoxia in a child are: diseases of the mother during pregnancy, polyhydramnios, oligohydramnios, multiple pregnancy, and so on. An acute form of hypoxia can be caused by severe bleeding, poor blood flow to the baby's brain during childbirth, disturbances in the uteroplacental circulation, and premature placental abruption.

The duration and severity of hypoxia affect the degree of damage to the central nervous system, because it is especially sensitive to a lack of oxygen in the body. If throughout the entire intrauterine development the child constantly needs oxygen, then this causes a number of very different pathological changes in the body.

Group 2 perinatal CNS lesions

The traumatic factor plays a very important role in spinal cord injuries. Quite often, the reason for this may be the lack of professionalism of obstetricians or special tools that they can use during childbirth. Also, the causes of damage can be the large weight of the child, the narrow hips of the woman, the breech presentation of the child, the thrust of the child by the head, the incorrect insertion of the head, and so on. Sometimes spinal cord injuries can even be caused by cesarean section, when a “cosmetic” incision is made along the pubic hairline and, accordingly, in the lower segment of the uterus.

Group 3 perinatal CNS lesions

This group includes metabolic disorders: fetal alcohol syndrome, nicotine, drug withdrawal syndrome, the presence of viral or bacterial toxins that are introduced into the child's body, drugs.

Group 4 perinatal CNS lesions

In the past few years, it has been noted that the number of cases with infection of a child during pregnancy has increased significantly. Of course, equipment has been invented that allows you to determine the presence of infection in the body of a child at an early stage. Of course, this does not remove all the risks of damage to the nervous system of the baby. It is also worth noting that the mechanism of damage to the central nervous system will depend entirely on the type of pathogen and the severity of the disease.

When a perinatal CNS lesion is detected, treatment should be started immediately, because the consequences can be even more severe.

Perinatal damage to the central nervous system in newborns: consequences

If you have any suspicions that the child is not all right, you should immediately consult a doctor. In this case, every minute will be important, because the sooner treatment is started, the faster you can restore all body functions. If treatment is started too late, then there is a high risk of not restoring functions, and then the child will have serious health problems.

Once again, I would like to remind you that only a doctor should make a diagnosis for a child. This diagnosis will reflect the form of perinatal CNS damage, the factors that caused it, the causes and syndromes to which the pathology will relate. During the diagnosis, you need to be as careful as possible, because further treatment will depend on it. If the doctor makes a wrong diagnosis, then, accordingly, the treatment will be inappropriate and will not solve the problem that your newborn has. Recall that the treatment should not only be correct, but also as early as possible so that the disease does not have time to progress.

Perinatal damage to the central nervous system is a pathology that includes a group of various conditions that, under the influence of negative factors, adversely affect the spinal cord or brain of a newborn.

To date, there is no clear terminology that describes PCNS in newborns. Until the 1990s, they used the classification proposed by Yakunin Yu. Ya., where terms were used that were not entirely appropriate from the point of view of modern medicine.

Thus, the term "perinatal encephalopathy" (literally means "brain weakness") indicated persistent, almost irreversible changes in the nervous system. But many perinatal disorders are reversible. In the initial period of life, the brain has enormous compensatory capabilities and is able to fully recover even with pathology of moderate severity.

And the term "impaired cerebral circulation" was associated by neurologists with strokes and did not have clear signs. Over time, it began to be called "cerebral ischemia." Separate conversation about hypertensive-hydrocephalic syndrome. Intracranial hypertension is diagnosed all the time, while measuring CSF pressure is quite difficult, and the diagnosis is often made on the basis of symptoms that are quite common for babies in the first weeks of life: chin trembling, irritability, shuddering, superficial sleep, anxiety and screaming. As a result, children unreasonably take serious drugs from an early age.

However, perinatal lesions do exist and should not be ignored. Pathology in severe form is really dangerous for the life of the baby. According to some estimates, between 5 and 55% of newborns are diagnosed with PCNS. This difference is explained by the inclusion here of mild forms of disorders in this period. Basically, this is a problem of premature babies, since body weight at birth directly affects the formation and functioning of the nervous system.

The diagnosis is relevant only for babies of the first year of life (that's why it is called "perinatal"; the word indicates the time close to birth). By the time the baby reaches 12 months, a different diagnosis is made, based on the totality of the symptoms present.

How the disease develops

We advise you to read: Consequences of cerebral ischemia in newborns

There are three phases (periods) of perinatal damage:

acute - from birth or even from the prenatal period to the 1st month of life;
restorative; it is divided into early (2-3 months) and late (4-12 months, in preterm infants up to 24 months);
outcome of the disease.

Each interval has its own clinical picture and manifests itself in the form of certain syndromes. From how they are expressed, they judge the severity of the disease. Consider their features.

Acute period

Hypertension-hydrocephalic syndrome. Cerebrospinal fluid accumulates in the ventricles of the brain due to a violation of its outflow - thus increasing intracranial pressure. Parents or doctors may notice a rapid increase in head circumference, as well as a protrusion of the fontanel. Indirectly, the development of hydrocephalus is indicated by frequent regurgitation, more like vomiting, eye nystagmus, poor superficial sleep.
Convulsive syndrome. Rarely occurs in the form of twitching of the arms, legs and head, episodic shuddering.
Vegetative-visceral syndrome. It is manifested by a marble skin tone (since the tone of peripheral vessels is impaired), problems from the gastrointestinal tract and the cardiovascular system.
apathy syndrome. The vital reflexes of sucking and swallowing are weakened, and motor activity is reduced along with reduced muscle tone.
Increased neuro-reflex excitability. It is characterized by muscular dystonia: the tone can be either increased or decreased; reflexes fade longer than usual, the chin trembles in children, especially when crying, which now and then occurs for no apparent reason. The baby sleeps superficially. The syndrome accompanies a mild severity of the disease.
coma syndrome. Occurs as a result of severe depression of the central nervous system and indicates a difficult situation for the newborn. An infant who has fallen into a coma is placed in intensive care in an unconscious state, since there are no signs of coordinating brain activity.

Muscle weakness is a warning sign

Recovery period

The early recovery period is misleading, because it seems that neurological disorders become less pronounced, muscle tone returns to normal, and reflexes are restored. But after a while the clinical picture worsens again. It should be noted that this situation occurs only when CNS damage has been diagnosed in newborns of moderate and severe form.

It is quite logical that a child who has undergone this pathology will develop late. Later than his peers, he will hold his head, sit and walk. Later, the first smile, interest in the world around will appear. All delays in motor and mental development should encourage parents to once again show the baby to a neurologist, although children with such a diagnosis are already registered with him.

Also, if intensive drug therapy is used during the acute period, then in the recovery phase, emphasis is placed on physiotherapy, massage courses, and psychocorrection.

Outcome of the disease

The results of the therapy are brought closer to the age of one. With a favorable prognosis, the following consequences may persist:

delayed development of speech skills, motor and mental state;
hyperactivity and attention deficit - the child cannot concentrate on the subject being studied for a long time, has difficulty remembering new things, tends to show aggression and impulsivity;
cerebroasthenic syndrome (expressed in a sense of anxiety, superficial sleep, manifestation of hysteria, meteorological dependence).

The severe course of the disease leads to the development of:

epilepsy;
children's cerebral palsy;
hydrocephalus.

Cerebral palsy - a consequence of severe damage to the central nervous system

In figures, the options for the development of the outcome of the disease can be expressed as follows: 30% - complete recovery, 40% - functional disorders, about 30% are organic disorders, in rare cases death occurs.

Causes

Speaking about the causes of depression of the nervous system, there are 4 main factors contributing to the development of the disease:

Our habits affect the future of our children

Acute hypoxia. Oxygen starvation can begin even during fetal development due to chronic maternal diseases (diabetes mellitus, nephropathy), placental insufficiency or infection. The development of hypoxia is quite possible during childbirth, if they are rapid or protracted, the position of the fetus is not head, placental abruption has occurred, etc.
Traumatization. Occurs during delivery due to unprofessional actions of the staff or due to other circumstances (narrow pelvis, large head size, cord entanglement, breech presentation).
Toxic-metabolic damage. It develops if the metabolism is disturbed in the baby's body or the mother used toxic products (drugs, nicotine, certain drugs, alcohol) during the gestation of the fetus.
Viral or bacterial infection.

Severity

Light. Muscle tone is moderately increased or decreased. Strabismus, Graefe's symptom, slight reflex excitability. The chin is trembling. Signs of depression may alternate with excitement.
Average. Inhibition of reflexes, rare seizures, restless behavior, disorders of the cardiac system, gastrointestinal tract and kidney function. The symptoms of oppression predominate over the symptoms of arousal.
Heavy. Respiratory and cardiac disorders, low Apgar score, the condition requires resuscitation.

Diagnostics

A neurologist can send the child for a consultation with an ophthalmologist and for additional examinations. What are their advantages and disadvantages?

Neurosonography

An affordable, safe and widely practiced method for examining the structures of the cranium using ultrasound. The procedure is performed by a special apparatus through an open fontanel. The study can be done in deeply premature babies in the intensive care unit, even if they are connected to artificial lung ventilation.

Neurosonography allows you to see the degree of filling of the ventricles of the brain and suggest for what reasons brain activity suffers. The disadvantage of the study is that any area with altered echogenicity can be mistaken for pathology. Also, the accuracy of the study is affected by the condition of the baby (he is calm or crying) and even how the sensors are attached.

Computed tomography and MRI

It happens that neurosonography did not reveal severe pathologies, and symptoms of CNS depression are present. Then a study is prescribed using magnetic resonance or computed tomography. This method is more informative, it allows you to "look" into the most remote corners of the brain, evaluate its smallest structures.

MRI is a modern diagnostic method

An important rule: during the study, the child should not move. Therefore, before the procedure, he may be given special medications.

EEG and dopplerography

Electroencephalography helps to see the bioelectrical brain activity, to assess the pulsation of blood vessels. That's just the brain in the perinatal period is immature, and the study must be carried out more than once, comparing the indicators. With the help of dopplerography, blood flow in the vessels is assessed.

Treatment

The task of the medical staff is to establish the fact of violations of the central nervous system as soon as possible and begin treatment in the maternity hospital. Recall that the first month of life is the most decisive, when the maturation of nerve cells and the full replacement of those who died after oxygen starvation are possible.

PCNS in the acute period is treated in the intensive care unit. The baby is placed in a special incubator and all efforts are directed to maintaining the heart, kidneys and lungs, eliminating convulsions, cerebral edema. During this period, treatment is indicated with medications that improve cerebral circulation and normalize the outflow of cerebrospinal fluid. At the same time, doctors take a responsible approach to choosing the dosage of drugs, especially when it comes to premature babies with a small weight. There is a round-the-clock observation by neonatologists. A neurologist can be invited for a consultation directly to the intensive care unit.

When the condition returns to normal, the infant is transferred to the neonatal pathology department or to the neurology department for further treatment. Reflexes gradually return to normal, the work of the heart muscle and gastrointestinal tract stabilizes, ventilation of the lungs improves. The choice of therapeutic drugs is aimed at eliminating the existing syndromes.

Recovery period

Rehabilitation activities during the recovery period include a course of massage, electrophoresis, and therapeutic exercises. Swimming is very helpful. On the one hand, it relaxes muscle tone, on the other hand, it strengthens the muscle corset. Massage elements will differ depending on the type of movement disorders. With hypertonicity, a relaxing massage is shown. And with muscle hypotension, massaging is designed to relax the limbs and activate the muscles of the back, abdomen, arms and legs.

Several massage courses are an indispensable condition during the recovery period

Warm baths have a beneficial effect on the nervous system. And if you add a decoction of motherwort or pine needles to the water, you get a balneotherapy with a sedative effect. The healing effect of heat is used in the treatment with paraffin and ozocerite, applying applications to the affected areas.

Doctors strongly recommend trying to maintain lactation during this difficult time. Why? Yes, because milk contains everything necessary to protect the baby from infections and allows him to quickly strengthen the immune system. Milk and motherly affection help to reduce stress and improve emotional state. When a newborn is placed in the intensive care unit, he is fed with a bottle or through a tube. To conserve milk, pump regularly. Attach the baby to the breast as soon as possible.

A child who has had a perinatal CNS lesion should be protected from loud sounds, overheating or excessive cooling, sources of infection (let only healthy relatives and friends into the house). In general, he should be as comfortable as possible to adapt to the environment. For psycho-correction, music therapy, tactile stimulation are used, parents are taught to interact with the baby, evaluate his reactions. All actions are aimed at maximizing the quality of life of the child and his social adaptation.

mladeni.ru

What a mother should know about perinatal CNS damage in a child

Pathological changes in the child's brain, formed during fetal development or during passage through the birth canal, are called perinatal lesions of the central nervous system. There are many causes of perinatal CNS damage in newborns, and there is a variety of clinical manifestations and consequences.

Modern medicine has great potential for diagnosing and treating such conditions. CNS damage in newborns and consequences - are there any reasons for mothers to be afraid of this pathology?

Varieties of pathology

There are many types of morphological damage to the substance of the brain during fetal development and childbirth. They differ in the mechanism of occurrence, in the clinical course, in the possible consequences. Perinatal lesions of the central nervous system resulting from oxygen starvation of brain cells:

cerebral ischemia of three degrees of severity;
hemorrhages in the brain;
traumatic and non-traumatic damage to the brain substance.

Lesions that arose as a result of metabolic disorders:

bilirubin encephalopathy;
hypoglycemic damage;
damage due to an imbalance of minerals;
toxic lesions of medicinal and infectious nature.

Sometimes there may be a perinatal CNS lesion of mixed origin - with a combination of several factors at the same time.

Symptoms of CNS damage in newborns depend on the mechanism of their occurrence. With oxygen starvation, three degrees of severity of the pathology are distinguished.

The first degree is characterized by:

excessive excitability of the child;
increase in physical activity;
restless sleep;
constant regurgitation while feeding.

This condition is completely reversible, all signs disappear after two weeks. With the second degree of severity:

respiratory disorders in the form of frequent superficial movements of the chest;
skin cyanosis; cardiopalmus;
decrease in the strength of physiological reflexes;
muscle hypotonia and decreased motor activity.

These signs also regress completely, but after a longer time - within two months.

In the third degree of severity, the child's condition is critical:

disturbed breathing and heartbeat;
skin is pale with a gray tint;
atony of the muscles of the limbs;
lack of physiological reflexes;
focal symptoms begin in the form of nystagmus of the eyes;
possible development of coma.

Hemorrhages in the substance of the brain are manifested by focal lesions corresponding to the localization of the hemorrhage. This often results in coma. Metabolic disorders lead to almost the same symptoms as hypoxic conditions.

Important! The severity of the signs will depend on the level of metabolic disorders - the amount of free bilirubin, blood sugar, and the concentration of minerals.

The neonatologist usually notices the first changes in the child's condition. He conducts an examination immediately after birth and assesses the degree of hypoxia. Metabolic disorders are diagnosed later, after laboratory tests. Cerebral hemorrhages can be suspected by the presence of focal symptoms, and the diagnosis is confirmed by imaging techniques, usually computed tomography.

The consequences of perinatal CNS damage primarily depend on the severity of the condition.

A mild degree, subject to full treatment, does not leave any consequences.
The second degree of severity - the symptoms can completely regress, but in the future, with the addition of certain somatic diseases, neurological manifestations are possible, which are the result of the pathology transferred in the neonatal period. The most frequent manifestation is asthenoneurotic syndrome - disorders of the nervous system, manifesting a change in behavior. The child becomes overly capricious, motor activity increases, sleep is disturbed, excessive irritability is observed.
Severe lesions - with third-degree hypoxia, hemorrhages, severe bilirubin encephalopathy - subsequently manifest as serious developmental defects. Among them are:

late physical development of the child;
violations of motor function;
mental retardation;
speech disorders;
decrease in skill learning.

Principles of treatment

Treatment of perinatal lesions of the central nervous system - the basic principle is its immediate onset, immediately after the diagnosis is clarified. Immediately after birth, the impaired vital functions of the body - respiration and cardiac activity - should be corrected.

At the same time, detoxification therapy is carried out to restore the activity of nerve cells. After the elimination of the main symptoms, restorative treatment should be carried out. Decongestant, infusion therapy, sedatives, anticonvulsants and nootropics are used.

Conclusion

Pathology of the nervous system in the neonatal period is not always a favorable condition. Some mothers must prepare to raise a child with developmental disabilities of varying severity. However, proper upbringing and treatment will make it possible to correct these deviations as much as possible and achieve a good learning ability of the child.

golmozg.ru

Perinatal damage to the central nervous system: symptoms and treatment of PCNS

The phrase perinatal period itself suggests that perinatal CNS damage develops in an unborn child, that is, a fetus.

Perinatal damage to the central nervous system (PPNS) is a diagnosis that implies a malfunction in the functioning of the fetal brain.

The entire period of the perinatal period is conditionally divided into three stages:

from the 28th week until the moment of delivery, the antenatal period lasts;
the process of childbirth itself is called the intranatal period;
The neonatal period is the period from birth to the first week of life.

In modern medicine, there is no exact name for the disease when the fetal central nervous system is affected, there is only a combined one, it is called PCNS or perinatal encephalopathy.

Perinatal damage to the central nervous system in newborns is manifested by disturbances in the functioning of the motor apparatus, speech and mental disorders.

With the development of medicine, they stopped using this diagnosis for children older than one month. After a month, the doctor must make an accurate diagnosis of the child. It is during this period that the neurologist accurately determines how badly the nervous system is damaged. Prescribes treatment and makes sure that it is chosen correctly.

The reasons why perinatal lesions of the central nervous system can develop are quite diverse, among the most popular:

All other causes of PCNS are situational and it is simply impossible to predict their occurrence to a greater extent.

Classification and varieties of syndromes

PPTSNS is conditionally divided into several periods, depending on the stage at which the violation was detected and how it manifested itself.

The acute period lasts from 7 to 10 days, it is extremely rare, but it can stretch up to a month. The period in which recovery occurs can last up to half a year. If the child's body recovers slowly, then this period can take up to 2 years.

Pediatric neurologists distinguish the following types of perinatal lesions of the central nervous system, depending on the accompanying symptoms and syndrome:

Violation of muscle tone, which is accompanied by a complex of disorders associated with breathing. This syndrome is diagnosed according to deviations from the norm, depending on the age of the newborn. In the initial period of a child's life, it is quite difficult to diagnose this syndrome, since in addition there is physiological hypertonicity.
Syndrome associated with sleep disturbance, twitching of the chin. This syndrome can be diagnosed only when flatulence is excluded.
Depression of the nervous system. This syndrome is diagnosed in children who are not active in the first months of their lives, they sleep a lot, they have low tone.
An unfavorable prognosis for a child if the syndrome of intracranial hypertension has developed. Its main signs are increased excitability and nervousness, while the fontanel begins to swell.
One of the most dangerous and severe syndromes in PCNS is convulsive, it is one of the most serious manifestations in perinatal CNS damage. In addition, any attentive mother can notice deviations in the state of health of her child much faster than a neurologist, if only because she watches him around the clock and more than one day.

In any case, the baby, living the first year with any (even minimal, but not passing) deviations in the state of health, requires repeated consultations with specialists (if necessary, an additional examination), careful observation and therapeutic measures, if necessary.

Symptoms and diagnostic criteria

Not every mother who does not have a medical education will be able at first glance to distinguish and determine that her child has a perinatal CNS lesion.

But, neuropathologists accurately determine the disease by the appearance of symptoms that are not characteristic of other disorders that are characteristic of the smallest patients.

Symptoms of PCNS:

when examining a baby, hypertonicity or hypotonicity of muscles can be detected;
the child is excessively restless, anxious and agitated;
the occurrence of shaking in the chin and limbs (tremor);
the appearance of seizures;
when viewed with a hammer, a violation of sensitivity is noticeable;
the appearance of an unstable stool;
changes in heart rate;
the appearance of bumps on the skin of the child.

As a rule, after a year, these symptoms disappear, but then they appear with renewed vigor, so this situation simply cannot be started.

One of the most dangerous manifestations and consequences of PCNS in the absence of a response to symptoms is the suspension of the development of the child's psyche. The speech apparatus does not develop, there is a delay in the development of motor skills. Also, one of the manifestations of the disease can be cerebrosthenic syndrome.

There are several ways of developing perinatal CNS damage in newborns, depending on the cause and subsequent symptoms, the analysis of which allows you to make an initial diagnosis:

Complex of therapeutic measures

In the case when a child develops an acute period of the disease, he is first sent to the intensive care unit. Diuretics are used in case of suspected cerebral edema - dehydration therapy can be carried out.

Depending on what symptoms the baby is experiencing, with the right treatment, you can get rid of convulsions, disorders in the respiratory tract and cardiovascular system, and muscle disorders.

If the disease is difficult, then the child is fed through a tube. To restore the main functions of the central nervous system, as well as to reduce the manifestation of neurological symptoms, the baby is prescribed a whole range of drugs:

for the relief of seizures, a course of taking Radodorm, Finlepsin, Phenobarbital can be prescribed;
if the child periodically burps, Motilium or Cerucal is prescribed;
if there are violations of the locomotor apparatus, Galantamine, Dibazol, Alizin, Prozerin are prescribed;
in order to reduce possible hemorrhages, it is recommended to use Lidaza.

Nootropic drugs can also be used in the treatment, which can restore trophic processes in the brain - Piracetam, Cerebrolysin, glutamic acid.

In order to stimulate the general reactivity, a newborn child is given a course of therapeutic massage and special gymnastics.

In the event that parents have found at least one of the signs of CNS lesions, an urgent need to consult a doctor. Do not forget that the development of each child is an individual process.

Such individual characteristics of each newborn child in each case play an important role in the process of restoring the functions of higher nervous activity.

Perinatal lesions of the central nervous system:

Danger and Consequences

There is an opinion among experts that if the central nervous system of the fetus has been affected, then it cannot be completely restored. But neurologists-practitioners argue the opposite. They say that if the disease is treated correctly, it is possible to achieve partial or complete restoration of the functions of the nervous system.

But even despite such an optimistic forecast, if you look at all diseases associated with the nervous system, then 50% of their total number leads to disability, while about 80% of it is allocated to perinatal damage to the central nervous system.

Preventive actions

In order for the baby to be healthy, you must:

completely abandon alcohol, drugs, smoking;
avoid infectious diseases during pregnancy;
in case of indications, carry out heat treatment, due to which blood flow improves and tissues are warmed;
as soon as the baby is born, you can attend a course of underwater shower-massage, which is carried out in warm water and has a beneficial effect on the development of muscle tone of the baby, but if this is not possible, you can perform a manual massage under water.

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Pathologies of the central nervous system in newborns | OkDoc

Pathologies of the central nervous system (CNS) in newborns are a large group of lesions of the spinal cord / brain. Such lesions can occur during fetal development, during childbirth and in the first days of life.

Table of contents: Causes of the development of CNS pathologies in newborns Classification of CNS pathologies in newborns - Hypoxic lesions - Traumatic lesions - Dysmetabolic disorders - CNS lesions in infectious diseases 3. Periods of the course of CNS pathologies in newborns - Acute period - Recovery period - Outcome of the disease 4. Diagnostic measures 5 Methods of treatment and rehabilitation - Rehabilitation period 6. Prevention of pathologies of the central nervous system in newborns

Causes of the development of CNS pathologies in newborns

According to statistics, up to 50% of newborns are diagnosed with perinatal pathologies of the central nervous system, because doctors often include transient disorders in the functioning of the central nervous system in this concept. If we consider the statistics in more detail, it will be found out:

60-70% of cases of diagnosing pathologies of the central nervous system in newborns occur at the birth of a premature baby;
1.5 - 10% of cases - on full-term children born in a timely and natural way.

A factor provoking the appearance of pathological changes in the work of the central nervous system in newborns can be absolutely any negative impact on the fetus during its intrauterine development. In general, doctors identify several main causes of the condition in question:

Fetal hypoxia. We are talking about oxygen starvation, when an insufficient amount of oxygen from the mother's body enters the child's blood. Hypoxia can also be provoked by harmful production (it is not for nothing that pregnant women are immediately transferred to lighter work), and infectious diseases transferred before pregnancy, and bad habits of a woman (especially smoking). It greatly affects the oxygen supply to the fetus and the number of previous abortions - artificial termination of pregnancy provokes a violation of blood flow between the mother and fetus in the future.
Newborn trauma. We are talking about injury during childbirth (for example, when forceps are applied for medical reasons), in the first hours / days of a newborn's life. It is physical trauma that is considered the least likely cause of the development of pathologies of the central nervous system in newborns.
Dysmetabolic processes in the newborn. Violations in the metabolic processes of the fetal body can occur due to maternal smoking, drug use, alcohol consumption, or the forced intake of potent drugs.
Infectious diseases of the mother during childbearing. Pathological damage to the central nervous system occurs with direct exposure of the fetus to viral agents, pathogenic microorganisms.

Please note: regardless of whether the above factors were present, more often CNS pathologies in newborns are diagnosed in case of premature birth, in premature babies.

Classification of pathologies of the central nervous system in newborns

Depending on what causes provoked the development of disorders in the work of the central nervous system of the newborn, doctors also classify them. Each type is characterized by specific symptoms and nosological forms.

Hypoxic Lesions

Oxygen starvation of the fetus can lead to the following lesions of the central nervous system in newborns:

cerebral ischemia. The nosological form of this pathology manifests itself in different degrees of severity of the course - cerebral ischemia of 1, 2 and 3 degrees of severity of the course. Clinical symptoms:

Please note: for the 3rd degree of severity of the course of the pathological condition under consideration, progressive depression of the central nervous system is characteristic - in some cases, the newborn enters a coma.

Intracranial hemorrhages of hypoxic origin. Nosological forms are diverse:

intraventricular hemorrhage type 1 degree - specific neurological symptoms, as a rule, are completely absent;
intraventricular hemorrhage of the 2nd degree - convulsions may develop, often the newborn falls into a coma, there is progressive intracranial hypertension, shock, apnea;
intraventricular hemorrhage of the 3rd degree - deep depression of the central nervous system (coma), shock and apnea, long convulsions, high intracranial pressure;
subarachnoid hemorrhage of the primary type - doctors diagnose hyperexcitability of the central nervous system, focal clonic convulsions, acute hydrocephalus;
hemorrhage in the substance of the brain - the appearance of specific symptoms depends only on the location of the hemorrhage. Possible: intracranial hypertension / focal convulsions / convulsions / coma, but in some cases, even such a serious violation of the central nervous system is asymptomatic.

The combination of ischemic and hemorrhagic lesions of the central nervous system. The clinical picture and nosological forms of this condition will depend only on the location of the hemorrhage, the severity of the pathology.

Traumatic lesions

We are talking about birth injuries that caused the development of pathological disorders in the work of the central nervous system. They are divided according to the following principle:

Intracranial birth trauma. It can manifest itself in several nosological forms:

epidural hemorrhage - the condition is characterized by high intracranial pressure (the very first sign), convulsive syndrome, in rare cases, doctors record pupil dilation on the side of the hemorrhage;
subdural hemorrhage - subdivided into supratentorial (asymptomatic course, but partial convulsions, pupil dilation from the side of hemorrhage, progressive intracranial hypertension) and subtentorial (acute increase in intracranial pressure, progressive cardiac / respiratory disorders, depression of the central nervous system with the transition to a coma);
hemorrhage of the intraventricular type - characterized by convulsions (multifocal), heart / respiratory failure, CNS depression, hydrocephalus;
hemorrhagic infarction - the course may be asymptomatic, but may be manifested by convulsions, depression of the central nervous system with the transition to a coma, high intracranial pressure;
subarachnoid hemorrhage - doctors diagnose acute external hydrocephalus, hyperexcitability and seizures.

Spinal cord injury during childbirth. There is a hemorrhage in the spinal cord - an anguish, stretching. It can either be accompanied by a spinal injury or proceed without this moment. The clinical picture is characterized by impaired functioning of the respiratory system, dysfunction of the sphincters, motor disorders and spinal shock.
Trauma of the peripheral nervous system during childbirth. Nosological forms and symptoms:

damage to the brachial plexus - there is a flaccid paresis of the proximal part of one or both hands at once in the case of the proximal type, flaccid paresis of the distal upper limbs and Claude Bernard-Horner syndrome in the distal type of damage. Total paralysis may develop - there is paresis of the total part of the arm or both arms at the same time, a violation of the respiratory system is possible;
damage to the phrenic nerve - often occurs without any pronounced symptoms, but respiratory disturbances may be observed;
traumatic lesion of the facial nerve - in a child, during a cry, the mouth warps to the healthy side, the nasolabial folds are smoothed out.

Dysmetabolic disorders

First of all, doctors consider transient metabolic disorders:

Newborns may develop dysmetabolic disorders of the central nervous system and against the background of toxic effects on the fetal body - for example, if the mother was forced to take potent drugs, did not rule out alcohol, drugs and tobacco. In this case, the clinical picture will be as follows:

convulsions - rare, but this syndrome may be present;
hyperexcitability;
depression of the central nervous system, turning into a coma.

CNS lesions in infectious diseases

If during pregnancy a woman was diagnosed with a cytomegalovirus infection, toxoplasmosis, rubella, herpes infection or syphilis, then the likelihood of having a child with pathologies of the central nervous system increases significantly. There are some infectious diseases that can contribute to the development of problems in the work of the central nervous system after the birth of a child - sepsis, pseudomonas infection, streptococcal and staphylococcal infections, candidiasis and others.

With lesions of the central nervous system of infectious etiology, the following symptoms will be revealed:

intracranial hypertension;
hydrocephalus;
focal disorders;
meningeal syndrome.

Periods of the course of pathologies of the central nervous system in newborns

Regardless of what causes the development of CNS lesions in newborns, experts distinguish three periods of the disease:

acute - falls on the first month of a child's life;
restorative - can take place from 2 to 3 months of a baby's life (early) and from 4 months to 1 year (late);
outcome of the disease.

For each of the listed periods, characteristic signs are inherent, which may be present separately, but more often appear in original combinations individually for each child.

Acute period

If the newborn has mild damage to the central nervous system, then hyperexcitability syndrome is most often diagnosed. It manifests itself as a sharp start, disturbances in muscle tone (it can be increased or decreased), trembling of the chin and upper / lower extremities, unmotivated crying and shallow sleep with frequent waking up.

In case of violations of the central nervous system of moderate severity, there will be a decrease in muscle tone and motor activity, a weakening of the reflexes of swallowing and sucking.

Please note: by the end of the first month of life, hypotonia and lethargy are replaced by increased excitability, uneven coloration of the skin (marbling of the skin) appears, disturbances in the digestive system (constant regurgitation, flatulence, vomiting) are noted.

Very often, the acute period of the disease is accompanied by the development of hydrocephalic syndrome - parents may note a rapid increase in head circumference, protrusion of the fontanel, divergence of cranial sutures, anxiety of the newborn and unusual eye movements.

Coma can occur only with very severe damage to the central nervous system in newborns - this condition requires the immediate assistance of medical workers, all therapeutic measures are carried out in the intensive care unit of a medical institution.

Recovery period

If up to 2 months the child looked absolutely healthy, the parents did not notice any strange / unusual syndromes, then the recovery period can proceed with pronounced symptoms:

facial expressions are very poor - the baby rarely smiles, does not squint, does not show any emotions;
lack of interest in toys and any other items;
the cry is always weak and monotonous;
baby talk and "cooing" either appear with a delay, or are completely absent.

Please note: it is the parents who should pay attention to the above symptoms and report them to the pediatrician. The specialist will prescribe a full examination of the child, send a small patient for examination to a neurologist.

Outcome of the disease

By the age of 12 months, the symptoms of CNS pathologies in newborns almost always disappear, but this does not mean that the lesions described above have disappeared without any consequences. The most common consequences of damage to the central nervous system in newborns include:

hyperactivity syndrome, accompanied by a lack of attention - memory impairment, learning difficulties, aggressiveness and tantrums;
delayed speech, psychomotor and physical development;
cerebroasthenic syndrome - characterized by meteorological dependence, disturbing sleep, sudden mood swings.

But the most severe, complex consequences of CNS pathologies in newborns are epilepsy, cerebral palsy and hydrocephalus.

Diagnostic measures

It is very important for a correct diagnosis to conduct a correct examination of the newborn and observation of his behavior / condition in the first hours of the baby's life. If pathological lesions of the central nervous system are suspected, it is advisable to prescribe a comprehensive examination:

Methods of treatment and rehabilitation

Help for newborns with CNS pathologies is necessary in the first hours of life - many disorders are completely reversible, there is an immediate start to rehabilitation / treatment.

The first stage of assistance

It consists in restoring the working capacity of vital organs and systems - we recall that in almost all types / forms of pathologies of the central nervous system of newborns, heart / respiratory failure and problems in the kidneys are manifested. Doctors with the help of medicines normalize metabolic processes, relieve the newborn from convulsive syndrome, stop swelling of the brain and lungs, and normalize intracranial pressure.

Second round of help

Very often, after providing emergency measures to help a newborn with CNS pathologies, visible signs disappear even in the maternity hospital, often the child's condition returns to normal. But if this does not happen, then the patient is transferred to the neonatal pathology department and continues treatment/rehabilitation.

The second stage of assistance involves the appointment of drugs that act to eliminate the cause of the pathologies in question - for example, antiviral, antibacterial agents. At the same time, therapy is prescribed aimed at restoring brain activity, stimulating the maturation of brain cells, and improving cerebral circulation.

The third stage of assistance

If the newborn shows significant improvement in the condition, then it is advisable to switch to non-drug treatment. We are talking about massages and physiotherapy procedures, the most effective of which are:

physiotherapy;
therapy by "position" - installation of splints, "collars", styling;
specially designed cycle of exercises in water;
hydromassage;
imitation of weightlessness;
Voight therapy;
vibration massage;
paraffin therapy;
alternating magnetic field;
color therapy and light therapy;
electrophoresis.

Please note: the third stage of assistance with the successful passage of the first two full-term babies is assigned at 3 weeks of life, and for premature babies a little later.

rehabilitation period

Doctors discharge a child with diagnosed pathologies of the central nervous system for outpatient treatment only in case of positive dynamics. Many experts believe that it is the rehabilitation period outside the medical institution that plays an important role in the further development of the child. Much can be done with drugs, but only constant care can ensure the mental, physical and psychomotor development of the baby within the normal range. Mandatory need:

protect the baby from harsh sounds and bright light;
create an optimal climate regime for the child - there should be no sudden changes in air temperature, high humidity or dry air;
protect the baby from infection as much as possible.

Please note: with mild and moderate damage to the central nervous system in newborns, doctors do not prescribe drug therapy at the second stage - usually it is enough to provide urgent medical care and restore the normal functioning of vital organs and systems. In the case of diagnosing severe CNS lesions in newborns, some drugs are prescribed in courses and at an older age, during outpatient treatment.

Prevention of pathologies of the central nervous system in newborns

Most often, the pathologies under consideration are easy to predict, so doctors strongly recommend taking preventive measures even at the stage of pregnancy planning:

Secondary prevention is considered to be the provision of full assistance when pathologies of the central nervous system in newborns are already detected, preventing the development of serious consequences.

At the birth of a child with pathologies of the central nervous system, you should not panic and immediately record the newborn as disabled. Doctors are well aware that timely medical care in most cases gives positive results - the child is fully restored and in the future is no different from his peers. Parents just need a lot of time and patience.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category.

So, the term (literally means "brain weakness") indicated persistent, almost irreversible changes in the nervous system. But many perinatal disorders are reversible. In the initial period of life, the brain has enormous compensatory capabilities and is able to fully recover even with pathology of moderate severity.

And the term "impaired cerebral circulation" was associated by neurologists with strokes and did not have clear signs. Over time, it began to be called ". Separate conversation about hypertensive-hydrocephalic syndrome. Intracranial hypertension is diagnosed all the time, while measuring CSF pressure is quite difficult, and the diagnosis is often made on the basis of symptoms that are quite common for babies in the first weeks of life: chin trembling, irritability, shuddering, superficial sleep, anxiety and screaming. As a result, children unreasonably take serious drugs from an early age.

However, perinatal lesions do exist and should not be ignored. Pathology in severe form is really dangerous for the life of the baby. According to some estimates, between 5 and 55% of newborns are diagnosed with PCNS. This difference is explained by the inclusion here of mild forms of disorders in this period. Basically, this is a problem of premature babies, since body weight at birth directly affects the formation and functioning of the nervous system.

How the disease develops

There are three phases (periods) of perinatal damage:

acute - from birth or even from the prenatal period to the 1st month of life;
restorative; it is divided into early (2-3 months) and late (4-12 months, in preterm infants up to 24 months);
outcome of the disease.

Each interval has its own clinical picture and manifests itself in the form of certain syndromes. From how they are expressed, they judge the severity of the disease. Consider their features.

Acute period

Hypertension-hydrocephalic syndrome. Cerebrospinal fluid accumulates in the ventricles of the brain due to a violation of its outflow - thus increasing intracranial pressure. Parents or doctors may notice a rapid increase in head circumference, as well as a protrusion of the fontanel. Indirectly, the development of hydrocephalus is indicated by frequent regurgitation, more like vomiting, eye nystagmus, poor superficial sleep.
convulsive syndrome. Rarely occurs in the form of twitching of the arms, legs and head, episodic shuddering.
Vegetative-visceral syndrome. It is manifested by a marble skin tone (since the tone of peripheral vessels is impaired), problems from the gastrointestinal tract and the cardiovascular system.
apathy syndrome. The vital reflexes of sucking and swallowing are weakened, and motor activity is reduced along with reduced muscle tone.
Increased neuro-reflex excitability. It is characterized by muscular dystonia: the tone can be either increased or decreased; reflexes fade longer than usual, the chin trembles in children, especially when crying, which now and then occurs for no apparent reason. The baby sleeps superficially. The syndrome accompanies a mild severity of the disease.
Coma syndrome. Occurs as a result of severe depression of the central nervous system and indicates a difficult situation for the newborn. An infant who has fallen into a coma is placed in intensive care in an unconscious state, since there are no signs of coordinating brain activity.

Muscle weakness is a warning sign

Recovery period

Also, if intensive drug therapy is used during the acute period, then in the recovery phase, emphasis is placed on physiotherapy, massage courses, and psychocorrection.

Outcome of the disease

The results of the therapy are brought closer to the age of one. With a favorable prognosis, the following consequences may persist:

delayed development of speech skills, motor and mental state;
hyperactivity and attention deficit - the child cannot concentrate on the subject being studied for a long time, has difficulty remembering new things, tends to show aggression and impulsivity;
cerebroasthenic syndrome (expressed in a sense of anxiety, superficial sleep, manifestation of hysteria, meteorological dependence).

The severe course of the disease leads to the development of:

epilepsy;
children's cerebral palsy;
hydrocephalus.

Cerebral palsy - a consequence of severe damage to the central nervous system

Causes

Speaking about the causes of depression of the nervous system, there are 4 main factors contributing to the development of the disease:

Our habits affect the future of our children

Acute hypoxia. Oxygen starvation can begin even during fetal development due to chronic maternal diseases (diabetes mellitus, nephropathy), placental insufficiency or infection. The development of hypoxia is quite possible during childbirth, if they are rapid or protracted, the position of the fetus is not head, placental abruption has occurred, etc.
Traumatization. Occurs during delivery due to unprofessional actions of the staff or due to other circumstances (narrow pelvis, large head size, cord entanglement, breech presentation).
Toxic-metabolic damage. It develops if the metabolism is disturbed in the baby's body or the mother used toxic products (drugs, nicotine, certain drugs, alcohol) during the gestation of the fetus.
Viral or bacterial infection.

Severity

Light. Muscle tone is moderately increased or decreased. Strabismus, Graefe's symptom, slight reflex excitability. The chin is trembling. Signs of depression may alternate with excitement.
Average. Inhibition of reflexes, rare seizures, restless behavior, disorders of the cardiac system, gastrointestinal tract and kidney function. The symptoms of oppression predominate over the symptoms of arousal.
Heavy. Respiratory and cardiac disorders, low Apgar score, the condition requires resuscitation.

Diagnostics

A neurologist can send the child for a consultation with an ophthalmologist and for additional examinations. What are their advantages and disadvantages?

Neurosonography

Computed tomography and MRI

MRI is a modern diagnostic method

An important rule: during the study, the child should not move. Therefore, before the procedure, he may be given special medications.

EEG and dopplerography

Treatment

The task of the medical staff is to establish the fact of violations of the central nervous system as soon as possible and begin treatment in the maternity hospital. Recall that the first month of life is the most decisive, when the maturation of nerve cells and the full replacement of those who died after oxygen starvation are possible.