Interesting facts about spastic tetraplegia. Signs and causes of cerebral palsy in a child, methods of treatment of cerebral palsy

Specific forms of cerebral palsy are determined based on the degree, type and localization of anomalies in the patient. Doctors classify cerebral palsy according to the type of movement disorder: spastic(tense muscles) athetoid(convulsive movements) or ataxic(impaired balance and coordination). To these types are added any additional symptoms that allow you to clarify the diagnosis. Often, information about disorders affecting the limbs is used to describe the type of cerebral palsy. To name the most common forms of the disease under consideration, Latin terms are used that describe the location or number of damaged limbs in combination with the terms "paresis" (weakening) or "plegia" (paralysis). For example, the term "hemiparesis" indicates that the limbs are weakened on only one side of the body, while the term "tetraplegia" means paralysis of all limbs.

Spastic paralysis/hemiparesis

This type of cerebral palsy usually affects the shoulder and hand on one side of the body, but it can also affect the leg. In preterm infants, it is usually caused by periventricular hemorrhagic infarction (in most cases unilateral) and a congenital cerebral anomaly (eg, schizencephaly) or ischemic infarction. In term infants, the main cause is intracerebral hemorrhage in one of the hemispheres (most often localized in the basin of the middle cerebral artery).

Children suffering from spastic hemiplegia tend to walk later and walk on their toes due to a stiff heel tendon. In patients with this diagnosis, often the limbs are much shorter and thinner than in children who do not have developmental abnormalities. A number of patients develop scoliosis (curvature of the spine). Depending on the location of the brain damage present, a child with spastic hemiplegia may experience seizures. The development of speech will also be slowed down and, at best, may be satisfactory, intelligence is usually normal.

Based on the above, the level social adaptation the child, as a rule, is determined not by the degree of motor defect, but by the intellectual development of the patient. Focal epileptic seizures often occur;

Spastic diplegia/diparesis

The most common type of cerebral palsy (this form of the disease accounts for ¾ of all spastic types of cerebral palsy). The shape is characterized early development contractures, deformities of the joints and spine. It is predominantly detected in children born before term (consequences of periventricular leukomalacia, intraventricular hemorrhages or other factors).

This type of cerebral palsy is characterized by muscle stiffness, predominantly affecting lower limbs, the effect on the hands and face is less noticeable, however, the hands can be somewhat clumsy. Tendon reflexes are hyperactive, fingers point up. The tension of certain leg muscles causes the legs to move like "scissors". Children with this diagnosis may need a walker or leg braces. Intelligence and language skills usually develop normally.

The most common manifestations also include: dysarthria, the presence of elements of pseudobulbar syndrome, etc. Often there are pathological disorders cranial nerves: hearing impairment, moderate decrease in intelligence (in most cases, due to the effect on the child environment: segregation and abuse hinder development), convergent strabismus, atrophy optic nerves.

This form is the most favorable in terms of social adaptation - its degree can reach the level healthy people(assuming good hand function and normal mental development).

Spastic tetraplegia/tetraparesis

The most severe form of cerebral palsy, often accompanied by moderate to severe mental retardation. This is due to the wide spread of brain damage or significant malformations of the brain.

It can be caused by intrauterine infections and perinatal hypoxia with diffuse damage to the cerebral hemispheres. In premature infants, the main cause of the development of this form of cerebral palsy is selective neuronal necrosis in combination with periventricular leukomalacia, and in full-term infants, diffuse or selective neuronal necrosis and parasagittal brain damage that occurs during intrauterine chronic hypoxia. 50% of children have epilepsy.

Children often suffer from severe stiffness in the limbs with a flaccid and relaxed neck. The form is characterized by the early formation of contractures, as well as deformities of the limbs and torso. In almost half of the cases, the disorder musculoskeletal system accompanied by pathologies of the cranial nerves: atrophy of the optic nerves, strabismus, hearing impairment and pseudobulbar disorders.

Often, microcephaly is noted in children, which is secondary. Patients with tetraplegia are rarely able to walk, have difficulty with speech and its understanding. Seizures are common and very difficult to control. Lack of motivation and severe hand dysmotility rules out simple labor activity and self-service;

Dyskinetic cerebral palsy

(also includes athetoid, choreoathetoid and dystonic types of the disease)

This type of cerebral palsy is characterized by slow and uncontrollable jerky movements of the arms and/or legs. One of the most common etiological reasons for the development of this form of cerebral palsy is the transferred hemolytic disease newborns, accompanied by the development of nuclear jaundice.

With this form of cerebral palsy, in most cases, the structures of the auditory analyzer and the extrapyramidal system are damaged. Clinical picture characterized by the presence of hyperkinesis: choreoathetosis, athetosis, torsion dystonia (diatonic attacks occur in children in the first months of life), oculomotor disorders, dysarthria, hearing impairment.

A striking manifestation of the disease are involuntary movements, salivation, increased muscle tone which may be accompanied by paresis and paralysis. Speech disorders are most often observed in the form of hyperkinetic dysarthria. There is no proper installation of the limbs and torso.

The patient's intelligence is rarely affected by pathology. Children with good intellectual development can graduate from a regular school, a specialized secondary or higher educational institution, and undergo adaptation to work.

Ataxic cerebral palsy

A rare subtype of cerebral palsy that affects the balance and depth of perception. It is characterized by low muscle tone (hypotonicity), high periosteal and tendon reflexes, and ataxia. Often accompanied by speech disorders in the form of pseudobulbar or cerebellar dysarthria. Occurs with predominant damage to the cerebellum, and, according to assumptions, the frontal lobes (due to birth trauma). Also, risk factors are congenital malformations and hypoxic-ischemic factors.

Children often have poor coordination and stagger around with their legs abnormally wide apart. They have difficulty performing quick and precise movements (buttoning a shirt, writing, drawing). They may also be prone to tremors, in which every conscious movement—such as picking up an object—is accompanied by tremors in the limbs that get worse as the hands get closer to the object;

Clinically, the disease is characterized by the usual for cerebral palsy symptom complex (ataxia, muscular hypotension) and various symptomatic manifestations of cerebellar asynergy (dysarthria, intentional tremor, dysmetria). With this form of cerebral palsy, there is a moderate delay in the development of intelligence, in some cases there is oligophrenia in the degree of imbecility. More than 50% of diagnosed cases of ataxic cerebral palsy are previously unrecognized hereditary ataxias.

mixed types

This category includes diseases, the symptomatic manifestations of which do not correspond to any of the above types of cerebral palsy. For example, in a child with mixed cerebral palsy, some of the muscles may be overly tense, while others may be overly relaxed.

Was the material helpful?

"Cerebral" means pertaining to the brain. "Paralysis" is a disorder of motor activity of part or all of the body. Cerebral palsy is a systemic disease that occurs as a result of underdevelopment or a defect in the brain and manifests itself in the inability to move, maintain balance and control the posture of the body.

In domestic practice, it is customary to add the word “children” to the name of the diagnosis, because. its causes are formed before birth or at the very beginning of life. Western medicine operates with a shortened name - cerebral palsy.

World statistics show that cerebral palsy occurs in different populations with a frequency of 1.5 to 4 cases per 1000 babies born (0.2-0.4%).

Features of children with cerebral palsy

The following features of children with cerebral palsy can be distinguished: mental, psychological and emotional. Defects in the motor activity of the child lead to a lack of development neural connections in the brain, which negatively affects mental abilities and the speed of solving problems (intelligence). In addition to this, children with cerebral palsy are in a state of varying degrees of social deprivation. Both factors together lead to infantilism and psychological immaturity.

Emotionally, children with cerebral palsy are vulnerable and often respond inappropriately to the stimulus. The restriction of social contacts and poor learning ability do not allow them to master informal norms of behavior and control their psychological and emotional state.

The reasons

Initial studies of cerebral palsy, which were carried out as early as the 19th century, showed that the cause of the disease is oxygen starvation fetus during the mother's pregnancy. During the twentieth century. knowledge about cerebral palsy was supplemented and expanded. This made it possible to formulate the most common cause diseases: defects in the formation of the brain during fetal development.

The version of fetal hypoxia was confirmed as one of the potential causes leading to changes in the nervous tissue during its formation. In the experiments nerve cells were extremely sensitive to lack of nutrition and oxygen.

Fetal hypoxia can occur not only from maternal smoking during pregnancy, but also as a result of the following reasons:

• Birth trauma.
• Incorrect position of the fetus during childbirth.
• preterm birth
• Too long or short delivery.

In addition to hypoxia, modern knowledge suggests that the main cause of cerebral palsy is a violation of the blood supply to the child's brain, which leads to ischemia and infarction of a part of the brain or hemorrhagic stroke. This can happen both in the prenatal period and after birth.

Other reasons include the following:

• Genetic mutations in the fetus.
• Infectious diseases of a woman during pregnancy, for example, hepatitis.
• Endocrine disorders in a pregnant woman.
• Toxic poisoning with poisons and chemicals, including medical devices.
• Radiation radiation, including x-rays.
• Incompatibility of Rh factors of mother and fetus.

Other causes can be considered as risk factors. Their presence increases the likelihood of brain defects in a child, but does not necessarily cause them:

• A period of prolonged infertility.
• Early (before 16 years) or late (after 40 years) pregnancy.
• The use of alcohol, drugs.
• Poor stress resistance of a pregnant woman.

In each individual case, it is usually not possible to establish a specific cause. It is customary to talk about a complex of reasons or to refer to an accident.

Classification

Hemiplegic form

It differs from other forms in that it affects one of the sides of the body (right or left) as a result of necrosis of a part of the brain in one of the hemispheres. Patients with the hemiplegic form can master movements. The arm is more affected than the leg, and is extended forward in a gesture reminiscent of a supplicant. The leg is straightened at the knee, twisted at the foot.

There is a lag in mental and psychological development, in mastering speech. However, a person with the hemiplegic form can learn social norms of interaction and perform simple self-care tasks.

Spastic tetraplegia

The most severe form of cerebral palsy. Neuronal destruction occurs in early stages formations, in connection with which the lesions are of a systemic all-encompassing nature:

• Paresis of legs and arms.
• Violation of muscle reflexes.
• Formation of contractures and ties in the limbs.
• Violation of the shape of the spine and the work of the joints.
• limb deformity.
• Violation of the ability to swallow and generate sounds.
• Suffering of visual ability, development of strabismus, blindness.
• Hearing impairment.
• Growth retardation of the cranium.
• Significant mental retardation.

A patient with spastic tetraplegia is unable to perform basic self-care tasks.

Spastic diplegia

The most common form. It was she who was clinically described for the first time as cerebral palsy. Peculiarities:

• Premature babies suffer.
• The lower extremities are more affected than the upper ones.
• Due to the contracture of the legs, there is a deformation of the spine.
• Delayed development of the intellect and psyche.

Patients with spastic diplegia can learn skills and knowledge. Learning and socialization depends on the degree of damage to the hands: what better baby owns hands, the more favorable the prognosis of social adaptation.

Ataxic form

Ataxia is a mismatch of muscle movement, impaired motor skills, hand trembling, inaccurate and awkward movements, lack of coordination, difficult to maintain balance. All symptoms are manifested against the background of reduced muscle tone and strong contractile reflexes.

Speech impairment and mental retardation characteristics ataxic form of cerebral palsy. Patients can perform simple tasks and take care of themselves. Fast movements and movements that require significant control, such as writing, are difficult or not given to them at all.

Dyskinetic (hyperkinetic) form

Patients have an average intellectual development and learning ability, they can understand complex abstract constructions and master knowledge.

At the physical level, the dyskinetic form manifests itself in the following features:

• Difficulty in controlling movements.
• Involuntary movements (dyskinesis).
• Variability in muscle tone: fast and jerky movements turn into slow and stretching ones.
• Deformation of the posture of the body, limbs.
• Violation of speech function.

mixed forms

As a result of exposure to a number of causes and damage to various parts of the brain, cerebral palsy sometimes develops in two forms. Usually it is a mix of dyskinetic and spastic forms.

Symptoms and signs

In the previous section, the signs of cerebral palsy were considered at the stage when they were formed in their final form and clearly manifested. Consider early symptoms which may indicate the presence of a disease. By general rule early initiation of therapy gives the best results.

For a child under 6 months of age, the signs of possible cerebral palsy will be as follows:

• Tense body of the child, unnatural position of the arms and / or legs.
• When you pick up a child from a prone position, his head is thrown back.
• When you hold a child in your arms, you feel how his body tenses up, as if he is trying to push off.

For a child aged 6 to 10 months:

• It always flips in the same direction and never in the opposite direction.
• Cannot put palms together.
• With difficulty brings his hands to his mouth.
• He spreads his palm on only one hand, and the second is clenched into a fist.

For a child older than 10 months:

• Always crawls sideways, pushing only with the right or only with the left hand and foot.
• Does not use all fours.

Based on the symptoms listed above, it is impossible to unequivocally say about the presence of cerebral palsy. They may indicate a number of other diseases. In this regard, professional diagnostics is necessary for the diagnosis.

Diagnosis of cerebral palsy

Diagnosis begins with the study of risk factors and the course of childbirth.

In addition to examining visible deviations in the position of the body and limbs, examining muscle tone, vision, hearing, vocal cords, cognitive abilities, psychological state, for the diagnosis of cerebral palsy, special methods are used:

• The study of biocurrents of the brain using EEG.
• Electrophysiological study of muscle conduction using EMG.
• X-ray diagnostics of bones.
• Examination of the skull by ultrasound.
• Chromosomal analysis.
• Neuroimmunological blood test for the presence of antibodies to specific brain proteins.
• Muscle biopsy.
• Computed and magnetic resonance imaging.

Some symptoms of cerebral palsy may indicate a brain tumor, the consequences of meningitis, chromosomal diseases, neuromuscular diseases. Differentiating cerebral palsy from similar ailments is the main task in making a diagnosis.

Rehabilitation treatment

The life of a child with cerebral palsy can be called a permanent rehabilitation. Brain damage hinders intellectual and psychological development. The restriction of motor ability aggravates the development process: new connections between neurons are not formed, development does not occur nerve fibers. Without daily rehabilitation measures the child may not develop at all.

Rehabilitation treatment should be started as early as possible and should not be interrupted. Special doctors- Rehabilitologists - are engaged in the targeted development of the motor potential of the child. The scheme of classes is selected based on the severity of the initial situation.

Mastering skills occurs as a result of gradual learning, starting with the simplest ones. For example, first the child is taught to roll over independently while lying down. After he masters this stage, they move on to learning to crawl on all fours. Gradually, from day to day, physical activity will force the nervous system to develop.

Today, in many cities there are special rehabilitation centers for children with cerebral palsy. They work with children several times a day. At the initial stage, classes last 10 minutes. Gradually, the duration of one session is brought to 1-2 hours. A significant advantage of visiting rehabilitation centers is that in it children receive basic social skills: they have the opportunity to observe their peers, come into contact with them.

Rehabilitation activities can be divided into several areas:

• Development of basic motor abilities.
• Training of coordination of movements and balance of the body.
• Workout well-coordinated work right and left parts of the body.
• Developing the ability to manipulate small details.

All developmental activities are dressed in the form of games. In addition, special simulators and devices are widely used.

• Method of Berta Bobath

Uses special body and limb positions for training

• Methodology of Vaclav Vojt

It is based on the principle of reflex locomotion - a complex of physical manipulations with the body that have a stimulating effect on the muscles and nervous system.

• Voldemar Pfaffenrot's method

Known as synergistic reflexology, it includes acupuncture, osteopathy and other manual techniques.

For children with cerebral palsy, there are special sanatoriums in which patients undergo physiotherapy procedures, and comprehensive rehabilitation assistance is provided.

One of the effective elements of rehabilitation is taking baths with ordinary or mineralized water and swimming. Water improves muscle tone, relieves tension, reduces twitching. Bathing has a tonic effect on the nervous system, mood and well-being.

Was shown positive influence on the state of children with cerebral palsy communication with nature. In many foreign clinics, special gardens and parks are equipped for this purpose, in which children not only learn about the plant world with pleasure, but also, thanks to the landscape originality, train physical activity.

Medical treatment

Treatment medicines complements physiotherapeutic procedures and rehabilitation measures and is not the main way to deal with cerebral palsy. As a rule, medications are prescribed in the first six months of therapy, as well as with severe pain, convulsions, epilepsy, to reduce twitching and spontaneous movements.

To reduce muscle tension, use:

• Mydocalm
• Diazepam
• Baclofen
• Dantrolene
• Botox
• Dysport

Use of nootropics:

• Cerebrolysin
• Cortexin
• Ceraxon
• Somazina
• Actovegin
• Piracetam

For epilepsy, prescribe:

• Valproic acid preparations
• Toparamat
• Lamotrigine

In addition, a wide range of drugs are used:

• Antidepressants
• Antispasmodics
• tranquilizers
• Painkillers

Proven effectiveness has such a conservative method of treating cerebral palsy as stem cell transplantation. The cells are injected into the cerebrospinal fluid or, rarely, directly into the brain. Positive result demonstrated by 85% of patients. After the procedure, the regeneration of muscle and nervous tissue, the development of nerve cells, the improvement of tactile and motor function, and the strengthening of immunity are noted.

Surgery

Surgical intervention for cerebral palsy is rarely used. It is aimed at correcting the consequences of the disease. Operations make it possible to transplant and transform muscles and tendons, remove contractures and ties, and correct bone deformities. In some cases, part of the nerve pathways that do not allow the muscles to relax is removed.

As a result surgical treatment the pain syndrome disappears, the mobility of the limbs improves, patients acquire the ability to move around with the help of crutches and other auxiliary items.

Physiotherapy treatment

Physiotherapy techniques in conjunction with daily rehabilitation programs form the basis of the treatment of cerebral palsy.

Physiotherapy treatment includes:

• Massage

Massage is one of the key techniques used in cerebral palsy. Kneading the muscles improves their blood supply and relieves tension. It has been proven that the impact on certain points of the body is able to regulate the processes occurring in nervous system.

• Physiotherapy

In addition to the fact that motor activity contributes to the formation of neural connections, specially selected exercises prevent the occurrence of contractures in patients with cerebral palsy.

• Polarization by current of low intensity

The microcurrent passed through the electrodes attached to the head changes the functional state of the nervous tissue. It acts systematically on different parts of the brain, improving neurodynamics, providing an adequate response to stimuli, stimulating the self-regulation of neural systems.

• Balneotherapy

All types of water procedures are very useful for cerebral palsy. This is, first of all, taking baths enriched with trace elements and essential oils. Swimming and wallowing in the pool has an excellent healing effect. Hydromassage, thanks to the effect of water jets, tones the whole body and improves mood. Baths with enriched beneficial substances water through which weak current pulses are passed.

• Acupuncture

Acupuncture, a traditional physiotherapy technique for Oriental medicine, has proven its effectiveness in the treatment of non-severe forms of cerebral palsy. It was shown that not only the motor ability improves, but also the emotional and intellectual sphere, the likelihood of speech development increases.

• Antigravity Therapy

This physiotherapy procedure is carried out using a special orthopedic suit, which is designed in such a way that it compresses all the muscles of the patient with cerebral palsy. The suit is put on the patient, then ropes are fastened to the suit, which lift the patient off the floor. The compression of muscles, joints and ligaments arising from lifting leads to the sending of appropriate signals to the brain. This has a positive effect on the central nervous system, helps to normalize speech and better control movements.

• Orthopedic devices

Various simulators and devices are used to stimulate the work of muscles, the nervous system, and joints.

• Lessons with a speech therapist

Mastering the speech skill is an important component of the treatment of cerebral palsy. Speech, as well as physical activity, makes the brain develop. Speech therapists have their own methods of work, which show high efficiency.

• Animal Therapy

Children with cerebral palsy lag behind in intellectual development and in social adaptation, but they perfectly find contacts with animals, receiving a lot of positive emotions from them. Hippotherapy - horse riding treatment - shows good results in teaching children to control their own body and maintain balance. For the muscular system, riding a horse is a lot like walking. Impulses from the movement of the horse are transmitted to the child, activating his neural connections.

Among restorative animal therapies, dolphin therapy is effective. Largely due to the emotional impact. Children have an amazing sympathy for dolphins. Dolphins harmlessly play with children, allow themselves to be touched, which delights the children. Among other things, dolphin therapy is carried out in water and is an element of hydromassage.

Social adaptation

All representatives of the human species are social beings for whom contacts with others like themselves are an essential factor in development. Considering that even for many healthy children, the period of social adaptation at preschool age (and sometimes at school) is not easy, then for children with such serious illness how cerebral palsy the process of interaction with society is a serious problem.

The main factor hindering the socialization of patients with cerebral palsy are severe forms mental retardation. Only 2% of patients successfully adapt to the social environment.

On the other hand, the Russian social reality itself is not very adapted to the assimilation of children and adolescents with disabilities. Despite the fact that potentially many people suffering from cerebral palsy master professional skills and even programs of higher educational institutions, finding their place in life for most patients remains an unrealizable dream.

The attitude towards patients with cerebral palsy is slowly changing in society. Boarding schools and rehabilitation centers are being opened for them. However, there is still a lot of work to be done in this direction.

Forecast

In most cases, the prognosis for patients with cerebral palsy is favorable both in terms of life expectancy and in terms of increasing the functionality of the body and intellectual development. The prognosis will be better the sooner treatment is started.

One of the studies conducted in the USSR (1979) showed that patients with hemiplegic (almost 71% studied at schools and institutes) and diplegic (almost 48% have normal intellectual development) have the best prognosis.

The prognosis for social adaptation is worse in the dyskinetic form due to a serious motor defect. However, more than 50% of them can perform tasks that are not related to fine motor skills.

Patients with bilateral hemiplegia, with ataxic form and, of course, with tetraplegia have the worst prognosis.

Prevention

It is highly likely that the risk of underdevelopment of the central nervous system can be reduced by observing certain rules:

1. The expectant mother should take care of her health long before the intended pregnancy.
2. smoking and others bad habits pregnant women are common cause lag in fetal maturation, the birth of premature babies, premature birth - all this increases the risk of cerebral palsy.
3. Monitoring the course of pregnancy and in the first days of birth is an important component of early diagnosis and, therefore, a better prognosis for a sick child. Modern methods allow to detect violations in the central nervous system of the child, even in the womb.

Spastic tetraplegia (cerebral palsy)

Spastic tetraplegia (with greater severity of movement disorders in the hands, the clarifying term "bilateral hemiplegia" can be used)- one of the most severe forms Cerebral palsy, which is a consequence of anomalies in the development of the brain, intrauterine infections and perinatal hypoxia with diffuse damage to the cerebral hemispheres.

In preterm infants, the main cause of perinatal hypoxia is selective neuronal necrosis and periventricular leukomalacia; in full-term - selective or diffuse necrosis of neurons and parasagittal brain damage during intrauterine chronic hypoxia.

Clinically diagnosed are spastic quadriplegia (quadriparesis; a more appropriate term compared to tetraplegia, since noticeable impairments are detected approximately equally in all four limbs), pseudobulbar syndrome, visual impairment, cognitive and speech impairment. 50% of children have epileptic seizures.

This form is characterized by early formation of contractures, deformities of the trunk and limbs. In almost half of the cases, motor disorders are accompanied by pathology of the cranial nerves: strabismus, atrophy of the optic nerves, hearing impairment, pseudobulbar disorders. Quite often, microcephaly is noted in children, which, of course, is secondary. Severe motor defect of the hands and lack of motivation preclude self-service and simple labor activity.

Mental and spiritual cause of the disease.

mental blocking.

The need to unite the family with an expression of love.

Spiritual blockage.

In order to understand the spiritual blockage that prevents you from meeting an important need of your true I, ask yourself the questions in the article . The answers to these questions will allow you to more accurately determine the real cause of your physical problem.

.

I contribute to the peaceful life of the family, where love reigns. Everything is going well. Life is change, and I easily adapt to the new. I accept life - past, present and future.

Rehabilitation program.

Includes - protection from the adverse effects of environmental factors; body cleansing; restoration of immunity; restoration of the myelin sheaths of nerve fibers (thus, including the elimination of the causes and consequences of the disease).

EMR is a source of stress for the human body. There is a synchronization of the processes of excitation and inhibition in the central nervous system.

- is able to restore damaged myelin sheaths of nerve fibers, normalize the conduction of nerve impulses, suppress the recession of brain tissue, and initiate the process of growth of new brain cells.

- leads to improved blood circulation in the brain and spinal cord, promotes better delivery of oxygen and nutrients to nerve cells, regenerates damaged brain cells, restores connections between them and speeds up the transfer of information. ​

- potentiates the action of superoxide dismutase, preventing the accumulation of free radicals. Induces stem cells from bone marrow, restoring body systems, organs and tissues, as well as nerve cells. It affects the nucleus (DNA) of the cell, restoring its altered forms to the true original form, and subsequently erases information about the disease.

0 medical procedures prescribed in the treatment of the disease Spastic tetraplegia

Medications that can reduce muscle tension may be used to improve functional ability, treat pain, and reduce complications associated with spasticity or other symptoms. It is important to discuss the risks of taking medications with your doctor. The choice of remedies depends on whether the disease affects isolated areas of the body, or all the muscles. Drug therapy may include: Isolated spasticity. When spasticity is isolated to one muscle group, your doctor may recommend that you inject botulinum toxin A directly into the muscle or nerve. Injections can help control drooling. Repeat injections are required every three months. Side effects may include pain, bruising, or severe weakness. More serious side effects are breathing and swallowing problems. Generalized spasticity. If the whole body is affected, oral muscle relaxants may help. These agents include diazepam, dantrolene, baclofen. There is a risk of developing dependence on diazepam, so it is not recommended for long-term use. Side effects include drowsiness, weakness, and drooling. Side effects of dantrolene are drowsiness, nausea, diarrhea. Side effects of baclofen include drowsiness, confusion, and nausea. Baclofen can be administered spinal cord through a special pump that is implanted under the skin of the abdomen. Your child may be given medication to reduce salivation. These include cyclodol, scopolamine, glycopyrrolate. Therapeutic treatments There are many non-drug therapies that can help improve functional ability. These include: Physiotherapy. Muscle training can help a child improve strength, flexibility, balance, motor development, and mobility. You will also be taught how to take care of your baby safely at home, such as how to bathe and feed him. Special stretch marks or splints can also be used. Some of these methods are used to improve a particular function, such as improving the ability to walk. Others help improve the flexibility of stiff muscles. Occupational pathology. Using special tactics and equipment, the occupational pathologist will work to ensure that the child can independently perform normal daily activities and self-care at home and at school. Equipment may include walkers, four-legged canes, electric chairs. speech therapy. A speech therapist will help your child improve their ability to speak correctly or use signs to communicate. A speech therapist can teach a child to use a computer or voice synthesizer. Other communication devices are boards with pictures of objects and daily activities. Sentences can be made up by pointing to different pictures. A speech pathologist can also help you deal with difficulties in controlling the muscles used in eating and swallowing. Recreational Therapy. Some children may benefit from certain types of recreation, such as horseback riding. These activities can help improve motor functions child, speech and emotional state. Surgical procedures Surgical procedures can be used to relieve muscle tension and correct bone deformities. These include: Orthopedic surgery. Children with severe contractures and deformities of the extremities may require surgery on the joints and bones of the hips and legs to correct posture disorders. Surgical procedures also lengthen muscles and tendons that may be short due to contractures. They can reduce pain levels and improve mobility. Disconnection of nerves. In severe cases where other treatments fail, surgeons may cut the nerve to the spastic muscles during a procedure called a rhizotomy. The procedure causes muscle relaxation, but can also lead to numbness.

Medical services for the treatment of the disease Spastic tetraplegia