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小儿脑瘫之二:预防及常见问题(附英文资料)
作者:home99
发表时间:2009-10-09
更新时间:2009-10-09
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::: 栏目 :::
写给准妈妈1
宝宝护理与成长3
写给准妈妈3
为人父母3
英语学习
为人处世
休闲娱乐
理财话题
为人父母2
写给准妈妈2
实用资料
宝宝护理与成长2
为人父母1
其它
医药健康话题
写给新妈妈
宝宝护理与成长1
异国他乡

贴出第二部分,仅供大家参考和了解啊。

这部分就归结一下小儿脑瘫的预防、注意事项、认识误区及常见问题的解答。并在最后附上英文资料供参考。

我总是觉得绝大多数宝宝都是健康的,准妈妈和妈妈们大可以放宽心,了解一些问题,并不是要对号入座、让自己紧张,而是为了知己知彼、百战百胜;还有毛主席的名言“在战略上我们要藐视一切敌人,在战术上我们要重视一切敌人”,不知放这里是否合适,不过觉得说得很有道理啊,呵呵。

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七、小儿脑瘫如何预防:

由于多数情况下,小儿脑瘫是由非遗传性因素引起的,所以尽可能减免这些可能导致小儿脑瘫因素的发生(在第一部分已详细列出),做好预防小儿脑瘫的工作,颇为关键,建议从以下三个方面着手:

(一) 出生前的预防:

做到优生优育,认真做好早期产前检查,做好孕妇围产期的保健,防止发生先天性疾病。妊娠期间发现胎儿异常及早终止妊娠。孕妇注意:避免病毒感染,如流感、风疹等。特别是在妊娠10至18周是胎儿神经系统发育迅速时期,此时更应注意防止感染。不要滥用药物,特别是麻醉药、镇静药,禁止吸烟、饮酒;避免接触有毒有害物质和放射线的照射。

1、实行婚前保健:对准备结婚的男女双方进行性卫生、生育和遗传病知识的指导;有关婚配、生育等问题的咨询及男女双方可能患影响结婚和生育的疾病进行医学检查,提出医学意见。

2、搞好孕期保健:定期产前检查;增加营养;防止感染性疾病的发生等。

(二) 围产期的预防:

造成脑瘫的一个重要原因就是分娩过程中引起胎儿窒息和颅内出血,预防早产、难产,避免分娩过程中对新生儿的伤害,是预防脑瘫至关重要的一个环节。一旦出现新生儿窒息、颅内出血等病症,要积极进行治疗,减少对新生儿的损害。
1、避免早产和低体重儿的出生
2、预防窒息和颅内出血
3、防治高胆红素血症

(三) 出生后的预防:

脑部感染、脑血管疾病、脑外伤等均可引起后天性脑瘫,要注意预防,彻底治疗原发病。一旦发生上述症状,要及时到有小儿神经科条件的医院治疗。这里特别提示,在孩子患病早期、生命体征平稳之后,要同时进行康复治疗,这是预防脑性瘫痪和减轻病情的有效方法。

1、防止感染性疾病的发生。
(1) 实行住院分娩。
(2) 注意保护新生儿的皮肤。
(3) 保持新生儿脐部的干燥、清洁。
(4) 密切观察黄疸的消长。
(5) 注意观察前囟。
(6) 实行母乳喂养。

2、预防高热惊厥的发生。

3、正确对待腰椎穿刺:腰椎穿刺抽取少量脑积液用于检查,以了解疾病的性质和病情,为正确诊断和治疗提供依据,从而减少颅内疾病后遗症的发生。为此家长应密切配合,共同为患儿的健康负责。

八、注意事项

【家庭康复训练注意事项】

1、保持正确姿态,当患儿有了较好的躯干控制能力与进食能力时,可以系统开始语言训练,交谈时要与患儿眼睛的高度保持一致,如果位置过高会使患儿全身过度伸展不利于发音。

2、增加说话和活动的量,父母不要因为与患儿说话得不到回应就丧失信心,应利用各种机会跟患儿说话;做游戏时与患儿一起已经进行呼吸和发声训练,寓教于乐引起患儿对训练的兴趣。

3、鼓励患儿说话,应多表扬鼓励患儿发声的积极性,帮助患儿树立说话的信心;当患儿发声时要立即回应多启发他表达想说的话,千万不要批评和指责患儿。
教育要持之以恒,语言的矫治和训练是长期而艰苦的,家长要有极大的耐心和毅力

4、只有持之以恒才能有所收获,才能给有语言障碍的脑瘫儿打下良好的语言基础。

5、对患儿不过分保护,不怜悯不放弃,不与其他孩子作比较,多鼓励患儿中心参加游戏和活动。

【小儿脑瘫患者家庭用药需要注意的事项】

1、注意药物的相互作用:两种以上药物同时服用,彼此可产生相互作用,有时可使其中一种药物降低药效或引起不良反应。如青霉素类和四环素族合用,其抗菌效力不及单独使用。土霉素等肠道杀菌药与整肠生同时服用,会使整肠生失效,因为整肠生是一种双歧杆菌制剂,可调节肠道菌丛失调。因此若要一次同服数种药物时,应经医生或药剂师指导,以免因药物的相互作用而失效。

2、掌握用药剂量:用药一定要按剂量,超量服用可产生不良反应,甚至可引起死亡。如老年人和小孩不注意退烧药物的剂量,可因出汗过多而使体温骤降,引起虚脱。

3、注意服药方法:服药除了要注意时间、次数外,尚须注意方法。绝大多数药物是采取吞服的,但有些药物如酵母片则宜嚼碎后吞服。又如硝酸甘油片宜舌下含服,这样可以不通过肝脏的破坏而保证药效。首先在明确诊断之前,最好不要随便用药。症状往往是疾病诊断的依据之一,随便用药会掩盖症状,造成诊断困难,甚至误诊。

【脑瘫儿童的家庭饮食】:五要、五不

脑瘫儿童由于身体缺陷,体质较弱,容易感染疾病而影响功能的康复,因此合理的饮食,注意营养是十分重要的,脑瘫儿童饮食有五不、五要,如下:

五要

1、食物要容易消化吸收,营养丰富,要选高蛋白质的食物,蛋白质是智力活动的基础与脑的记忆、思维有密切的关系,牛奶、豆浆、鸡蛋、酸奶、肉类等都是富含蛋白质的食物,还多选维生素高的食物,因维生素A能增强身体的抵抗力,促进大脑的发育。维生素 B族能提高机体各种代谢功能,增强食欲,维生素D能帮助钙的吸收和利用。
2、要以碳水化合物如米饭、面食、馒头、粥、粉为主食,过多杂食会影响食欲,造成营养障碍。
3、要多吃蔬菜和水果,少吃脂肪肥肉,蔬菜和水果含有维生素和纤维,能保持大便通畅,如小孩不吃蔬菜,可以把菜剁烂,做成菜肉包子、菜肉饺子、菜泥、菜汤,教育孩子养成吃蔬菜的习惯。
4、饮食要有定时,一般早、午、晚各进食一次,有条件者可以在上下午各增加点心一次,按时进食,可以增加食欲。
5、每日要适当进行户外活动,让阳光照射皮肤,可增进食欲,帮助吸收。

五不

1、不要吃油炸、辣、油腻、辛热、等有刺激性食物和难消化的食物,因小儿体质多热,再食油炸等辛热食品易引起热病。
2、不宜滥食温补,因小儿为纯阳之体,只宜滋养清润食物。
3、不要过多食糖,因口腔内的细菌会使糖发酵,易患蛀齿而影响食欲。
4、不要偏食,因偏食会造成营养不良。
5、 不要过多食用姜、葱、味精、胡椒、酒等调味品。

九、小儿脑瘫认识误区

小儿脑瘫,是小儿出生前后脑实质性损伤引起的运动功能障碍、智力低下、癫痫、失语、耳聋等一组综合征。若能及时发现,及时干预,预后基本比较理想。但当对这种病认识有误,不积极治疗,或乱投医时,就会给患儿留下不可逆转的后遗症。

对小儿脑瘫常见的误解有:

1、缺钙所致
常碰到一些家长带患儿看病时,一问病史,有明显的脑瘫发病危险因素,加上患儿的特殊表现,基本可以诊断为脑瘫。然而,有些家长对此病缺乏认识,认为软、瘫、抽筋就是缺钙引起的,一味地补钙,给患儿开大量钙制剂,结果钙补得不少,患儿仍抬不起头,到该坐、站、走的年龄仍不能坐、站、走,延误了治疗的最佳时机。这并非补钙补错了,一些脑瘫患儿同时也有钙缺乏,而其“软”、“瘫”的真正病因是脑瘫。治疗的原则应是先治本,解决中枢问题,再治标,解决钙缺乏问题,或者是标本兼治。切不可以治标补钙来代替解决治本的中枢问题。

2、不可治
治疗脑瘫在国内外都是比较棘手的。按原来的西医观点,脑瘫是不可治的。但是随着科学的发展,实践已证实只要尽早进行合理干预,脑瘫患儿的康复治疗还是大有希望的。

3、愚昧、迷信
不少家长为患儿烧香拜佛,钱白花了事小,可小孩年龄大了,治疗起来已非常困难。

4、欲速不达
有些家长为患儿治病过于心切,只要一听到哪里能治这种病,都要去试一下,有的跑遍全国,却得不到有效治疗,有的受骗上当,叫苦不迭;也有的心情急躁,住院几天,效果不明显,就认为治疗无效。殊不知,脑瘫是脑实质性损伤引起的,只有当损伤的脑组织达到激活状态时,才能恢复正常的生理功能。同时,在治疗脑瘫的过程中,往往会出现治疗麻痹阶段,患儿的反应很可能不如初进院时,有部分家长就沉不住气了,以为越治越坏,而放弃治疗。事实上,这种暂时的麻痹,往往是治疗高潮即将到来的征兆,越过这个阶段,治疗效果就会明显表现出来。因此,家长应有思想准备,不可半途而废。

5、单一疗法
有些家长希望能用一种单一治疗方法,让小孩少受苦,是不可能的。因为手术疗法有严格的适应症,具有高选择性,各种物理疗法也不能解决根本问题。经过临床治疗实践,认为治疗小儿脑瘫还是康复训练。

十、小儿脑瘫常见问题及解答

Q:什么是小儿脑瘫
A:脑瘫是指由于出生前、出生时、婴儿早期的某些原因造成的非进行性脑损伤所致的综合症,主要表现为中枢性运动障碍和姿势异常,可伴有智能落后及惊厥发作、行为异常、感觉障碍及其他异常。尽管临床症状可随年龄的增长和脑的发育成熟而变化,但是其中枢神经系统的病变却固定不变。

Q:导致小儿脑瘫的原因有哪些
A:可能有以下4种原因:
1、低体重儿(小于2500g):包括早产未成熟儿,足月小样儿。

2、先天性异常:包括各种原因引起的脑发育异常,在四肢性瘫痪的脑瘫病人中53%与先天性异常有关;在非四肢性瘫的脑瘫病人中,35%是先天性发育不良所致。

3、脑缺血缺氧:在脑瘫患者中,20%是由窒息及产伤所引起,导致缺血缺氧的因素有:①母亲因素:如患妊娠高血压综合症、心力衰竭、大出血、贫血、休克或吸毒、药物过量等;②胎盘因素:如胎盘早剥、前置胎盘、胎盘坏死或胎盘功能不良等;③脐带血流阻断:如脐带脱垂、压迫、打结或绕劲等;④分娩过程异常:如臀位产、滞产、手术产(产钳)或应用麻醉药等;⑤新生儿因素:除窒息外,还有许多心肺功能异常疾病。如:先天性心脏病、呼吸窘迫综合症、周身循环衰竭、红细胞增多症。

4、核黄疸:为脑瘫重要原因,随着国产医学的进步,核黄疸引起脑瘫的比例下降。

Q:小儿脑瘫早期的异常表现有哪些?
A:1、过度激惹:持续哭叫,入睡困难,大约有30%脑性瘫痪小儿在生后前3个月有类似严重“肠绞痛”的表现。
2、喂养困难,吸吮及吞咽不协调,护理困难,频繁吐沫,以及持续体重不增。
3、非常“敏感”或激动,但如果患儿(特别是低出生体重儿)仅在饥饿时有如此表现则意义不大。
4、对噪音或体位改变“敏感”时难将大腿外展,洗澡时不易将拳头掰开,家长常反映“孩子不喜欢洗澡”,当脚用触及浴盆边缘,背部即僵硬竖弓形。以上某一种情况也可能在正常小儿出现,不能根据具有其中某一两项就诊断为脑性瘫痪,若存在多种情况,而且是发生在有高危因素的患儿,就要考虑有脑性瘫痪的可能。

Q:小儿脑瘫有哪些临床表现?
A:脑性瘫痪临床表现多种多样。由于类型、受损部位的不同而表现各异,即使同一病人,在不同年龄阶段表现也不尽相同。
1、运动发育落后:100天不能抬头;4个月后拇指向收,手张不开;5个月后不会伸手抓物;4~6个月不会笑,不认人,面貌异常;8个月不会坐;10个月不会爬;15个月不会走。(2)主动活动减少(3)反射异常:原始反射延迟消失;保护性反射减弱或不出现。如坐位时,向各方向推患儿,患儿不会用手支撑。(4)肌张力异常及姿势异常。
●直立位下肢内旋伸直,足下垂,双腿交叉呈剪刀状。
●从仰卧到坐起,头后倾,下肢伸,足屈,躯干后伸,伸肌张力增高。
●仰卧位伸肌张力增高,颈向后伸,下肢伸或交叉,双手拿不到前方正中位,呈角弓反张性躯干伸展。
●俯卧位屈肌张力增高,不能抬头,臀抬起,肩着床,四肢屈曲。
●头向一侧偏时,同侧上肢伸直,对侧上肢屈曲,呈射箭状。

Q:脑瘫会不会传染?
A:脑瘫是一种非传染性疾病,绝对不会通过接触传染。因此,不应将患儿与正常儿童隔离,而应让他们相互接触,一起做游戏和进行活动,以促进脑瘫患儿的生长发育。

Q:脑瘫是否一定会导致弱智?
A:虽然有些脑瘫患儿智力上有缺陷,但脑瘫并不等于弱智。而且,有很大一部分智力发育延迟的脑瘫患儿,并非智力本身有问题,而是因为长期缺少外界环境的适宜刺激,以及学习的机会少于正常儿童所致。很多资料显示,有些脑瘫患儿的智力甚至高于一般儿童,只要给予机会,他们完全可以创造出令人瞩目的成就。

Q:脑瘫能够治愈吗?
A:脑瘫是一种非进展性疾病,一旦患病,已经受损伤的脑组织是不可能通过治疗而被修复的。因此,从这个意义上而言,脑瘫不可能通过治疗而达到通常所说的痊愈。但是,通过积极的治疗,脑瘫患儿的功能却是可以得到很大程度的改善和发展。所以,决不可以放弃对脑瘫患儿的治疗和训练,应该坚持不懈,持之以恒。

Q:脑瘫患儿是否永远不会行走?
A:这是每个家长都极为关注的问题。可以肯定的是,并不是所有的脑瘫患儿都能学会走路。但对每个患儿来说,则要视其病情轻重而定。另外,有许多脑瘫患儿直到 7岁甚至 10岁以后才能够行走。因此,需谨慎对待这一问题,切勿过早草率定论而放弃努力。从孩子的需求角度来而言,也许其他方面的技能训练更为重要。有人提出,一个孩子要想幸福、独立地生活,下列方面是必不可少的: (1)自信、自爱 ;(2)与他人能很好地交流和建立良好的关系 ;(3)生活能自理,如能自己吃饭、穿衣等 ;(4)能自己从一处转移至另一处 ;(5)可能时,能自己行走。

上述 5个方面是根据其重要性大小的顺序排列。从中可以看出,行走并非是孩子所需要的最为重要的技能。因此,即使孩子不能行走,也还有许多更重要的方面应予以注意,如进食、洗漱、穿衣、玩耍、交流等。同时,也可采用多种方式帮助不能行走的孩子到他们想去的地方,如使用轮椅、手摇三轮车、特制行走架等。

Q:药物对脑瘫有无帮助?
A:一般地说,药物对脑瘫没有作用。但若患儿有癫痫发作时,则可用抗癫痫药物来控制。

Q:手术能不能治疗脑瘫?
A:手术不能治疗脑瘫本身,但有时可用于矫正挛缩 (使缩短的肌腱延长 ),或减少痉挛肌肉的拉力,以预防挛缩发生,但这有可能使运动更加困难。因此,只有在患儿已学会行走时,才能考虑手术治疗。还应注意的是,帮助患儿的最好方式,是鼓励其在良好的体位和姿势下,对张力增高的肌肉进行主动牵伸运动。

Q:脑瘫会在同一家庭中再次发生吗?
A: 一个家庭内同时有两个脑瘫患儿的情况极为罕见,因此不必过虑。

Q:脑瘫患儿成年后能结婚和生育吗?
A:一般而言,脑瘫患儿的后代不会出现脑瘫,除非是有家庭性痉挛性截瘫的患者。因此,脑瘫患儿成年后可以结婚,生育。

家有脑瘫患儿固然不幸,但是应该看到,脑瘫患儿在很多方面有着发展的空间和缓解的条件,只要给患儿更多、更全面的关爱,一样能够长成有用之才。

Q:脑瘫患儿家长如何对待脑瘫患儿?
A:1、正视问题,面对现实,坚持科学治疗;
2、对患儿要有耐心,有爱心,有康复信心;
3、对患儿不过分保护,不怜悯、不放弃、不恐吓、不与其他孩子相比,鼓励参加游戏和活动。

Q:祖国医学对脑瘫的病因病机的认识
A:中医儿科学中没有脑性瘫痪这一病名。根据其临床的表现,属于五迟、五软、五硬的范畴。五迟是指立迟、行迟、发迟、齿迟、语迟而言:五软是指头颈软、口较、手软、脚软、肌肉软而言;五硬在是指头颈硬、口硬、手硬、脚硬、肌肉硬而言。属儿科难治之症。
1、病因:本病病因多见于先天性、后天性和外伤性三种:
①先天因素:父精不足,母血气虚,导致胎儿禀赋不足,精血亏损,不能充养髓脑;或其母孕中受惊吓或抑郁悲伤,扰动胎气,以致胎育不良。②后天因素:小儿初生,肘气怯弱, 扩理不当,致生大病,损伤脑髓。③外伤因素:各种原因引起的产时脑部揭伤。
2、病机:禀贼不足,胎育不良,以致脑部受损,通过经络而累及四肢百骸,五官九窍,以及产生脑瘫的种种症候。

Q:脑瘫的诊断标准是什么?
A:脑性瘫痪的诊断主要依靠病史及体格检查、脑电日、CT及MRI等。

CT及MRI能了解颅脑结构有无异常,对探讨脑性瘫痪的病因及判断预后可能有所帮助,但不能据此肯定或否定诊断,脑电图可以了解是否合并癫瘸,对治疗有参考价值。诊断脑性瘫痪应符合以下几个条件:
①致病因素发生在母妊娠时,围产期或新生儿时期;③婴儿时期出现的中枢性瘫疾;③除外进行性疾病(代谢病、肿瘤等)所致的中枢性瘫痪;④除外正常小儿一过性运动发育落后。

Q:治疗脑瘫的原则是什么?
A:1、早期发现、早期治疗婴幼儿运动系统处于发育阶段,早期发现运动异常,早期加以纠正,容易取得较好的疗效。
2、促进正常运动发育,抑制异常运动和姿势按小儿运动发育规律,进行功能训练,循序渐进促使小儿产生正确运动。
3、综合治疗利用各种有效的手段对患儿进行全面、多样化的综合治疗,除针对运动障碍进行治疗外,对合并的语言障碍、智力低下、癫痫、行为异常也需进行干预,还要培养他面对日常生活、在会交往及将来从事某种职业的能力。
4、家庭训练和医生指导相结合 脑瘫的康复是个长期的过程,短期住院治疗不能取得良好的效果,许多治疗需要在家庭里完成,家长和医生密切配合,共同制定训练计划,评估训练效果,在医生指导下纠正不合理的训练方法。
5、脑力多由禀赋不足,胎育不良,外邪侵袭,导致脑髓不能充养,或受到损伤,通过经络累及四肢百骸,五官九窍,以致产生脑瘫的各种症侯。故滋补肝肾,营养脑细胞促进用组织发育为治疗本病之关键。瘫复康系列药的据此研制,是脑瘫患者康复的科学保证。

Q:为什么小儿脑瘫越早治疗越好?
A:1、从脑和神经系统的发育特点看,发现越早,脑和神经系统的可塑性越大,治疗效果越佳。研究表明:新生儿脑重340~400g见他,出生后6个月达800g;3岁前脑和神经系统的发育达60%;6岁前脑和神经系统的发育达90%。

2、早治疗可避免不良姿势的形成、肢体畸形而造成的终生残疾。

3、性格及思维能力的形成主要在学龄前,特别是教育心理的康复越早越好,有利于患儿全面成长。

Q:脑瘫患者如何进行家庭语言训练?
A:家庭是脑瘫小儿学习的自然教育环境.父母与患儿相处时间最长,接触最密切,亦是最早的启蒙教师。家教,使全家人有更多机会参与训练过程,不仅可以一对一的个别化教学,而且不受时间与空间的限制,尤其是关键性的学前阶段,若能及早给予各种基本训练,往往达到事半功倍的效果。家教中注意以下几点:

1、保持正确姿势 当患儿有了较好的躯干控制能力与进食能力时,可以开始语言训练。训练中要保持患儿眼睛的高度来与其交谈。如果从过高位置对着患几讲话,会使其全身过度伸展,不利于发音。

2、增加说话和活动的量 父母不要因为和患儿讲话得不到回答而丧失信心。不管患儿懂或不按懂。家庭成呐都利用各种机会去跟患儿说话。做游戏时与患儿一起进行呼吸训练,发声训练,寓教于乐,以引起患儿训练的兴趣。

3、鼓励患儿发声 当患儿发声时,要立刻与其对话和答应。即使还说不成句,也应点头示意,反复教他,启发他想要表达的话语。要多表扬或夸奖,避免过多的批评和指责,让患儿树立学说话的信心。利用患儿的各种要求和欲望,鼓励其发声的积极性。

4、教育要持之以恒 语言的矫治和训练是长期而艰苦的,家长要有极大的耐心和毅力,教育要持之以恒,这样才能有收获,才能使语言障碍的脑瘫儿获得良好的语言基础。

Q:脑瘫推拿与按摩方法有哪些?
A:推拿与按摩疗法是治疗小儿脑瘫的重要疗法之一,是经络调节的主要内容,也是祖国医学对小儿脑瘫的主要康复治疗手段之一。推拿与按摩手法熟练与否将直接影响着治疗效果的好坏,也是治病成败的关键。小儿与成人不同,皮肤娇嫩,肢端位小,又不配合,所以只有熟练掌握操作手法,才能收到满意的效果。熟练手法除着重练用力均匀,稳妥着实,持久有力,使之达到轻而不浮,重而不滞,刚中有柔,柔中有刚,刚柔相兼的程度以外,还必须注意手势得当,否则也会影响施术。小儿推拿与按摩手法甚多,其中有的手法虽与成人相同,但动作姿势却不一样,特别是脑瘫患儿推拿不包括矫形动作。如推法,小儿推法是以拇指或食、中指指腹向一个方向推抹或同时向相反方向直线分推;而成人推法则是以拇指端着力,以拇指末节作屈伸活动,逐渐向前移行。两种推法无论动作手势和感觉上均不一样。小儿常用的推拿与按摩手法:推、运、揉、摩掐、搓、理、擦、捏、挤、摇、抖、矫形等十几种。这些手法实施于5岁以下的患儿,年龄越小越易奏效。5岁以上的患儿可配合矫形手法同时进行。

Q:如何预防脑性瘫痪的发生?
A:小儿脑瘫是较常见的致残性疾患,严重影响小儿日后的生活,若能做到早期预防,对减轻家庭及社会负担、提高人口素质意义重大。

如何进行预防呢?

首先是出生前,即从母亲怀孕到分娩这段时间。胎儿的神经系统发育是优于其他系统发展的,而胎儿依赖母体生存,故孕妇的健康及营养状况与胎儿的生长发育关系密切,这就需要积极开展早期产前检查、胎儿预测,开展优生优育宣传教育,做好围产期保健工作,防止胎儿发生先天性疾病。孕妇应戒除不良嗜好,如吸烟、饮酒; 不要滥用麻醉剂、镇静剂等药物;避免流感、风疹等病毒感染及接触猫、狗;避免放射线等有害、有毒物质接触及频繁的B超检查、最好不看电视及操作计算机。另外,有下列情况的孕妇应尽早做产前检查:(1)大龄孕妇(35岁以上)或男方50岁以上。(2)近亲结婚。(3)有不明原因的流产、早产、死胎及新生儿亡史。(4)孕妇智力低下,或双方近亲有癫痫、脑瘫及其他遗传病史。若怀孕早期发现胎儿异常,就尽早终止妊娠。

其次是出生时,即分娩过程中。产时因素引起的胎儿窒息和颅内出血是造成小儿脑瘫的一个重要原因。因此,应预防早产、难产,提高医护人员的医技、医德,认真细致地处理好分娩的各个环节,做好难产胎儿各项处理,这是预防小儿脑瘫发生的极为重要的一环。

再次是胎儿出生后一个月内要加强护理,合理喂养,预防颅内感染、脑外伤等疾病,若出现应尽早去医院诊治。

Q:小儿脑瘫不治会自愈吗?
A:不会。有人认为小儿脑瘫运动障碍是非进行性的,小孩长大后自然也能好。即使小儿脑瘫运动是非进行性,不治疗而康复自然是很困难的。从我们几年来的治疗调查来看,1994年调查的17例来进行系统治疗患儿中,17例全部不能生活自理。1996年调查6例小儿脑瘫患儿,女4例,男2例,最大16岁,最小6岁,全都未进行系统康复治疗而全部不能生活自理。

1997年3月至1999年3月我们系统治疗2~5个疗程(2月为1疗程)小儿脑瘫者中调查 215例,追踪调查137例中,31例入学或上幼儿团,60例运动障碍明显好转继续治疗,尚余46例,寄回报告有不同程度好转。此外,尚有一对双胞胎女婴 8个月(小的运动障碍轻于大的女婴),同患小儿脑瘫前来我院就诊,40天后因父母离异,只有大的女婴前来就诊,经过3年定期治疗已能入幼儿园。而双胎小女孩只能仰卧在床上活动,而且四肢、躯干运动障碍进行性加重。

因此,小儿脑瘫要及早发现,及早治疗,不要寄希望于不治自愈。

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下面是脑瘫常见问题的英文资料,贴出来供大家参考:

Cerebral Palsy FAQ

★ What is cerebral palsy?
★ What are causes of cerebral palsy?
★ What are the types of cerebral palsy?
★ What is spastic cerebral palsy?
★ What is choreoathetoid cerebral palsy?
★ What is hypotonic cerebral palsy?
★ What is mixed cerebral palsy?
★ What other conditions are associated with cerebral palsy?
★ How is a child evaluated for cerebral palsy?
★ How is cerebral palsy treated?
★ What are specific treatment plans for cerebral palsy?
★ What is the long-term outlook for patients with cerebral palsy?
★ Cerebral Palsy At A Glance

★ What is cerebral palsy?

Cerebral palsy (CP) is an abnormality of motor function (as opposed to mental function) and postural tone that is acquired at an early age, even before birth. Signs and symptoms of cerebral palsy usually show in the first year of life.

This abnormality in the motor system is the result of brain lesions that are non-progressive. The motor system of the body provides the ability to move and control movements. A brain lesion is any abnormality of brain structure or function. "Non-progressive" means that the lesion does not produce ongoing degeneration of the brain. It is also implies that the brain lesion is the result of a one-time brain injury, that will not occur again. Whatever the brain damage that occurred at the time of the injury is the extent of damage for the rest of the child's life.

Cerebral palsy affects approximately one to three out of every thousand children born. However, it is much higher in infants born with very low weight and in premature infants.

Interestingly, new treatment methods that resulted in an increased survival rate of low-birth weight and premature infants actually resulted in an overall increase number of children with cerebral palsy. The new technologies, however, did not change the rate of cerebral palsy in children born full term and with normal weight.

★ What are causes of cerebral palsy?

The term cerebral palsy does not indicate the cause or prognosis of the child with cerebral palsy. There are many possible causes of cerebral palsy.

In full term infants the cause of cerebral palsy is usually prenatal and not related to events at time of delivery; in most instances it is related to events that happened during the pregnancy while the fetus is developing inside the mother's womb.

Premature birth is a risk factor for cerebral palsy. The premature brain is at a high risk of bleeding, and when severe enough, it can result in cerebral palsy. Children that are born prematurely can also develop serious respiratory distress due to immature and poorly developed lungs. This can lead to periods of decreased oxygen delivered to the brain that might result in cerebral palsy. A poorly understood brain process observed in some premature infants is called periventricular leukomalacia. This is a disorder in which holes form in the white matter of the premature infant's brain. The white matter is necessary for the normal processing of signals that are transmitted throughout the brain, and from the brain to the rest of the body.

White matter abnormalities are observed in many cases of cerebral palsy. Nevertheless, it is important to recognize that the vast majority of premature infants, even those born very prematurely, do not suffer from cerebral palsy. There have been many advances in the field of neonatology (the care and study of problems affecting newborn infants) which have enhanced the survival of very premature infants.

Other important causes of cerebral palsy include accidents of brain development, genetic disorders, stroke due to abnormal blood vessels or blood clots, or infections of the brain.

Even though it is widely believed that the most common cause of cerebral palsy is a lack of oxygen to the brain during delivery (birth asphyxia), it is actually a very rare cause of cerebral palsy. When cerebral palsy is the result of birth asphyxia, the infant almost always suffers severe neonatal encephalopathy with symptoms during the first few days of life. These symptoms include:
● seizures,
● irritability,
● jitteriness,
● feeding and respiratory problems,
● lethargy, and
● coma depending on the severity.

In rare instances, obstetrical accidents during particularly difficult deliveries can cause brain damage and result in cerebral palsy. Conversely, it is very unlikely that cerebral palsy symptoms would develop after a few years of age as a result of obstetrical complications.

Child abuse during infancy can cause significant brain damage which, in turn, can lead to cerebral palsy. This abuse often takes the form of severe shaking from a frustrated parent or caregiver, causing hemorrhage in or just outside the brain. To further compound the problem, many children with developmental abnormalities are at risk for being abused. Thus, a child with cerebral palsy may be made significantly worse or even killed by a single incident of abuse.

Despite the diversity of causes of cerebral palsy, many cases remain without a defined cause. However, the enhanced ability to see the brain structure with magnetic resonance imaging (MRI) and CT scans as well as improved diagnostic capabilities for genetic disorders has made the number of such cases much lower.

★ What are the types of cerebral palsy?

Based upon the form of motor impairment, cerebral palsy can be divided into types:
● spastic cerebral palsy,
● choreoathetoid cerebral palsy, and
● hypotonic cerebral palsy.

These categories are not rigid, and the majority of patients probably have a mixture of these.

★ What is spastic cerebral palsy?

Spastic cerebral palsy refers to a condition in which the muscle tone is increased, causing a rigid posture in one or more extremities [arm(s) or leg(s)]. This rigidity can be overcome with some force, ultimately giving way completely and suddenly -- very much like the familiar jackknife (or clasp knife). The spasticity leads to a limitation of use of the involved extremity, largely due to the inability to coordinate movements. Often the spasticity occurs on one side of the body (hemiparesis), but it can also affect the four limbs (quadriparesis) or be limited to both legs (spastic diplegia). When the condition occurs in both legs, the individual often has a scissoring posture, in which the legs are extended (straightened) and crossed.

Besides the increased muscle tone there is also increased deep tendon reflexes, impaired fine and gross motor coordination, muscle weakness, and fatigability among other problems.

Spasticity is often the result of damage to the white matter of the brain, but it can also be due to damage of gray matter.

The degree of spasticity can vary, ranging from mild to severe. Children who are mildly affected may experience few limitations of their function while severely affected children may have little to no meaningful use of the affected limb(s). Spasticity, if not properly treated, can result in contractures, which are permanent limitations in the ability of joint movement. Contractures can be greatly limiting in the care of children with cerebral palsy. Spasticity can also be quite painful, requiring medication to relax the muscle tone.

The same fundamental processes that influence spasticity of the limbs can also result in abnormalities of movement and muscle tone in other body systems. In the muscles of the head and face, for example, cerebral palsy can greatly limit the coordination and production of speech, even when the child is perfectly capable of understanding speech. There can also be limitations of chewing, swallowing, and facial and eye movements. These symptoms can be particularly troubling for afflicted children and their families.

Many patients with spastic cerebral palsy cannot control their output of urine. This inability is not necessarily due to problems in thinking but is caused by heightened reflexes of the bladder. When the bladder fills in these children, it is just like tapping on it with a reflex hammer, thus making it contract more vigorously than normal and causing a spilling of urine. This incontinence can be quite embarrassing, especially in a cognitively intact child.

★ What is choreoathetoid cerebral palsy?

Choreoathetoid cerebral palsy is associated with abnormal, uncontrollable, writhing movements of the arms and/or legs. Different from spastic cerebral palsy, persons with choreoathetoid cerebral palsy have variable muscle tone often with decreased muscle tone (hypotonia). Contractures of extremities are less common. The abnormal movements are activated by stress, as well as by normal emotional reactions such as laughing. Any attempt to do voluntary movements, for example extending the arm in an attempt to reach an object might result in many involuntary movements in arms, legs, trunk, and even the face. There are different types of abnormal movements. Two of the most common are choreoathetotic movement disorder with rapid, irregular, unpredictable contractions of individual or small muscles groups and dystonia with a persistent but not permanent, abnormal posture of some body parts (arms, legs, trunk) due to abnormal muscle contractions. The dystonic disorder also affects the muscle of the facial expression, swallowing, deglutition and speech, resulting in severe functional deficiencies.

These movements can be quite debilitating and greatly limit the child's ability to perform many motor tasks. Furthermore, the movements are akin to constant exercise, thereby causing the affected child to metabolize a huge number of calories. Choreoathetoid cerebral palsy is often associated with damage to specialized brain structures that are involved in movement control -- the basal ganglia. Like spastic cerebral palsy, the degree of symptom severity often varies, from mild to severely affected.

★ What is hypotonic cerebral palsy?

Hypotonia is diminished muscle tone. The infant or child with hypotonic cerebral palsy appears floppy -- like a rag doll. In early infancy, hypotonia can be easily seen by the inability of the infant to gain any head control when pulled by the arms to a sitting position (this symptom is often referred to as head lag). Children with severe hypotonias may have the most difficulty of all children with cerebral palsy in attaining motor skill milestones and normal cognitive development.

Hypotonic cerebral palsy is often the result of severe brain damage or malformations. It is believed that hypotonic cerebral palsy is the result of an injury or malformation at an earlier brain developmental stage than that which causes spastic or choreoathetoid cerebral palsy.

Hypotonia in infancy is a common finding in many neurological conditions, ranging from very mild abnormalities to severe or even fatal neurodegenerative or muscle disorders. It is important to note that many children with spastic cerebral palsy go through a short stage of being somewhat hypotonic in early life, before presenting the full syndrome.

★ What is mixed cerebral palsy?

Many (possibly most) children with cerebral palsy have multiple symptoms with combinations of the various forms of cerebral palsy. For example, children with spastic cerebral palsy often continue to have a head lag, which is representative of hypotonia. Children with choreoathetoid or hypotonic cerebral palsy often have increased deep tendon reflexes, which are suggestive of some spasticity.

★ What other conditions are associated with cerebral palsy?

Since cerebral palsy is indicative of damage to or malformation of the brain, it stands to reason that other symptoms that are associated with brain dysfunction can be present in children afflicted with cerebral palsy. In fact other disorders, besides the motor dysfunctions already described, are almost always seen in these patients. Some of them such as poor speech, swallowing disorders, drooling, and poor fine or gross motor coordination are the result of the motor disorder affecting specific muscles involved in those functions. Other conditions are the results of simultaneous injuries in areas of the brain besides the motor areas.

Cognitive disabilities, sometimes referred to as developmental delay, is often associated with cerebral palsy. Up to 50% of patients with cerebral palsy have cognitive disabilities. However, many of these children can be educated and lead productive lives. It is also just as important to note that many children with severe motor impairment due to cerebral palsy, as is the case with many children with the choreoathetotic or the diplegic form of cerebral palsy, are only mildly or not at all intellectually impaired.

Virtually all testing of a young child's cognitive development involves some sort of motor activity on the part of the child. If a child is capable of complex thoughts, but incapable of motor activity, the observer will not be able to detect his or her mental aptitude. Therefore, one must be very careful in assigning labels to patients with cerebral palsy. Certain features, however, are more likely to be associated with significant cognitive disabilities in the patient with cerebral palsy. These include extensive damage occurring on both sides of the brain, children with spastic quadriplegia, microcephaly (small head size), a documented genetic disorder, and a documented prenatal infection.

Seizures are a common finding in patients with cerebral palsy. Perhaps a third of all cerebral palsy patients have seizures. Seizures are caused by abnormal electrical activity of the neurons in the brain. The damaged or malformed brain is more prone to seizures. Moreover, cognitive disability is frequently associated with epileptic seizures.

The symptoms of seizures can vary depending on where in the brain they originate. Generalized seizures engage the entire cerebral cortex at once, while partial seizures only involve part of the cerebral cortex. Often, generalized seizures begin as partial seizures but spread throughout the brain rapidly. Generalized seizures may take the form of true convulsions ("grand mal"), in which the entire body jerks in a rhythmic fashion, or the form of absences ("petit mal"), which interrupt the patient's activities for a brief period, but does not cause a fall.

Other forms of generalized seizures can occur in the cerebral palsy patient. Atonic seizures cause the patient to slump suddenly to the ground or forward in their chair, resembling a marionette in which the puppeteer suddenly cut the strings. Tonic seizures are just the opposite and cause the entire body to suddenly stiffen. Both tonic and atonic seizures can result in drop attacks in which the patient falls to the ground, often resulting in injury.

Partial seizures may involve the jerking of the arm and leg on the same side of the body. Alternatively, they may be associated with strange sensory phenomena, such as flashing lights, or emotions, such as fear, depending on where in the brain the seizure occurs.

Vision deficiencies are frequently seen. Some of them, for example, strabismus ("lazy eyes") can be corrected by surgical procedures in the muscles of the eyes. Some can be corrected with eye glasses (that may be difficult to implement in non-cooperative children). In other children the visual deficiencies are the result of brain injuries to the areas of the brain that are associated with vision, rendering the child blind ("cortical blindness") even if the eyes themselves are perfectly normal. At the present time there is no treatment to improve this condition.

Children with cerebral palsy can have speech disorders of many types. Some, like poor word pronunciation (dysarthria), are the result of impairment of the peripheral mechanism of speech (poor lips, tongue, or palate coordination). In another circumstance there is brain injury in the gray matter of the brain that controls the central mechanism of speech (aphasia).

It is difficult for children with cerebral palsy to gain weight and frequently have delayed growth. This is the result of several factors including feeding disorders, gastroesophageal reflux, and in some instances, for example, children with choreoathetotic disorders, excessive caloric consumption. On the other, hand obesity could be a problem in those children with cerebral palsy that have and limited mobility.

Individuals with the choreoathetotic form of cerebral palsy might have compressed nerves or damage to the neck bones that can lead to damage to the spinal cord.

Other issues to be aware of are dental diseases, respiratory problems, urinary tract infections, osteoporosis and subsequent fractures, enuresis, encopresis, constipation.

★ How is a child evaluated for cerebral palsy?

Most of the information leading to the diagnosis of cerebral palsy is generally obtained from a thorough medical history and examination. The most critical tasks of the healthcare provider are to identify potentially treatable causes of a child's impairment. The healthcare provider evaluating the child with possible cerebral palsy should be experienced in neurological examination and assessment of impaired children and well-versed in the potential causes of cerebral palsy. Often, but not necessarily, this practitioner should be a pediatric neurologist. Once the examination is complete, depending on the findings, the practitioner may order laboratory tests to help in the assessment.

There is no single test to diagnose cerebral palsy. But since cerebral palsy is the result of multiple different causes, the tests performed are used to identify specific causes when possible. Other tests will be performed to assess the condition of the child (nutritional status for example) or to assess other concomitant conditions that the child might have.

Blood and urine tests may be used to identify some of the more common inborn errors of metabolism. Blood tests may also be used for chromosomal or other genetic studies. Brain imaging studies can also be used to detect structural changes in the brain. The most sensitive brain imaging study is the MRI examination. Nuclear medicine neuroimaging studies such as SPECT or PET have no place in the initial evaluation of a child with cerebral palsy, but may prove very useful in the assessment of selected candidates.

Despite all of these tests, it may not be possible to answer some of the burning questions in the mind of a parent of a neurologically impaired infant, such as "Why does my child have cerebral palsy?" or "Will my child be normal?" This is particularly true if a specific diagnosis is not reached and the child is under one year of age. Some severely impaired young infants can grow up to be independent, productive members of society, while other children, seemingly less impaired, may require care throughout their lives.

Once the diagnostic evaluation is complete, further testing may be needed in order to define the specific needs of any individual child. For example, if seizures are present or suspected, an EEG (electroencephalogram) is performed. However, this test is not needed if there are no signs of epilepsy.

★ How is cerebral palsy treated?

Most of the causes of cerebral palsy do not have specific, curative treatments. However, children with cerebral palsy present many medical problems that can be treated or prevented. The initial stage of treatment involves an interdisciplinary team, consisting of a pediatrician, preferable one with experience in neurodevelopmental disorders, a neurologist (or other neurological practitioner), a mental health practitioner, an orthopedic surgeon, a physical therapist, a speech therapist, and a occupational therapist. Each member of the team has important, independent contributions to make in the care of the affected child.
●The physical therapist evaluates muscle tone, strength and gait (walking).
●The occupational therapist reviews the child's ability to perform tasks of self-help and care -- from feeding to manual dexterity.
●The speech therapist evaluates the child's ability to speak and understand speech.

Most children with neurological impairment have significant emotional distress and also require therapy from a mental health practitioner.

Virtually all states have federally-mandated programs for the assessment and treatment of children with cerebral palsy and other developmental conditions. In many states, these programs are termed "Regional Centers" and can be found in local phone books. Also Children's Hospitals usually have special clinics with experience with children with cerebral palsy. Furthermore, when a child reaches the age of 3 years, the school district may become formally involved in the review of at-risk children. These programs protect children up to the age of 21 years.

At the present time there is a vacuum in the provision of medical care for adults (young and old) with cerebral palsy living in the community settings. There are a limited number of services in adult hospitals geared to the treatment of adults with cerebral palsy or developmental disabilities.

★ What are specific treatment plans for cerebral palsy?

After the initial evaluation, specific treatment plans are outlined for each child:

Seizure medication

If the child has seizures, the treatment is based on the type and frequency of the seizures. Complete seizure control can often be achieved using a single medication, but some children with cerebral palsy have particularly difficult-to-control seizures. Medication can have side effects affecting the brain, ranging from sedation to hyperactivity. They can also affect liver function, white and red blood cells, and bone metabolism. Side effects are usually not harmful and resolve when the offending medication is discontinued. The goal of the treating physician should be for the child to become seizure free with few or no side effects. It must be noted that it is of no benefit to the child to be seizure-free but significantly impaired by medication side effects.

Medications for spasticity: The treatment of spasticity can involve multiple health professionals. Treatments involve the use of medications and surgical procedures to decrease the spasticity, facilitate movement, and prevent contractions. Among the most commonly medications are dantrolene sodium (Dantrium) and diazepam (Valium). Diazepam is both a muscle relaxant and a sedative. Baclofen (Lioresal) can be taken by mouth or infused continuously with an implanted pump (intrathecal infusion) directly in the cerebrospinal fluid (the liquid that bathe the spinal cord and the brain). This treatment might be specifically useful for patients with spasticity in the lower legs. The most common complications with these medications are drowsiness, sleepiness, some degree of weakness. The sedative side effects of such medications often limit their usefulness. In the case of the baclofen pump the most common complication seen in small number of patients is the infection of the catheter. Additionally, a muscle relaxing agent called botulinum toxin can be injected into tight muscles to relax them. When used prudently, this procedure may prevent surgical intervention.

Surgery

Surgery for spasticity: In the case of severe muscle spasticity, surgery may be a valuable option. Tendon release procedures, usually performed by an orthopedic surgeon, allow improved range of motion in some cases. Such procedures are usually performed on the muscles of the calf or inner thigh. A less commonly used procedure, is the dorsal rhizotomy. During this operation, the surgeon cuts some of the nerve roots that send sensory information from the muscles to the spinal cord and brain. This procedure relieves some of the spasticity and thereby helps the child walk with a more normal gait. Most neurosurgeons performing dorsal rhizotomies very carefully select only those patients whom they feel may be helped by the surgery. From time to time, other surgical interventions are required in children with cerebral palsy. In very rare cases of choreoathetoid cerebral palsy, in which the writhing movements severely limit the ability of the child to function, highly selective neurosurgical techniques can curtail these movements without significantly harming other functions.

Other surgical procedures

Ophthalmologists (eye specialists) can help strabismus by operating on the muscles that control the movement of the eye or to correct some other complications such as cataracts.

Neurosurgeons can treat intractable seizure control. Operations such as callosotomy, hemispherectomy, focal resections of areas of abnormal brain tissue responsible for the seizures, might be indicated in some cases. An alternative procedure for the treatment of epilepsy is the vagal nerve stimulation, an implantable device, that can be useful in selected patients with difficult to control seizures.

Scoliosis, or curvature of the spine, is often the result of severe hypotonia. This condition can create discomfort for the patient and difficulty for caregivers in performing the activities of daily living. Furthermore, severe scoliosis may actually restrict a patient's ability to breathe. Several surgical procedures are available in specialized centers for the correction of scoliosis.

Children who are unable to take adequate calories by mouth may require the placement of a feeding gastrostomy tube (PEG tubes) directly into the stomach.

Therapy

The treatment of spasticity can involve multiple allied healthcare professionals. Physical and occupational therapists play an important role.

Physical therapy: The extent of physical therapy depends on the degree of spasticity, hypotonia, and motor impairment. The main therapeutic effect of physical therapy is maintaining range of motion at the joints, thereby preventing contractures. Some scientists and therapists feel that physical therapy actually helps maintain the connections in the brain, although this is controversial. Other skills, such as improved gait, stance, and balance can be helped by physical therapy. A strong, proactive physical therapy program greatly aids in the life of a child with cerebral palsy.

Occupational therapy: Occupational therapy assists children with the skills needed for day-to-day life in school and at home, including eating, writing, and work skills. In early infancy, occupational therapists can provide assistance in feeding a child with a poor or uncoordinated sucking response.

Speech therapy: Speech and language pathologists are involved with the development and improvement of speech production. Using different techniques the speech pathologist helps to improve the quality and the quantity of the speech production. The role of these specialists is not limited to speech production alone, but they also teach the patients other communication techniques (sign language, use of communication boards) to facilitate the communication abilities.

Medical care

Medical care of children with cerebral palsy is often seriously hampered by the inability of the child to communicate his or her needs and sensations. Relatively common childhood illnesses in children with cerebral palsy, such as ear infections, urinary tract infections, and appendicitis, which are easily treatable in most children, may prove to be life-threatening due to delayed recognition on the part of caregivers and physicians. Each child with cerebral palsy should have a primary care practitioner that is experienced with the special medical needs of affected children.

Because physicians have offered limited hope in curing cerebral palsy, many families have turned to alternative methods in the treatment of their children. Such therapies may include diets, herbal remedies, aromas, play with animals, and hyperbaric oxygen. The scientific evidence supporting the use of diets is inadequate. Some of them such as hyperbaric oxygen therapy, which is delivered in specialized centers, can be quite expensive and has not been scientifically proven to help children with cerebral palsy. Other remedies must be investigated on a case-by-case basis. Hopefully, the family of the affected child will be able to approach their physician regarding these alternative treatments.

★ What is the long-term outlook for patients with cerebral palsy?

The answer is complex. Since cerebral palsy is actually a set of symptoms associated with a variety of causes, potential treatments will have to be diverse. Many scientists are now focusing on recent discoveries that suggest we will be able to replace lost or damaged brain cells. While such therapies are not yet available, it is likely that real clinical trials will begin in the next 5 to 10 years.

The more we know about the causes of cerebral palsy, the more we can do to prevent it. For example the use of folic acid in sexually active women may prevent central nervous system malformations that might lead to cerebral palsy. Avoiding the use of certain drugs during the pregnancy whether legal, such as prescribed medications, alcohol or tobacco, or illegal such as cocaine and crack, will also decrease the changes of cerebral palsy in a child.

It cannot be overemphasized that the most important person in the lives of children with cerebral palsy is their caregiver. The caregiver, whether a parent or other person, must be able to recognize a child's needs and provide for him or her in a loving, positive environment. Because of the difficulty that many children with cerebral palsy have in expressing their needs, they are at great risk for unintentional and intentional neglect as well as overt child abuse. Often, the care of children with cerebral palsy can be quite taxing emotionally and financially on the family. The appropriate care for children with cerebral palsy, therefore, must take into account mental health and financial support for families and caregivers. Many state-run programs provide out-of-home schooling as well as respite care for the caregivers, but these services often falls short of what is truly needed. Healthcare practitioners can very simply improve the lives of their patients by taking some extra time to listen to the concerns and hopes of the caregivers and provide thoughtful answers to their questions.

We must recognize that many, and possibly most, children with cerebral palsy can lead full, meaningful, and happy lives. The team of parents, caregivers, and health practitioners have the responsibility to help the child with cerebral palsy achieve this goal.

★ Cerebral Palsy At A Glance

● Cerebral palsy (CP) is an abnormality of motor function, the ability to move and control movements.
● Cerebral palsy is acquired at an early age, usually less than a year of age.
● Cerebral palsy is due to a brain abnormality that does not progress in severity.
● The causes of cerebral palsy include prematurity, genetic disorders, strokes, and infection of the brain.
● Taking certain precautions during the pregnancy might decrease the risk of cerebral palsy.
● Asphyxia, the lack of oxygen to the brain, at birth is not as common a cause of cerebral palsy as had been thought.
● There are different types of cerebral palsy based on symptoms -- spastic, hypotonic, choreoathetoid and mixed types.
● The best approach for diagnosis, treatment, and management is through and interdisciplinary team.
● Cerebral palsy may be associated with many other medical conditions, including mental retardation or seizures. Many of these conditions can be treated with improved quality of life.
● Many children with cerebral palsy have a normal intellect and have no seizures.
● Treatment of cerebral palsy is for the symptoms only; there are few treatments for the underlying causes.
● There are many alternative medicines promoted for the treatment of cerebral palsy that have never been proven to be helpful. Families and advocates of persons with cerebral palsy should be aware of the lack of scientific basis for these treatments.

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