How to determine cerebral palsy in premature infants
Release time : 06/08/2025 09:30:01
Cerebral palsy in preterm infants refers to a syndrome caused by non-progressive brain damage that occurs from conception to newborn or infancy.
How to judge cerebral palsy in premature infants so that they can receive treatment as soon as possible? How to judge the earlier treatment of cerebral palsy in premature infants, the better the effect, so early diagnosis of cerebral palsy is of great significance to treatment.
Parents who discover any abnormal manifestations in their children should pay attention, especially parents who have high-risk factors during pregnancy and childbirth. They should go to a professional hospital for examination as soon as possible and never miss the best treatment opportunity.
How to judge cerebral palsy in premature infants? 1. Early symptoms: (1) Newborns or three-month-old babies are prone to panic, crying, breast aversion and sleep difficulties.
(2) Difficulties in early feeding, eating, chewing, drinking, swallowing, as well as salivation and breathing disorders.
(3) A low sensory threshold, manifesting as sensitivity to noise or changes in posture, proneness to startle, increased hugging reflex accompanied by crying.
Normal infants, shortly after birth, exhibit a bipedal gait when standing due to an ataxic gait.
At 3 months of age, although it may subside at one time, there remains no indication of standing or stepping by 3 months. This should raise the suspicion of cerebral palsy in a child.
The baby, who has passed the "100 days" period, still cannot lift up its head. At 4-5 months of age, when it attempts to stretch its neck, the head remains unstable and sways back and forth.
(6) Grip: Generally, infants under 3 months can hold a fist without opening it. If there is still thumb adduction and hand not opening at 4 months, suspicion of cerebral palsy should be raised.
(7) A normal infant should be able to reach out and grab an object by the time they are 3 to 5 months old. If a child cannot do so by the age of 5, it is suspected that they may have cerebral palsy.
(8) Generally, children begin to smile around the 4th to 6th week postnatally, and then recognize people.
Children with spastic cerebral palsy often exhibit a somber and melancholic demeanor, while those with limb ataxia often appear troubled and discontent.
(9) The muscles are soft and flaccid, unable to turn over.
When touching the inner thigh of the child, or having the child's foot touch the bed, or when the child is jumping up and down, an extension and crossing of the lower limbs are observed.
(10) stiffness, especially in the upper limbs, makes it difficult to get sleeves on.
During diaper changing, the thighs are difficult to extend.
When wiping the palms, or when bathing, limb stiffness occurs.
Babies don't like to take baths.
(11) Premature development: Children with cerebral palsy can turn over prematurely, but there is a sudden reflexive turning over, and the whole body turns over like a rolling wood rather than a conscious segmental turning over.
Babies with spastic diplegia may experience stiffness in their lower limbs before sitting down and stand on toes like a ballet dancer.
2. The main symptoms (1) Movement disorders, poor self-control ability in exercise. In severe cases, they cannot grasp things with both hands, cannot walk with both feet, and can not even turn over, cannot sit up, cannot stand, and cannot chew normally.
(2) Posture disorders, various postures are abnormal, posture stability is poor, the head cannot be straight after 3 months, and the head is accustomed to tilting to one side, or shaking left and right back and forth.
Children have a reluctance to bathe, and they find it difficult to open their fists during handwashing.
Children with normal intelligence account for 1/4, those with mild or moderate intellectual deficiency constitute 1/2, and those with severe intellectual deficiency are only 1/4.
(4) Language barriers, difficulties in language expression, unclear pronunciation, or stuttering.
(5) Visual and auditory impairments are most frequently observed in cases of strabismus and difficulty in recognizing the rhythm of sounds.
(6) Developmental and growth disorders, stunting.
Teeth developmental disorders with porous and fragile structure.
Oral and facial dyskinesias, spasms or incoordination of facial or tongue muscles, difficulty in chewing and swallowing, difficulties in oral closure, and drooling.
Emotional and Behavioral Disorders: Obstinate, stubborn, prone to anger, aloofness, emotional instability, sometimes exhibiting compulsions, self-harm, and aggressive behavior.
39% to 50% of children with cerebral palsy induce epilepsy due to fixed lesions in the brain, especially children with severe mental retardation.
Treatment of cerebral palsy in premature infants. The earlier cerebral palsy in premature infants is treated, the greater the possibility of cure. Parents must pay attention to it. Once diagnosed, they must go to a regular hospital for treatment in time.
1. Comprehensive rehabilitation medical treatment such as exercise (sports) therapy, including rough exercise, fine exercise, balance and coordination training.
Such as crawling, purposeful identification (nose, ears, etc.), training to grasp objects, hold objects, sit up, swing, walking support (leaning against the wall, facing the wall), in-situ exercise (bending over to pick up objects, lifting training, one foot Independent, taking off in situ), walking, running.
Another example is physical therapy, including electrical nerve stimulation therapy, thermotherapy, and hydrotherapy.
There is also occupational therapy, which is ability training, but the effect is average.
Modern medical treatment methods include: ① Surgery.
② Orthosis.
③ Water, electricity, light and sound therapy.
④ Treatment of language and communication.
③ Treatment of motor function.
④ ADL training.
2. Drug therapy: Oral or injection of relevant drugs, such as neurotrophic drugs, muscle relaxants, blood circulation drugs, etc.
Drugs that include building and repairing brain tissue (cells), such as phosphatidylcholine (including phospholipids, sphingomyelin, and cephalin), can repair damage to the cell membrane of brain cells caused by trauma, bleeding, or lack of oxygen. They protect nerve cells and speed up the conduction of nerve excitation, improving learning and memory functions.
Additionally, there are medications that can promote the synthesis of DNA in brain cells, enhance the utilization of oxygen by brain cells, improve energy metabolism within the brain cells, and strengthen brain function. These include various amino acids required for repair and regeneration of brain tissue, as well as modulating neurological activities. Examples include Gulixi (brain enzyme hydrolysate tablets) and Spirulina tablets (capsules).
Additionally, it is important to actively supplement with a variety of vitamins, such as 21-Kinet.
Conditional hospitals may choose the following injections alternatively: cerebrolysin, cerebropeptide, acetylglucosamide, choline diphosphate chloride and so on.
3. Traditional Chinese Medicine treatments include acupuncture therapy (should be used with caution in cerebral palsy patients with high muscle tone), massage therapy, and traditional Chinese medicine therapy.
4. Pediatric cerebral palsy physical therapy for children: Physical therapy for pediatric cerebral palsy is based on kinesiology and neurophysiology. It involves the use of devices or manual techniques by therapists, as well as the child's own strength, to achieve active and passive motions that restore and treat the entire body and localized functions.
(1) The common goal of exercise therapy for children with cerebral palsy: try to exercise in normal ways.
Use both sides of the body.
Maintain straight position while lying, sitting, kneeling and standing.
Actions and activities related to daily life.
Prevent deformity.
(2) Training goals for various types of children with cerebral palsy.
① Spastic type: Relax stiff muscles, avoid exercise in spasmodic positions, and prevent deformity.
② Athetosis type: Use hand grasping movements to train to stabilize involuntary movements. If abnormal body positions change infrequently, follow the goal of spasticity type.
Ataxia: Improve balance in kneeling, standing and walking, stand and walk stably, and control unstable shaking, especially hands.
Care for premature infants with cerebral palsy The incidence of cerebral palsy in children has gradually increased in my country in recent years, affecting the physical and mental health of many children.
Experts point out that there are many reasons for cerebral palsy in children, and premature birth is one of the important factors.
So, what should I pay attention to in the care of premature infants with cerebral palsy? 1. Dietary care: Premature infants with cerebral palsy should pay attention to dietary care. They need to supply high-calorie, high-protein, vitamin-rich and easy-to-digest foods in their diet.
Diet training should be carried out for children with difficulty eating independently. When feeding, do not forcibly withdraw the spoon while the child is clenching his teeth to prevent damage to the teeth.
According to expert guidance, the child's head should be kept in the midline position during feeding. If the child's head is tilted back, it may cause foreign bodies to be inhaled.
To enable the child to learn to eat independently, it is essential to encourage them to take on the responsibility of feeding themselves as early as possible.
2. In the daily care of preterm infants with cerebral palsy, attention must also be paid to their daily living care.
To maintain cleanliness and hygiene in cerebral palsy patients, bathing should be carried out on a regular basis. Additionally, it is essential to change their clothes, linens, and bedding promptly.
Ensure the indoor air is fresh, sunlight is abundant, ventilation is good, and the temperature is appropriate.
Regular ultraviolet irradiation disinfection and frequent cleaning with disinfectant solutions are performed to ensure the cleanliness and hygiene of the indoor environment for children with cerebral palsy.
According to expert guidance, children with cerebral palsy develop later in various movements than healthy children in the same period due to development delay, making them difficult to move.
Therefore, special personnel should be assigned to guard and pay attention to safety to avoid accidental injuries.
3. Functional training: Attention should also be paid to functional training in the care of premature infants with cerebral palsy.
Experts point out that brain damage in paralyzed children is static, but the resulting neurological deficits are not fixed forever.
If appropriate treatment is not carried out early, abnormal postures and movement patterns will be fixed, and at the same time, tendon contractures, bone and joint deformities will also be caused, which in turn exacerbates intellectual disability.
According to expert guidance, paralyzed limbs should be maintained in functional positions and passive or active exercise should be carried out to promote muscle and joint activity and improve muscle tone.
Especially from 0 to 6 years old, it is a critical period for learning language. Children should be given rich language stimulation at ordinary times, encourage them to speak, correct abnormal pronunciation, and persevere in language training to enhance their adaptability to social life.
Rehabilitation training for premature infants with cerebral palsy. The symptoms of cerebral palsy are often accompanied by physical activity disorders, which brings a lot of inconvenience to patients in life and is a considerable burden for the entire family. Therefore, for cerebral palsy, early intervention should be given to improve cerebral palsy limb function.
So, what does the rehabilitation training for premature infants with cerebral palsy include? 1. Training for head control. Learning to look up during infant development is the main prerequisite for learning other activities.
During training, hold both sides of the child's head so that the head can be stably maintained in an upright mid-position.
During most of the sitting time, when the head is accustomed to maintaining the correct posture, the child can be made to lean forward and tilt the sides, allowing him to learn to control the head and keep the head stable.
2. Functional training of the upper limbs and hands is best carried out in a stable posture, with the focus on correcting the spasticity pattern of the upper limbs of children with cerebral palsy.
The child's elbow can be grasped with one hand, and the child's hand can be held in a way that raises and extends the arm.
Supinate the shoulder and extend the elbow, palm facing up.
Encourage the child to place their hands in front of their chest, play with fingers, and grasp various shapes and colors of toys.
3. Lower-body Exercises: a. Walk barefoot in front of a gymnastics mirror, or walking on two parallel lines on the ground.
B. Squat exercise, jumping exercise, single-leg standing exercise, knee flexion exercise and heel-bend exercise.
Walking on a balance beam.
Certain types of patients require assistance from their family members or the use of orthopedic braces for limb exercises.
D. Slurping and swallowing exercises are performed daily by 100 times for those with drooling, while simple sentences are practiced for those with language difficulties. Special attention is given to practicing singing under the guidance of music to improve language and intelligence in patients with cerebral palsy.
4. The feeding training should encourage the child to eat independently, which is very beneficial to improving the child's dexterity and upper limb motor abilities.
Children with good swallowing function should have their feeding training done in a sitting position.
Children who have poor hand grip can use assistive devices for eating.
5. Clothes-on and off training is designed to enable children to gradually learn to put on and take off their clothes, thereby enhancing their ability to perform basic self-care tasks.
Balance and coordination training are essential for maintaining stability in sports.
Balance boards, balls, and rollers can be utilized for training.
Training can facilitate the timely adjustment of posture, enhance reaction and control over head, neck, trunk and balance and coordination movements.
When conducting rehabilitation training for children, parents must be patient, children must be dedicated (cooperating), and doctors must have determination. With unified effort, the recovery of a child is within reach.
Parents should use language to guide, because children with cerebral palsy have a slow response to feedback. Many years of experience have shown that parents who train while also using language to stimulate the child can achieve significant results, as well as enhancing both their intelligence and language skills.
Prevention of Premature Infant Cerebral Palsy: Babies with cerebral palsy can experience various neurological disorders, abnormalities in the skeletal and musculature, and even seizures. This condition can have a severe impact on a baby's life.
Among preterm infants, the incidence of cerebral palsy is extremely high, with 3 out of every 100 preterm infants suffering from cerebral palsy.
As the saying goes, prevention is better than cure. It is essential to take measures to prevent cerebral palsy in premature infants to ensure their healthy growth.
1. Pregnancy should prevent rubella virus infection.
2. During pregnancy, regular health checkups should be conducted to identify factors that may predispose to difficult labor. If hypertension or diabetes is present, active treatment should be pursued.
Ensure nutrition and prevent premature birth.
Avoid unnecessary medication.
Select a good maternity hospital according to the expected date of delivery and carry out safe delivery in a prepared manner.
3. After the baby is born, focus on protecting immature infants, asphyxiated infants and severely jaundiced infants, and carry out necessary treatment.
Such as oxygen inhalation, entering an incubator, etc.
Infants with brain injury should be followed up with a card and screened regularly.
4. Encourage breastfeeding and immunize infants with one, two, three vaccines, polio, rubella or tuberculosis.
5. Identify early symptoms of meningitis, such as fever, stiff neck, drowsiness, etc., and treat them promptly once discovered.
6. Children with fever should take off their clothes, rub themselves with ice water, drink enough water, and treat them promptly.
7. Pay attention to hydrating children suffering from diarrhea; if the diarrhea is severe, seek medical attention promptly.
8. Attention should be paid to the possibility of cerebral lesions in cases where motor development lags, posture abnormalities, poor breastfeeding, shrieking without sleep, or excessively soft or hard muscles are observed.
The medical information provided in this text is for reference only and should not be used as a substitute for professional medical advice.
In case of discomfort, it is advised to seek medical attention immediately. The diagnosis and treatment should be based on the professional medical assessment in person.