Brain cells are fragile and vulnerable. A variety of factors can affect their condition and viability. Children's neurons are especially vulnerable. We will tell you in this article about what the diagnosis of encephalopathy means and what parents should do if such a pathology is found in a child.
What it is?
Encephalopathy is an organic lesion of the brain. This means that under the influence of unfavorable trigger factors, neurons (cells of the nervous system) began to die. First, metabolic processes in neurons are disrupted, then, if the negative factor is not eliminated, the cells begin to die, and therefore the functions of the brain in particular and the central nervous system as a whole begin to be disrupted.
Encephalopathy is of two types - congenital and acquired. The peculiarities of the diagnosis in childhood are that most often children are diagnosed with congenital pathology, and acquired forms of brain disease are more characteristic of adults and the elderly. Moreover, the diagnosis can be made already in the first months of a child's life. Most often, the first signs become noticeable within a week after birth, if the baby is full-term, and within 4 weeks if the baby was born earlier than the due obstetric term.
Detection of encephalopathy is not a sentence, but just an incentive to act. With a timely medical response and adherence to all recommendations from the parents, in 90% of cases, it is possible to compensate for the loss of cells and cure the child. Therapy will require a collaborative approach to the treatment of the pediatrician, neurologist and other specialists.
Causes
The most common causes of the development of perinatal encephalopathy are negative factors that influenced the fetus while it was in the mother's womb. The most dangerous are long-term intrauterine hypoxia, as well as infectious diseases transferred by the mother and intrauterine infection of the baby. Damage to brain cells can also occur as a result of rapid or prolonged labor, in which the child experienced acute hypoxia, as well as birth trauma to the head and neck.
Very often, encephalopathy is closely associated with other malformations, for example, with heart and vascular defects. Often premature babies are susceptible to the disease. Encephalopathy acquired at an early age can develop due to trauma, for example, as a complication of traumatic brain injury, due to poisoning with toxins, as a serious complication of an infectious disease that a child has had. Organic brain damage can occur in congenital diabetes mellitus, in adrenal insufficiency, in the presence of tumors in the brain.
Malformations of the kidneys and liver of the baby can become a concomitant cause of the development of encephalopathy.
The defeat in newborns can be anoxic, developed after a long resuscitation period (most often found in premature infants), residual-organic, in which some congenital factors are combined with residual ones, for example, after a difficult birth, focal and unspecified. Residual encephalopathy occurs less frequently in infants than in older children. An unspecified form of the disease is also common, when the true cause of the death of central neurons cannot be established.
Symptoms and Signs
The specific signs and manifestations of organic lesions can be different, it all depends on how large the lesions are, which centers and parts of the brain are involved in pathological processes. Most often, the first signs of perinatal encephalopathy are:
- the absence of crying after birth during the period established by the obstetricians;
- weak cry after birth;
- Apgar score is lower than 7/7;
- sluggish sucking reflex or its absence;
- sleep disturbances (frequent awakenings, restless sleep, too long sleep);
- nervous, frequent and tearful crying or quiet monotonous frequent crying;
- violation of the heart rhythm;
- tilting the head and arching the back;
- pulsating and visually "swollen" fontanelle;
- strabismus;
- profuse and often spitting up "fountain";
- excessive lethargy of the child, sluggish emotional reactions, as well as excessive excitability and activity;
- convulsions.
The signs are far from always clear and obvious. Quite often there is one (two, three) signs, and they are expressed sluggishly, so parents may not even guess about the true origin of problems in the behavior of the baby.
An older child with resistant encephalopathy may begin to complain of systematic headaches, memory problems, dizziness, attacks of loss of consciousness, impaired coordination of movements and balance.
Diagnostics
A pediatrician and a neurologist can suspect an acute cerebral organic disorder in a child. Modern diagnostic methods such as neurosonography, MRI, EchoEG, CT, EEG can confirm or deny their fears. When conducting an ultrasound of the brain, the child must undergo an additional Doppler study of the characteristics of the blood supply to the brain. This information allows you to identify the lesions.
Additionally, the child is prescribed general blood and urine tests, hormone tests, and sugar levels. If necessary, ultrasound of other internal organs is performed (if defects are suspected), and consultations of related specialists are also recommended. Sometimes it becomes necessary to puncture the cerebrospinal fluid.
It is impossible to make a diagnosis "by eye" in this case, and if some neurologist assures the parents that the child has encephalopathy, but does not order additional examinations, the diagnosis cannot be trusted.
Treatment
It is said that nerve cells do not regenerate. In general terms, this is so, but in childhood, the compensatory capabilities of the body are greater than ever, and therefore proper care and adherence to the recommendations prescribed by the doctor help to neutralize "losses" - the functions of dead neurons are taken over by healthy cells.
Treatment is aimed at eliminating the cause that caused organic damage. If this is an infection, then it is the infection that begins to be treated, if the cause was poisoning with toxins, detoxification therapy is carried out. If encephalopathy is caused by hypoxia, vitamin therapy, oxygen masks, drugs to improve cerebral circulation, and vascular agents are recommended for treatment. At the same time, massage, therapeutic exercises, water procedures are recommended, and physiotherapy for children who have come out of infancy.
Where the treatment will take place - at home or in a hospital, depends on how severe the severity of the lesion is. In severe cases, the baby is placed in intensive care, artificial lung ventilation is performed, and hemodialysis is performed. Treatment for encephalopathy is always quite lengthy, so parents should be patient.
In addition to drugs that are designed to mobilize compensatory capabilities, drugs are prescribed to relieve individual symptoms. With convulsions, anticonvulsant therapy is performed, with vomiting, antiemetic treatment is prescribed.
In the most severe cases, the child is shown surgical treatment, but the services of neurosurgeons have to be resorted to, fortunately, quite rarely.
During treatment, the child should receive adequate nutrition, he is shown walks, hardening.
Forecast and possible consequences
As already mentioned, the vast majority of cases of perinatal encephalopathy respond well to treatment, provided that the diagnosis is made in a timely manner and the treatment is provided correctly. The likelihood of the development of consequences in the future is minimal.
In the case of encephalopathy of the second and third degrees, the consequences of the death of central neurons for future health can be quite noticeable. Among them are the emergence and development of hydrocephalic syndrome, systematic migraines, attacks of dizziness, fainting, paralysis and paresis, asthenia, various neuroses and hysteria, epilepsy, hearing and visual impairment, difficulties with social adaptation, deviant behavior.
Severe forms of encephalopathy often lead to the death of a child, to the development of cerebral palsy, a wide range of mental disorders, idiocy, and dementia.
Prevention
Preventive measures to prevent organic brain damage in a child should be taken even during pregnancy. It is important to be registered in the antenatal clinic, to pass all the necessary tests on time. In the case of an infectious disease during the period of bearing a child, it is important to urgently receive qualified medical care.
By all possible methods, a woman during gestation should avoid situations that are dangerous for the child from the point of view of the development of hypoxia - do not smoke or take alcohol and drugs, avoid severe stress, do all prescribed ultrasound and CTG on time, walk more in the fresh air, take vitamins , eat well. After the birth of a child, it is important to avoid the action of toxic substances on the baby, as well as to prevent infection with influenza and SARS.
For information on how to treat encephalopathy in children, see the next video.
