A pediatric neurologist is a very important specialist who monitors the central and peripheral nervous system of a child, from birth to 18 years of age. What does a pediatric neurologist treat and what does a pediatric neurologist do? The primary task of this specialist is periodic observations of the stages of formation and development of the nervous system of a small patient, during which many progressive pathologies can be prevented. If it is impossible to prevent them and prevention does not help, an experienced pediatric neurologist determines the diagnosis and prescribes appropriate comprehensive treatment, which in most cases successfully cures the disease.

Today, there are many different diseases of the nervous system that differ from each other, which are classified according to a certain order. Let's list the main lesions of the nervous system and answer the question - what does a pediatric neurologist treat.

• Pathology associated with infection caused by exposure to harmful viruses and bacteria. A newborn child is most susceptible to such infectious diseases due to insufficiently developed immunity. That is why doctors do not recommend that parents visit crowded establishments with a small child.
• Epilepsy. It can be formed either as a result of injury or congenitally. Consultation and treatment with a neurologist are simply mandatory here.
• Diseases associated with severe bruises of the head area, traumatic injuries.
• Toxic pathology. Some drugs and medicines, namely their incorrect prescription and use, can provoke such damage to the nervous system.
• Genetic pathology. Passed on from parents or relatives due to appropriate heredity.
• Hypoxia, which in turn was observed in utero in the fetus.

From this video you will learn what the consequences of not visiting a neurologist may be:

What is mmd in neurology in children

MMD is a minimal brain dysfunction caused by acute failure of the central nervous system, disorders mental state child, as well as a number of other dangerous symptoms.

How does mmd manifest itself in neurology in children?

• Overly active behavior, namely constant movements of both arms and legs, lack of perseverance.
• Quick distraction to the presence of any irritants.
• Inability to play alone.
• He talks incessantly, interrupts adults, and does not hear others when they ask him questions.
• Moves from one task to another without completing the first.
• Losing things in kindergarten, school, absent-mindedness.

What is neurology in children?

Neurology in children is a complex, multifaceted medical discipline that deals with diseases of the nervous system of a small patient. If a qualified doctor still detects neurology in a child, this can be explained by the following most common reasons:

• Receiving a birth mechanical injury;
• fetal hypoxia, as well as insufficient oxygen supply due to possible repeated entanglement in utero;
• complex birth process and labor activity;
• acute toxicosis of pregnant women throughout the entire period;
• genetic inheritance.

What is neurology in eight-year-old children?

The child’s psyche is like plasticine; it is very susceptible to stress and any circumstances; parents, in turn, are advised to ensure that it is not damaged. In what cases does neurology occur in school-age children, namely 8 years old?

1. Excessively heavy loads on the child’s body.
2. A feeling of constant fear caused by the behavior of parents, as well as their pressure.
3. Adaptation period at school.

Such neurosis is accompanied by anxiety, sometimes stuttering, tics, and fainting. At the slightest manifestation of these symptoms, you should immediately consult a doctor.

Pediatric neurology - a relatively young branch of medicine, which originated at the intersection of two areas: neuropathology and pediatrics. However, it has become very important in the field of clinical disciplines.

This area is one of the most complex in medicine. It is in childhood that developmental deviations and various pathologies that affect the development of neuropsychic activity can begin to appear.

Definitely work neurologist in this area is incredibly responsible, because the child’s future life, his social adaptation, physical and mental health depend on his decision.

In this article we will look at some of the most frequent illnesses, as well as their diagnosis and treatment methods. Let us designate the most common neurological diseases in children.

TBI and back injuries

Traumatic brain injuries include compression, concussion, or contusion of the brain. As a consequence of TBI, a child may develop asthenic syndrome, characterized by fatigue, irritability, isolation and self-doubt. Also, the patient often develops vegetative dystonia syndrome, which includes arterial hypertension, sinus tachycardia, bradycardia, hypotension and impaired thermoregulation.

Spinal cord injuries are divided into contusion and compression. With a bruise, persistent neurological disorders such as paralysis, anesthesia and various pelvic disorders can be observed. Another serious consequence of injury is impaired urination.

Microcephaly

This disease is characterized by a significant reduction in the skull, which affects the size of the brain. As a result, the child may experience mental deficiency to one degree or another. The disease may be congenital, or it may appear in the first years of a child’s life. This is a fairly serious defect that affects the functioning of the brain and central nervous system. In some cases, microcephaly can lead to mental retardation.

Also, with this disease, in addition to mental retardation, defects in speech and motor skills may appear, caused by muscle spasms or paralysis.

Hydrocephalus

Another name for this disease is dropsy of the brain. It is characterized by an increase in the volume of the ventricles of the brain, sometimes to critical sizes, resulting from excessive secretion of cerebrospinal fluid and its accumulation in the area of ​​the brain cavities.

Symptoms of hydrocephalus in children most often appear during intrauterine formation, making it difficult to establish the causes. Because of this disease, deformation of the skull occurs - a strong convexity of the frontal lobe, a noticeable manifestation of venous vessels on the temples, as well as a significant expansion of the fontanelles and a syndrome of displacement of the eyes upward, where they are hidden under the superciliary arches.

Hyperactivity

Hyperactivity is expressed in the child’s excessive energy and mobility, which often leads to impaired attention. TO behavioral characteristics Behaviors in most cases include sleep disturbances, lack of appetite, restlessness and neurological habits (for example, when a child constantly bites his nails).

Because the brain of a child with hyperactivity does not process information coming to it well, it becomes uncontrollable. It is much more difficult for such a child to master the skills of reading, writing, etc., and conflicts often arise when communicating with peers.

The syndrome of this disease often arises in a number of ways the following reasons:

• the mother has chronic diseases during pregnancy;
• toxic effects of the mother on the fetus (alcohol, smoking, chemical poisoning, etc.);
• injuries and bruises of the mother during pregnancy;
• complications of labor, manifested in hemorrhage, asphyxia;
• unnatural course of labor (caesarean section, induction of labor, rapid birth or, conversely, slow progress of labor)
• ecology in the region of residence;
• transmission of certain diseases.

Mental retardation

Oligophrenia (also known as mental retardation or dementia) is a congenital or acquired form of underdevelopment of the child’s psyche. The symptoms of this disease can be traced in the form of damage to the mind due to inhibition of personality development against the background of pathological abnormalities of the brain. It often manifests itself in the child’s speech and motor skills, his volitional and emotional qualities.

There are several options for classifying oligophrenia, but we will consider the most traditional:

In this case, oligophrenia syndrome can be differentiated and undifferentiated.

Autism

This disease is characterized by the fact that a child with it has problems with social adaptation and perception of society. Such patients are rarely able to express their own emotions and practically do not understand other people's expressions of feelings. Autistic people are also characterized by speech inhibition and, in rare forms of development, decreased mental activity.

Autism is primarily congenital disease, whose symptoms are manifested in the slightly inhibited development of the child: in his poorly developed or absent speech, inability to behave in the same way as children of his age, avoidance of eye contact.

However, autistic people do not have any characteristic behavior; each case is considered separately. The causes of autism are not known for certain. We can only say with certainty that this disease is inherited and has absolutely no connection with the psychological situation in the family.

Diagnosis and treatment

Below are a number of reasons why you may want to seek advice and examination by a pediatric neurologist .

Pediatric neurologist (neurologist)

The most common pathologies of the central nervous system in children under one year of age include the so-called perinatal encephalopathy. Detects deviations and pathologies of the child’s nervous system pediatric neurologist (neurologist). The development of perinatal encephalopathy in an infant can be provoked by entanglement of the fetal neck with the umbilical cord during pregnancy, premature placental stratum, prolonged or premature labor, and general anesthesia during childbirth. Many pathologies of the child’s nervous system are associated with cerebral hypoxia, which arose due to external or internal unfavorable factors in the last month of pregnancy - toxicosis, taking potent drugs, smoking, the development of acute infectious diseases, the threat of miscarriage, etc.

Various pathologies of the child’s central and peripheral nervous system must be taken seriously. By contacting in a timely manner to a pediatric neurologist at the slightest sign of a disorder of the nervous system in a child, severe developmental consequences can be avoided. If pediatric neurologist does not diagnose in a timely manner and does not prescribe a course of treatment for a child with certain disorders of the nervous system, then inaction can lead, at a minimum, to a delay in the speech and psychomotor apparatus. Pathologies of the nervous system can also lead to attention deficit disorder, behavioral disorders, emotional instability, and impaired development of reading, writing, and arithmetic skills.

Pediatric neurologist must necessarily examine the child when the first signs of pathology of the nervous system appear, which include following symptoms(may appear immediately after birth or several months later):
1. Hands and chin shake violently at the slightest excitement, crying and even sometimes in a calm state;
2. Very superficial, restless sleep in the baby. The baby has difficulty falling asleep and often wakes up;
3. Frequent and profuse regurgitation in the baby;
4. Convulsions (twitching) during an increase in body temperature;
5. When leaning on the foot or on tiptoes, the toes become very tight

As noted pediatric neurologists,severe lesions of the nervous system are easily diagnosed and are much less common than mild lesions (especially in the first year after the birth of the child). Minor pathologies of the nervous system are much more difficult to diagnose, but it is the early detection of disorders of the central or peripheral nervous system and the subsequent complex of treatment that makes it possible to avoid the dangerous consequences of perinatal damage to the child’s brain. It is extremely important that within the first few weeks after birth, the baby is examined by a specialist - pediatric neurologist.

According to recent statistics, more than 50% of childhood disability is associated with pathologies of the nervous system, 70% of which appear during pregnancy and in the first month after the birth of the child (perinatal period). Pathologies of the nervous system during the perinatal period cause the development of perinatal encephalopathy, minimal brain dysfunction(V Lately referred to as ADHD). Untimely treatment of these nervous system disorders can lead to excessive irritability, impulsiveness of the child, and poor performance at school. Later, lesions of the central and peripheral nervous system can lead to various diseases of the musculoskeletal system, motor awkwardness, severe headaches, and autonomic dysfunction syndrome.

During the inspection, pediatric neurologist collects the developmental characteristics and illnesses of the child from the moment of birth. The specialist also analyzes information about how the last weeks of pregnancy proceeded, how the birth went, and what diseases the mother suffered in the last month of pregnancy. If any signs and symptoms of a nervous system disorder are detected in a child, the pediatric neurologist prescribes additional studies - ultrasound (USG), fundus examination, EEG, ultrasound doppler (Doppler), brainstem auditory evoked potentials, MRI (in rare cases). After analyzing the research results, the neurologist prescribes and monitors specific treatment.

In the first month of a child’s life, intensive maturation and development of brain structures, mental and motor functions occur. The sooner the pathology of the nervous system is identified and the appropriate course of treatment is prescribed, the higher the likelihood of avoiding dangerous consequences for the child’s health. Today in the arsenal pediatric neurologist There are many different methods for treating both severe and mild pathologies of the nervous system. These include physical methods of influence (physical therapy for children, massage, physiotherapy), and medications with studied clinical effectiveness, and latest methods neurological rehabilitation (specialized computer speech programs, methods for improving cerebellar stimulation).

Many modern medical centers are equipped with the latest equipment for diagnosing diseases of the nervous system, developing and using effective techniques of manual and emotional therapy in order to avoid, if possible, the use of chemotherapy drugs that have side effects.
Here are some of the techniques they use chiropractors and pediatric osteopaths for the treatment of pathologies of the nervous system in children:
1. Visceral manual therapy.
Restoring mobility and normal functioning of organs.
2. Vertebroneurology (soft technique of pediatric manual therapy).
This technique is based on working with ligaments and muscles at a slow pace, stretching spasmodic, tense areas.
3. Craniosacral therapy. Normalization, alignment of the bones of the child’s skull.
When the movement of the skull bones is displaced or disrupted, the movement of brain fluid and blood flow are disrupted and, as a result, brain function deteriorates, intracranial pressure increases, the ventricles of the brain expand (dropsy), and headaches intensify. This technique is very relevant for children early age.
4. Emotional techniques.
Very relevant for behavioral disorders and various neuroses in children. Emotional techniques are associated with the impact on the channel-meridian and stress points, with the emotional state.
5. Working with muscles to relax them.
As you know, muscles are connected to internal organs, bones, and vertebrae. The technique is aimed at muscle-ligamentous relaxation, post isometric relaxation (holding a special pose, and then relaxing)

Pediatric neurologist also deals with the diagnosis and treatment of traumatic and infectious lesions of the nervous system, tumors, cerebral palsy, diseases of the autonomic nervous system, convulsive conditions (for example, epilepsy in children), chromosomal and hereditary diseases of the nervous system related to nervous diseases(endocrinological, orthopedic, psychiatric diseases).

At an older age to a pediatric neurologist should be contacted if the following symptoms occur:
1. Frequent headaches
2. Piercing pain in the back
3. Memory and attention problems
4. Spinal dysfunctions at different levels
5. Decreased concentration
6. Panic attacks
7. Delayed speech development, writing, sound pronunciation
8. Diseases of peripheral nerves (neuropathy, neuralgia)
9. Fatigue

Routine examination of the child from a pediatric neurologist:
At three months
At six months
At nine months
At 1 year
After a year - mandatory annual examination by a neurologist.

The following childhood neurological lesions are distinguished:
1. As a result of toxic disorders
2. Hereditary, genetic
3. Infectious
4. Hypoxic lesions
5. As a result of traumatic injuries
6. Epilepsy (post-traumatic and hereditary)
7. Specific syndromes (including combinations of the above mentioned lesions of the nervous system)

If you do not notice the first symptoms in time, precious time will be lost, and the consequences of such diseases are very serious and often simply irreparable: speech and psychomotor delays, serious behavioral disorders, emotional instability. One of the most serious and common diseases of the nervous system is neuralgia in children. This is a disease of the child’s peripheral, not central nervous system. The difficulty is that neuralgia in infants is difficult to diagnose, since the child cannot talk about the pain that torments him.

Symptoms of childhood neuralgia

How to recognize neuralgia in a newborn, if he may have a large number of reasons for crying? Considering the symptoms of neuralgia in children requires attention, care and observation.

• the baby may, when chokingly crying, constantly reach with his hands to his face, and the facial muscles, upon careful examination, may twitch involuntarily - this is the first sign of trigeminal facial neuralgia;
• sometimes when a child cries he cannot open his jaws, which are cramped, this also indicates a pinched trigeminal nerve;
• the child begins to scream heart-rendingly if he is picked up or his body position is simply changed - this may be a symptom of intercostal neuralgia;
• tearfulness and profuse sweating, which is not typical for newborns;
• the baby involuntarily retracts his head when touched.

All of the above symptoms may also be accompanied by the following additional phenomena:

The main symptoms by which neuralgia can be recognized are convulsions and strong pain when touching the affected area of ​​the body.

Causes of childhood neuralgia

The main cause of any neuralgia is pinching of the nerve ending by vessels, which, due to improper blood circulation, can expand and thereby put pressure on nearby nerve cells.

An expectant mother may well protect her unborn child from this disease, since the causes of neuralgia in newborns lie precisely in the mother’s lifestyle during pregnancy.

• lack of oxygen, which, in turn, can be caused by ordinary anemia, previous infection, smoking;
• great physical and psycho-emotional stress during pregnancy;
• birth injury;
• fetal prematurity.

A child may acquire neuralgia due to parental neglect:

• intercostal neuralgia in children can be caused by the fact that the child was simply picked up incorrectly;
• constant presence in so-called kangaroo pouches can also cause neuralgia;
• drafts and any hypothermia in general;
• diseases of the spine.

Treatment of childhood neuralgia

Neuralgia in children is a fairly common phenomenon, and modern pediatric neurology has made great strides in the treatment of diseases of the nervous system, so if you discover signs of neuralgia in a child, you should not panic. An urgent consultation is necessary with a specialist who will determine an accurate diagnosis and prescribe appropriate methods and drugs for treatment. For neuralgia in children, the following effective methods are used:

• massotherapy;
• swimming;
• daily bathing;
• Exercise therapy has a great effect in neurology - therapeutic physical training complex special exercises which help improve blood circulation and eliminate vascular pressure on nerve endings;
• analgesics to relieve pain;
• Considering that a child cannot be given medications until 3 months of age, homeopathy is a reliable and effective remedy.

To avoid the development of neuralgia in a child, parents must think and take care of the health of their baby from the moment of conception: the mother must lead a healthy lifestyle and provide the unborn child with everything necessary already in the womb.

Symptoms of neurological diseases in children

Symptoms of neurological diseases may appear as early as infancy. Constant crying should be an alarm bell for parents. Most often, parents consider this to be whims. In fact, what is considered a whim is not a whim at all. Small children cry either when they are not cared for properly or when they are physically or mentally unwell. Not all children can calmly withstand the difficulties they face, but believe me, learning about the world and acquiring basic skills is very difficult task. Some children react in difficult situations by becoming hysterical or withdrawn. Over time, such attacks become a system. Most often, the bad character to which parents tend to attribute such behavior is not character at all, but a real neurosis.

It is believed that a child’s nervousness is normal and there is no need to see a doctor. Often only a doctor can identify a nervous disorder.

If you don’t want to make the mistakes of other parents, then be wary if:

Your child is very ahead of his peers mentally. At a high rate of development, the child’s psyche has every chance of being “strained.”

He is very passionate about any activity to the point of fanaticism. This could be some kind of subculture, learning an exotic language, or any hobby that is non-standard for his peers.

Complete escape from reality in some kind of game (there are cases when a child imagines himself as an animal and all his behavior is subordinated to such behavior).

The child suffers from daydreams – hallucinations. This manifests itself in a conversation with someone invisible, constantly listening and asking if you see or hear something? Lies and fantasies of a child about something that he really believes in, for example, that he is being abducted by aliens and so on.

Obvious signs of a nervous disorder are: nervous tics, headaches, obsessive fears, hysterics, tearfulness, desire for loneliness, various phobias, hypochondria, refusal to eat, stuttering, insomnia, neurotic enuresis. If you notice one sign or a whole complex, immediately consult a doctor, because the sooner you contact, the easier it will be for the child to get out of this state.

Most often, neurological disorders affect children with low or high self-esteem, individualist children, as well as timid children, children under strict parental control, anxious by nature, children with increased suggestibility, touchy children, unwanted children.

If you honestly look at your child, evaluate your relationship with him, his predispositions and characteristics, then it will be much easier for you to influence the situation, because most often you need to start with yourself.

Pediatric neurology

The child’s nervous system is one of the most important components of the whole organism. With the help of the nervous system, not only the activity of the entire organism as a whole is controlled, but also the relationship of this organism with external environment. This relationship is carried out with the help of sensory organs, receptors on the surface of the child’s skin.

The nervous system is a very complex formation in a child’s body. Any disruption in its coordinated activity can lead to the development of quite serious diseases.

The development of the nervous system occurs unevenly. The formation of the brain occurs in the early stages of pregnancy (1st week of the child’s intrauterine development). But even after childbirth, the process of division and formation of new nerve cells does not complete. The most intensive period of formation of a child’s nervous system occurs in the first 4 years of life. It is during this period that the child receives more than 50% of the information that helps him in later life. Adverse influences environment, infectious diseases, injuries during this period lead to the formation of the largest number of neurological diseases.

The motor activity of the child, which is also controlled by the nervous system, is also important. While inside the uterus, the child takes a certain position, which allows him to occupy a smaller volume. After birth, various reflexes can be detected in a child. The presence of these reflexes, on the one hand, is associated with the immaturity of the nervous system, and on the other hand, they help the child survive in environmental conditions. Gradually, during the maturation of the nervous system, many of the reflexes disappear, but some, such as swallowing, remain with us for the rest of our lives.

The sense organs (vision, smell, touch, hearing) are very important in a child’s life. These organs help the child navigate the environment, form an idea of ​​objects and phenomena, communicate and explore the world. Any violations of these sense organs lead to the fact that it becomes very difficult for the child to perceive the world and communicate with his peers. Speech, which will also be controlled by the nervous system, plays an important role in the formation of communication. Speech impairment can be a consequence of brain damage or organic diseases organs involved in the formation of speech. It is necessary to promptly identify various speech disorders and treat these conditions, since speech is necessary not only for communication, but also for the correct assimilation of the acquired knowledge.

In some cases, it is quite difficult to recognize neurological diseases in children in the early stages, since they may be hidden behind the functional immaturity of the nervous system. In this case, only parents are able to provide all possible assistance. medical workers, since they are next to the child almost 24 hours a day, and can immediately determine whether the child’s behavior has changed. Another feature of neurological disorders in children is that many of them, with early, timely, correct, although long-term treatment disappear almost completely.

By studying the articles collected in this section, you will be able to learn how to identify various conditions in children that may indicate that the child has a pathology of the nervous system and bring this to the doctor’s attention in time.

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For any diseases, especially during pregnancy or in a child, do not diagnose symptoms and treat them yourself; you must consult a specialist doctor.

Symptoms and treatment of childhood neurological lesions

Pediatric neurologist (neurologist)

The most common pathologies of the central nervous system in children under one year of age include the so-called perinatal encephalopathy. A pediatric neurologist (neurologist) is involved in identifying deviations and pathologies of the child’s nervous system. The development of perinatal encephalopathy in an infant can be provoked by entanglement of the fetal neck with the umbilical cord during pregnancy, premature placental stratum, prolonged or premature labor, and general anesthesia during childbirth. Many pathologies of the child’s nervous system are associated with cerebral hypoxia, which arose due to external or internal unfavorable factors in the last month of pregnancy - toxicosis, taking potent drugs, smoking, the development of acute infectious diseases, the threat of miscarriage, etc.

1. Hands and chin shake violently at the slightest excitement, crying and even sometimes in a calm state;

2. Very superficial, restless sleep in the baby. The baby has difficulty falling asleep and often wakes up;

3. Frequent and profuse regurgitation in the baby;

4. Convulsions (twitching) during an increase in body temperature;

5. When leaning on the foot or on tiptoes, the toes become very tight

Here are some techniques that chiropractors and pediatric osteopaths use to treat pathologies of the nervous system in children:

1. Visceral manual therapy.

Restoring mobility and normal functioning of organs.

2. Vertebroneurology (soft technique of pediatric manual therapy).

This technique is based on working with ligaments and muscles at a slow pace, stretching spasmodic, tense areas.

3. Craniosacral therapy. Normalization, alignment of the bones of the child’s skull.

When the movement of the skull bones is displaced or disrupted, the movement of brain fluid and blood flow are disrupted and, as a result, brain function deteriorates, intracranial pressure increases, the ventricles of the brain expand (dropsy), and headaches intensify. This technique is very relevant for young children.

4. Emotional techniques.

Very relevant for behavioral disorders and various neuroses in children. Emotional techniques are associated with the impact on the channel-meridian and stress points, with the emotional state.

5. Working with muscles to relax them.

As you know, muscles are connected to internal organs, bones, and vertebrae. The technique is aimed at muscle-ligamentous relaxation, post isometric relaxation (holding a special pose, and then relaxing)

1. Frequent headaches

2. Piercing pain in the back

3. Memory and attention problems

4. Spinal dysfunctions at different levels

5. Decreased concentration

6. Panic attacks

7. Delayed speech development, writing, sound pronunciation

8. Diseases of peripheral nerves (neuropathy, neuralgia)

9. Fatigue

At six months

At nine months

After a year - a mandatory annual examination by a neurologist.

The following childhood neurological lesions are distinguished:

1. As a result of toxic disorders

4. Hypoxic lesions

5. As a result of traumatic injuries

6. Epilepsy (post-traumatic and hereditary)

7. Specific syndromes (including combinations of the above mentioned lesions of the nervous system)

Neurological diseases in children

Every day the child interacts with the environment, that is, he grows and develops, which is necessarily controlled by the nervous system. This explains the importance of the role assigned to it in the child’s body. The slightest disturbance in the functioning of the nervous system can result in unpleasant neurological diseases, which are very common in childhood. The lack of understanding of parents about the symptoms of such disorders contributes to untimely contact with a specialist and delayed initiation of therapy, which is unacceptable.

Photo: Disturbances in the child’s nervous system

Neurological diseases are recognized as pathologies in which there is a disruption in the functioning of the central and peripheral nervous systems.

When can violations be noticed?

The appearance of the first signs of one of the neurological ailments can be noted as early as early infancy. Regular crying of a baby should be the first signal for parents, prompting them to immediately visit a specialist. Instead, most mothers and fathers prefer to attribute this behavior of the baby to banal capriciousness. But we all know that babies can cry for several reasons: due to improper care and illness.

As a child gets older, tantrums may be a common reaction to difficult situations and the difficulties encountered along the way. Parents are again trying to isolate themselves from the problem, blaming the child’s obnoxious character. Of course, in such cases, do not go to the doctor. In fact, it is a mistake to attribute all kinds of behavioral disturbances in a child of any age to character traits. More often, the problem lies in something more complex, for example, neurosis, which only a qualified specialist can identify.

What are the consequences of delay?

The NS is comparable to a clock mechanism: if a small part fails, full operation will be disrupted. If a child has a neurological problem, and even in an advanced form, complications may soon appear. The most optimistic of them is a disruption in the functioning of the psychomotor apparatus. If you continue to do nothing, the child may become hyperactive and develop attention deficit disorder, or even become hostage to a nervous tic. In this case, the child’s behavior becomes really complex, in some cases even inadequate.

Reasons for the development of pathology

Even experienced doctors cannot predict how the nervous system will respond to negative external influences. TO possible reasons Violations of the normal psycho-emotional state of a child include:

hereditary factor; brain tumors; diseases of internal organs of a chronic nature; low immunity; traumatic brain injuries; infections; reaction to taking medications.

This is not a complete list. According to some reports, even the environmental situation and gender can affect the state of the nervous system.

Risk group

Doctors identify a group of children who are more susceptible to neurological disorders than others. First of all, these are children with too low or, on the contrary, high self-esteem. Even at a very early age, it is difficult for them to develop normally in society, which is why they become withdrawn. This group also includes children with signs of individualism, anxiety and touchiness. Often, neurological diseases overtake children with a high degree of suggestibility and too timid.

Unwanted children can also be considered a risk group.

Neurological diseases in children: symptoms

It is sometimes difficult even for an experienced specialist to recognize problems in the functioning of a child’s nervous system during a clinical examination. To parents who are far from medicine, such a task will seem completely impossible. But observing the child’s behavior from the very first days of his life is their direct responsibility.

Infants must undergo examinations by a neurologist, which makes it possible to identify the disease at an early stage and begin its treatment as early as possible. Missing an appointment with the doctor is unacceptable!

Obvious manifestations of a nervous disorder include:

• nervous tic;
• obsessive states;
• fears;
• speech disorder;
• tearfulness and hysterics;
• loss of appetite or complete refusal of food;
• stuttering;
• enuresis;
• insomnia;
• hypochondria;
• fainting;
• impaired coordination of movements;
• tingling in different parts bodies.

Parents should pay attention to the child's condition if he constantly or with noticeable regularity complains of dizziness, tinnitus and problems with swallowing. Increased fatigue for no apparent reason should also be a concern.

Having noticed one, and especially several signs in their child, parents should immediately go to see a pediatric neurologist. Consultation with a specialist is also recommended because often the symptoms presented do not indicate neurological problems at all, but diseases of the digestive tract, viral infection or problems with endocrine system. This is explained by the inextricable connection between the nervous system and the entire body.

Photo: Neurological problems The child has

A little about headaches

Chronic malaise, as headache is commonly called, occupies one of the leading places in terms of prevalence among children. In many cases, it is considered a symptom indicating a number of diseases - from common ophthalmological to brain tumors. The presence of a constant headache is an alarming signal that may indicate serious problems and neurological abnormalities developing in the child. If the pain is characterized by gradual intensification, localization on both sides of the head and dull nature, while the child’s appetite and sleep are disturbed, do not postpone the examination!

In order for the treatment of neurological diseases to be more effective, parents should seek help in a timely manner. But first, you need to remember about constant monitoring of the child’s behavior and well-being, which are the main indicator of his condition.

Neurology in children

Neurology is usually called pathologies of the nervous system, although in reality it is a science that studies them. Pathological phenomena of the nervous system should never be left without the attention of doctors! Neurology in children - especially. Diseases of the nervous system lead to serious consequences, because the most optimistic diagnosis if the disease is ignored is a delay in the development of the speech and psychomotor apparatus. This may be followed by hyperactivity and attention deficit disorder. Such children are on the verge of neuroses, nervous tics and inappropriate behavior.

Symptoms of pathologies of the nervous system

Some signs of neurology in children appear quite eloquently, so sleep disturbances, a shaking chin or arms, legs, frequent regurgitation, tucking up the toes in a standing position should alert parents. These symptoms are a reason to contact a pediatric neurologist. However, neurological symptoms in children may be vague, but if it is difficult for parents to notice them, then an experienced neurologist will be able to draw the right conclusions.

Treatment of pathologies and prognosis

Fortunately, neurology in infants in most cases can be corrected and treated. The doctor must carefully analyze the features of the baby’s lifestyle, starting with monitoring the mother’s pregnancy. If the neurology of premature babies or infants with pathologies has an unclear etymology, then additional studies are prescribed. The child’s parents are offered to conduct an examination of the baby’s fundus, ultrasound, Doppler, and EEG. In extreme cases, an MRI may be required.

In the first months of a baby’s life, the brain develops very actively, its structures mature, as do mental and motor functions. It is for this reason that it is very important to make a diagnosis as early as possible and prescribe effective treatment.

Combination methods are often used as treatment, combining medications, the clinical effectiveness of which has already been proven, and massages, physical therapy, physical therapy. In addition, modern neurologists are constantly expanding their arsenal with new methods of neurological rehabilitation: computer speech programs, methods for improving movement coordination, cerebellar stimulation, etc.

In order to be confident in the health of their child, parents should visit a neurologist once every three months until they reach one year of age. Then the inspection is carried out annually.

Pediatric neurology is a branch of medicine that deals with diseases of the children's nervous system. It arose at the intersection of 2 disciplines - neurology and pediatrics. It is also closely related to neurosurgery and psychiatry. Neurology in children is one of the most complex disciplines of medicine.

A little history

Yakunin Yu.A., Badalyan L.O., Shabalov N.P. made a great contribution to the development of child neurology. and, of course, Ratner A.Yu. They have done a lot for the development of perinatal pathology, i.e. in neonatal neurology.

Also, in order to improve the diagnostic and treatment processes, pediatric neurologists released the third edition of the book in 2015 - “Children’s neurology in newborns and clinical guidelines” ed. prof. Guzeeva V.I. and co-authors.

Here are all the latest materials on the etiology, definition and treatment of pathologies of the nervous system in childhood; The entire algorithm of the doctor’s actions is indicated.

Particularly detailed information is given on issues of pathology of newborns. Much attention was paid evidence-based medicine and her achievements.

Neurologist (more modern name specialty of neurologist) - specializes in the study, prevention, identification and treatment of diseases affecting all parts of the nervous system.

This is especially important in children, because neurological pathologies leave a mark on the future for life. The work of a pediatric neurologist is very responsible, because with his decisions he decides the future fate of the child: his social adaptation, mental and physical health; and even his illnesses in adulthood.

Today, a new section of diseases has been opened in pediatric neurology: hereditary metabolic diseases. This was done because out of 2.5 thousand nosologies in neurology, 70% of them are hereditary.

Visits to a pediatric neurologist should be scheduled in the first month of life, every 3 months for 1 year of life. Then they are performed annually as necessary.

The importance of timely contact with a pediatric neurologist

Pediatric neurology differs markedly from that of adults; The nervous system of children changes with age and is not a miniature copy of an adult. In children, many diseases have an atypical course and are quite rare.

The main problem of pediatric neurology is perinatal lesions of the nervous system. The perinatal period begins at 22 weeks of gestation and ends 7 days after birth. During this very important period for mother and fetus, a variety of factors can influence it.

The last month before childbirth and health are very dependent on external factors: late toxicosis; nicotine; taking drugs; stress; infections - all this is a lot for the body of the unborn baby, these are harmful factors. For example, even minor stress in the mother during pregnancy leads to an oversaturation of the child’s bones with calcium.

As labor approaches, the bones of the fetus harden; The result is a painful birth for the mother and difficulty for the baby as it passes through the birth canal. It is also undeniable that today the number of stresses in a person’s life is growing exponentially.

The functioning of the nervous system can be disrupted even in the prenatal period. Therefore, a neurologist examines the child in the first weeks of life and immediately after birth.

If the mother’s birth was pathological and the child was born in asphyxia, forceps were applied and other obstetric manipulations were performed, this will definitely affect the nervous system. Many researchers in the West consider current childbirth to be non-physiological.

The only neurologist who studied newborns during the perinatal period spoke about this in the book - A.Yu. Ratner Neurology of Newborns. This monograph describes the injuries that become inevitable for the baby during obstetric manipulations.

Also A.Yu. Ratner, all neurologists, osteopaths and massage therapists insist that during childbirth the most vulnerable place in the fetus is the neck and shoulder girdle. They are under maximum stress. This is the border between the spinal cord and the brain.

Here are the structures that orient a person in space; are responsible for biorhythms, breathing, and providing the body with energy. They are laid later than everyone else and continue to mature in the perinatal up to 3 years. They are called block I of the brain.

This is why it is so important to treat pathology of the nervous system in the first year of life. If the baby's neck is injured, this will manifest itself muscle spasms in the neck area; the neck will be recessed into the shoulders.

Such babies do not like to lie on their stomach - it hurts; It’s hard for them to hold their head up, it falls and sticks its nose down. This happens because when you raise your head, your neck and shoulders reflexively tense.

Such babies often have sleep disturbances; rickets occurs more often. At an older age, they will suffer from headaches because the spasticity of the muscles in that area will persist.

Vessels feeding the brain pass through 1 block and this will also be reflected on it. This clearly demonstrates how great value is given to neurological impairment in the first 3 years of life, with an emphasis on the first year. Detachment of the child's place, the speed of labor in any direction, and anesthesia during childbirth also have a negative effect. And you don’t have to hope for chance, if the baby screamed immediately during birth, was put to the chest and immediately took the breast, etc. If you ignored the neurologist, the baby may have mental retardation at a minimum, and the child will remain disabled. Organic lesions are quite possible.

Children with retardation may lag behind in society, basic skills, be inadequate, emotionally unstable, etc. According to statistics, in 50% of cases a child is given a disability due to neurological diseases.

Moreover, 70% of diagnoses are related to the condition of the pregnant woman during the pregnancy period and the health of the baby during the newborn period.

With early contact with a pediatric neurologist, half of such problems can be successfully solved.

This is possible because it is in the first months of a newborn’s life that the brain actively develops and matures, it has more opportunities to adapt, and therefore the treatment will be most noticeably effective. If time is lost, one can only talk about meager rehabilitation opportunities. In other words, everything is fine on time.

When is it urgent to contact a neurologist?

The first symptoms of disorders are possible in the first month of life. The main symptoms that parents should be alert to and pay attention to are the following:

1. When crying, the baby's chin trembles and his arms shake; sometimes this can be observed at rest.
2. The child is easily excitable.
3. The child does not fall asleep well, his sleep is shallow and he easily wakes up from the influence of external factors, for example, from the sound of a voice; is constantly capricious. Parents of such children should not try to create ideal ways at home to improve sleep, such as curtained windows, darkening, complete silence, whispering conversations - this is not the answer. All this will aggravate the situation and delay diagnosis.
4. Abundant and frequent regurgitation in infants, even with a small amount of food.
5. The appearance of seizures in a child even at low temperatures.
6. Placed on piles of support, the baby curls his toes or stands on tiptoes, like a ballerina.
7. Older children may experience: frequent headaches, which can be prolonged.
8. Fainting conditions.
9. Pain and shooting in the back.
10. Disturbances in performing normal movements at different levels of the spinal column.
11. Absent-mindedness, inability to attract attention, memory impairment.
12. Apathy, lethargy, fatigue, no interest in the environment.
13. Doesn't have contact with peers.
14. Bad dream.
15. Panic attacks against the background of complete well-being.
16. Neuralgia and signs of peripheral nerve damage.
17. Spontaneous twitching of various muscles.
18. Enuresis in children 5-6 years old.
19. Hyperactivity.
20. Delayed speech, mastering writing, decreased intelligence.

In all of these cases, there is no need to wait for a scheduled examination; you need to go to the doctor right away.

1. In children under one year of age, examination every 3 months; if there are violations monthly.
2. Then examination in the pre-preschool period - 4 - 5 years.
3. During the primary school period - 7 years;
4. 13-14 years - puberty.

All medical examinations are necessary for the early detection of pathologies in order not to lead them to a serious condition. Also, early detection of psychomotor deficiency and mental retardation is possible.

How is an examination by a pediatric neurologist performed?

After a traditional examination (visual examination, palpation, manipulations to determine the motor and sensory spheres), the neurologist always clarifies the entire list of diseases from the birth of the child; analyzes all the negative aspects of pregnancy in the mother; the course of childbirth. Diseases suffered in the 3rd trimester of pregnancy are specified.

Diagnostic measures

Diagnostic methods for suspicious symptoms include:

• Ultrasound with Dopplerography of cerebral vessels;
• fundus examination;
• MRI (in extreme cases).

During admission, the following must be checked:

• visual reflexes;
• muscle tone and strength;
• conditioned and unconditioned reflexes;
• sensitivity and its loss are determined;
• coordination in space;
• cognitive cognitive functions.

Additional research methods include assessment of hearing, brain stem, and speech apparatus. Since many problems are often of a polyetiological nature, treatment is carried out together with other specialists.

Treatment methods

How to treat congenital pathologies? At congenital pathologies The main goal is to stop the worsening of the pathology and help the child adapt. Medicines are not used immediately.

To begin with use:

• manual therapy;
• craniosacral technique;
• muscle relaxation;
• emotional technique;
• physio-, reflexology and binaural therapy;
• massages;
• Exercise therapy, etc.

Manual therapy – restores mobility and function of the spine. In children, it is carried out gently, at a slow pace, removing all spasms from tense areas.

Craniosacral technique - its goal is to manually gradually align the bones of the skull. This restores blood supply to the brain; reduces ICP. The technique is used in infants.

Emotional techniques – used for behavioral deviations and neuroses.

Muscle relaxation - it consists of relaxing muscle fibers. This has a positive effect on skeletal system, especially on the spine. The internal organs also relax.

New methods include computer speech programs and techniques for improving motor coordination (cerebellar stimulation).

As can be seen, when neurological treatment little is acceptable at home.

The neurologist does not just prescribe treatment and send the child home without thinking about it until the next medical examination. He always controls the treatment.

In order to stimulate motor skills and mental development, parents can successfully carry out simple exercises at home after consultation with a doctor to develop and improve fine motor skills:

1. Pour a little buckwheat into a bowl and, sorting it out, pour it from palm to palm. You can hide small objects in this cereal and let the child try to feel them.
2. Pour warm water from a basin into a bucket with a glass;
3. When your child takes his first steps, let him run barefoot more often. Let him feel the surface in piles; this will enrich his tactile sensations. In this case, the surface alternates texture - floor, carpet, rubber mat, fabric, etc.
4. Make plasticine modeling with your child and paint with finger paints.

Common pathologies

This article will identify the most common neurological pathologies in children.

1. Brain dysfunction, or otherwise attention deficit hyperactivity disorder, first manifests itself as decreased concentration of attention, then the child becomes irritable and easily excitable. The muscles are hypotonic, which causes awkward movements and disrupts the functioning of the musculoskeletal system as a whole. Posture is impaired, flat feet develop, and urinary incontinence appears. Children cannot learn the school curriculum, they have vegetative symptoms: increased heart rate, dizziness, headaches.
2. Perinatal pathology also includes birth trauma, fetal hypoxia, intracranial hemorrhages. At the first examination, there may be complete health, but the manifestation of pathologies will appear after a few months.
3. Hypoxic-ischemic encephalopathy is a consequence of fetal hypoxia. The brain suffers completely: the cortex and subcortex. If left untreated, this will result in decreased intelligence, paralysis, convulsive syndrome, cerebral palsy. Disturbances at an early stage are clearly visible on the EEG.
4. Birth trauma is a broad concept that includes violation of the integrity of tissues in the fetus during childbirth. These include spinal cord injuries and facial nerve palsies. Facial paralysis produces symptoms: swelling, drooping and immobility of the mouth; eyelids do not close tightly; the nasolabial fold is absent. Treatment can lead to complete recovery. Spinal cord injury during childbirth can occur when the fetus is breech, due to the use of obstetric manipulations. Under such conditions, vertebral subluxations, pinching and spasm of the vertebral artery, and hemorrhages into the membranes of the spinal cord easily occur. With spinal cord injuries, bruising and compression are especially common. Neurological disorders manifest themselves in the form of paralysis, pelvic disorders, and urinary disorders. Signs of damage are determined by the segment level. In these diseases, to treat such disorders, the child’s neck and head are immobilized. They relieve tissue swelling and pain with medications, and restore the functioning of damaged brain structures.
5. Intracranial hemorrhages - these include hypoxia, impaired blood clotting, infections during the mother’s pregnancy; prematurity. With all of them, the condition of the wall of the brain vessels is disturbed, and the pathology of childbirth becomes the trigger. Treatment consists of following a gentle and protective regimen (exclusion of any irritants - light, sound; only gentle swaddling); drug treatment. If the hemorrhage progresses, it is possible surgical intervention in the form of blood removal by suction with ultrasound control.
6. Traumatic brain injuries: The concept of TBI includes bruises and concussions. In a child this manifests itself as asthenic syndrome; it is often accompanied by vegetative dystonia: increased blood pressure, changes in heart rhythm; impaired functioning of the thermoregulation center.
7. Microcephaly. A pronounced decrease in the size of the skull and, accordingly, the brain is characteristic. Mental disability will definitely be observed. Speech and motor skills are impaired.
8. Hydrocephalus. Another name is dropsy of the brain. With it, the cavities of the ventricles of the brain are sharply enlarged due to increased secretion of CSF, which accumulates in the brain cavities. Signs of hydrocephalus are formed in the womb. As a result, the skull becomes deformed, the forehead becomes excessively convex, and the network of veins on the skull and temples is pronounced. The fontanelles are noticeably enlarged, the eyes roll up under the brow ridges. Often pathologies in older children are a late result of failure to recognize them in the first months of life.

Pediatricians always require knowledge in neurology, because many childhood diseases simultaneously affect the nervous system. Practice shows that often the professional training of doctors in neurology is insufficient, so mistakes and neglected cases in diseases that are easy to diagnose are not uncommon. This needs to be given special attention.

The main types of neurological pathology in children of the first year of life

To identify diseases of the nervous system, manifested by a specific delay in psychomotor development, it is important to assess the neurological and psychopathological signs. The age-related immaturity of the nervous system of a child in the first year of life determines the fragmentation and undifferentiation of the signs observed in him. The body, especially the newborn and infant, reacts to various harmful effects with a limited number of typical reactions, the nature of which primarily depends on the age phase of neuropsychic development. Below are the main options, reflecting mainly the type of neuropsychic reaction in the first year of life.

General examination of a newborn - what parents should pay attention to

Considering the high incidence of perinatal pathology of the nervous system and the possible difficulties of obtaining qualified specialized care, there is no doubt that there is an urgent need for parents to receive relevant popular scientific information.

What can we see for ourselves? - general examination of the newborn

The child normally breathes rhythmically, makes automatic movements of the limbs in sufficient volume and symmetrically. The slightest restrictions in movement in the arms or legs should be the basis for a targeted study - are there any movement disorders? The nature and volume of the baby's crying is important. The posture of a newborn can tell a lot. In some cases, the child is lethargic, inactive, and sometimes literally lying flat. In other cases, on the contrary, the tone in the limbs is evenly increased - when swaddling, a peculiar stiffness of the limbs immediately attracts attention. It is very important not to miss even small convulsive twitches during examination.

Examination of a newborn's head reveals a lot. A birth tumor is typical for most newborns. How larger sizes This tumor, therefore, makes the birth of a child more difficult, and such a child should be the subject of a particularly careful examination. Some children notice bruises on the face, neck, and torso as a result of a traumatic birth - in these cases, neurological symptoms are more often detected.

Head deformations (the so-called “configuration”) almost always indicate a birth injury to the skull, and among these children craniocerebral symptoms are much more common, which is quite understandable and easily explainable.

In everyday practice, cephalohematoma is sometimes underestimated, usually only because it is “common” and “located outside the skull.” Indeed, we are talking about a subperiosteal hematoma, sometimes quite significant in size. It is indeed common, but this cannot serve as an argument against it - it is an injury, and what is important for the diagnosis is not even the cephalohematoma itself, but what it indicates - at the level of such a hematoma, there are undoubtedly areas of microhemorrhages in the underlying areas of the brain , which, regardless of the patient’s age, indicate cerebral contusion. One of the important indicators of difficulties with childbirth is such a sign as the location of the skull bones on top of each other. This small dislocation usually does not lead to damage to the underlying brain tissue, but it certainly indicates that the fetal skull passed through the birth canal, experiencing great resistance - in these cases, signs of damage to the nervous system are often revealed.

The condition of the fontanelles plays a major role in assessing the child’s condition: tension, bulging of the fontanelles is a very serious symptom of increased intracranial pressure. The size of a newborn's head tells the doctor a lot: signs of hydrocephalus, if detected from the first days of life, usually indicate intrauterine brain pathology, while the gradual development of hydrocephalus can often be a consequence of birth damage to the brain.

Here it should be noted the catastrophic frequency of the unjustifiably expanded diagnosis of “hypertensive-hydrocephalic syndrome”, which in many hospitals and clinics is made for no reason or no reason. The worst thing is that in such cases, massive and long-term therapy with diacarb immediately begins, which is not only unjustified, but exhausting for the child.

In some newborns, the head is smaller than normal in size, and in addition, the brain part of the skull is smaller than the facial part - sometimes this indicates intrauterine and genetic pathology (microcephaly) and, unfortunately, has severe consequences. Recently, more and more often there are children with very early closure of the fontanel, while the growth rate of the head in such newborns clearly lags behind the norm.

The sign of a “short neck” is quite common, and it is usually very demonstrative and striking. It seems that the child's neck is very short (although there is no anatomical defect), the head seems to be located directly on the shoulders. With age, the degree of these manifestations gradually decreases. In these same children, attention is drawn to the severity of the transverse folds on the neck with persistent weeping in the area of ​​these folds. It can be assumed that the symptom of a short neck occurs as a result of overextension of the neck during difficult childbirth, followed by a reflex contraction of the neck like the “accordion phenomenon”. Later, it is these children who develop another very important sign - a sharp protective tension in the cervical-occipital muscles.

Assessing the condition of the abdominal wall is very important. It is known that many newborns have a flabby, flat stomach, and in these cases it is impossible to exclude a violation of the contractility of the abdominal muscles as a result of birth injuries thoracic spinal cord. This is especially demonstrative when the lesion is predominantly unilaterally localized - the “weak” half of the abdominal wall protrudes slightly, the navel moves when screaming. With a bilateral lesion, it is more difficult to judge. The following test can be useful: if such a newborn cry is weak, then when the doctor’s hand presses on the child’s stomach, the voice becomes much louder.

Priapism, a spontaneous erection of the penis in a newborn, should be considered equally unfavorable. Pediatricians often encounter this sign, but do not know how to interpret it. At the same time, in adult neurology, this symptom is well known and indicates significant spinal pathology.

We tried to look at some possibilities general examination newborn to look for signs that suggest one or another neurological pathology.

Each of the above signs cannot be considered conclusive, but taken together they acquire great diagnostic meaning. In any case, only a doctor specializing in perinatal neurology can resolve your doubts.

Perinatal cerebral depression (nervous hypoexcitability)

Low motor and mental activity of the child, which is always below his motor and intellectual capabilities; high threshold and long delayed period for the occurrence of all reflex and voluntary reactions. Depression is often combined with low muscle tension and reflexes, slow switching ability nervous processes, emotional lethargy, decreased motivation and weakness of volitional efforts.

Hypoexcitability can be expressed to varying degrees and manifest itself either episodically or persistently. The episodic occurrence of the syndrome is characteristic of somatic diseases, especially pathologies of the gastrointestinal tract, accompanied by malnutrition. Sometimes mild but persistent manifestations of the syndrome may be due to the type of higher nervous activity. The predominance of cerebral depression in the first months of life is observed in cases of prematurity, in children who have had oxygen starvation, intracranial birth injury. Severe and persistent depression is often accompanied by delayed psychomotor development, which acquires some characteristic features.

Delayed psychomotor development in hypodynamic syndrome is characterized by a delayed formation of all conditioned reflexes. During the neonatal period and in the first months of life, this manifests itself in a lag in the development of the conditioned reflex during feeding; subsequently, the development of all food conditioned reflexes is delayed (reflex to the position of feeding, the appearance of a breast or a bottle of milk, etc.), the development of food, and then visual and auditory dominance and sensitive local reactions is delayed. Particularly characteristic is the delay in the development of chain motor combined reflexes, which most clearly begins to manifest itself from the second half of life! Such a child at the age of 6-8 months does not pat a blanket or toy with his hand, does not knock an object against an object, does not repeatedly throw out an object by the end of the year, does not put an object into an object. This is also manifested in vocal reactions: the child rarely repeats sounds and syllables, i.e., performing single movements and pronouncing individual sounds, he does not strive to repeat them. As a result of the delay in the formation of conditioned reflexes on the combination of a word with an object or action in both a specific and non-specific situation, the initial understanding of speech and submission to verbal commands in these children occurs at a more advanced stage. late dates. At the same time, a lag in such functions as object-manipulative activity, crawling, babbling, speech understanding, and one’s own speech is formed.

In the case of hypoexcitability, the formation of positive emotional reactions is noted at a later date. This manifests itself both when communicating with an adult and in the spontaneous behavior of a child. During the newborn period, when communicating with an adult, such children usually lack oral attention; at the age of 2 months, the reaction of joyful animation at the sight of an adult and a gentle voice is not expressed or is weakly expressed. Often, instead of facial expressions of animation, you can only see a reaction of concentration in a child. A smile appears after 8-9 weeks; its appearance requires a complex of stimuli, including proprioceptive ones, and their repetition; the latent period of a smile in response to a stimulus is extended.

While awake, the child remains lethargic, passive, indicative reactions occur mainly in response to strong stimuli. The reaction to novelty is sluggish and in most cases has the character of passive amazement, when a child with wide open eyes remains motionless at the sight of a new object, without making active attempts to approach it or grab it. The longer the period of absence of active wakefulness and indicative-exploratory behavior, the more pronounced the lag in psychomotor development.

The revival complex - one of the main manifestations of active forms of emotional behavior in a child in the first months of life - with hypoexcitability is either absent or manifests itself in a rudimentary form: a weak facial reaction without sparkle in the eyes and vocal reactions or the absence of a motor component, clear vegetative manifestations. Active negative emotional reactions are also weakly expressed and have almost no effect on the child’s general behavior.

Features of the emotional sphere determine the secondary underdevelopment of intonation expressiveness of vocal reactions, as well as the specifics of the formation of sensory functions. Thus, at the second age stage, a hypoexcitable child usually fixes and tracks an object well, but the movements of his eyeballs following a moving object do not begin immediately, but after a certain latent period, as is typical for a newborn: the eyes seem to constantly catch up with the object moving in the field. view subject. These visual reactions are variable, and for their occurrence often special optimal conditions are necessary: ​​a certain state of the child, sufficient strength and duration of the stimulus, etc. In the second age period, these reactions most clearly and often occur not in the supine position, but in vertical position in the arms of an adult. A feature of visual perception with hypoexcitability at this age stage is also that the child spontaneously almost does not examine surrounding objects, he does not actively search for a stimulus. A hypoexcitable child usually turns his head and eyes towards an invisible sound source after repeated repetition and a long latency period; auditory perception, like visual perception, usually does not acquire a dominant character.

Delayed psychomotor development in hypoexcitability syndrome is characterized by developmental disproportion, which manifests itself in all forms of sensory-motor behavior. Thus, with sufficient development of differentiated emotional reactions to “friends” and “strangers,” the child shows active joy in communicating with friends and protest in communicating with strangers, i.e., at the age stages, insufficient communication activity remains pronounced. Along with the timely development of individual sensory functions, there is a lag in the formation of intersensory connections, especially in the tactile-kinesthetic analyzer system, so hypoexcitable children later begin to examine and suck their hands, feel toys, and their hand-eye coordination is formed with a delay. The lack of active exploratory behavior is expressed in the disproportionality of the development of visual perception. Therefore, with sufficient development of differentiated visual perception in a child, the automatic nature of object tracking can be maintained.

With dynamic quantification age development of a child with hypoexcitability syndrome in different periods loses 7-9 points, with the maximum loss observed at the age of 4-5 months, when normally the first intersensory connections and active forms of behavior should be actively formed.

Perinatal cerebral hyperexcitability

Motor restlessness, emotional instability, sleep disturbance, increased innate reflexes, increased reflex excitability, a tendency to pathological movements, often in combination with a reduced threshold of convulsive readiness. Hyperexcitability is not causally specific and can be observed in children with perinatal pathology, some hereditary enzymopathies and other metabolic disorders, congenital childhood nervousness and minimal brain dysfunction. These children may not have a pronounced lag in psychomotor development, but with a thorough examination it is usually possible to note some mild deviations.

Disorders of psychomotor development in hyperexcitability syndrome are characterized by a lag in the formation of voluntary attention, differentiated motor and mental reactions, which gives psychomotor development a peculiar unevenness. By the end of the first year of life, such children usually have well-expressed cognitive interest in the environment and active forms of communication, and at the same time, with strong emotions, a general complex of revival with diffuse motor reactions may appear.

All motor, sensory and emotional reactions to external stimuli in a hyperexcitable child arise quickly, after a short latent period, and fade away just as quickly. Having mastered certain motor skills, children constantly move, change positions, constantly reach for and grab objects. At the same time, manipulative research activities, imitative games and gestures are poorly expressed. Children usually show a keen interest in their surroundings, but increased emotional lability often makes it difficult for them to communicate with others. Many of them have a long-term reaction of fear when communicating with unfamiliar adults with active reactions of protest. Typically, hyperexcitability syndrome is combined with increased mental exhaustion. When assessing the age-related development of a hyperexcitable child, they are usually classified not as a delay group, but as a “risk group” if hyperexcitability is not combined with other neurological disorders.

Postpartum intracranial pressure regulation disorder

Increased and unstable intracranial pressure in young children is often combined with hydrocephalic manifestations, which are characterized by the expansion of certain intracerebral spaces as a result of the accumulation of excess amounts of cerebrospinal fluid. Increased intracranial pressure in newborns and infants can be transient or permanent, hydrocephalus can be compensated or subcompensated, which, along with the anatomical and physiological characteristics of early age, causes a wide range of clinical manifestations.

In most cases, with hypertensive-hydrocephalic syndrome, there is an increase in the size of the head, which is determined by dynamically measuring its circumference and comparing it with the dynamics of height and body weight. An increase in head circumference that exceeds normal by more than 2 sigma deviations is considered pathological. As the head circumference increases, a disproportion between the cerebral and facial skulls is revealed. Enlargement of the skull can be asymmetrical due to a unilateral pathological process or a defect in child care.

An increase in intracranial pressure in infants is also accompanied by a divergence of cranial sutures, which can be determined by palpation and x-ray examination. Dehiscence of the sutures occurs quickly with progressive hydrocephalus and more slowly when intracranial pressure is mildly increased or has stabilized. When percussing the skull, the sound of a “cracked pot” is noted.

Another sign of increased intracranial pressure is bulging and enlargement of the large fontanel. With severe hydrocephalic syndrome, the small and lateral fontanelles may be open. It should, however, be borne in mind that changes in cranial sutures and fontanels are detected only at a certain stage of development of the pathological process, therefore their absence during a single examination cannot be regarded as evidence against the presence of hypertensive-hydrocephalic syndrome.

With increased intracranial pressure in newborns and infants, the venous network scalp and the skin on the temples becomes thinner.

Neurological symptoms in hypertensive-hydrocephalic syndrome depend both on the severity of the syndrome and its progression, and on the brain changes that caused it. First of all, the behavior of children changes. They become easily excitable, irritable, the cry is sharp, shrill, sleep is superficial, children often wake up. This complex of signs is more typical for the predominance of hypertension syndrome. With hydrocephalic syndrome, on the contrary, children are drowsy in most cases. Decreased appetite, regurgitation, and vomiting lead to a decrease in body weight. Damage to the cranial nerves is manifested by the “setting sun” symptom, convergent strabismus, and horizontal nystagmus.

Muscle tone changes depending on the severity of intracranial hypertension and the course of the disease. In the first months of life, with increased intracranial pressure, especially if it is accompanied by hyperexcitability and the volume of the skull is not increased, muscle tone is often increased, tendon reflexes are high, with an expanded zone, and foot clonus is sometimes observed. With hydrocephalic syndrome with moderate severity intracranial hypertension Initially, muscle hypotension is observed. If hydrocephalus progresses, you can later notice an increase in muscle tone, first in the legs. This is due to the stretching of the pyramidal fibers of the parasagittal region due to the enlargement of the ventricles of the brain.

In newborns and infants with hypertensive-hydrocephalic syndrome, hand tremor is often pronounced. It can be frequent, small-scale or rare, large-scale, such as hemibalism. Seizures are observed much less frequently; they usually occur with a rapid increase in intracranial hypertension.

Changes in the fundus of the eye in young children do not necessarily develop due to the possibility of an increase in the volume of the skull due to divergence of the cranial sutures. However, in some cases, dilation of the veins and blurring of the nipple boundaries can be detected optic nerve, and later, with the progression of hydrocephalus, its swelling and atrophy.

Determination of cerebrospinal fluid pressure during lumbar puncture, which is normally mmH2O in newborns, is important for diagnosing hypertension syndrome. Art., at chest mm waters. Art. With hypertension syndrome, cerebrospinal fluid pressure in infants can increase to 200-3Q mm of water. Art. and higher. The composition of the cerebrospinal fluid in hypertensive-hydrocephalic syndrome depends on the characteristics of the pathological process as a result of which it arose, the nature of the course of the syndrome, and the stage of its development. More often, a normal composition of the cerebrospinal fluid is observed, but there may be protein-cell or cell-protein dissociation.

Along with clinical, ophthalmological and liquorological data, the following are important for the diagnosis of hypertensive-hydrocephalic syndrome: transillumination of the skull, EchoEG, craniography, computed tomography.

The transillumination method is safe, it can be performed repeatedly and on an outpatient basis. The principle of the method is to propagate light rays in a space filled with liquid. Normally, in newborn infants, a ring of luminescence with a width of 0.5 to 3 cm appears around the tube with a light source, depending on the density of the bones of the skull. The most intense glow is observed in the frontal regions (up to 3 cm), the least in the occipital region (0.5-1 cm). An increase in the boundaries of the luminescence occurs when the subarachnoid space expands to 0.5 cm. Transillumination of the cavities of intracerebral tissue or ventricles is possible only when the thickness of the brain tissue is less than 1 cm.

In children with external and internal hydrocephalus, a symmetrical glow is detected. Asymmetrical luminescence occurs with unilateral expansion of the ventricle and suoarachnoid space.

On EchoEG with hydrocephalus, an increase in the number of reflected echo signals, ventricular index (normal 1.9) and amplitude of echo pulsations is recorded. In case of asymmetric expansion ventricular system m-exo is shifted to the side opposite to the enlarged ventricle.

In infants with easy promotion intracranial pressure without dehiscence of cranial sutures, craniography does not provide sufficient information for diagnosis. At the same time, it is the craniogram that can provide objective evidence of increased intracranial pressure. With the progression of hydrocephalus, craniograms show divergence of the cranial sutures, most often the coronal and sagittal sutures, already after 2-3 weeks. Asymmetrical expansion of the cranial sutures indicates the localization of the lesion. Thinning of the bones of the cranial vault and pronounced digital impressions in children of the first year of life indicate the relative duration of the process that led to the limitation of intracranial space.

Computed tomography is a safe and painless method x-ray examination skull and brain structures, the radiation load at which is minimal (0.3 load when receiving a regular x-ray of the skull). For young children, the significance of these advantages is very great. In addition, it can be performed on an outpatient basis. Computed tomography gives a clear picture of the size of the ventricles of the brain in hydrocephalus, as well as the presence and location of lesions.

The depth and nature of the delay in psychomotor development in hydrocephalus and hypertension syndrome vary widely depending on the primary changes in the nervous system that caused hydrocephalus, and those secondary to increasing hypertension. If the destructive changes in the brain that caused hydrocephalus were pronounced, even if hydrocephalus is compensated by conservative or surgical measures, the child’s development is significantly delayed. At the same time, the addition and progression of hypertensive-hydrocephalic syndrome in any pathology makes the developmental delay even more pronounced and peculiar, despite compensation of the primary process. Finally, with timely effective compensation of both the primary process and hydrocephalus, a slight developmental delay, often partial, is quickly eliminated.

Neurological symptoms in children have different character. They may differ in each age period, but they always indicate disturbances in the functioning of the nervous system.

In this article, we will look at the symptoms of neurological diseases and signs of neurological disorders in newborns and older children.

Neurological diseases do not always manifest themselves with a clear symptomatic picture. Often only a doctor can notice a deviation.

Brain structures mature at certain times. If this does not happen, marker signs appear, by which the neurologist can assume the presence of pathology.

Ignoring neurological symptoms in children leads to disappointing consequences. As a rule, the disease progresses and causes even more serious pathologies. This is fraught with disruption of the psychomotor system.

A number of manifestations of neurological pathology require immediate intervention, as they pose a threat to life.

A child is born with an immature nervous system. Its formation continues until adolescence. However, the most active processes occur in the first year of life.

It is especially important not to miss signs of pathology immediately after birth and until the age of one, since at this time the child’s nervous system has great compensatory abilities.

Among the neurological diseases that can be diagnosed by symptoms are the following:

• encephalopathy;
• epilepsy;
• neuralgia;
• disorders of the autonomic nervous system;
• hydrocephalus;
• mental and speech development disorders;
• enuresis;
• pathologies of vision and hearing;
• autism.

What manifestations of neurological disorders should you pay attention to?

Do infants have up to 28 days of life?

Some symptoms in the first time after birth may be normal. For example, hypertonicity of muscle tissue should alert parents if it does not subside a week after the baby is born.

When examining newborns, great importance is given to the assessment of reflexes. Their absence or weakening indicates neurological pathology:

In a baby up to one year old

In infants up to one year old, reflexes are also checked during examinations. But over time, they pay attention to their attenuation. Many reflex movements, as a rule, do not remain with a person for life. They are needed only in the first months after birth:

In addition to reflex movements, the following symptoms should alert a baby under one year of age:

1. Tremor of the chin and limbs, marbling of the skin. In the first month of life, such symptoms may be physiological. Keeping them over long time indicates the presence neurological disorders due to trauma either during the childbirth period or after birth.
2. Head growth too fast. It may occur due to an increase in cerebrospinal fluid in the cerebrospinal fluid spaces. This can be confirmed using neurosonography. In particularly severe cases, excessive amounts of cerebrospinal fluid indicate the death of brain cells. Only bypass surgery can save the child.
3. Strabismus. This problem is not only ophthalmological, but also neurological in nature. The cause of strabismus is insufficient functioning of the III, IV, VI cranial nerves innervating the extraocular muscles. The result of the disorder is paralysis of the eyeball.
4. Delays in motor, mental and speech development. There are certain periods during which a child develops new skills (the ability to hold his head up, roll over, sit, stand, walk, and demonstrate age-appropriate speech activity). Lack of progress in one or more areas may be due to damage to the central nervous system.
5. When leaning on the foot, the toes curl tightly. This sign is an indicator of increased muscle tone, the cause of which is a pathology in the functioning of the nervous system.

10 signs of a nervous system disorder in a newborn that you can determine yourself:

At a preschooler

At the schoolboy's

The description of the neurological status of a school-age child is largely based on the same symptoms as in a preschooler. Noteworthy:

Treatment methods

Just born babies

In severe cases, in the presence of a hematoma and diagnosed hydrocephalus, the child requires surgical intervention.

If the situation is limited to the manifestation of neurological symptoms without a critical picture based on the results of an instrumental examination, drug treatment is prescribed.

It includes:

Baths with soothing infusions of chamomile and motherwort help the baby calm down.

Infant swimming is practiced from two weeks of age.. Exercises performed in an aquatic environment relieve muscle tension.

From 1 to 12 months

After the first month of life, massage is added to drug therapy and swimming. During the session, the specialist determines the state of muscle tone and performs appropriate massage movements.

With hypertonicity, it is necessary to relax tense muscles, so movements should be smooth, stroking, calm. With hypotonicity, the opposite task is faced, which can be accomplished by more active pats.

During the massage session, infant gymnastics is performed. It is necessary to strengthen the muscle corset. This is especially important for weak back muscles, pathologies in cervical spine spine.

Preschoolers and schoolchildren

In preschool and school age, drug treatment, physiotherapy, massage and water treatments are also used to eliminate neurological symptoms.

It is also important that the child maintains a daily routine, which is often disrupted after graduation. kindergarten . One of the ways to prevent neurosis in preschoolers and schoolchildren is to change types of activities.

It is important to limit your exposure to the computer and TV.

Unlike the neonatal period and infancy, neurological symptoms in preschoolers and schoolchildren can be prevented by preventive measures.

Neurological abnormalities vary in nature and cause. Some of them are treatable and go away completely, others can be compensated for with timely treatment.