Neurological problems in newborns today are very common. Bad ecology not proper nutrition parents, stress. All this subsequently reflects on our little ones!
In addition to poor ecology, the causes of the most common neurological disorders infants are birth trauma, lack of oxygen at different stages intrauterine development fetus, complicated labor, heredity, as well as the condition of the newborn can be affected by mom's severe toxicosis during pregnancy.
Over the past nine years, we have treated more than three hundred children for Lyme disease in the hospital, because they had significant neurological manifestations of Lyme disease or, in a smaller number of cases, arthritis requiring hospitalization for intravenous antibiotics.
Unscheduled visit to the neurologist
It is impossible to know how many children Lyme got sick in our area. Obviously, most children who see on early stagethat show rashes do not have chronic problems, but this is a small percentage. Many of these children are not diagnosed initially, because their complaints are vague and are considered functional. Others are sick for three and four years before they are diagnosed.
Unfortunately, in our country there are not many institutions that specialize in the rehabilitation of children. infancy. The BiATI Clinic is a rehabilitation center for young children with severe neurological and orthopedic problems.
The development of a young child is a very sensitive sign of health. It depends on both hereditary characteristics and the complex set of social conditions and requires dynamic observation of the baby on time from -1-3-6-9-12 months. Let's talk about the dynamics of the motor, mental and to speech development child in the first year of life:
Recently, we have become more concerned about children, who are considered vague symptoms and become more aggressive in the diagnosis and treatment. Others will not develop symptoms for one year or more. Parents recall that children have a flu-like illness that preceded their development of these fairly persistent symptoms, and it’s common for a flu-like illness to occur six or more weeks after a tick bite or exposure to ticks. Many parents claim that after this "flu-like illness" the child was not healthy again.
1 MONTH - trying to hold his head. He fixes his eyes, traces moving bright objects, listens to sounds, smiles unconsciously. Guttural sounds, jerking.
3 MONTHS- confidently holds his head, rising on his forearms, turns from back to side. He tries to take a toy, reacts to the voice of the mother, her face (revitalization complex), voice reaction to discomfort, hunger. Smiles, laughs. Long melodious walking, reviving facial expressions to the voice.
Most, over ninety percent, of the children we treated complain of a headache. The headache, in some cases, was very acute, accompanied by papillomas, but in most cases the headache comes gradually, becomes rather stable and does not respond to over-the-counter analgesics.
In addition to a headache, children complain of photophobia, dizziness, stiff neck, back pain, drowsiness, and those who are in school have problems with memory and difficulty concentrating. Some patients developed progressive weakness.
6 MONTHS - sits by herself, gets up on all fours, swings, tries to crawl. Takes items with one hand, interested in and manipulates toys. The first syllables appear, babble (imitation of speech), imitates the intonations of an adult well.
9 MONTHS - actively creeps, stands with support or holding onto a support. Manipulates toys, takes small objects. He knows loved ones and reacts to strangers, performs actions to imitate (ladies, forty-crow) shows parts of the body, understands the word "no", utters the first words "mom", "dad". Performs simple tasks, independently drinks from a mug.
Parents complain that preschoolers develop mood swings and become very irritable, and they see a change in personality. Among children of school age and those who are in adolescence, chest pain is a very frequent complaint. At least seventy percent complained of chest pain. About fifty percent complained of abdominal pain. More than half of the children have arthralgia, usually including the knee, and sometimes the wrist.
What is the sucking reflex? Why does the child constantly suck something: fingers, dummy, chest? Maybe he wants to eat?
Other complaints include heart palpitations, tingling, numbness, a rash that comes and goes, usually Malaria rash, and sore throat, which are excruciatingly painful. It is easy to understand how this long list can be very non-specific, and many of these children have functional problems.
12 MONTHS - walks independently. Understands the addressed speech. Plays a doll, helps to dress oneself, tidiness skills are formed. Say up to 10 words. It should be noted that in the process of forming speech, there are 2 options:
1 - Gradual increase in the number of words;
2 - Uneven development of speech (the child begins to pronounce the simplest syllables, at 6-12 months he stops, consciously repeats syllables by 9 months). By the 1st year a healthy child should say 10-12 words.
Children often display central or peripheral nervous system. Manifestations of the central nervous system include encephalopathy. These children have difficulty with memory, concentration and learning new material in school. They have an excessive amount of fatigue and sleep disturbance after sleep, either becoming hypersomnic or sleepless.
Unconditioned reflexes of newborns
We rarely saw children with an encephalitic picture. There were reports of people who had a stroke from Lyme. We have one child who suddenly manifested hemiplegia and aphasia. Patients may have optic nerve involvement with optic neuritis or papillomas, which leads to loss of vision.
The most common lesions of the nervous system at this age are functional changes in the central nervous system due to hypoxia during pregnancy and (or) childbirth, namely: increased excitability, sleep and eating disorders, movement disorders, including muscle tone, as well as the disorder of the regulation of intracranial pressure (hypertensive and hydrocephalic syndrome), perinatal autonomic dysfunction (includes skin marbling, palm and foot moisture, cold extremities, meteo-stability); different types of cramps.
Peripheral neuropathy with distal parasthesis, subtle weakness, diminished deep tendon reflexes were also observed. Laboratory work is not quite revealed. The decision to make a spinal tap on a patient with Lyme disease is based on physical results. But in other cases, the decision to make taps is based mainly on the need for additional diagnostic information or where the question arises whether the diagnosis is anything other than Lyme. So far, we have used about twenty-five patients.
PARENTS, you should know that the lack of proper attention to the pathological manifestations of the nervous system, as a rule, is fraught with delayed psycho-motor and speech development, and this, in turn, leads to behavioral disorders, namely, hyperactivity, “attention deficit” emotional instability, impaired writing, reading, counting skills, which will be accompanied by a delay in the pace of development of the functional systems of the brain. This means that the child's speech, attention, memory is disturbed.
Most had normal spinal fluid results. Usually they do not have the height of white cells. Proteins and sugars are normal. It is interesting, however, that at least fifty percent of them show increased pressure with an opening pressure of more than 200, sometimes as high as each patient with papillomay had a pressure of at least 300 or more, except for one girl, whose opening pressure was 260 but she had obvious papillomas, as well as loss of vision in her left eye.
Causes and consequences
Eight patients had pleocytosis with cells from 60 to 700, mostly lymphocytes. The diagnosis of Lyme disease is clinical. Serology, if positive, is helpful. Urine antigens can also be measured. Urine antigen tests are still considered by researchers.
IN ADDITION, IN OUR CLINIC, CHILDREN'S NEUROLOGIST IS TAKEN INTO DIAGNOSTIC, DIFFERENTIAL DIAGNOSTIC AND TREATMENT OF VARIOUS KINDS:
headache (migraines, tension headaches, cervicogenic headache, etc.)
seizures (ferbilnye, observed in age from 3 months to 5 years, associated with fever; convulsions in minerals (calcium) deficiency; low sugar levels; poisoning; sunstroke, with severe TBI, SGM. These convulsions are rare and do not occur in the absence provoking factors.
We will treat patients with negative serology without hesitation if they do have a number of symptoms and are incapable of them. We had children who did not attend school for a year because they were too sick to leave home. Other children had to give up all extracurricular activities, sports, etc. Because they are too sick and too weak to participate. Every patient we treated with a diagnosis of Neurological Lyme Disease had constant complaints.
These children have a headache and often chest pain. Many of them have seen numerous doctors without any specific diagnosis, and many of them had antibiotics for various reasons throughout the way, sore throat, otitis media, rash and, therefore, never developed a response to antibodies to their spirochetal infection.
Including much attention is paid epileptic syndromeu, which has a clinical polymorphism of seizures in children. You need to pay attention to: sudden fading of the gaze, bending of the head (nods) and shoulders (pecks), visual hallucinations and illusions, sudden sensations of a smell of a child, paroxysmal sensations of bitter, sweet, salty, sensation of flight, falling, rotation your body or space; sudden short-term vegetative symptoms (vomiting, pallor, redness and pallor of the face, sweating, dilated pupils), as well as various types of automatisms (re-chewing, smacking, swallowing, licking the lips, tongue protruding, wincing, crying, pedaling movements of the legs, sleep rate and so on).
The diagnosis of neurological Lyme disease is clinical, not laboratory. If the patient's symptoms are compatible with the diagnosis, the patient is sick, the disease has a significant impact on the person's ability to function, then they deserve treatment.
The treatment consists of intravenous antibiotics, ceftriaxone, cefotaxime, ampicillin, as long as necessary, at least 4-6 weeks. Many patients are treated for several months if they continue to remain clinically ill.
Patients may take Benadril if they develop itching. During the treatment and even after that they need to rest. They cannot resume full activity as soon as they are processed. About twenty-five percent of the patients we treated had to be re-treated, and they were re-treated, then most of them succeeded.
Besides, pediatric neurologist deals with problems: sleep disturbance in obsessive-compulsive neonosis in children, manifested by involuntary eye movement, nose whipping “khkanie”, lips pulling, nose wings moving, jaw flipping and grimacing, twitching shoulders, fingers movement, fast twitching of people’s parts or objects, "dropping" sharply head, winding hair on the finger, biting nails. as well as problems of attention deficit hyperactivity, dorsopathies (this is the instability of the vertebrae, pain in the back, neck); incontinence of urine and feces, cranial neuropathies (facial, trigeminal nerve); treatment of logoneuroses and ZRR together with a speech therapist and physiotherapist.
Once patients have these neurological complaints and, in some cases, positive neurological data, they really deserve a course of aggressive intravenous antibiotic treatment, perhaps more than once. Below are some illustrative cases.
Why do we need a routine inspection?
It was assumed that he had a pseudo-tumor, given the Decadron and he lost control. Tim Lyme at the time was 1: he was given a fourteen-day course of intravenous penicillin water. During the treatment, his headache went away, and as a result, he did not have any more attacks of arthritis. The main complaint when he was noticed was strong pain in both thighs. A few days later he developed facial paralysis, and then bilateral facial paralysis. He had lively reflexes and upside down. Spinal fluid revealed 300 white cells and elevated protein, which he started with intravenous penicillin, and was treated for fourteen days.
Correctional measures are not limited to medical prescriptions, they are usually complex, including physiotherapy, massage, exercise therapy, educational games and classes with a neuropsychologist.
Specialists of our clinic are happy to help you! We sincerely wish you to be happy parents of happy and healthy children!
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There was a dramatic improvement in full resolution of facial paralysis. His reflexes were physiological. His Lyme caption was weakly positive. At that time, it took more than seven weeks to get Lyme's titer, and he was approached before the results were available because he was so sick.
He does not recall any tick bites or rashes. Spinal fluid: opening pressure was 190, total 7 cells. Timer Lyme was sent to the State Laboratory. Seven weeks later, results were available. He was transferred to the hospital. This time the amount of cerebrospinal fluid was 100 cells. He received aqueous penicillin for fourteen days with dramatic improvement. In the end, his Lyme caption was 1: he sometimes complains of pain in his knee, but otherwise everything is fine.
- posthypoxic states,
- high intracranial pressure
- blood supply disorders brain,
- violation of liquorodynamics, spasticity,
- respiratory distress,
- disorder of swallowing,
- indigestion,
- violation of motor functions,
- asymmetry of body deformation,
With all the problems listed, we can provide effective assistance!
During the weeks when we waited for his results in Lyme credits, he got a very bad headache. A nine-year-old girl had a complaint about the progressive weakness of her limbs after a flu-like illness. By the time she was ill for almost two months. Her inspection showed a girl who was supposed to hold on to the wall when she entered the office because she was so weak. She had a clinical diagnosis of Guillain Barré syndrome. She lacked deep tendon reflexes and weakness. Its cerebrospinal fluid protein.
Sleep disorders in a child
She lived in an area where there were many ticks. The five-year-old boy had a two-year history of weakness and arthralgia and fatigue. After this bite, he developed a fever, pain in the joints, pain in the abdomen, rash. After that, he developed weakness, moreover, on the right than on the left, and, indeed, he had very mild right hemiparesis. The weakness became more progressive, and in the end, at the insistence of the mother, and not in relation to the doctor, Lyme was titrated, who was 1: he was given a course of ceftriaxone, and then had to retreat with another course so that he received only twenty eight days .
A child with severe CNS damage should be formed and developed constantly and steadily until the neurological symptoms disappear. Such an approach requires coordinated coordinated work of specialists of various specialties: neonatologists, neurologists, pediatricians, rehabilitologists. This is a comprehensive coordinated work of a team of doctors, aimed at effectively helping your child with his specific problems.
He still had hypoactive reflexes, but his strength returned, and he was significantly better. A two-year-old girl was noticed, whose parents felt that she had become excessively irritable. She had a diaper rash that did not respond to the treatment that the pediatrician prescribed. Because of her impact on field mice and the fact that they carried a tick, her parents insisted that Lyme's titer was positive - 1: because she was irritable and because of the constant rash, she was given fourteen days of ceftriaxone with dramatic improvement her behavior.
Specialists in various areas understand the goals and objectives that other doctors set themselves and the whole group of curators for one child works for one thing - for the result! This is the approach to the problem we offer you in our clinic. Our experience shows that only in this way you can achieve the desired results. In addition to the need to rehabilitate the baby, there are calmer, regular situations that also need to be paid attention to parents.
If your baby often cries for a long time, sucks badly at the breast, starts to hold his head late and sit down, does not speak for a long time, does not start walking in time, is quickly excited and, at the same time, gets tired quickly - it makes sense to consult a specialist!
P.S. In our center, everything starts with the consultation of a neurologist, orthopedist, rehabilitologist. At the consultation, you will state your vision of the problem, your fears, fears, hopes, experience of treatment. We, in turn, have our own vision of problems and ways to resolve them. We explain the possibilities and effectiveness of various medical techniques. We will tell you the expediency of their use and the possible result. The techniques used in the clinic are highly effective and allow us to work with a wide range of diseases and combine the efforts of specialists in various fields of medicine to solve your problems.
Contact, we will help you!
- Sign up for a consultation: 8 800 500 77 02 (toll free)
- Address of the clinic: Moscow, m. "October field", st. Raspletina, 4, building 1
Even in children of the first year of life, pathology of the nervous system can be detected, the causes of which are abnormalities in the period of intrauterine development of the fetus (infection, hypoxia of the fetus) or severe delivery. Consequences of damage to the nervous system may be a delay in the mental and physical development of the child, speech impairment, and others. Observation by a neurologist is thus shown to each child at a certain frequency. In this article, we will answer possible questions from parents and eliminate their concerns about what the neurologist is looking at in children.
The defeat of the nervous system in infants occurs quite often. But these diseases may have a latent form, so in the first year of life, babies are repeatedly examined by a neurologist: at birth, at 1 month, at 3, 6, 9 months. and upon reaching the year. Sometimes doctors prescribe and more frequent observation of the baby on an individual schedule. Particular attention is paid.
In some cases, in addition to the examination of the neurologist, an additional hardware examination is appointed. Early detection and timely treatment can significantly reduce or even eliminate the effects of neurological pathology in older children.
Neurologist examinations of infants should always be carried out even in the absence of complaints from parents. It is in the first year of life that the baby develops intensively, and it is easier for the doctor to identify abnormalities.
When examining a baby, a neurologist conducts an inspection of the head, determines its size, condition and size of the spring. Pays attention to the symmetry of the face and eye slits, the size of the pupils, the movement of the eyeballs (detection). At each examination, reflexes, muscle tone, range of motion in the joints, sensitivity, skills, and sociability of the child are checked.
Even in a maternity hospital, an infant is subjected to an ultrasound of the brain to exclude cysts that often appear during fetal hypoxia. If cysts are found, then such an examination is carried out in dynamics. Cysts up to 3-4 mm in size should disappear without a trace.
Inspection in 1 month
The doctor draws attention to the position of the child (it still resembles the intrauterine), checks for the presence and symmetry unconditioned reflexes in a baby, muscle tone (predominance of flexor tone - arms and legs are bent, cams are compressed) - it must be symmetrical.
The movements of the baby are still chaotic, they are not coordinated. A child at the age of one month may hold his gaze on an object for some time and follow its movement. The crumb already smiles, having heard gentle speech.
A neurologist measures the circumference of the baby’s head and checks the size and condition of the large fontanel. In the first half of the year, the head size increases by 1.5 cm every month (the average circumference at birth is 34-35 cm), and in the second half of the year - by 1 cm.
Inspection in 3 months
The baby's pose is more relaxed, since the flexor tone has already decreased. A child can put his fists in his mouth, grab objects with his hands. He holds the head well. If the baby does not hold the head - this may indicate a developmental lag. The crumb can already laugh, shows revival at contact and display of a toy.
Inspection at 6 months
The baby should independently roll over on his stomach and back, lift the head, leaning on the handles. In position on the back of the child can raise the foot and play with them. By 6 months the child is sitting, can not only hold the toy, but also shift it from the handle to the handle. Half-year-old child learns loved ones, especially mom. To strangers can react crying. Sometimes the baby in 6 months utters syllables.
Inspection at 9 months
Some kids are already crawling, with support stand on their feet. The child can cross the legs, holding onto the support. The doctor also evaluates fine motor skills: the ability to take an object with two fingers and hold it. The kid imitates the movements of an adult: he is able to wave a pen at parting, clap his palms, etc.
Scarce knows his parents well, understands the meaning of many words and the word "cannot", finds (at the request) a subject familiar to him from among others. If the spring in a child remains open, then an additional examination is scheduled (ultrasound of the brain, MRI).
Inspection per year
The doctor assesses the development of the baby, his skills and abilities. The child should be able to stand up, stand, walk by the handle. The head circumference increases by 12 cm over the year. The baby is well drunk from a cup, must properly hold a spoon and eat from it. The baby recognizes all family members, knows the names and shows parts of the body (ear, nose, eyes, etc.), says some words.
Unscheduled visit to the neurologist
Parents should be on their guard and visit a doctor unplanned for such symptoms:
- frequent or abundant regurgitation;
- hyperexcitability, frequent startle;
- or limbs (at rest or when crying);
- at elevated temperature;
- bulging and pulsation of fontanel;
- disturbances in gait: the baby does not fully stand on the foot, walks on the fingers or presses them;
- developmental delay.
Inspections after the year
Examination and assistance of a neurologist may be necessary for a child at any age. The schedule of examinations is as follows: a neurologist routinely has to examine children at 3, 6, 7, 10, 14, 15, 16, 17 years.
During examinations, physical development, muscle tone, the presence and symmetry of reflexes, coordination, color and turgor of the skin, sensitivity, speech, are evaluated. mental development, presence or absence of focal neurological symptoms.
If necessary, the doctor may pre-examine: an oculist examining the fundus of the eye, ultrasound of the brain, Doppler ultrasound, X-ray of the skull, brain MRI, electroencephalography.
Parents should turn unplanned to a neurologist with these symptoms:
- speech impairment (, delayed speech development);
- urinary incontinence ();
- sleep disorders;
- tics (repetitive, often involuntary, movements or statements, twitching of mimic muscles, grimacing, blinking, sniffing, feeling things, dropping hair, repeating words or phrases, etc.);
- fainting;
- motion sickness in transport;
- increased activity, restlessness, scattered attention;
- traumatic brain injury.
Resume for parents
Depending on the course of pregnancy and childbirth, hereditary factors, the child may have neurological pathology even in early age. Examinations by a neurologist provide an opportunity to identify changes in the nervous system on early termsthat will allow for timely treatment.
Do not be afraid or avoid examinations by a neurologist. Only careful observation by parents and doctors will help raise the child healthy.