Perinatal encephalopathy in children: what it is, symptoms and treatment

Diagnosis "perinatal encephalopathy" or abbr. PEP has recently been placed in almost every second baby.

Parents of such incomprehensible medical terms lead to a state of anxiety and fear for their child.

However, one should not panic. Firstly, in many cases, the parents of the baby do not have real reasons for grief, because often doctors diagnose a similar problem in a child with absolutely no reason. And secondly, perinatal encephalopathy, even when it is actually confirmed symptomatically, does not belong to the number of hopeless situations, doomed in their resolution to the most adverse consequences.

The child's body has an outstanding ability to heal and regenerate. The main thing is to create the most comfortable living conditions for the baby, taking into account the peculiarities of his diagnosis and to ensure the implementation of proper treatment.

What is perinatal encephalopathy?

Originally, the phrase "perinatal encephalopathy" emerged among medical terms in 1976. In short, this diagnosis looks like an abbreviation - PEP.

PEP develops in the perinatal period - that is, from the beginning of the 28th week of pregnancy to the 7th day after the birth of the child (inclusive).

The diagnosis of perinatal encephalopathy indicates impairments to the functioning of the central nervous system and represents a certain a collective unit that combines a whole mass of a wide variety of conditions, syndromes, symptoms and diseases of the fetus or newborn.

Photos

The photo below shows children with PEP

Causes of AED

The condition of AED develops as a result of exposure of an unborn or newborn child to any adverse factors during gestation, during delivery or in the first days after birth.

Often such factors cannot be specified and identified with sufficient certainty. But most often this factor is an insufficient supply of oxygen to the cells, tissues, organs of the developing fetus in the womb, the child during childbirth or the newborn. In a word, hypoxia.

To assume the presence of AED, hypoxia allows the assessment of a newly born child on the Apgar scale.

To set points on such a scale, doctors evaluate: breathing, physical activity, reflex processes, baby's cry, skin color, etc.

A low score indicates the possibility of neurological damage.

Although even high scores are often not reliable evidence of the absence of problems from the field of neurology: AED, hypoxia. It happens that symptoms are found only during the infancy of the child.

Factors that increase the risk of developing the disease

The circumstances that increase the likelihood of having a child with the disease are as follows:

• the birth of a child by a woman with a number of hereditary and chronic diseases;
• diseases of an infectious nature in the mother during pregnancy (the so-called TOCH infections are especially dangerous);
• improper malnutrition of the expectant mother during pregnancy;
• the presence of bad habits of the mother during pregnancy (smoking, alcoholic beverages, drugs);
• alcoholism, drug addiction of the child's father;
• the birth of a child by a woman whose pregnancy was early;
• the frequent finding of a woman carrying a child in a state of stress;
• heavy loads of the expectant mother;
• pathology of pregnancy (toxicosis, preeclampsia, threats of miscarriage, etc.);
• pathology of labor (rapid labor, weak labor);
• delivery through surgery (caesarean section);
• malposition;
• anatomical features of the structure of the pelvis of a pregnant woman;
• entanglement of the fetus with the umbilical cord;
• the birth of a child earlier or later;
• fetal hypoxia;
• exposure of a pregnant woman to negative environmental factors (inhalation of gases, toxic substances, harmful work, drug overdose, etc.).

It should be noted that this list is only approximate, since it is often not possible to establish the factor that provokes PEP.

It happens that seemingly healthy parents give birth to a child with significant dysfunctions of the central nervous system, although the pregnancy was proceeding safely.

Symptoms of perinatal encephalopathy by the age of the baby

In order to make a timely diagnosis, the parents of a newborn child should be extremely attentive to such manifestations of the child as:

• dysfunction of breast sucking;
• weak cry;
• throwing the head back;
• profuse, frequent regurgitation, especially in the form of a fountain;
• inactivity, lethargy, lack of response to loud unexpected sounds;
• bulging of the eyes when they are simultaneously lowered down, a white stripe is noticeable above the iris - Gref's syndrome or rising sun syndrome;
• sudden attacks of crying baby while sucking a bottle or breast;
• swelling of the fontanelle;
• restless sleep, difficulty falling asleep.

When the baby is 3 months old, the presence of the following manifestations will become alarming:

• stiffness of movement, difficulty in flexion and extension of the limbs;
• constant compression of the handles into the cams, unclenching requires effort;
• difficulty holding the head while on the stomach;
• tremor of the chin, arms; flinching, convulsions, twitching;
• the gaze is not focused;
• monthly increase in head circumference by more than three centimeters.

Alarming symptoms of 6 months of life:

• lack of interest in the world (toys, people, surroundings);
• emotionlessness, unsmiling;
• monotony of movements.

Alarming symptoms of eight to nine (8-9) months of age:

• lack of emotion, complete or partial;
• lack of interest in playing with adults;
• lack of independent sitting skills;
• activity of only one hand when grasping.

Alarming symptoms by the end of the twelfth (12) month of life:

• standing or walking on tiptoe;
• pronunciation of lowing sounds;
• monotonous emotionless crying;
• the main way to play is to destroy, scatter
• misunderstanding of simple requests and phrases.

Alarming symptoms by 3 years of age:

• violation of gait;
• lack of proper coordination of movements;
• lack of social and domestic skills (dressing, buttoning, tying, potty walking, using a mug, spoon, etc.).

Periods of AED development

There are three periods of the development of the disease:

• acute (during the first 30 days of life);
• recovery period (from the second month of life to a year - for children born on time and from the second month of life to two years - for children born earlier);
• the period when the results are judged, here are several options for the result:
  • recovery;
  • developmental delay;
  • vegetative-visceral disorders (disruption of the functioning of any internal organs);
  • brain dysfunction (as a result - excessive activity, problems with concentration and perseverance);
  • epilepsy;
  • neurotic reactions;
  • hydrocephalus of the brain;
  • Cerebral palsy (infantile cerebral palsy).

Diagnostic methods

• Neurosonography. Provides the ability to study the internal structure of the brain, the state of tissues, identify various neoplasms or excess cerebrospinal fluid.
• Electroencephalogram. Allows you to obtain data on the functional activity of the brain, the presence of pathological formations or dysfunctions.
• Electroneuromyography. Allows you to check for the presence of neuromuscular diseases.
• Doppler ultrasonography. Allows you to assess the characteristics of blood flow in the vessels of the brain.

Such examination methods are rarely used in pediatric neurology as computed tomography, magnetic resonance imaging. An examination by an ophthalmologist will indirectly help to judge the presence of the disease.

Late consequences of the disease

The consequences of AED can manifest themselves much later than in infancy. So, preschoolers who have not previously been correctly diagnosed with AED or have been untreated:

• suffer from delayed speech, stuttering;
• hyperactivity (ADHD);
• lethargy;
• increased excitability;
• irritability;
• insomnia;
• bouts of rage, aggression and hysteria.

During school years, such children may have:

• headache;
• violations of writing, reading, concentration;
• fast fatiguability;
• restlessness;
• low level of development of thinking, memory, and, as a result, poor academic performance.

Treatment

In the period of the acute course of the disease, inpatient treatment is indicated for newborns with pathologies of high or moderate severity, treatment at home is indicated for newborns with a mild course of the disease.

The psychological attitude of the adults around the baby is of great importance in the treatment of AED.

An exceptionally friendly atmosphere, full of love and care for the baby, should triumph in the house. This is extremely important for an infant with PEP symptoms. Often used as methods of treatment:

• physiotherapy procedures;
• massages;
• baths with sea salt or medicinal infusions and decoctions (needles, oregano, string, chamomile, oats).

Doctors recommend taking herbs and medications ("Novo-Passit", "Elkar", "Glycine") with a sedative effect, vitamin, strengthening syrups. Also popular among doctors are drugs that activate cerebral circulation:

• "Hopantenic acid"
• "Piracetam"
• Vinpocetine
• "Actovegin"
• "Pyritinol".

Homeopathic, osteopathic treatment is characterized by a great effect.

With the syndrome of increased intracranial pressure drugs with a diuretic effect are used ("Acetazolamide"Together with" Asparkam "), it is recommended to slightly raise the baby's head when he lies (put a special orthopedic pillow, put something under the mattress).

Anticonvulsants are used for symptoms of epilepsy. Severe forms of the course of the disease require surgical intervention.

Recovery prognosis

Thus, the diagnosis in question is not a verdict; with early diagnosis and treatment, the prognosis is quite favorable.

In many cases, complete recovery is achieved. However, it should be remembered that, even after the symptoms of the disease have disappeared, one should remain vigilant by regularly visiting a neurologist.

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