Are children diagnosed with cerebral palsy a sin of modern medicine? Rehabilitation of children with cerebral palsy: description of methods.

legislation Russian Federation there is a special mechanism
allowing families with disabled children to obtain housing. Document defining
procedure for improving housing conditions and providing housing
placement of disabled children in need of such assistance is provided for in Article 17 of the Federal Law
No. 181, adopted on November 24, 1995.

Division by time of registration

The legislative act itself does not contain gradations, according to
which housing can only be provided to disabled children of certain
groups. The only factor that affects quality and conditions
provision of state assistance in the form of housing is temporary
the period during which a person who may qualify for benefits was diagnosed
for registration. Thus, the division occurs into beneficiaries registered
before January 1, 2005 and after this date.

Families who have a disabled child in their care and who
registered before the specified date have the right to receive funds from
special funds, the same procedure applies to WWII veterans. For
citizens registered earlier than January 1, 2005 are also retained
the right to receive living space under a social tenancy agreement.

For those who were registered after the beginning of 2005,
Housing premises are provided in accordance with the norms of Article 57 of the Housing Code
Code, the order and time of registration are taken into account.
Disabled children who suffer from severe
forms of chronic diseases, according to the second part of Article 57 of the LC.

Conditions for obtaining living space

Reasons for the family of a disabled child to be
recognized as requiring improved living conditions, are listed in
Decree of the Government of the Russian Federation No. 901. This resolution is devoted to issues
providing benefits directly to disabled people and members of their families. Conditions
and circumstances that allow persons in this preferential category
count on government assistance as follows:

·
The family of a disabled child is provided with living space the size of
in terms of each family member is lower than the level established by law
RF;

·
The family of a disabled child lives in a building that is not
intended for this purpose – does not comply with sanitary and technical standards
requirements;

·
An apartment or other type of housing where a disabled child lives,
occupied by several families;

·
Among the seven disabled children there are patients who
suffer from certain chronic diseases that occur in severe
form. This refers to diseases in which living with the patient on the same
living space is impossible, this is determined by employees of state medical
institutions;

·
A disabled child lives in a non-isolated room where
persons who are not related to him also live;

·
A disabled child and his family live in a dormitory room,
The exception is cases when such residence is due to settlement in
seasonal work, during training;

·
A disabled child and his family live for a long time
time in the premises of the state fund on a sub-rental basis or in living space,
belonged to other citizens.

Required documents

In order for a disabled child and his family to receive housing
premises for living, you must register as a disabled person in need of
improving living conditions. Registration for such registration is carried out
authorized employees of local government bodies, the basis for
this is a statement. An application and attached documents are required
submit to the relevant authority at your place of residence directly, or through
Multifunctional Center.

An application is submitted in which a person in a preferential category
informs about his desire to take advantage of the benefit, and copies of the following documents:

·
Extract from the house register;

·
A certificate stating the fact of disability;

·
Individual program rehabilitation of a disabled person;

·
Document on opening a personal account and extract;

·
Documents that document other circumstances, in
depending on the case (this may be certificates from medical institutions or from
Bureau of Technical Inventory).

So that a disabled child and his family can
apply for living space from the state, fact of disability
must be installed. Also in the corresponding conclusions there should be
the causes of disability have been established, the facts of the disabled person’s need for certain
types social protection. It helps to establish all the above facts
medical and social examination conducted by federal institutions.

The law on benefits for disabled children does not
determines the procedure for submitting documents - can a representative do this?
on legal grounds or this must be done directly by the beneficiary. With another
hand, the law provides for the opportunity for any citizen to delegate his
powers to another person under a power of attorney executed by a notary.

Standards for provided living space

The size of the area that is provided under the social contract.
hiring cannot be less than certain standards. These standards, according to
law, are established by local governments, depending on
many factors. So, in Moscow these norms are established in accordance with Article 20
Moscow city law number 29 and amount to 18 square meters. meters per person.
The area of ​​social housing provided may exceed the norm, but this
the excess cannot be more than twice if this room is
one-room apartment or room.

In addition, the same norm is reflected in the Federal Law,
Article 17 (No. 181-FZ) specifies that the provided area may be
increased if the disabled person suffers chronic disease V
severe form. The list of diseases is approved and determined by the Resolution
Government of the Russian Federation No. 817

On the website Change.org, where she pointed out many casuistic situations in Russian legislation that actually deprive people with disabilities from childhood with a diagnosis of cerebral palsy and serious neurological diseases from the opportunity for habilitation and rehabilitation. The petition is addressed to the public, Russian authorities, doctors and lawyers.

The petition states that the provisions of many legislative acts regulating the conduct of rehabilitation measures Spa treatment, provision of means of rehabilitation very often do not comply with the provisions of the basic laws on disabled people, and often completely contradict each other.

So, for example, Article 11 of Federal Law No. 195 “On the social protection of people with disabilities in Russia” prescribes the mandatory implementation of medical, professional and rehabilitation measures specified in the IPR, but many departmental documents of the Ministry of Health deprive people with disabilities of this right. An example is the order of the Ministry of Health of the Russian Federation dated May 5, 2016 No. 281n “On approval of lists medical indications and contraindications for sanatorium-resort treatment”, where in Appendix 1 “List of medical indications for sanatorium-resort treatment of the adult population”, paragraph G80 “Cerebral palsy” is not mentioned at all. It also does not contain a number of serious neurological diseases.

Another example: the provisions on special departments for the rehabilitation of patients with the consequences of paralysis prescribed in the order of the Ministry of Health of the Russian Federation dated October 18, 1999 No. 378 “On the organization of work of institutions for medical and social rehabilitation of adolescents and adults with the consequences of cerebral palsy” are virtually impossible to implement. The whole point is that specialized centers for the rehabilitation of patients with the consequences of cerebral palsy - there are only a few throughout Russia (by and large, there are only two of them - in Moscow and Chelyabinsk) and they are physically unable to accept all patients, especially from other regions of the Russian Federation. Rehabilitation of such patients in clinics and day hospitals- ordinary profanity.

The petition also claims that the Ministry of Health is using legal loopholes in the legislation to deprive people with disabilities since childhood of the right to habilitation and rehabilitation, sanatorium treatment, benefits for travel in suburban and intercity transport, and is also making attempts to eliminate the institution of accompanying persons. In addition, after 18 years of age, any specialized assistance patients with cerebral palsy actually stops, in the system Russian healthcare they have the right only to visit a neurologist as part of the compulsory medical insurance policy.

The means of rehabilitation that disabled people have received under the rehabilitation program since childhood do not stand up to criticism either. Orthopedic shoes, corsets, Shants collars, and wheelchairs are of extremely low quality and are often simply impossible to use. Many disabled people have to purchase similar foreign-made products with their more than modest pensions.

The way out of this situation, according to the author of the petition, may be to put things in order Russian legislation and the exclusion of casuistic situations from it, as well as changes in the regulations of the State Duma and the Federation Council of the Russian Federation, which must include control over the revisions of federal laws. Such changes, in particular, need to be made to the order of the Ministry of Health of the Russian Federation dated May 5, 2016 No. 281n “On approval of lists of medical indications and contraindications for sanatorium and resort treatment.” The petition also proposes to change federal legislation regarding the amount of compensation for purchased rehabilitation equipment, increasing it to 70-80% of the cost of such products. In addition, the need to create a rehabilitation system for disabled people over 18 years of age is indicated, for which it is necessary to open 2-3 rehabilitation departments in each federal district. And finally, the author of the petition proposes to create an organization in Russia that would deal with the problems of people with cerebral palsy, similar to the American Cerebral Palsy Worldwide, which accompanies patients with cerebral palsy from birth and helps them throughout their lives.

Regional public Charitable organization disabled people “Promoting the protection of the rights of people with disabilities with consequences of cerebral palsy” reports that it has begun the procedure for voluntary liquidation of the organization due to the lack of funds to rent premises to continue its activities.
Information published in "Bulletin" state registration» No. 48 (506) from 09.12.2015
Disabled people with consequences of cerebral palsy and parents of disabled children can seek advice from e-mail: [email protected]

In accordance with the Classifications and criteria for conducting MSE, in force since February 2, 2016, new Criteria have been established for establishing disability groups and the category “disabled child” (Order of the Ministry of Labor and Social Protection of the Russian Federation dated December 17, 2015 No. 1024n ). The Appendix to the Order provides a quantitative system for assessing the severity of persistent dysfunctions of the human body caused by diseases, as a percentage (depending on their form and severity).

Cerebral Palsy Included in SCROLL diseases, defects, irreversible morphological changes, dysfunctions of organs and body systems..., approved under the ICD-10 code - G80.

For you, Elena, I am attaching a table of ratios for assessing the severity of impairments in cerebral palsy as a percentage.

QUANTITATIVE SYSTEM
ASSESSMENTS OF THE DEGREE OF SEVERITY OF PERSISTENT FUNCTIONAL IMPAIRMENTS
OF THE HUMAN BODY CAUSED BY DISEASES,
CONSEQUENCES OF INJURIES OR DEFECTS (IN PERCENTAGE,
IN APPLICATION TO CLINICAL AND FUNCTIONAL CHARACTERISTICS
PERSISTENT DISORDERS OF HUMAN BODY FUNCTIONS)

Application
to classifications and criteria,
used in the implementation
medical and social examination
citizens federal state
medical and social institutions
examination approved by order
Ministry of Labor and Social
protection of the Russian Federation
dated December 17, 2015 N 1024n
(Excerpts)

CEREBRAL PALSY

Note to subclause 6.4.

Quantitative assessment of the severity of persistent impairment of human body functions due to cerebral palsy (CP) is based on clinical form diseases; nature and severity motor disorders; degree of impairment of grasping and holding objects (unilateral or bilateral damage to the hand); degree of impairment of support and movement (unilateral or bilateral impairment); the presence and severity of language and speech disorders; degree of mental disorder (mild cognitive impairment; mental retardation mild degree without language and speech disorders; mild mental retardation combined with dysarthria; mental retardation medium degree; severe mental retardation; profound mental retardation); the presence and severity of pseudobulbar syndrome; the presence of epileptic seizures (their nature and frequency); purposefulness of activity corresponding to biological age; productivity; the potential ability of the child in accordance with the biological age and structure of the motor defect; opportunities for realizing potential abilities (factors facilitating implementation, factors hindering implementation, factors

Check with your doctors: how do they quantify (in percentage) the impairments caused by this disease in your child?

This is very important, since now, when establishing disability, the severity of persistent impairment of body functions is assessed as a percentage and set in the range from 10 to 100, in increments of 10 percent.

Stand out 4 degrees of severity of persistent disorders of body functions person:

IMPORTANT ADDENDUM

Often parents ask: But where can I find out why they don’t give me a life sentence? After all, there are no changes, with injections every day, transplantation is in question. When and how to achieve this?

I answer:

as for the so-called " permanent disability”, then, of course, we are not talking about establishing a “lifelong” disability for the child. It is important for parents to achieve the establishment of the category “disabled child” before the age of 18, and then the establishment of disability “without a period for re-examination” - but as a disabled person since childhood, because All persons who are classified as a “disabled child” are subject to re-examination upon reaching the age of 18 (already in the “adult” ITU bureau). There you can seek to establish a disability group “without a period for re-examination.”
Unfortunately, as the procedure for conducting MSE is “improved” (from the point of view of officials), parents increasingly perceive it as a rather humiliating procedure, because are forced to prove that their child is disabled, and the doctors of the expert bureau assess the degree of limitation of the child’s life activity quite biasedly.

What should you follow and what should you know when conducting an examination of a disabled child with any disease (since 2016)?

• RULES recognition of a person as disabled (approved by Decree of the Government of the Russian Federation No. 95 of 20.02.2006 and those points thereof that entered into force on January 1, 2016(introduced).
• SCROLL diseases, defects, irreversible morphological changes, dysfunctions of organs and systems of the body, in which the disability group without specifying the period for re-examination (category “disabled child” before the citizen reaches the age of 18) is established for citizens no later than 2 years after the initial recognition as disabled (establishment of the category "disabled child") (introduced).
• CLASSIFICATIONS AND CRITERIA, used in the implementation of medical and social examination of citizens by federal government agencies medical and social examination (approved by order of the Ministry of Labor and Social Protection of the Russian Federation dated December 17, 2015 No. 1024n)

In the absence of positive results rehabilitation or habilitation measures carried out to a child (citizen) before he is sent for a medical and social examination, it is possible to achieve the establishment of the category “disabled child” before the citizen reaches the age of 18 years: this must be formalized in a referral to MSA issued to the citizen by the medical organization providing him medical care, or medical documents(in case the child is sent for re-examination).

If, during the re-examination of the child, the doctor notes that the limitations of the child’s life activity, which were noted during the first examination, not only remained, but they cannot be eliminated or reduced in the course of rehabilitation/habilitation measures, then the irreversibility of the child’s disease is obvious, and it can be recommended to establish disability before reaching the age of 18 years.
According to the RULES, group I disability is established for 2 years, II and III groups- for 1 year. Re-examination of disabled people of group I is carried out once every 2 years, disabled people of groups II and III - once a year, and disabled children - once during the period for which the child is classified as a “disabled child” (clause 39 of the Rules).

The category “disabled child” is established for 1 year, 2 years, 5 years, or until the citizen reaches the age of 18 years. For 5 years, this category is established upon re-examination in case of achieving the first complete remission malignant neoplasm, including any form of acute or chronic leukemia(clause 10 of the Rules)

When is a disability group established without specifying the period for re-examination (category “disabled child” before the citizen reaches the age of 18)?

Here are the possible options (clause 13 of the RULES):

1. No later than 2 years after the initial examination - when the child’s life limitations are associated with diseases, defects, dysfunctions of organs and body systems according to the LIST of diseases.

2. No later than 4 years after the initial recognition of a child as disabled - if it is identified that it is impossible to further eliminate or reduce the degree of limitation of the child’s life activity in the course of rehabilitation or habilitation measures.

Practice has shown that over 4 years, doctors and ITU experts, who can draw up and insist on the implementation of a program for additional examination of a child, accumulate facts confirming the irreversibility of his disease.

3. No later than 6 years after the initial establishment of the category “disabled child” - in the case of a recurrent or complicated course of a malignant neoplasm in children, including any form of acute or chronic leukemia, as well as in the case of the addition of other diseases that complicate the course of a malignant neoplasm.

4. This is also possible if the child is initially recognized as disabled(as we already mentioned above) – if it is revealed that it is impossible to eliminate or reduce the limitation of his life activity before he is sent for a medical and social examination, i.e.

Diseases that cannot be cured by modern methods have been identified,

There are documents confirming the lack of positive dynamics of the rehabilitation/habilitation measures carried out.

The main thing is that now, using the LIST of diseases, defects, irreversible morphological changes..., you can resolve this issue 2 years earlier, saving the child and yourself from numerous procedures. The LIST includes 23 groups of the most common diseases and defects that cause disability, and on the basis of which (after re-examination) you can insist on establishing a disability for the child before he reaches the age of 18.

I have been diagnosed with cerebral palsy (cerebral palsy) since birth. More precisely - with one year old(around then the doctors finally determined the name of what was happening to me). I graduated from a special school for children with cerebral palsy, and 11 years later I came to work there. 20 years have passed since then... According to the most conservative estimates, I know, more or less close, more than half a thousand people with cerebral palsy. I think this is enough to dispel the myths that those who are faced with this diagnosis for the first time tend to believe.

Myth one: Cerebral palsy is a serious illness

It is no secret that many parents, upon hearing this diagnosis from a doctor, experience shock. Especially in last years, when the media more and more often talk about people with severe cerebral palsy - about wheelchair users with damage to their arms and legs, slurred speech and constant violent movements (hyperkinesis). They don’t even know that many people with cerebral palsy speak normally and walk confidently, and with mild forms they do not stand out among healthy people at all. Where does this myth come from?

Like many other diseases, cerebral palsy ranges from mild to severe. In fact, it’s not even a disease, but common cause a range of disorders. Its essence is that during pregnancy or childbirth, certain areas of the cerebral cortex are affected in the baby, mainly those responsible for motor functions and coordination of movements. This is what causes cerebral palsy - a disorder proper operation individual muscles to the point of complete inability to control them. Doctors count more than 1000 factors that can trigger this process. It is obvious that different factors cause different consequences.

Traditionally, there are 5 main forms of cerebral palsy, plus mixed forms:

Spastic tetraplegia– the most severe form, when the patient, due to excessive muscle tension, is unable to control either his arms or legs and often experiences severe pain. Only 2% of people with cerebral palsy suffer from it (hereinafter statistics are taken from the Internet), but they are the ones most often talked about in the media.

Spastic diplegia– a form in which either the upper or lower extremities are severely affected. The legs are more often affected - a person walks with bent knees. Little's disease, on the contrary, is characterized by severe damage to the hands and speech with relatively healthy legs. Consequences of spastic diplegia occur in 40% of cerebral palsy patients.

At hemiplegic form motor functions of the arms and legs on one side of the body are affected. 32% have signs of it.

In 10% of people with cerebral palsy, the main form is dyskinetic or hyperkinetic. It is characterized by strong involuntary movements - hyperkinesis - in all extremities, as well as in the muscles of the face and neck. Hyperkinesis often occurs in other forms of cerebral palsy.

For ataxic form characterized by decreased muscle tone, sluggish slow movements, severe violation balance. It is observed in 15% of patients.

So, the baby was born with one of the forms of cerebral palsy. And then other factors are included - factors of life, which, as you know, is different for everyone. Therefore, what happens to him after a year is more correctly called the consequences of cerebral palsy. They can be completely different even within the same form. I know a man with spastic diplegia of the legs and quite strong hyperkinesis, who graduated from the Faculty of Mechanics and Mathematics of Moscow State University, teaches at the institute and goes on hikes with healthy people.

According to various sources, 3-8 babies out of 1000 are born with cerebral palsy. The majority (up to 85%) have mild to moderate severity of the disease. This means that many people simply do not associate the peculiarities of their gait or speech with the “terrible” diagnosis and believe that there are no cerebral palsy in their environment. Therefore, the only source of information for them is publications in the media, which do not at all strive for objectivity...

Myth two: Cerebral palsy is curable

For most parents of children with cerebral palsy, this myth is extremely attractive. Without thinking about the fact that disorders in the functioning of the brain today cannot be corrected by any means, they neglect the “ineffective” advice of ordinary doctors, spending all their savings and collecting huge sums with the help of charitable foundations to pay for an expensive course at the next popular center. Meanwhile, the secret to alleviating the consequences of cerebral palsy is not so much in fashionable procedures, but in constant work with the baby, starting from the first weeks of life. Baths, regular massages, games with straightening the legs and arms, turning the head and developing precision of movements, communication - this is the basis that in most cases helps the child’s body partially compensate for the disturbances. After all, the main task early treatment consequences of cerebral palsy - not correcting the defect itself, but preventing improper development of muscles and joints. And this can only be achieved through daily work.

Myth three: Cerebral palsy does not progress

This is how those who are faced with mild consequences of the disease console themselves. Formally, this is true - the state of the brain does not really change. However, even light form hemiplegia, almost invisible to others, by the age of 18 inevitably causes curvature of the spine, which, if not addressed, is a direct path to early osteochondrosis or intervertebral hernia. And this means severe pain and limited mobility, up to the inability to walk. Each form of cerebral palsy has similar typical consequences. The only trouble is that in Russia this data is practically not generalized, and therefore no one warns growing children with cerebral palsy and their relatives about the dangers that await them in the future.

Parents know much better that the affected areas of the brain become sensitive to the general condition of the body. A temporary increase in spasticity or hyperkinesis can be caused even by a common flu or a surge in blood pressure. IN in rare cases nervous shock or serious illness cause a sharp long-term increase in all the consequences of cerebral palsy and even the appearance of new ones.

Of course, this does not mean that people with cerebral palsy should be kept in greenhouse conditions. On the contrary: the stronger the human body, the more easily it adapts to unfavorable factors. However, if the procedure or physical exercise regularly cause, for example, increased spasticity, they should be abandoned. Under no circumstances should you do anything through “I can’t”!

Parents should pay special attention to the condition of the child from 12 to 18 years of age. At this time, even healthy children experience serious overload due to the peculiarities of the body's restructuring. (One of the problems of this age is the growth of the skeleton, which outstrips the development of muscle tissue.) I know several cases when children who are walking due to problems with the knees and hip joints at this age they sat in a wheelchair, and forever. This is why Western doctors do not recommend putting cerebral palsy children aged 12-18 years on their feet if they have not walked before.

Myth four: everything comes from cerebral palsy

The consequences of cerebral palsy are very different, and yet their list is limited. However, relatives of people with this diagnosis sometimes consider cerebral palsy to be the cause of not only a disorder motor functions, as well as vision and hearing, but also such phenomena as autism or hyperactivity syndrome. And most importantly, they believe that if cerebral palsy is cured, all other problems will be solved on their own. Meanwhile, even if the cause of the disease is indeed cerebral palsy, it is necessary to treat not only it, but also the specific disease.

During the birth process, Sylvester Stallone was partially damaged nerve endings his face - part of the actor's cheeks, lips and tongue remained paralyzed, however, slurred speech, a grin and large sad eyes later became his calling card.

The phrase “You have cerebral palsy, what do you want!” is especially funny! sounds in the mouths of doctors. I heard it more than once or twice from doctors of different specialties. In this case, I have to patiently and persistently explain that I want the same thing as any other person - relief from my own condition. As a rule, the doctor gives in and prescribes the procedures that I need. IN as a last resort, going to the manager helps. But in any case, when faced with a particular disease, a person with cerebral palsy has to be especially attentive to himself and sometimes suggest to doctors the necessary treatment in order to minimize negative impact procedures.

Myth five: people with cerebral palsy don’t get hired anywhere

It is extremely difficult to say anything based on statistics here, because there is simply no reliable data. However, judging by the graduates of the mass classes of special boarding school No. 17 in Moscow, where I work, only a few remain at home after school. About half go to specialized colleges or departments of universities, a third go to regular universities and colleges, and some go straight to work. At least half of the graduates are subsequently employed. Sometimes girls quickly get married after finishing school and begin to “work” as a mother. The situation is more complicated with graduates of classes for children with mental retardation, however, even there, about half of the graduates continue their studies in specialized colleges.

This myth is spread mainly by those who are unable to soberly assess their abilities and want to study or work where they are unlikely to meet the requirements. Having received a refusal, such people and their parents often turn to the media, trying to force their way. If a person knows how to balance desires with possibilities, he finds his way without showdowns and scandals.

A good example is our graduate Ekaterina K., a girl with a severe form of Little’s disease. Katya walks, but can work on a computer with just one finger of her left hand, and her speech is understood only by very close people. The first attempt to enroll in a university as a psychologist failed - after looking at the unusual applicant, several teachers declared that they refused to teach her. A year later, the girl entered the Academy of Printing in the editorial department, where there was a distance learning option. Her studies went so well that Katya began earning extra money by taking tests for her classmates. Get a job after graduation permanent job she failed (one of the reasons was the lack of an ITU labor recommendation). However, from time to time she works as a moderator of educational websites in a number of universities in the capital ( employment contract is registered to another person). And in free time writes poetry and prose, posting works on his own website.

Dry residue

What can I advise parents who find out that their baby has cerebral palsy?

First of all, calm down and try to give him as much attention as possible, surrounding him (especially in early age!) only positive emotions. At the same time, try to live as if your family is growing ordinary child– walk with him in the yard, dig in the sandbox, helping your baby establish contact with peers. There is no need to remind him about the disease once again - the child himself must come to an understanding of his characteristics.

Secondly, do not rely on the fact that sooner or later your child will be healthy. Accept him for who he is. One should not think that in the first years of life all efforts should be devoted to treatment, leaving the development of intelligence “for later.” The development of mind, soul and body are interconnected. Much in overcoming the consequences of cerebral palsy depends on the child’s desire to overcome them, and without the development of intelligence it simply will not arise. If the baby does not understand why he needs to endure the discomfort and difficulties associated with treatment, there will be little benefit from such procedures.

Third, be lenient with those who ask tactless questions and give “stupid” advice. Remember: recently you yourself knew no more about cerebral palsy than they did. Try to calmly conduct such conversations, because their attitude towards your child depends on how you communicate with others.

And most importantly, believe: your child will be fine if he grows up to be an open and friendly person.

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Anastasia

I read the article. My theme:)
32 years old, right-sided hemiparesis (mild form of cerebral palsy). An ordinary kindergarten, an ordinary school, a university, an independent search for a job (in fact, that’s where I am now), travel, friends, ordinary life….
And I went through the “lame-footed” one, and through the “club-footed” one, and through God knows what. And there will be much more, I'm sure!
BUT! The main thing is a positive attitude and strength of character, optimism!!

Nana

Should we really expect things to get worse with age? I have mild degree, spasticity in the legs

Angela

And people's attitude doesn't favorable conditions lives were ruined. At 36 years old, I have no education, no job, no family, although it is a mild form (right-sided hemiparesis).

Natasha

After vaccinations, a lot of “cerebral palsy” appeared. Although the children do not have cerebral palsy at all. There is nothing congenital or intrauterine there. But they attribute it to cerebral palsy and, accordingly, incorrectly “heal” it. As a result, they actually get a type of paralysis.
Often the cause of “congenital” cerebral palsy is not trauma at all, but an intrauterine infection.

Elena

A wonderful article that raises a huge problem - how to live “with it”. It has been well shown that it is equally bad not to take into account the presence of limitations associated with the disease and to attach excessive importance to them. You shouldn't focus on what you can't do, but rather focus on what's available.
And it is indeed very important to pay attention to intellectual development. We even injected Cerebrocurin, it gave us a huge boost in development, after all, embryonic neuropeptides really help to use the existing capabilities of the brain. My opinion is that you shouldn’t wait for a miracle, but you shouldn’t give up either. The author is right: “this can only be achieved through the daily work” of the parents themselves, and the sooner they do this, the more productive it will be. It’s too late to start “preventing improper development of muscles and joints” after one and a half years of age - “the locomotive has left.” I know on personal experience and from the experiences of other parents.
Ekaterina, all the best to you.

* Kinesthesia (ancient Greek κινέω - “move, touch” + αἴσθησις - “feeling, sensation”) - the so-called “muscular feeling”, a sense of position and movement of both individual members and the whole human body. (Wikipedia)

Olga

I completely disagree with the author. firstly, why didn’t they say anything about double hemiplegia when considering the forms of cerebral palsy? it differs from ordinary hemiplegia and from spastic tetraparesis. secondly, cerebral palsy is truly curable. if we mean the development of compensatory capabilities of the brain and improvement of the patient’s condition. thirdly, the author has seen heavy children in the eyes??? those that are out of the question to bear playing in the sandbox. when you look at a child almost in the wrong way and he shakes with convulsions. and the screaming doesn't stop. and he arches in such a way that there are bruises on mom’s arms when she tries to hold him. when the child cannot only sit or lie down. fourthly. the form of cerebral palsy is nothing at all. the main thing is the severity of the disease. I saw spastic diplegia in two children - one is almost no different from his peers, the other is all crooked and with convulsions, of course, he cannot even sit upright in a stroller. but there is only one diagnosis.

Elena

I don’t quite agree with the article as a mother of a child with cerebral palsy - spastic diplegia, moderate severity. As a mother, it’s easier for me to live and fight thinking that if this is incurable, then it’s fixable—it’s possible to bring the child as close as possible to “norms.” social life. For 5 years we have heard enough that it is better to send our son to a boarding school and give birth to a healthy one ourselves... and this is from two different orthopedic doctors! It was said in front of a child whose intellect was preserved and he heard everything... of course he closed himself off, began to avoid strangers... but we have a huge leap - our son walks on his own, although he has poor balance and his knees are bent... but we are fighting. We started quite late - from 10 months , other consequences were treated before premature birth and the doctors don’t care...

Currently, the problem of rehabilitation of disabled people in all Western countries is one of the key ones in the implementation of various public and privately funded social programs. Disability associated with disorders of the musculoskeletal system makes up a significant share in the structure of disability as a whole. At the same time, the leading place among such disorders is occupied by cerebral palsy (cerebral palsy). With this disease, there is damage to the musculoskeletal system of varying severity, often leading to severe disability, and changes in work internal organs, and, most importantly, intellectual and characterological disorders. In this regard, cerebral palsy belongs to the group of psycho-diseases (handicapted diseases), leading to the patient going beyond the standard framework of existence familiar to most healthy people. Therefore, social and physical adaptation of such patients is very important, especially in Russia, where social issues faces virtually the entire population. It is natural that disabled people, disabled children with disabilities nervous system It is especially difficult to adapt to the complex socio-political situation that has created in Russia in recent years. In view of this, the task of social care authorities, medical services and many other organizations is to create systems of measures aimed at the rehabilitation of disabled children and their adaptation into society. It is no secret that despite the disability associated with musculoskeletal disorders due to cerebral palsy, many, many people are talented scientists, artists, athletes, etc.

Cerebral palsy is a composite diagnosis that requires additional decoding. According to the nature of motor disorders, this disease is based on the classification of K.A. Semenova can be divided into five main forms.

1. The first of them is the so-called spastic form.

Children suffering spastic form(diplegic child), have increased muscle tone in the back and front muscle groups of the legs, muscle imbalance, and, as a result, it is difficult for them to stand and move. Often the hands are also involved in the pathological process. The spastic form of cerebral palsy or, as it is called, spastic diplegia in the structure of cerebral palsy is the most common - 65% among other forms.

2. Another form of the disease is hemiparetic, which is in second place after spastic. With this type of lesion, either one of the sides of the body or one of the limbs - an arm or a leg - is affected.

In the hyperkinetic form, patients experience all sorts of involuntary movements that prevent them from carrying out purposeful activities and disorders of the autonomic nervous system, such as salivation.

3. The severe form of the disease is the atonic-astatic form, which occurs in approximately 5% of cases and leads primarily to the difficulty of maintaining balance in patients when standing and walking.

4. An almost incurable (not treatable) and rare form of the disease is double hemiplegia, in which movements in the upper and lower extremities on both sides are affected. In general, these are bedridden patients who require special social care and attention, since hospital treatment They are practically not indicated due to the form of the disease that is difficult to treat.

5. Intellectual deficiency (oligophrenia) is a formidable symptom that can accompany any form of cerebral palsy, but especially atonic-astatic. On the other hand, in addition to intellectual disability with cerebral palsy, as with a number of other severe, disabling diseases, characterological disorders are possible.

Cerebral palsy is a disease that occurs perinatally (during pregnancy) or in early childhood, which means the depth and size of the damage to brain structures is very large here. Therefore, prevention of this disease is very important and, if it occurs, then the earliest possible start of treatment and rehabilitation measures is required. Due to the difficulties of social adaptation and job search for such patients, targeted support for programs aimed at their social adaptation vital. In the 18th children's psychoneurological hospital, a targeted integrated approach to the treatment and rehabilitation of patients with all forms of cerebral palsy is carried out. Children's Psychoneurological Hospital No. 18 is the leading medical rehabilitation institution in Russia. It was founded in 1983. Here they receive rehabilitation assistance, conservative and surgical treatment children aged from 7 days to 20 years with cerebral palsy, consequences of injuries to the spine and spinal cord, as well as other psychoneurological diseases. The only pediatric neurosurgical department in Russia operates here, where patients with consequences of spinal cord and spinal cord injuries are treated. Hospital doctors are the authors original techniques rehabilitation and surgical correction motor disorders in cerebral palsy, consequences of spinal and spinal cord injuries, inventors of devices for restoring motor functions and studying muscle tone disorders. Every year, 3,300 patients undergo treatment and rehabilitation here, and the advisory clinic serves more than 25,000 children.

The hospital uses various exercise equipment and methods of physical therapy, balneotherapy (mud therapy), water treatments in the form of hydromassage and swimming in the pool, especially useful for patients with spastic cerebral palsy. Psychologists and teachers work with sick children; the hospital has high school and an occupational therapy room with an exhibition of works by disabled children. IN Lately A widely used method for treating patients with all forms of cerebral palsy is dynamic proprioceptive correction by wearing the PENGUIN space load suit and its modification - the ADELI suit. Results were obtained demonstrating, after using this new method, an improvement in gait and standing in patients, a reduction in spasticity, hyperkinesis, an increase in stability and, very importantly, the development of intellectual functions. An important area of ​​the hospital's activities is physical rehabilitation patients with cerebral palsy, for which surgical treatment is also widely used, especially for patients with a spastic form. The use of surgical intervention allows, in severe children with serious contractures in the joints, with pathological synkinesis and deformities, to almost completely equalize muscle tone and restore range of motion in the limbs.