Estimation of the level of endothelial factor of vascular growth and monocytic chemoattractant in children cerebral palsy

Objective. The aim of this article is to assess the role of vascular endothelial growth factor and monocytic chemoattractant in the development of cerebral palsy in children. Materials and methods. Examination of 77 children with different clinical forms of infantile cerebral palsy in the age group from 1 to 16 years was carried out. The content of monocyte chemoattractant (MCP) and vascular growth factor (VEGF) was determined in different forms of cerebral palsy. The obtained data were processed statistically. Results. The analysis of the obtained data revealed a significant increase in the indicators of monocytic chemoattractant and vascular growth factor in children with infantile cerebral palsy compared with healthy children. There were no significant differences between the indicators of MCP and VEGF in children with cerebral palsy and comorbid pathology and children with cerebral palsy without concomitant pathology. Conclusion. The authors of the presented analysis conclude that the determination of monocytic chemoattractant and vascular growth factor has a high diagnostic value for identifying a predisposition to the development of cerebral palsy. Timely detection of an increase in the level of these factors provides a broader prospective for early diagnosis of the disease and for the early implementation of rehabilitation measures accordingly.

IncobotulinumtoxinA in the treatment of sialorrhea in patients with infantile cerebral palsy

Sialorrhea is a severe medical problem that is difficult to treat, which can lead to serious complications. In almost all cases, chronic sialorrhea is accompanied by a restriction of the child's contacts with peers, socialization difficulties, and a significant decrease in the quality of life. Nowadays, botulinum therapy can be an effective tool that significantly reduces sialorrhea manifestation.Oblective: to evaluate the effectiveness of Xeomin (incobotulinumtoxinA) in the treatment of sialorrhea in patients with spastic infantile cerebral palsy (ICP).Patients and methods. We enrolled 24 children with ICP (14 (58.3%) females, and 10 (41.7%) males) with various disease forms: 4 (16.6%) — with spastic hemiparesis, 6 (25.0%) — with spastic diplegia, and 14 (58.3%) — with spastic quadriparesis. IncobotulinumtoxinA injections were performed bilaterally in the parotid and submandibular salivary glands under ultrasound control at a total dose of 40-100 U (min 1.3, max 4.5 U/kg of body weight). IncobotulinumtoxinA. The Drooling Impact (DIS) and the Global Impression of Change Scale (GICS) were used 1, 3 and 6 months after IncobotulinumtoxinA injections to assess treatment effectiveness.Results and discussion. Botulinum toxin therapy resulted in a significant decrease in saliva discharge from the oral cavity 1 and 3 months after IncobotulinumtoxinA injections, which was demonstrated by a reduction in mean DIS score from 78.6±9.6 (min 62, max 95 points; 95% CI 74.6—82.7) to 48.7±6.7(min 25, max 61 points; 95% CI45.8—51.6) and 52.7±8.5points (min 22, max 65; 95% CI49.1—56.3), respectively, as well as an increase in delta GICSscore up to +1.3+0.8(min 0, max 3points; 95% CI 1.0—1.6) and +1.0+0.7points (min 0, max 3points; 95% CI 0.8—1.3), respectively. Adverse events were observed in 4patients (16.6%), which were classified as mild in 3 patients (did not require special treatment and completely stopped within six days) and moderate in 1 patient (also did not require special treatment and completely stopped within three weeks).Conclusion. In the majority (79.1%) of patients with ICP, it is possible to achieve high efficiency in reducing sialorrhea and this effect persists for at least 3 months.

Pneumosinus dilatans associated with infantile cerebral palsy and nasal polyposis: Case report

Pneumosinus dilatans is a rare disease characterized by air-filled expansion of a paranasal sinus. Approximately 134 cases are reported in the literature, but not only one associated with infantile cerebral palsy (ICP) and nasal polyposis. We herein present this case report aimed to further characterize this uncommon condition: a 28-year-old female diagnosed with infantile cerebral palsy and nasal polyposis, in whom the cranio-facial CT scan revealed the association of a pneumosinus dilatans involving the frontal sinus. The patient is currently undergoing a protocol for endoscopic surgery of the nose and paranasal sinuses.

Rehabilitation of patients diagnosed with infantile cerebral palsy using reflex gymnastics by Vojta method

This paper presents the long-term experience of using reflex gymnastics according to the Vojta method in several medical centers in Russia, which is an important aspect of this method of therapeutic exercises, since no study has provided enough information about such experience. Combining the results of studies from Moscow and Russian cities made it possible to demonstrate the advantages of a highly effective method of treating a serious disease such as cerebral palsy. The variability and variety of technical approaches of the Vojta method depend on the severity and orthopedic manifestations of various diseases, which is an undoubted advantage of the technique. Vojta therapy not only works with human motor activity but has a pronounced and varied effect on numerous actions that are of higher nervous activity. Based on the presented experience of working with patients of different ages diagnosed with cerebral palsy, we can confidently recommend the need to use Vojta therapy in the complex treatment of the disease.

Preliminary results of surgical treatment of flexion-adduction contracture of the first ray of the hand in combination with dislocation in the metacarpophalangeal joint in patients with infantile cerebral palsy

Background. Surgical methods of treating flexionadduction contracture of the first ray of the hand in combination with dislocation in the metacarpophalangeal joint in patients with infantile cerebral palsy are divided into surgical interventions on soft tissues and bone surgeries aimed at stabilizing the metacarpophalangeal joint. We have developed a technique of temporary arthrodesis of the metacarpophalangeal joint in combination with the previously used operation to widen the first intercarpal space, combining the positive effects of both groups of operations: stability of arthrodesis with an installed metal structure that enable active movements in the joint in sufficient amplitude after its removal and early postoperative rehabilitation with a stabilized joint. Aim. This study aimed to evaluate the effectiveness of a new method of surgical correction of flexionadduction contracture of the first ray of the hand in combination with metacarpophalangeal joint dislocation in the form of temporary arthrodesis of this joint and widening of the intermetacarpal space in patients with cerebral palsy. Materials and methods. The study analyzed treatment outcomes of patients (n = 11) who underwent temporary arthrodesis of the metacarpophalangeal joint with an extra-bone plate for a period of 1 year and expansion of the first intermetacarpal space. Comparative analysis of the results was carried out 6 months after the operation, 1 year after the operation, and after hardware removal. The amplitude of passive and active movements in the metacarpophalangeal joint was analyzed. The functionality of the upper limb was assessed according to the international classification system MACS 2002 and the block and box test. Results. At 1 year after surgery and removal of the fixation structure, the amplitude of both passive abduction (32.0) and extension (9.5) in the metacarpophalangeal joint increased, and the amplitude of the same movements (leads) increased by 25.5 in abduction and by 4.0 in extension when performed actively. The MACS indicator improved by 1 point. The average dynamics of the block and box test was seven additional cubes. Conclusion. The proposed technique for temporary extra-articular arthrodesis of the metacarpophalangeal joint does not affect the intra-articular structures, unlike intra-articular arthrodesis, and therefore has clear advantages over the latter. This surgical treatment method is effective in increasing the amplitude of active and passive movements of the first ray of the hand and reduces muscle imbalance, which ultimately improves the function of the upper limb as a whole.

Emulador de Equinoterapia para la Rehabilitación de Pacientes con Parálisis Cerebral Infantil

Nowadays, animal-assisted therapies are becoming more common in the rehabilitation field, one of the most outstanding is equine therapy or horse-assisted therapy, whose simple principles serve as an effective treatment for patients with infantile cerebral palsy conforming to various studies. Due to the conditions that are particularly necessary to maintain this type of therapy center, it tends to come at a high price, thus limiting its access to different patients. For this reason, a new alternative is presented that provides the same effects as equine therapy, designing an emulator so that this procedure is more affordable and can benefit a substantial number of people. For the outline of the prototype was realized an analysis of the equine gait to create a record and control of data, also a sketch of the electromechanical and monitoring system that will allow recreating the movements of the gait using the data collected. To corroborate the correct implementation of the therapy by checking the output variables, as well as protecting the physical integrity of the patients by verifying the limits and ranges allowed for the main blocks of the system. By comparing the operating principle on which the prototype proposal is based with the fundamentals of conventional therapy with animals, a new alternative could be composed for this procedure that would only require a study that proves its validity once developed.

Infantile cerebral palsy and dental anomalies

The term cerebral palsy has been around for more than a century, and the disease itself has probably existed without a name throughout human history. However, despite its long history, there is still no unity in views on this issue.

Prevention of Cerebral Palsy and Fetal Demise with Hypoxia Index, FHR Score and Pathologic Sinusoidal FHR in Fetal Monitoring

Although fetal deaths was decreased by intrapartum Fetal Heart Rate (FHR) monitoring, infantile cerebral palsy was not decreased in Dublin trials of Electric Fetal Monitor (EFM), thus, an analysis to reduce cerebral palsy was studied, where cerebral palsy is prevented by setting the threshold of hypoxia index at 24 or less, in the analysis of FHR deceleration.

Effectiveness of physical therapy interventions for children with cerebral palsy

Cerebral palsy (CP) describes a group of permanent disorders of motor development and posture that cause limiting activity that are attributed to non-progressive dysfunctions occurring in the development of fetal brain or of the child.The main purpose of the paper is to study the clinical and functional aspects with implications in the design and evaluation of the complex recovery therapy of the child with psycho-neuro-motor disabilities diagnosed with infantile cerebral palsy (ICP).The study took place during the period June 2016 - March 2018, is of the type prospectively and comprised 5 children diagnosed with ICP, aged 4 to 12 years. Criteria for inclusion in the recovery group: children diagnosed with infantile cerebral palsy form spastic tetra- spastic, without orthopedic surgery, during the study period. Children have been given a comprehensive assessment of body attitude, upper and lower limb hypertonia, upper limbs functionality, and global motor function.The major objective of recovering the child with infantile cerebral palsy was to improve the quality of life by creating conditions for minimum patient autonomy. The functional recovery program was carried out three times a week using exercises and methods of neuro-motor rehabilitation. Duration of the session was 50-60 min.Due to the results obtained at the initial and final evaluation, a tonus improvement was observed in all the tested muscles, with a decrease in the mobilization resistance of all the muscle groups. In global functional evaluation the total score on the 5 sections of the 5 children with CP had an initial mean value of 34.92 (± 16.60) and a final of 47.72 (± 26.53)Stretching, neuro-motor reeducation methods and active physical exercises help to increase the degree of the functional independence.