Therapeutic Methods in Cerebral Palsy From the Standpoint of Evidence-Based Medicine

Pak, Lale A.; Zherdev, K. V.; Kuzenkova, L.M.; Куренков, А. Л.; Бурсагова, Б. И.

doi:10.18821/1560-9561-2018-21-3-168-174

jour

2019

DOI: 10.18821/1560-9561-2018-21-3-168-174

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Therapeutic Methods in Cerebral Palsy From the Standpoint of Evidence-Based Medicine

Lale A. Pak

K. V. Zherdev

L.M. Kuzenkova

et al.

Abstract: In the article the authors consider such methods of the alternative/complementary treatment of the cerebral palsy (CP), presented in the modern domestic and foreign literature, as metabolic (amino acid composites), metamer (I.A. Skvortsov), intravenous administration of baclofen, antiepileptic (vagal stimulation, levetiracetam), acupuncture, transcranial cerebral micropolarization, epidural stimulation, modified motion-induced restriction therapy (MMIRT), stem cell therapy, as well as some other complementary/… Show more

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Cited by 2 publications

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Neurophysiological and Neuroradiological Characteristics of Children With Hemiplegic Cerebral Palsy With Regard to Gender and Laterality of Hemiparesis

Asilova,

Ganieva,

Zaripov

2023

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Objective: This study aims to analyze the neurophysiological and neuroimaging characteristics of children diagnosed with hemiplegic cerebral palsy (HCP) while considering the impact of gender and laterality of hemiparesis. Methods: We analyzed 125 children between the ages of 7-9 (with a mean age of 8.2±0.9 years) diagnosed with HCP (ICD-10 Code: G80.2). Our analysis focused on the lateralization of cerebral injury. The patients were divided into 2 groups based on the hemispheric focus lateralization. In each group, subgroups were distinguished by gender. After examining the patients, it was found that the most prevalent were male children, children aged eight years, and those with left-sided hemiparesis. Results: The EEG of patients with HCP showed diffuse changes and signs of brainstem dysfunction (disorganization of the α-rhythm at a reduced amplitude level). Furthermore, there were fluctuations in the brain's bioelectrical activity (BEA) of varying degrees of intensity. Residual organic disorders (slowing down of the cortical rhythm) were found in 64 (88.9%) children of group I and in 42 (79.2%) children of group II (p>0.05; χ2 =1.52). MRI data analysis revealed brain pathological changes in all examined patients. In group I, periventricular lesions of the white matter were present in 36.4% (12) and 38.5% (15) of female and male pediatric patients, respectively. In both female and male pediatric patients, atrophic and subatrophic changes were detected in the cerebral cortex with a prevalence of 51.5% (17) and 53.8% (21), respectively. Brain scans revealed that 84.8% (28) of female and 89.7% (35) of male pediatric patients had focal brain lesions. In group II, periventricular lesions of the white matter occurred in 34.8% (8) and 36.7% (11) of female and male pediatric patients, respectively. Gray matter atrophy in both female and male pediatric patients was detected in 47.8% (11) and 53.3% (16) cases, respectively. Focal brain lesions were in 65.2% (1 5) and 76.7% (23) of female and male pediatric patients, respectively. Conclusion: There is no correlation between the neurophysiological and neuroimaging characteristics of children with HCP and their hemiparesis laterality or gender. From the available data, it can be inferred that HCP is likely caused by focal cerebral damage and brain malformations.Keywords: Cerebral palsy, electroencephalogram, brain bioelectrical activity, magnetic resonance imaging, slow sensorimotor rhythm.

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Neurophysiological and Neuroradiological Characteristics of Children With Hemiplegic Cerebral Palsy With Regard to Gender and Laterality of Hemiparesis

Asilova,

Ganieva,

Zaripov

2023

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Dystonia in children

Lyalina

Pak

Фисенко

et al. 2021

RPJ

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Dystonia is a motor disorder characterized by sustained muscle contractions producing twisting, repetitive, and patterned movements or abnormal postures. Dystonia is among the most commonly observed motor disorders in clinical practice in children. Unlike dystonia in adults that typically remains focal or spreads only to nearby muscle groups, childhood dystonia often generalizes. Classification of dystonia has direct implications for narrowing down the differential diagnosis, choosing the diagnostic work-up, predicting the prognosis, and choosing treatment options. The etiology of pediatric dystonia is quite heterogeneous. The etiological classification distinguishes primary dystonia with no identifiable exogenous cause or evidence of neurodegeneration and secondary syndromes. Dystonia can be secondary to any pathological process that affects the basal ganglia. The treatment options of childhood dystonia include several oral pharmaceutical agents, botulinum toxin injections, and deep brain stimulation therapy. Botulinum toxin treatment is the first choice treatment for most types of focal dystonia. In children it is less used because dystonic forms are mainly generalized, but it might also be helpful in controlling the most disabling symptoms of segmental or generalized dystonia. Long-term electrical stimulation of the globus pallidum internum is now established as an effective treatment for various types of movement disorders including dystonia. However, this method has not yet found its application in Russia due to the difficulty of implementation and the lack of patient routing. To increase the effectiveness of complex therapy of dystonia in children, new pathogenetic methods of treatment of common forms of primary dystonia and dystonic syndromes in the structure of degenerative diseases of the central nervous system are needed, as well as the development of optimal algorithms for the diagnosis and treatment of these patients.

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Therapeutic Methods in Cerebral Palsy From the Standpoint of Evidence-Based Medicine

Cited by 2 publications

References 54 publications

Neurophysiological and Neuroradiological Characteristics of Children With Hemiplegic Cerebral Palsy With Regard to Gender and Laterality of Hemiparesis

Neurophysiological and Neuroradiological Characteristics of Children With Hemiplegic Cerebral Palsy With Regard to Gender and Laterality of Hemiparesis

Dystonia in children

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