Early childhood brain damage

Classification according to ICD-10
P91.9	Neonatal cerebral disorder, unspecified
G80.-	Infantile cerebral palsy
ICD-10 online (WHO version 2019)

The early childhood brain injury is the collective term for damage to the central nervous system between the 6th month of pregnancy and 3 to 6 years old. In any case, this damage is complete and does not progress due to an ongoing congenital disease. It manifests itself among other things through differently pronounced movement disorders, which relate to the coordination and the movement sequences. The term is often used synonymously with infantile cerebral palsy . Strictly speaking, the latter is only a symptom of early childhood brain damage. In addition to the motor functions, other functions of the central nervous system can also be impaired. Since the damage usually cannot be reversed (irreversible), there is no causal, curative treatment; instead, the therapy consists of symptomatic measures to alleviate the symptoms and improve mobility.

causes

Since the damage to the developing child's brain can occur over a long period of time , the causes are manifold and different. Any prolonged lack of oxygen before, during or after birth leads to early childhood brain damage due to the death of nerve cells, such as uglyria . Certain infections ( e.g. toxoplasmosis , cytomegaly ) can damage the brain development of the unborn child even during pregnancy in the womb. Cerebral haemorrhages mainly affect premature babies because the walls of the blood vessels in the brain are still particularly brittle due to their immaturity and can be injured with low mechanical loads. Untreated metabolic disorders such as phenylketonuria or organ dysfunction such as hypothyroidism (underactive thyroid) or deficiency situations such as iodine deficiency can lead to severe brain damage. Severe neonatal jaundice can cause bilirubin encephalopathy, a special type of brain damage in early childhood. In children beyond the neonatal period, traumatic brain injuries or meningitis are a common cause of permanent brain damage. In rare cases, alcohol or drug poisoning can also be the cause.

Symptoms

Depending on the type and severity of the damage, only mild symptoms or even the most severe disabilities can occur. Immediately after birth, a newborn baby who has already suffered brain damage in the womb can be noticed, for example, due to lack of or reduced spontaneous movements and reduced muscle tension. Later, increased muscle tension arises during voluntary movements (spasticity) with equinus foot position (infantile cerebral palsy). Any permanent brain damage can also cause seizures , some of which can only occur in adolescence. The sensory functions can only be slightly impaired in the form of perceptual disturbances or even completely destroyed up to blindness and deafness . In addition, mental development can be disturbed to different degrees ( developmental delay ).

diagnosis

A detailed survey of the previous history ( anamnesis ) with regard to pregnancy and childbirth as well as maternal illnesses provides important information. Tumors or inflammations are also ruled out after thorough examinations . An EEG (measurement of brain waves ) makes changes visible and the examination also shows whether there are seizures . In a newborn, an ultrasound examination ( sonography ) can determine whether there are bleeding or other defects.

therapy

Various symptoms can be alleviated or controlled with medication. Baclofen , among other things , can be used to reduce muscle tension . Treatment of individual muscles with botulinum toxin to reduce muscle tension in spastic paralysis is also established. Anticonvulsants may suppress seizures or at least reduce their frequency. Medical treatment is supported by physiotherapy , occupational therapy and speech therapy . The physical therapy is important to contractures as low as possible and maintain the remaining movements. The parents are involved and instructed so that the corresponding exercises can also be carried out at home. The occupational therapy playfully trains the gross and fine motor skills as well as everyday practical movement sequences and thus helps the little patient to find his way in everyday life. In speech therapy , the limited linguistic ability is promoted and improved. It also aims to improve oral motor skills to alleviate swallowing disorders and thus improve nutritional ability. Remedial early intervention is also part of a holistic treatment concept for affected children.

Legal consequences

Brain damage in early childhood places a significant financial burden on the affected family. The need for care and the therapy are associated with high costs. Often professional activities have to be given up, which leads to further losses. If the early childhood brain damage is due to a treatment error or to another culpable cause by a third party, there are claims in the context of medical liability or the right to compensation . As a rule, these are major loss cases that require intensive legal processing. The aim is to provide financial compensation for the material and immaterial losses suffered.

Individual evidence

1. ↑ Alphabetical index for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 294
2. ↑ On the medical law processing of cases of hypoxic brain damage , accessed on December 8, 2015

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !