Serious diseases equally affect not only adults, but also children. Many of them are successfully treated, while others bed a person forever. The latter include Little's disease or syndrome.
Medical certificate
Diplegia is a type of cerebral palsy. It is characterized by a violation of the full functioning of the muscles of the upper and lower extremities. Under cerebral palsy, it is customary to understand the pathology of bone and muscle tissue growth against the background of damage to the brain hemisphere. Such a lesion appears only on one side. With diplegia, damage occurs on both sides. As a rule, the muscles of the lower extremities suffer.
Little's disease is called a spastic form of diplegia. She got her name by the name of the English obstetrician. In 1853, he presented a description of this pathology in newborn children. It is characterized by the presence of lower spastic paraparesis, which affects mainly the lower extremities. The disease can be pronounced or be mildly awkward.
Causes and Risk Factors
Little disease and cerebral palsy in their etiology have the same causes of development. Pathology is characterized by the following prerequisites:
- Hereditary predisposition. Sick parents have little chance of having a healthy baby. Therefore, even at the planning stage, it is necessary to undergo an examination and appropriate treatment.
- Ischemia or hypoxia in the fetus. In the first case, we are talking about a violation of blood supply during intrauterine development, in the second - about oxygen deficiency. Such disorders lead to brain damage.
- Intoxication. Reception during pregnancy of potent drugs, smoking or alcohol abuse - all these factors can adversely affect the development of the fetus.
- Infectious damage to the brain and musculoskeletal system. Infection of a newborn with an infection, which often occurs in utero, leads to the development of such ailments as meningitis, encephalitis. The body of the child is not yet formed enough to fight diseases. Therefore, they often lead to complications.
- Physical impact. Exposure to radiation is one of the causes of cerebral palsy in children.
- Mechanical factors. We are talking about birth injuries or mechanical damage immediately after the baby is born.
Little's disease is mainly diagnosed in children of the first year of life.
Clinical picture
A typical manifestation of the disease is considered spastic tetraparesis with lesions mainly of the lower extremities. Muscular hypertonicity, which helps to keep the legs bent and brought to the body, is characteristic of the life of the fetus inside the womb. After birth, it gradually weakens and finally passes to 4-6 months. In Little's disease, hypertonicity does not disappear over time. Its severe forms are noticeable from birth. For example, the baby is passive during swaddling. All attempts to bend or straighten the limbs end in strong resistance due to muscle tone. With a mild form of pathology, the development of the child in the first 6 months is normal.
Hypertonicity is most pronounced in the flexor muscles of the feet and adductors of the thigh. This disease is characterized by a delay in the development of the motor sphere. Children begin to fully walk only to 3-4 years. At the same time, their knees rub against each other. Toddlers walk mainly on toes, with their legs extended.
The pathology of the cranial nerves is represented by strabismus, hearing loss, and smoothness of the nasolabial folds. Dysarthria, hoarseness, and swallowing are also possible. Little's disease is characterized by the following intellectual disorders: delayed speech development, oligophrenia. The latter disorder occurs in 20-25% of patients, but in its severity does not go beyond the stage of debility.
Diagnostic Methods
The pediatric neurologist is involved in the identification and subsequent treatment of Little's pathology. During the diagnosis, much attention is paid to the history of the small patient, the course of pregnancy. Additionally, a comprehensive examination may be required. It consists of the following activities:
- Inspection by an ophthalmologist, otolaryngologist to identify concomitant health problems.
- Electroencephalography. Allows you to evaluate the bioelectric activity of the brain.
- Neurosonography The technique eliminates congenital malformations of the brain, cysts, tumors, and hydrocephalus. It is carried out by means of an ultrasound device through an unclosed fontanel.
- MRI of the brain. It is recommended as an alternative to neurosonography and for patients with a closed fontanel.
As part of the differential diagnosis, consultation with a geneticist, biochemistry of blood and urine is often required.
Therapy Features
Completely cure Little's disease is not possible. Therapy with this ailment is aimed at mitigating muscle damage and preparing the child for adaptation in society. Drug treatment includes taking drugs from the following groups:
- Vascular agents ("Cinnarizine") to improve blood circulation and tissue nutrition.
- Muscle relaxants ("Baclofen") - help stop muscle spasticity.
- Neurometabolites ("Glycine", "Thiamine") - provide the substances necessary for the full functioning of the central nervous system.
- Nootropics ("Piracetam") - activate cognitive functions.
Rehabilitation therapy consists of:
- Massage. Regular procedures improve blood circulation in the affected muscles.
- Physiotherapy. Initially, the exercise is carried out under the supervision of a doctor. Then they can be done at home with parents. The exercise therapy course includes passive and active movements, exercises on special simulators.
- Correction of speech disorders. Speech therapist classes are recommended.
- Swimming. Exercises in water are performed according to a special technique designed for children with developmental disabilities.
Forecast and Prevention
In the absence of timely and high-quality treatment for Little's disease, the prognosis is poor. Only 20% of patients can walk independently, and half of patients are forced to use improvised means in the form of crutches and special supports. The rest remain bedridden for life. With timely treatment, it is possible to achieve the adaptation of the child in society.
As for the issue of prevention, it comes down to following the doctor's recommendations during pregnancy. For example, it is necessary to abandon addictions, to avoid the use of potent drugs. After a child is born, it is important for him to provide quality care.