Детский церебральный паралич: современное состояние проблемы (обзор литературы)

В статье представлен обзор современных данных литературы о факторах риска, эпидемиологии, этиологии, клинической картине, диагностике, профилактике и лечении детского церебрального паралича (дЦП).

детский церебральный паралич – наиболее распространенная патология, приводящая к инвалидности в детском возрасте, с нарушением двигательной функции в результате повреждения центральной нервной системы. При дЦП имеет место широкий спектр расстройств, нарушающий повседневную деятельность ребенка. Кроме того, возможны когнитивные и поведенческие нарушения, коммуникативные проблемы, развитие эпилептических приступов. Ранее считалось, что причиной дЦП является недостаток кислорода при рождении. Однако современные исследования позволили установить, что наряду с этим существует множество других причин и факторов риска, которые в совокупности вызывают повреждение головного мозга в период онтогенеза и способствуют развитию патологического процесса. данный обзор литературы направлен на освещение современных разработок в области дЦП и определение новых путей для последующих исследований в этой области.

1. Бадалян О.Л., Трепилец В.М., Трепилец С.В. Клинический опыт применения зонисамида при структурной фокальной эпилепсии у детей с детским церебральным параличом. Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски 2018;118(10–2):90–7.

2. Зыков В.П., Мурачуева Ф.А., Чебаненко Н.В. и др. Эпилепсия и церебральный паралич: клиническая синдромология, исходы и прогноз. Доктор.Ру 2022;21(7):20–7. DOI: 10.31550/1727-2378-2022-21-7-20-27

3. Мухин К.Ю., Пылаева О.А., Бобылова М.Ю., Чадаев В.А. Генетическая эпилепсия, вызванная мутациями в гене CDKL5, как пример эпилептической энцефалопатии и энцефалопатии развития: обзор литературы и собственные наблюдения. Русский журнал детской неврологии 2021;16(1–2):10–41. DOI: 10.17650/2073-88032021-16-1-2-10-41

4. Мухин К.Ю., Пылаева А.О., Петрухин А.С. Безопасность и переносимость антиэпилептических препаратов у женщин c эпилепсией (обзор литературы и собственные данные). Русский журнал детской неврологии.2018;13(4):7–22. DOI: 10.17650/2073-8803-2018-13-4-7-22

5. Семенова К.А. Восстановительное лечение детей с перинатальным поражением нервной системы и детским церебральным параличом. М.: Закон и порядок, 2007. 616 с.

6. Чебаненко Н.В., Соколов П.Л., Притыко А.Г. Врожденные церебральные параличи, сопровождающиеся эпилепсией: клинико-генетические сопоставления. Русский журнал детской неврологии 2022;17(3):43–54. DOI: 10.17650/2073-8803-2022-17-3-43-54

7. Agarwal S., Scher M.S., Tilton A. Cerebral palsy and rehabilitative care: The role of home-based care and family-centered approach. Indian Pediatrics 2021;58(9):813–14. DOI: 10.1007/s13312-021-2298-z

8. Alves-Pinto A., Turova V., Blumenstein T. et al. The case for musical instrument training in cerebral palsy for neurorehabilitation. Neural Plast 2016;2016:1072301. DOI: 10.1155/2016/1072301

9. Arnaud C., Ehlinger V., Delobel-Ayoub M. et al. Trends in prevalence and severity of pre/perinatal cerebral palsy among children born preterm from 2004 to 2010: A SCPE collaboration study. Front Neurol 2021;12:624884. DOI: 10.3389/fneur.2021.624884

10. Ates F., Brandenburg J.E., Kaufman K.R. Effects of selective dorsal rhizotomy on ankle joint function in patients with cerebral palsy. Front Pediatr 2020;8:75. DOI: 10.3389/fped.2020.00075

11. Badawi N., Mcintyre S., Hunt R.W. Perinatal care with a view to preventing cerebral palsy. Dev Med Child Neurol 2021;63(2): 156–61. DOI: 10.1111/dmcn.14754.

12. Baud O., Trousson C., Biran V. et al. Association between early low-dose hydrocortisone therapy in extremely preterm neonates and neurodevelopmental outcomes at 2 years of age. JAMA 2017;317:1329–37. DOI: 10.1001/jama.2017.2692

13. Boychuck Z., Andersen J., Bussières A. et al. International expert recommendations of clinical features to prompt referral for diagnostic assessment of cerebral palsy. Dev Med Child Neurol 2020;62(1):89–96. DOI: 10.1111/dmcn.14252

14. Brandenburg J.E., Fogarty M.J., Sieck G.C. A critical evaluation of current concepts in cerebral palsy. Physiology 2019;34(3):216–29. DOI: 10.1152/physiol.00054.2018

15. Chandna A., Ghahghaei S., Foster S. et al. Higher visual function deficits in children with cerebral visual impairment and good visual acuity. Front Hum Neurosci 2021;15:711873. DOI: 10.3389/fnhum.2021.711873

16. Chen Y., Fanchiang H.D., Howard A. Effectiveness of virtual reality in children with cerebral palsy: A systematic review and metaanalysis of randomized controlled trials. Physical Ther 2018;98(1):63–77. DOI: 10.1093/ptj/pzx107

17. Cherni Y., Ballaz L., Lemaire J. et al. Effect of low dose robotic-gait training on walking capacity in children and adolescents with cerebral palsy. Neurophysiol Clin 2020;50(6):507–19. DOI: 10.1016/j.neucli.2020.09.005

18. Chollat C., Marret S. Magnesium sulfate and fetal neuroprotection: Overview of clinical evidence. Neural Regen Res 2018;13(12):2044–9. DOI: 10.4103/1673-5374.241441

19. Cottrell M.A., Russell T.G. Telehealth for musculoskeletal physiotherapy. Musculoskelet Sci Pract 2020;48:102193. DOI: 10.1016/j.msksp.2020.102193

20. Da Fonseca E.B., Damião R., Moreira D.A. Preterm birth prevention. Best Pract Res Clin Obstet Gynaecol 2020;69:40–9. DOI: 10.1016/j.bpobgyn.2020.09.003

21. Eliasson A.C., Krumlinde-Sundholm L., Rösblad B. et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: Scale development and evidence of validity and reliability. Dev Med Child Neurol 2006;48(7):549–54. DOI: 10.1017/S0012162206001162

22. Fahey M.C., Maclennan A.H., Kretzschmar D. et al. The genetic basis of cerebral palsy. Dev Med Child Neurol 2017;59(5):462–9. DOI: 10.1111/dmcn.13363.

23. Garfinkle J., Li P., Boychuck Z. et al. Early clinical features of cerebral palsy in children without perinatal risk factors: A scoping review. Pediatric Neurol 2020;102:56–61. DOI: 10.1016/j.pediatrneurol.2019.07.006

24. Gibson N., Blackmore A.M., Chang A.B. et al. Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement. Dev Med Child Neurol 2021;63(2):172–82. DOI: 10.1111/dmcn.14640

25. Graham D., Paget S.P., Wimalasundera N. Current thinking in the health care management of children with cerebral palsy. Med J Australia 2019;210(3):129–35. DOI: 10.5694/mja2.12106

26. Guindos-Sanchez L., Lucena-Anton D., Moral-Munoz J.A. et al. The effectiveness of hippotherapy to recover gross motor function in children with cerebral palsy: A systematic review and metaanalysis. Children 2020;7(9):106. DOI: 10.3390/children7090106

27. Harvey A., Waugh M.C., Rice J. et al. A pilot feasibility study of gabapentin for managing pain in children with dystonic cerebral palsy. BMC Pediatr 2021;21(1):368. DOI: 10.1186/s12887-021-02847-1

28. Horber V., Sellier E., Horridge K. et al. The origin of the cerebral palsies: Contribution of population-based neuroimaging data. Neuropediatrics 2020;51(2):113–9. DOI: 10.1055/s-0039-3402007

29. Hulst R.Y., Gorter J.W., Voorman J.M. et al. Sleep problems in children with cerebral palsy and their parents. Dev Med Child Neurol 2021;63(11):1344–50. DOI: 10.1111/dmcn.14920

30. Hutchon B., Gibbs D., Harniess P. et al. Early intervention programmes for infants at high risk of atypical neurodevelopmental outcome. Dev Med Child Neurol 2019;61(12):1362–7. DOI: 10.1111/dmcn.14187

31. Jayaraman D., Jacob N., Swaminathan M. Visual function assessment, ocular examination, and intervention in children with developmental delay: A systematic approach. Ind J Ophthalmol 2021;69(8):2012–7. DOI: 10.4103/ijo.IJO_2396_20

32. Jin S.C., Lewis S.A., Bakhtiari S. et al. Mutations disrupting neuritogenesis genes confer risk for cerebral palsy. Nat Genet 2020;52(10):1046–56. DOI: 10.1038/s41588-020-0695-1.

33. Jobst C., D’Souza S. J., Causton N. et al. Somatosensory plasticity in hemiplegic cerebral palsy following constraint induced movement therapy. Pediatric Neurol 2022;126:80–8. DOI: 10.1016/j.pediatrneurol.2021.09.019

34. Kim S.J., Kim S.N., Yang Y.N. et al. Effect of weight bearing exercise to improve bone mineral density in children with cerebral palsy: A meta-analysis. J Musculoskelet Neuronal Interact 2017;17(4):334–40.

35. Klobucká S., Klobucký R., Kollár B. Effect of robot-assisted gait training on motor functions in adolescent and young adult patients with bilateral spastic cerebral palsy: A randomized controlled trial. Neurorehabilitation 2020;47(4):495–508. DOI: 10.3233/NRE-203102

36. Labaf S., Shamsoddini A., Hollisaz M.T. et al. Effects of neurodevelopmental therapy on gross motor function in children with cerebral palsy. Iranian J Child Neurol 2015;9(2):36–41.

37. MacIntosh A., Vignais N., Biddiss E. Biofeedback interventions for people with cerebral palsy: A systematic review protocol. Systematic Reviews 2017;6(1):3. DOI: 10.1186/s13643-017-0405-y

38. Medley N., Vogel J.P., Care A. et al. Interventions during pregnancy to prevent preterm birth: A novel review of Cochrane systematic reviews. Cochrane Database Syst Rev 2018;11(11):CD012505. DOI: 10.1002/14651858.CD012505.pub2

39. Mlodawski J., Mlodawska M., Pazera G. et al. Cerebral palsy and obstetric-neonatological interventions. Ginekologia Polska 2019;90(12):722–7. DOI: 10.5603/GP.2019.0124

40. Montoro-Cárdenas D., Cortés-Pérez I., Zagalaz-Anula N. et al. Nintendo Wii balance board therapy for postural control in children with cerebral palsy: A systematic review and meta-analysis. Dev Med Child Neurol 2021;63(11):1262–75. DOI: 10.1111/dmcn.14947

41. Morgan C., Fahey M., Roy B. et al. Diagnosing cerebral palsy in full-term infants. J Paediatr Child Health 2018;54(10):1159–64. DOI: 10.1111/jpc.14177.

42. Novak I., Morgan C., Adde L. et al. Early, accurate diagnosis and early intervention in cerebral palsy: Advances in diagnosis and treatment. JAMA Pediatrics 2017;171(9):897–907. DOI: 10.1001/jamapediatrics.2017.1689

43. Novak I., Morgan C., Fahey M. et al. State of the evidence traffic lights 2019: Systematic review of interventions for preventing and treating children with cerebral palsy. Curr Neurol Neurosci Rep 2020;20(2):3. DOI: 10.1007/s11910-020-1022-z

44. Påhlman M., Gillberg C., Himmelmann K. One-third of schoolaged children with cerebral palsy have neuropsychiatric impairments in a population-based study. Acta Paediatr 2019;108(11):2048–55. DOI: 10.1111/apa.14844

45. Palisano R.J., Avery L., Gorter J.W. et al. Stability of the gross motor function classification system, manual ability classification system, and communication function classification system. Dev Med Child Neurol 2018;60:1026–32. DOI: 10.1111/dmcn.13903

46. Palomo-Carrión R., Romay-Barrero H., Pinero-Pinto E. et al. Early intervention in unilateral cerebral palsy: let’s listen to the families! What are their desires and perspectives? A preliminary family-researcher co-design study. Children 2021;8(9):750. DOI: 10.3390/children8090750

47. Park E.Y., Kim W.H. Effect of neurodevelopmental treatment-based physical therapy on the change of muscle strength, spasticity, and gross motor function in children with spastic cerebral palsy. J Physical Ther Sci 2017;29(6):966–9. DOI: 10.1589/jpts.29.966

48. Patel D.R., Neelakantan M., Pandher K. et al. Cerebral palsy in children: A clinical overview. Transl Pediatr 2020;9(1):S125–35. DOI: 10.21037/tp.2020.01.01

49. Paul S., Nahar A., Bhagawati M. et al. A review on recent advances of cerebral palsy. Oxid Med Cell Longev 2022;2022:2622310. DOI: 10.1155/2022/2622310.

50. Paulson A.V. Overview of four functional classification systems commonly used in cerebral palsy. Children (Basel) 2017;4(4):30. DOI: 10.3390/children4040030

51. Poon L.C., Shennan A., Hyett J.A. et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet 2019;145(Suppl 1):1–33. DOI: 10.1002/ijgo.12802.

52. Rabe H., Andersson O. Maternal and infant outcomes after different methods of umbilical cord management. JAMA 2019;322(19):1864, 1865. DOI: 10.1001/jama.2019.16003

53. Sadowska M., Sarecka Hujar B., Kopyta I. Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatric Dis Treat 2020;16:1505–18. DOI: 10.2147/NDT.S235165

54. Samanta D. Recent advances in the diagnosis and treatment of neonatal seizures. Neuropediatrics 2021;52(2):73–83. DOI: 10.1055/s-0040-1721702

55. Speyer R., Cordier R., Kim J.H. et al. Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: A systematic review and meta-analyses. Dev Med Child Neurol 2019;61(11):1249–58. DOI: 10.1111/dmcn.14316

56. Stavsky M., Mor O., Mastrolia S.A. et al. Cerebral palsy-trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention. Front Pediatr 2017;5:2017. DOI: 10.3389/fped.2017.00021

57. Tanner K., Noritz G., Ayala L. et al. Assessments and interventions for sleep disorders in infants withor at high risk for cerebral palsy: A systematic review. Pediatric Neurology 2021;118:57–71. DOI: 10.1016/j.pediatrneurol.2020.10.015

58. Tebani A., Marret S. Early intervention in cerebral palsy and beyond. JAMA Pediatrics 2021;175(8):785–7. DOI: 10.1001/jamapediatrics.2021.0884

59. Upadhyay J., Tiwari N., Ansari M. N. Cerebral palsy: Aetiology, pathophysiology and therapeutic interventions. Clin Exp Pharmacol Physiol 2020;47(12):1891–901. DOI: 10.1111/1440-1681.13379

60. Ventola C.L. Mobile devices and apps for health care professionals: Uses and benefits. Pharm Ther 2014;39(5):356–64.

61. Vitrikas K., Dalton H., Breish D. Cerebral palsy: An overview. Amn Fam Physician 2020;101(4):213–20.

62. Wassink G., Davidson J.O., Dhillon S.K. et al. Therapeutic hypothermia in neonatal hypoxic-ischemic encephalopathy. Curr Neurol Neurosci Rep 2019;19(2):2. DOI: 10.1007/s11910-019-0916-0