THERAPEUTIC AND PREVENTIVE ASPECTS OF DENTAL PROBLEMS OF CHILDREN WITH CEREBRAL PALSY

Abstract

According to the classification of Semenov K.S. (1973), Ford (1952), Futera D.S. (1955) and Zucker M.B. (1962), five forms of cerebral palsy are distinguished: double hemiplegia; spastic diplegia (Little's disease); hyperkinetic form; hemiparetic or hemiplegic form; atonic-astatic form. Bilateral hemiplegia is the most severe form of this disease and occurs in 12-15% of the total number of patients with cerebral palsy. Bilateral hemiplegia is characterized by the absence or even almost complete absence of the controlling influence of the cortex on subcortical root mechanisms. The activity of the latter is usually pathological in nature and determines the main clinical symptoms of double hemiplegia: muscle rigidity, absence or sharp restriction of voluntary motor skills, which does not repeat in the first weeks of life and turns into pathological tonic reflexes - labyrinthine, cervical symmetrical, asymmetric tonic and many other reflexes. Patients with cerebral palsy in the form of double hemiplegia usually do not have basic skills not only walking, but also self-care. Symptoms of pseudobulbar palsy are almost always present, which makes it difficult to chew and swallow food. In 50-70% of cases, diencephalic, gravitational, and hyperkinetic syndromes are detected. Mental development is minimal, there are pronounced speech disorders. Speech disorders in the form of dysarthria were observed in 80% of patients with spastic diplegia, mental disorders occurred in about 50% of patients. Spastic diplegia may be accompanied by diencephalic traction or hyperkinetic syndromes. At the same time, athetoid or choleretoid hyperkinesis was more pronounced in the fingers and facial muscles. An urgent task is to organize the joint work of specialists of different profiles in order to increase the level of multidisciplinary therapeutic, preventive and rehabilitative care for this category of patients. The complexity of carrying out therapeutic, preventive and rehabilitative measures in children with cerebral palsy is associated with the presence of various syndromes of central nervous system damage. Early dysontogenetic damage to the motor analyzer at an early age is accompanied by generalized spasticity. Children with cerebral palsy have impaired motor function formation, coordination of subtle, differentiated movements, so it is difficult for such children to take care of the oral cavity [1.3.5.7.9]. A correlation was revealed between the pathology of the dental system and the delay in the neuropsychiatric development of the child.