In the first part, you learned what the PPP of the central nervous system is and what is the role of a pediatric neurologist in the treatment of this disease. And one of the syndromes of this disorder is muscular dystonia syndrome.

Here I will focus on the syndrome of increased neuro-reflex excitability. This is a fairly common syndrome in children aged 1-4 months. This syndrome manifests itself in the child's excitability, flinching, throwing hands around, chin trembling, screaming for no apparent reason, sleep disturbance. Such disorders are most often associated with somatic rather than neurological disorders.

A child may cry and worry for many reasons. Intestinal colic is very common in young children. After 1 month, pediatricians and pediatric neurologists recommend giving the child vitamin D, the lack of which can cause excitement. Children can get colds, overheat, or overcooling. The child may scream because he is hungry. And there is even such evidence that children may have a spontaneous unreasonable cry. The experience of a pediatrician is very important here, and, if necessary, consultation of a pediatric neurologist, and, possibly, a surgeon or other specialist. I am often approached with such complaints to exclude an increase in intracranial pressure in a child.

Indeed, there is an increase in intracranial pressure in children, but, firstly, it is very rare, and secondly, contrary to popular belief, with an increase in intracranial pressure, children are lethargic and drowsy, and not excitable. Does a grown man scream when he has a headache? No. But when the stomach hurts, both children and adults will worry and scream. Many more argue that if the child does not sleep well, then this is a sign of increased intracranial pressure. A newborn baby has a naturally immature nervous system. They often have sleep disturbances.

Children do not have a "biological clock" (sleep-wakefulness). They can confuse day with night, they can sleep 15 minutes during the day, etc. Such a “biological clock” is clearly formed in children only after 3 years of age. Experienced pediatric neurologists explain all this to parents at an appointment in the office or when they call at home.

Due to this immaturity of the central nervous system, children may even have seizures. And they can be caused by impaired metabolism of trace elements (magnesium, potassium, calcium), lack of vitamin B6, etc.

Speaking about the immaturity of the nervous system of newborns, I would like to tell you about one more syndrome: the syndrome of vegetative-visceral disorders. Often, to make it clearer for people, children's neurologists in Moscow tell the parents of the child that this is VSD (vegetative-vascular dystonia) in children under 1 year old. This syndrome is characterized by the child's “marbling” of the skin, possible “blue” upper lip, sweating of the arms and legs (although this can also be observed with a lack of vitamin D), “blue” feet, regurgitation and other disorders. I notice that such children react to weather changes, more often to precipitation (snow or rain) or strong winds. Such autonomic disorders do not require drug treatment, but decrease and then completely disappear with age.

Unfortunately, almost every second baby has pathological changes in the nervous system, which is referred to as hyperexcitability in babies. This syndrome is determined at the first visit to a neurologist. However, not all parents are serious about the unusual condition of the child, deciding that over time everything should go away by itself, refusing to give the child the medications prescribed by the doctor.

The syndrome of hyperexcitability occurs with somatovegetative disorders and neuro-reflex excitability, therefore, it cannot be treated indifferently. After a while, more serious disorders of the nervous system may develop, which often manifests itself in a delay in the mental and speech development of the child. The kid can grow up nervous, weather-dependent. Often, a small degree of dysfunction of brain activity is observed, which leads to inattention, hyperreactivity, and the development of epilepsy.

Such children should grow up under the strict supervision of a neurologist, and parents should carefully follow all the doctor's prescriptions. Only then can the risk of complications be reduced.

Causes of occurrence

All the main causes of hyperexcitability in infants depend on the mother's pregnancy. The child's nervous system largely depends on it and is formed while the baby is in the womb.

There is a great dependence on a pregnant woman's intake of a variety of foods, on the sufficiency of oxygen supply, on the emerging stresses and disorders of the nervous system of the expectant mother.

Many babies born prematurely do not have time to fully develop neurons, which leads to this pathology. Complicated childbirth also often affects the state of the baby's nervous system.

The nervous system of infants is well restored with minor pathological changes, but supervision by specialists is necessary. Sometimes it happens that without medication it is not possible to relieve the excitation of the nervous system.

Remember: if left untreated, the pathological symptoms can worsen.

Main symptoms and signs

Parents need to be very attentive to their baby in order to notice the development of pathology in the early stages and consult a doctor in time. Then it will be possible to cure the child without consequences. The syndrome is diagnosed based on certain symptoms and signs.

These include:

• frequent restless behavior of the child, manifested by flinching and waking up at the slightest noise;
• poor falling asleep and poor sleep;
• weak sucking and frequent regurgitation of food;
• tearfulness;
• weak muscle tension;
• tremor of the chin and arms.

In addition to the listed signs, pathologies of the child's body system are observed, associated with disturbances in the work of nervous-regulatory processes:

• the child often sweats;
• when crying, the nasolabial triangle turns blue;

• pulse quickens;
• irregular stools with alternating constipation and diarrhea;
• the skin becomes marbled.

As soon as mothers notice these symptoms, they must definitely react: pay the attention of a pediatrician and visit a pediatric neurologist.

What treatment is prescribed and what to do for parents

Before starting treatment, the neurologist establishes the causes of the child's hyperexcitability. If the nervous system is damaged while the fetus was in the womb, soothing baths are prescribed at birth. Decoctions of herbs with a sedative effect, mineral solutions are added to the water. Physiotherapy can be prescribed with an apparatus - electrophoresis, physical education and paraffin heating.

To cure this syndrome, parents will need a lot of time and patience: the result will be noticeable only by 4-6 months.

To restore the baby are useful:

• walks in the open air;
• taking soothing herbal decoctions;
• prolonged sleep in a calm environment.

It is necessary to protect the child from everything that can irritate him: family scandals, loud conversations, screams, noises.

Among the medications for treatment, drugs are prescribed that relieve tremors of the limbs and chin. If the child does not fall asleep well and sleeps, it is recommended to give sedatives before bedtime.

To relieve hyperexcitability, which takes a lot of energy from children, neurologists recommend carrying out hardening procedures that strengthen blood vessels, and autonomic disturbances gradually stop.

Massage

For any disorders associated with the nervous system, massage is prescribed. It can be done by a specialist, but many mothers can do it on their own, having received a little consultation from a masseur or pediatrician.

The massage should be done at the same time every day. It will be useful for the child, as it is a relaxing and restorative procedure that relieves the symptoms of hyperexcitability, and at the same time it is a pleasant tactile contact between mother and child.

It is important to choose the right time for the procedure. The first half of the day is best when the baby is awake. Massage is recommended before feeding, about half an hour. If he has to after a meal and the child does not sleep, then you need to wait 1 hour and only then start the procedure.

Basic techniques

The first massage should last 5 minutes and stop as soon as the child's dissatisfaction is noticeable. Over time, the baby will get used to it, then the duration of the massage should be 30 minutes.

Massage is best done on a changing table, in a ventilated area, but the temperature should not drop below 22 ° C, that is, it is necessary to create comfortable conditions for mother and child.

In the first months, you just need to lightly stroke the child, the movements can be shown by the visiting nurse. It is desirable to carry out stroking, starting from the tips of the fingers to the shoulder, from the foot to the groin. Then stroke the tummy: the direction of the hand should only go clockwise. The chest is stroked, directing the hands from the bottom to the neck: from the center to the armpits.

The baby is laid out on the stomach for 2 minutes, the back is stroked. The reflexes of the newborn are then tested. To do this, put their hands on the feet, and the child begins to crawl, as it were. They put the baby on the side, alternating between the right and the left, and run a finger along the spine: the child should arch his back. Then you need to press near each toe on the foot, they should bend at the same time.

It must be borne in mind that there are certain areas in the child that cannot be touched so as not to injure them. These include: nipples, groin, genitals, navel, joints. It is not recommended to massage babies with damage to the skin and irritation, if it is unpleasant for the child at this time. In this case, it must be rescheduled for another time.

If the hyperexcitability syndrome has a serious form, then the child will always have to be under the supervision of many specialists: a neurologist, psychologist, speech therapist, chiropractor and massage therapist. Regardless of the causes of the pathology, it is recommended that the child be given mild sedatives and vitamins.

9 Feb 2014

The syndrome of neuro-reflex excitability

Syndrome of increased neuro-reflex excitability (hereinafter referred to as SNRV) refers to neurological disorders. It is diagnosed in children from birth to one year. The diagnosis can be made by a neurologist based on examination and some research. Mostly SNRV is diagnosed in children under 3 months of age.

Often this syndrome is not detected on time, since consultation with a neurologist is not mandatory after the birth of a child. In this article, we will look at the main signs of RADS and show you how not to miss out on timely treatment.

First of all, every mother should understand that a healthy child needs little - food, sleep, comfort. A week after being discharged from the hospital, the newborn is already getting better, and you will see how much he sleeps, how often he eats, how long he is awake. If the child is well-fed, dry, and does not want to sleep, he should not cry. The cry of a newborn is not a whim, but a signal of discomfort.

Children with RADS do not sleep much and are difficult to feed and reassure. They react painfully to any touch, often flinch .. These are the first signs that you should pay attention to.

It is necessary to observe the child's motor activity. If at least one of the following clinical symptoms is found, the baby needs to be shown to a specialist. Site-specific site

The syndrome occurs as a result of damage to the child's nervous system perinatally. Various factors can contribute to this, such as:

• hypoxic disorders during intrauterine development;
• complications during childbirth (placental abruption, bleeding, asphyxia, etc.);
• cesarean section;
• drug addiction of the mother;
• multiple pregnancy;
• diseases of the mother during pregnancy (infections, diabetes).

Clinical symptoms of SNRV:

• sweeping movements of the limbs;
• decreased sucking reflex;
• chin trembling;
• poor sleep;
• throwing the head back;
• tremor of the limbs;
• frequent crying;
• increased tendon reflexes;
• motor restlessness;
• long glance at one point.

Based on what is the diagnosis

During a visual examination by a specialist, the child tenses, a high-pitched cry appears. Anxiety is manifested, convulsions are often noted. In response to stimuli (sounds, light, loud voices, touch, changes in body position), the motor activity of the muscles increases.

Muscle tone, spasms are manifested. Intracranial pressure may be increased. The specialist will check the compliance of the child's behavior with his physical development.

Sometimes the child is so agitated that it is impossible to calm him down. In this case, the presence of other lesions of the nervous system is likely (syndrome of motor disorders, syndrome of delayed psychomotor development, vegetative-visceral dysfunction, hypertensive-hydrocephalic syndrome, etc.)

With an insufficient number of visual signs, an additional study is prescribed - neurosonography. This is an ultrasound scan of the child's brain, which does not carry radiation exposure to the body. This diagnostic method has no contraindications.

SNRV treatment

Appointed by a neurologist. Does not require hospitalization, includes conservative methods.

1. Massage. It is one of the most effective treatments. An acupressure, general, relaxing massage can be prescribed. The main action is aimed at reducing muscle tone and general excitability.

For children, it is best not to use aromatic oils for massage, as they can cause allergies. Better to do with baby cream or special baby oil, allowed from birth. The massage should be performed only by a specialist, preferably within the walls of the clinic.

1. Preparations to improve cerebral circulation. Newborns are usually given drugs in the form of a suspension. Some drugs are available in the form of pills or tablets - in this case, they need to be crushed and mixed with breast milk or water. The dosage is calculated according to the weight of the child.
2. Setting the mode. Any specialist will confirm that the daily routine is the basis for the normal development of the child... For children with disorders of the central nervous system, adherence to the regimen is necessary for therapeutic purposes. Infants cannot control their rest due to imperfect nervous systems. Sleep should be by the hour, walks in the fresh air are required.
3. Swimming, gymnastics. Time consuming but effective method. Its essence lies in the daily supply of the correct impulses to the brain. Performing physical activity, the brain "gets used" to process more information, and against the background of drugs it starts to work faster. Thus, damaged tissues are restored faster.

The benefits of water are invaluable: it relaxes tense muscles, and weakened ones - tones up. Spasms are relieved, metabolism is stimulated, blood circulation is improved. Water relieves stress, has a hardening effect, which is especially useful for newborns.

It is better to swim with a child in the pool, according to a specific program for the little ones. A specially trained trainer will help you do the exercises in the water, which you can then repeat at home. The method of temperature difference is effective: gymnastics in water of different temperatures gives positive results 2 times faster.

A child cannot perform gymnastics on his own. You will need the help of a massage therapist or a pediatric specialist.

1. Aromatherapy. Natural oils can be prescribed with caution to neutralize excessive excitability. It can be lavender, geranium, marjoram, mint. For very young children, diluted, non-concentrated oils are used.

Dose the oil carefully, 1-2 drops at a time. To do this, it is better to purchase an aroma lamp and place it in the room where the child is. It is strictly forbidden to add essential oils to baby bathing water - they can cause burns!

1. Herbal baths. It can be a herbal or a specific plant. Chamomile, string, mint, lemon balm, hawthorn, pine are widely used. Children's skin is highly permeable due to the abundance of nerve endings, so the healing properties of plants penetrate into it instantly. The water temperature for newborns should be 36-37 degrees. The course is 10-15 procedures.
2. Prescribing diuretics. It is justified in case of increased blood pressure in a child. Additionally, drugs with potassium are prescribed.

Any method of treatment must be followed by a course. Therapy usually involves a combination of medications with functional methods. The implementation of all the recommendations usually gives a visible result. At one year of age, the symptoms of CHRV usually no longer appear.

There is a myth that this neurological syndrome goes away on its own, regardless of the treatment. This is not true. SNRV is a malfunction of the nervous system, and ignoring treatment can lead to a number of complications in the future.

The main complications of ROS include:

• the development of vegetative-vascular dystonia at an older age;
• frequent headaches;
• attention deficit disorder;
• hyperactivity.

These ailments have a significant impact on the mental health of the child, and can cause problems in kindergarten and school. Untreated syndrome leaves a mark in the cells of the central nervous system, and its development is inhibited. By increasing the load, the nervous system will cease to cope and will periodically block information.

SNRV, a syndrome of increased neuro-reflex excitability, is a neurological disorder that is quite common in babies in the first year of life, especially up to 3 months of age. Such children are restless, sleep little, fall asleep poorly and suckle sluggishly. They often flinch, worry and cry at any touch, and it can be difficult to calm them down.

Very often, the syndrome is not detected on time, since consultation with a pediatric neuropathologist is not included in the list of mandatory ones. Therefore, it is better for parents who notice symptoms of increased excitability in their baby to show him to a specialist as soon as possible. This will help to avoid deterioration of the condition in the future, namely: the development of hyperactivity syndrome and even epileptic syndrome. When the correction of the NRVD is started on time, the baby's condition is normalized by the age of one year.

Why does it develop, how does the syndrome of increased excitability manifest itself in infants, how is it carried out? Let's talk about it:

Causes of the hyperexcitability syndrome in infants

Most often, this condition is diagnosed in babies who have experienced oxygen starvation or hypoxia even before birth or during childbirth.

A great influence on the work of the baby's brain, the state of his nervous system is exerted by the state of health of the mother during pregnancy, as well as himself immediately after birth. These are, first of all, various infectious diseases.

Also, risk factors for the development of this syndrome include: experiences, stress of the mother during pregnancy, severe toxicosis, rapid childbirth.

SNRV in infants - symptoms of hyperexcitability in infants

During communication with the parents' baby, as well as during a medical examination, when they touch him, they turn him, they talk to him, he starts screaming loudly. At the same time, the cry is high-pitched, irritated. In addition, he shows motor restlessness, shudders, tremors of the limbs and chin are observed.

In addition, the syndrome of increased excitability in infants manifests itself in increased muscle tone. With nervous excitement, he throws back his head, the movements of the arms and legs become large-sweeping. Convulsive syndrome is expressed by various paroxysmal phenomena.

It is difficult to calm the baby, he does not fall asleep well, sleeps a little, does not suckle well. Often, parents notice that he just lies there with his eyes open and looks at one point.

Correction methods

The need for corrective measures is determined, developed by a specialist neuropathologist. Before this, the baby is examined in order to exclude other diseases that cause similar symptoms. Such pathologies include, among other things, increased intracranial pressure in a child. The condition is also often manifested by anxiety, sleep problems, and frequent crying.

When confirming the diagnosis of SAD, the doctor will determine the measures your baby needs, and the drug will not necessarily be prescribed. Prescribing drugs depends on the condition of the child and is always individual.

Traditional methods of correction include:

Massage (general, acupressure or relaxing). This very effective method helps to reduce muscle tone and reduce nervous irritability. The course of therapeutic massage is carried out only by a specialist. For classes, you will need to visit a children's clinic or other medical institution.

Swimming and gymnastics. Exercise in the water is very beneficial for a child, especially with CHSD. Swimming trains muscles, reduces their tone, relaxes. Gymnastics trains the baby's brain by directing the correct impulses to it. When performing exercises, its damaged tissues recover faster and more actively. Remedial gymnastics is carried out under the guidance of a specialist in a polyclinic.

In addition, the child should establish a daily routine. In general, this is a simple but extremely effective method for promoting the normal development of a child. With the syndrome of hyperexcitability, it is also used for therapeutic purposes. Hours for sleeping, playing, eating, walking in the fresh air, etc. should be determined. The attending physician will help to develop the correct regimen.

Medication of increased excitability in infants

Sometimes it is necessary to carry out medical correction of increased excitability in infants. Prescribe magnesium preparations, soothing herbs, for example, motherwort or valerian, vitamin B6. According to indications, drugs are used that improve cerebral circulation.

When diagnosing increased intracranial pressure, the doctor will prescribe diuretics, drugs containing potassium. Naturally, in age-appropriate dosages.

Usually, dosage forms in the form of suspensions are prescribed for infants. If the drug is produced only in tablet form, the required amount of pills is crushed and then mixed with water, breast milk or infant formula.

People's increased excitability in infants

Healing baths with infusions and decoctions of medicinal plants give a good soothing, relaxing effect. The baby's skin is permeated with nerve endings and quickly absorbs all the beneficial substances contained in plants. These baths are recommended to be taken before bedtime.

Bathing water temperature should not exceed 36-37 degrees. Therefore, always use a thermometer. The course of treatment is 15 procedures.

For example, here's a good healthy recipe:

Finely chop 50 g of calamus roots and 20 g of willow bark, mix. Combine with 20 g of dried juniper berries. Pour everything into a large saucepan. Top up with 3 liters of boiling water. Simmer with a light boil for 15 minutes. Then insulate, wait until it cools. Pour the cooled broth through cheesecloth into a prepared bath of water. The duration of the baby's bath is 10 minutes.

In addition to this collection, it is useful to make baths with infusion of mint, chamomile, string, decoction of pine needles. A bath with sea salt will well relax and soothe. The possibility of using therapeutic baths for your baby, be sure to discuss with the doctor.

In conclusion, it should be noted that any corrective technique usually includes a whole range of different measures. If there is such a need - with the inclusion of medicines. If all the recommendations of the attending physician are followed, the symptoms of CHRV disappear without a trace already by the age of one year and the baby does not bother more.