What is cerebral palsy in children?

Children's cerebral palsy is the abbreviation of cerebral palsy, which refers to the disease that children develop into paralysis due to non-progressive central motor dysfunction caused by various reasons (such as infection, bleeding, trauma, etc.). ). Severe cases are accompanied by mental retardation. Epilepsy, limb spasm and visual, auditory and language dysfunction. clinical symptoms

1. Central dyskinesia: It is characterized by slow motor development and obviously lags behind children of the same age. Only when the child has difficulty in raising his head, turning over and sitting can he be found by his parents. The limbs of sick children rarely move, especially the lower limbs, which are often characterized by hemiplegia, bilateral paralysis and quadriplegia. Because of the difficulty of voluntary movement, stiff and uncoordinated movements, abnormal movement patterns often appear. 2. Abnormal muscle tension and posture: When there are lesions in the extrapyramidal system or basal ganglia, the main manifestations are abnormal movements, enhanced exercise, hand and foot peristalsis, chorea and myotonia; Ataxia and hypotonia occurred in cerebellar lesions; Muscle stiffness, tremor, etc. It happens when the brain is extensively diseased.

Early symptoms

Through the five symptoms of 1, prenatal, intrapartum and postpartum, children's cerebral palsy can be found at an early stage and the high-risk factors of cerebral palsy can be found. Such as infection during pregnancy, rubella, severe pregnancy-induced hypertension, asphyxia at birth, premature infants, severe jaundice, intracranial hemorrhage after birth, etc. 2, the child is difficult to feed after birth, such as sucking weakness, crying weakness or crying more, easily frightened. 3, too quiet, less active exercise. 4. Sports development is backward. For example, children from 3 months to 4 months can't stand upright or look up unsteadily in prone position, and can't support the load with their forearms after 4 months. When standing, they touch the ground with their toes or cross their lower limbs too straight. 5. Abnormal muscle tone and posture often occur, such as adduction of two fingers, clenching fist, forearm pronation, head and neck backward, etc. Experts remind that if parents find that their children have the above symptoms, they should immediately go to the hospital for screening and diagnosis, and conduct intelligence tests if necessary.

(a) physical examination in addition to the general physical examination, should pay attention to the presence of superficial lymphadenopathy, as well as specific nervous system examination, combined with medical history and focus. If saddle lesions are suspected, the visual field should be carefully examined, and the hearing and vestibular function should be paid attention to in cerebellar lesions. Patients with unconsciousness should have a nervous system examination as much as possible, including fundus examination. The localization signs of nervous system are the main basis for tumor localization; Some parts, such as frontal lobe and intraventricular tumors, have no obvious signs of localization and need to be correctly located according to other special examinations. (2) Special test of1. X-ray skull plain film can provide evidence and location of increased intracranial pressure. 2. Ultrasonic examination: the midline wave deviates to the healthy side. B-mode ultrasound can show the size of the occupying lesion. 3.CT and MRI scanning: it can scan different images of specific internal structures and brain tissues at all levels to increase the density of lesions. 4. Radioisotope brain scan shows isotope concentration. 5. EEG examination: The positive rate of supratentorial tumor localization is high, and slow waves appear in the cortex of the lesion area. 6. Angiography: It can be used for localization and qualitative diagnosis. 7. ventriculography: it is suitable for tumors located in the midline, indoor life and posterior cranial window. According to the clinical manifestations, combined with the choice of examination, a diagnosis can generally be made.

Principles and methods of treatment

1) comprehensive rehabilitation: such as exercise therapy, including large amount of exercise, small amount of exercise and balanced and coordinated training; Such as crawling, purposeful recognition (nose, ears, etc. ), grasping training, holding training, sitting up, swinging, walking (back against the wall, facing the wall), moving in place (bending down to pick up things, lifting feet training, standing alone, jumping in place), walking, running; Another example is physical therapy, including nerve electrical stimulation therapy, hyperthermia and hydrotherapy; There is also occupational therapy, that is, ability training. Now this kind of specialized hospital or clinic is also available in cities, and families with good economic conditions can choose it, but the effect is average. Modern medical methods are as follows: 1. Operation; 2. orthosis; 3. Water, electricity, light and sound therapy; 4. Language and communication therapy; 5. Treatment of motor function; 6.ADL training 2) drug therapy: oral or injection of related drugs: brain nerve nutrition drugs, muscle relaxants, blood circulation drugs, etc. Including drugs for constructing and repairing brain tissues (cells), such as lecithin (including phosphatidylcholine, cephalin, sphingomyelin, etc. ), 0. 1g/ 1 tablet each time, three times a day, can repair brain cell membrane damage caused by trauma, hemorrhage, hypoxia, protect nerve cells, accelerate nerve excitation conduction, and improve learning and memory function. You can also choose drugs that can promote DNA synthesis of brain cells, promote oxygen utilization rate of brain cells, improve energy metabolism of brain cells, enhance brain function, supply various amino acids needed for brain tissue repair and regeneration, and regulate brain nerve activity; Such as gulixi (brain enzyme hydrolysis tablets), each time 1-2 tablets, three times a day; Spirulina tablets (capsule) 1-2 tablets, three times a day. Then actively take multivitamins, such as 2 1- gemcitabine, once 1 tablet, twice a day 1-2 times. Conditional hospitals can alternately choose the following injections (with the same effect as tablets): cerebrolysin, brain polypeptide, acetylglutamine, cytidine diphosphate choline, etc. 3) Selective posterior rhizotomy (referred to as SPR operation) is a very effective method to treat spastic cerebral palsy. 1978 was founded by an Italian surgeon and soon became popular all over the world. Because the upper motor neurons in the cerebral cortex can't control the activity of the lower motor neurons after injury, some nerve fibers are the main reason for the increase of muscle tension. Therefore, SPR surgery is to find and remove these nerve fibers by using modern electrophysiological technology and microsurgical technology, so as to stabilize the overactive reflex arc and improve spasm. The success rate is about 50-80%. Rehabilitation training and muscle strength balance coordination training should be carried out after operation. The indications for this operation are simple spastic cerebral palsy, aged 5-7 years old, with normal intelligence, muscle tone above grade 3, certain motor control ability, and no hypotonia, hand and foot peristalsis, ataxia and muscle contracture. 4) Chinese medicine therapy: including acupuncture therapy (cerebral palsy with high muscle tension should be used with caution); Massage therapy; Chinese medicine therapy. 5) Insist on family rehabilitation training, and pay attention to the following points: keep the correct posture. When children have good trunk control and eating ability, they can systematically start language training and keep their eyes high during conversation. If the position is too high, the child's whole body will be overstretched, which is not conducive to pronunciation. Increase the number of conversations and activities. Parents should not lose confidence because they don't get a response when talking to their children. They should take advantage of every opportunity to talk to their children. When playing games with children, they were trained in breathing and vocalization, which aroused children's interest in training through entertaining. To encourage children to speak, we should pay more attention to the enthusiasm of encouraging children to speak and help them establish confidence in speaking; When a child speaks, he should respond immediately and inspire him to express what he wants to say. Never criticize or blame children. Education should be persistent, language correction and training are long-term and arduous, and parents should have great patience and perseverance. Only by perseverance can we gain something and lay a good language foundation for children with cerebral palsy with language barriers. Don't protect children too much, don't give up without pity, don't compare with other children, and encourage children's centers to participate in games and activities.

Acupuncture physiotherapy

1. Acupuncture has a certain effect on mild illness and can improve symptoms, so attention should be paid to early treatment. 2. At the same time of acupuncture treatment, functional training and intellectual training should be strengthened.

Daily life training

Daily life activities are the most fundamental activities for people to maintain their lives. According to the opinion of the Japanese Rehabilitation Medical Association, ADL in a narrow sense refers to people's self-care activities in family life, such as eating, changing clothes, plastic surgery, going to the toilet, taking a bath, etc. As well as changing posture on the bed, shifting between the bed and the chair, walking and other mobile activities. Broadly speaking, ADL also includes some activities related to ADL, such as housework, transportation and so on. Daily life activities are the most fundamental activities for people to maintain their lives. According to the opinion of the Japanese Rehabilitation Medical Association, ADL in a narrow sense refers to people's self-care activities in family life, such as eating, changing clothes, plastic surgery, going to the toilet, taking a bath, etc. As well as changing posture on the bed, shifting between the bed and the chair, walking and other mobile activities. Broadly speaking, ADL also includes some activities related to ADL, such as housework and transportation. In ADL, people have the following common basic movements, such as moving posture, sitting alone, sitting, standing and walking for upper limbs and hand activities. Children with cerebral palsy usually have many ability defects. In sports rehabilitation, ADL training is also needed to promote the recovery of the above sports functions. ADL training enables patients to combine the above actions in real life environment and apply them to real life. It can not only promote the rehabilitation effect of both, but also enable patients to finally achieve the purpose of self-care. At present, ADL training has been listed as an important goal of rehabilitation medicine. ADL training should not be ignored in the rehabilitation of children with cerebral palsy.

Matters needing attention in family medication

(1) Pay attention to drug interaction: When two or more drugs are taken at the same time, they can interact with each other, sometimes reducing the curative effect of one of them or causing adverse reactions. Such as penicillin and tetracycline, its antibacterial effect is not as good as that of single use. Taking oxytetracycline and other intestinal bactericidal drugs at the same time will make the whole intestine ineffective, because the whole intestine is a Bifidobacterium preparation, which can adjust the imbalance of intestinal flora. Therefore, if you want to take several drugs at a time, you should do it under the guidance of a doctor or pharmacist to avoid failure due to the interaction of drugs. (2) master the dose: the dose must be taken. Excessive use will cause adverse reactions and even death. If the elderly and children don't pay attention to the dosage of antipyretics, their body temperature may drop suddenly due to excessive sweating, causing collapse. (3) Pay attention to the method of taking medicine: In addition to the time and frequency of taking medicine, we should also pay attention to the method. Most drugs are swallowed, but some drugs, such as yeast tablets, should be chewed before swallowing. For example, nitroglycerin tablets should be taken sublingually, which can ensure the curative effect without damaging the liver. First of all, before the diagnosis, it is best not to use drugs casually. Symptoms are often one of the basis of disease diagnosis, and random medication will cover up symptoms, leading to difficulties in diagnosis and even misdiagnosis.

Four-part therapy

Nerve repair+traditional Chinese medicine research characteristic therapy+modern rehabilitation technology+family rehabilitation guidance = encephalopathy rehabilitation. "Four-part therapy" is a new therapy for children with cerebral palsy at home and abroad. Most patients with cerebral palsy can take effect in a short time, and they are expected to recover after 2-5 courses of treatment. Four-part therapy has created a new field in the treatment of cerebral palsy in children, especially for severe cerebral palsy with long-term increased muscle tension and ineffective treatment by other therapies. Four-part therapy can be effective in a short time, which is beyond the reach of other treatment methods at home and abroad. 1. Nerve repair 1, biotechnology therapy 2, acupuncture, massage therapy 3, modern rehabilitation technology 2, TCM treatment methods unique to TCM research 1, TCM dredging therapy 2, meridian conduction therapy 3, small needle knife acupuncture therapy 4, water acupuncture therapy 5, scalp acupuncture, body acupuncture, ear acupuncture, point acupuncture, magnetic round acupuncture and other acupuncture therapies 6.

[Edit this paragraph] Health care

Family diet of children with cerebral palsy

Children with cerebral palsy are prone to illness due to physical defects. Therefore, it is very important to have a reasonable diet and pay attention to nutrition. From years of clinical experience, we have summarized five essentials of diet for children with cerebral palsy, which are as follows: five essentials 1, food should be easily digested and absorbed, and food with high protein content should be selected. Protein is the foundation of intellectual activities, which is closely related to brain memory and thinking. Milk, soybean milk, eggs, yogurt, meat, etc. Are all foods rich in protein? Choose foods with high vitamin content, because vitamin A can enhance the body's resistance and promote the development of the brain. Vitamin B can improve various metabolic functions of the body, enhance appetite, and vitamin D is helpful for the absorption and utilization of calcium. 2, with rice, pasta, steamed bread, porridge, flour and other carbohydrates as the staple food, too much omnivorous food will affect appetite and cause malnutrition. 3, to eat more fruits and vegetables, eat less fat fat, fruits and vegetables contain vitamins and fiber, can keep the stool unobstructed, such as children don't eat vegetables, you can chop vegetables, make steamed stuffed bun, jiaozi, puree, soup, education children to develop the habit of eating vegetables. 4, the diet should be timed, generally eat once in the morning, at noon and at night. If conditions permit, you can add a snack in the afternoon and eat it on time, which can increase your appetite. 5, daily outdoor activities should be properly carried out, so that the sun shines on the skin, which can increase appetite and help absorption. Five don't 1, don't eat fried, spicy, greasy, spicy food and indigestible food. Because the child's constitution is hot, eating spicy and irritating foods such as fried foods is easy to cause fever. 2, it is not appropriate to overeat and warm up, because the child is pure yang, only suitable for nourishing and moistening food. 3, don't eat too much sugar, because the bacteria in the mouth will ferment sugar, which is easy to tooth decay and affect appetite. 4, don't be partial eclipse, because partial eclipse will cause malnutrition. 5, don't eat too much ginger, onion, monosodium glutamate, pepper, wine and other condiments. Steps of standing training for children with cerebral palsy: 1. One knee standing training; 2. Knee standing training; 3. One-knee standing conversion training; 4. Help station training; 5. Posture conversion training; 6. Standing posture control training; 7. Pelvic control training; 8. Training from sitting posture to standing posture; 9. Conversion training from standing posture to sitting posture. Characteristics of children with flaccid cerebral palsy An obvious feature of children with flaccid cerebral palsy is dyspnea. Children's respiratory function is impaired, which always makes people feel that children's own respiratory movement is shallow and weak, and their cough is weak, which is prone to respiratory obstruction, so the incidence of respiratory diseases in such patients is relatively high. An obvious feature of children with flaccid cerebral palsy is dyspnea. Children's respiratory function is impaired, which always makes people feel that children's own respiratory movement is shallow and weak, and their cough is weak, which is prone to respiratory obstruction, so the incidence of respiratory diseases in such patients is relatively high. Children with flaccid cerebral palsy are prone to difficulties in sucking, swallowing and eating due to low muscle tone. Generally speaking, children with flaccid cerebral palsy are slow to respond to the outside world. Because of low muscle tension, low anti-gravity ability and low ability to maintain a certain posture, it is difficult for children to raise their heads and trunks and support their limbs, so most of these children like to use supine position. In supine position, his upper and lower limbs are in abduction and external rotation state, and his head leans to one side, which looks like a frog, commonly known as frog posture. Flaccid cerebral palsy is actually only a stage of special performance. Generally, after 2-3 years old, most children may turn into hand and foot peristalsis and spasms, and some may turn into ataxia. In addition, due to the lack of anti-gravity ability and low voluntary movement ability of patients with flaccid cerebral palsy, flaccid cerebral palsy has almost no function of maintaining posture, and this child's muscle tension changes greatly. When there is no external stimulus, the child is completely paralyzed; However, once the child is suddenly stimulated by the outside world or influenced by some factors, the child's muscle tension will immediately increase rapidly, resulting in hypertonia. At this time, it is mainly the extensor muscles of the back, showing a state of resisting the tension of the horn arch.

[Edit this paragraph] Evaluation of motor dysfunction

1. Assessment of motor developmental disorders There is a certain time and sequence for normal children's motor and posture development, such as lying flat and raising their heads for 2-3 months, and reaching out and touching things with a toy in each hand for 4-5 months. Can sit up with one hand or both hands for 6-7 months. You can climb in 8- 10 months. 1 year old can stand alone, 1 year old-1 year old can walk alone. You can run at the age of two. I can ride a tricycle when I was three years old. You can climb a ladder at the age of four. Patients with cerebral palsy generally can't get in touch with normal children, or show a decrease in active activities at the above age stage. 2. Evaluation of Muscle Tension and Joint Mobility There has always been continuous muscle tension activity in human muscles and muscle groups. Under normal circumstances, the change of muscle tension is limited, otherwise the human body will lose the possibility of exercise. Muscle tension mechanism of cerebral palsy is impaired. Students show a high or low muscle tension because of overreaction or late reaction. This determines the importance of evaluating children's muscle tension. Abnormal muscle tension affects the range of motion of joints. When muscle tension increases, it produces a greater sense of resistance to joint activities. Limb swing is small and joint flexion and extension are limited. On the contrary, when the muscle tension is reduced, the movable joints have no resistance, the limbs swing greatly, and the joints flex and stretch excessively. In addition, the degree of muscle tension can be indirectly understood through the following joint activity. Children are supine, with their heads and bodies centered. A. adduction angle: the patient's lower limbs are straight and abduct to the maximum, and the angle between the two thighs. B. Popliteal angle: the angle between the leg and the calf when a child lifts one leg straight. C dorsiflexion angle of foot: passive dorsiflexion of ankle joint, the angle between instep and calf. D. Heel ear test: pull the child's side. Normal children's range of joint motion adduction angle, range of joint motion popliteal angle and foot dorsiflexion angle1-March 40-8080-10060-704-June 70-1090-12060. 010-160 60-7010-65438+February130-150170 60 The commonly used methods are: a. Finger nose test: children straighten their arms at any position, and then touch the tip of the nose with their forefinger. It is difficult to accurately complete the finger pointing test when there is ataxia. B. Finger pointing test: Patients in any position point their thumbs at their fingers in turn, which is difficult to complete accurately in case of ataxia. C. Wheel arm movement: rapid and repeated forearm pronation and supination movement, which is difficult to complete accurately when ataxia occurs. 4. The evaluation of primitive reflex and automatic response is very important, and the level of nerve development and motor development can be judged through examination. It is the basis of guiding training. Original reflection evaluation. A. Tension labyrinthine reflex: the head is in the middle position and the upper and lower limbs are extended. When lying on your back, your head leans back, and the tension of the whole body extensors increases, showing a "stretching mode". When prone, the head bends forward, the limbs bend, and the tension of the whole body flexors is "buckling mode", which is positive and disappears in March and April. Persistent positive will hinder the normal sports development of children. B. Tension neck reflex (TNR) (1) ATNR: supine, with head centered, limbs straight, and head turned to one side. The positive performance is that the face extends to the lateral limb and the pillow bends to the side. Disappeared in March-April (1) STNR: prone, head and neck flexion, back extension as far as possible, upper limb flexion and lower limb extension when flexion, upper limb extension when back extension, lower limb flexion is positive and negative. It turns cloudy in about 5 months. If TNR persists, it will affect the motor development, balance ability and head-up ability of children's limbs. C. Holding reflex: Stimulate the child's palm to make the child's fingers bend and hold quickly, and this reflex disappears in 2-3 months. D. Cross stretching reflex: supine, with the head as the center, let one lower limb bend and then stretch, and the positive performance is that the other lower limb is reversed, and the 1-2 month reflex disappears. B automatic response evaluation automatic response evaluation includes righting reaction, equilibrium reaction and protective stretching reaction. The righting reaction, also known as righting reaction, is a reaction that children immediately return to normal posture and posture when their head, neck, trunk and limbs change in space. Including neck rotation righting reaction, disorientation, upright reaction and trunk righting reaction, including tilting reaction, sitting reaction and standing balance reaction. FUGL—MEYER evaluation method can be used to understand the patient's ability to keep the balance reaction: hold the child's armpit down to the table top, and the child's upper limbs appear bed surface reaction, which appears at 6 months. 5. Muscle strength assessment has different requirements for patients of different ages. In the early stage of development, patients have less active exercise, so it is of little significance to evaluate their muscle strength. However, it is of great practical value to evaluate the muscle strength of patients who can sit, climb or even stand and walk. Several manifestations of complications in children with cerebral palsy: (1) Mental retardation: It is reported that more than two-thirds of children are mentally retarded. The intelligence of children with spastic quadriplegia and tonic cerebral palsy is often worse, and very few children have severe mental retardation of hand and foot peristalsis. (2) Visual impairment: About half of the children have visual impairment, and the most common are esotropia and ametropia, such as myopia and amblyopia. A few have nystagmus and occasionally are completely blind; Hemiplegic children may have ipsilateral hemianopia. Visual defects will affect the coordination function of eyes and hands. (3) Hearing impairment: Some children have hearing loss or even complete deafness, especially hand and foot peristalsis caused by hyperbilirubinemia. Most high-frequency hearing loss needs to be detected by brainstem auditory evoked potential measurement. (4) Other sensory and cognitive abnormalities: Children with cerebral palsy often lack sense of touch, position, entity and two-point discrimination. Children often lack the correct visual space and three-dimensional sense, and the cognitive function defect is more prominent. Therefore, in the training of rehabilitation medicine, it is often difficult to learn new sports skills and various knowledge and activities. (5) Language barrier: The language defect of children with cerebral palsy is closely related to brain injury before and after birth and secondary brain retardation after injury, and can also be caused by hearing impairment and other factors. It is reported that about 1/3 to 2/3 children have language barriers to varying degrees. It is characterized by slow language development, difficulty in pronunciation, unclear articulation and inability to express correctly, and some children are completely aphasia. Children with hand-foot peristalsis and ataxia are often accompanied by language barriers; Children with spastic quadriplegia and bilateral paralysis are often accompanied by language barriers. (6) Seizure: From literature to reports, the incidence of epilepsy in children with cerebral palsy varies greatly. At least 65,438+0/4-65,438+0/3 or 65,438+0/4 children have had seizures at different ages, especially spastic quadriplegia, hemiplegia, monoplegia and mental retardation, while hand and foot peristalsis and ataxia are very common. (7) Oral and dental dysfunction: Some children with cerebral palsy have weakness in sucking, difficulty in swallowing and chewing, poor mouth and lip closure, frequent salivation, and some suffer from dental caries or tooth hypoplasia. These symptoms are most common in children with wriggling hands and feet. (8) Emotional and behavioral disorders: Most children with cerebral palsy have emotional or behavioral abnormalities, which are related to impaired brain function. A large number of clinical data show that when the limbic system of the brain (especially the hippocampus) is damaged, it can cause emotional abnormalities in children. Children are prone to crying, willful, stubborn, withdrawn and eccentric, emotionally fragile and excitable, and some have a sense of clarity, happiness and emotional instability. These symptoms are more common in children with wriggling hands and feet. In addition, most children with cerebral palsy are hyperactive, distracted and distracted. Occasionally see the "compulsive" behavior of children hitting their heads and jaws with their hands. (9) Others: Most infants with poor physical development, malnutrition and severe dyskinesia are more common, and respiratory tract infections are often prone to occur due to low immune function. Most children often have difficulties in learning and socializing because of single or multiple defects in body movement, feeling, intelligence, language, emotion and behavior. Usually, the dyskinesia of children with cerebral palsy interacts with the related defects mentioned above. For example, hearing and intellectual disabilities aggravate language barriers, and various sensory and cognitive barriers, seizures and learning difficulties aggravate mental disabilities. The superposition of these factors makes the rehabilitation training of children with cerebral palsy very difficult. Nerve evoked potential (NEEP) test for children with cerebral palsy usually refers to averaging the instantaneous electrical response of nervous system to sensory stimulation by computer, so as to obtain electrophysiological detection technology with constant response potential waveform. By judging the latency and amplitude of the reaction, we can understand the integrity of sensory conduction pathway and the related damage in its adjacent areas. Because of the different receptors of stimulation, it can be divided into brainstem auditory evoked potential, visual evoked potential and somatosensory evoked potential. These examinations can selectively observe the functional state of specific afferent nerve pathways and can be used for objective examination of various senses. (1) Examination of brainstem auditory evoked potential (BAEP) BAEP examination reflects the conduction function of nerve impulse caused by sound stimulation in brainstem auditory pathway. At present, there is no unified diagnostic standard. On the basis of Pan Fu Ying's standard, BAEP is divided into four grades according to the PL waves related to different age groups of children as normal reference values: ① The normal range is that I-V waves are stable and tidy, and PL of each wave is normal; ② Mild abnormality is I-V wave, but some PL and IPL are prolonged by more than 2.5 standard deviation of the average; ③ Moderate abnormality is that only I and V waves exist, all intervals are prolonged and the waveforms are irregular; ④ The height anomaly is unclear differentiation or disappearance of I-V wave. Yang Jian and others of the Capital Institute of Pediatrics found that most of the abnormalities were increased threshold, prolonged latency of I wave and V/I amplitude ratio less than 0.5. It is reported that the abnormal rate of brainstem auditory evoked potentials in children with cerebral palsy is 365,438 0.6%, including peripheral damage 24.3%, central damage 3.68% and mixed damage 3.68%. Diagnostic significance of brainstem auditory evoked potential: Generally speaking, I wave originated from auditory nerve, II wave originated from cochlear nucleus, III wave originated from superior olivary complex, IV wave originated from lateral colliculus nucleus, V wave originated from inferior colliculus of midbrain, and VI wave and VII wave represented the potentials of medial geniculate body and auditory radiation respectively. Therefore, the abnormality of these parts can show the change of auditory evoked potential. Children with cerebral palsy often don't cooperate, and the traditional hearing examination often misses the diagnosis, thus delaying the treatment opportunity. It has been reported that about 2/3 children with cerebral palsy have peripheral or central auditory pathway damage (especially the former), suggesting that the lesions mainly involve cochlear and distal auditory nerve fibers, and very few are purely central. Because children with cerebral palsy are mainly characterized by high-frequency hearing loss, they maintain low-frequency sound response to varying degrees in general speech, which leads some parents to mistakenly think that their children have no hearing abnormality and delay diagnosis and treatment. BAEP induces a series of reaction waves under the stimulation of high-frequency short sound, so it can sensitively detect the damage of auditory nerve pathway in children with cerebral palsy, which is one of the important criteria for diagnosing ultra-early cerebral palsy and is of great significance for early correction, which cannot be replaced by skull CT. (II) Examination of visual evoked potentials The examination of visual evoked potentials can be used to distinguish pseudoblindness from hysteria, retinopathy, anterior visual pathway lesions and optic chiasma lesions in children with cerebral palsy, especially suggesting optic atrophy. (3) Sensory pathway and motor conduction pathway belong to afferent nerve and efferent nerve respectively, and the two nerve conduction bundles are very close in the central part or peripheral nerve. The damage of motor conduction pathway may affect the integrity of sensory conduction pathway. In addition, the generation of normal motor function is closely related to sensory conduction function, especially to deep sensation. Therefore, although patients with cerebral palsy show abnormal limb movements and postures, SEP examination can still have important clinical value for early diagnosis of cerebral palsy. Clinical SEP examination is generally to detect the somatosensory evoked potential of the median nerve of the upper limb. SEP anomaly criteria are: ① the absolute latency of each wave is abnormal; ② A certain wave component disappears or its amplitude is lower than that of the opposite side by more than 50%. Kong Jie of Tianjin Children's Hospital established the following criteria for judging SEP anomalies: based on the control group, any PL and IPL greater than the average value of the control group plus 2.5 standard deviations are delayed; Absence of N2O waveform, unclear differentiation or peak amplitude lower than 50% of normal value are considered as anomalies. 52 children with cerebral palsy were examined by BAEP and SEP. The abnormal rate of the former was 76%, and the abnormal rate of the latter was 90%, and the latter was significantly higher than the former. SEP mainly reflects cerebral cortex potential, which can sensitively and accurately reflect various electrophysiological changes after lesions involving cerebral cortex. Moreover, it is also found in the experiment that the severity of symptoms of cerebral palsy patients is not directly proportional to the results of various examinations, nor is it directly related to clinical classification. Combined with clinical rehabilitation treatment, it is found that when the latency of N20-P25 is prolonged, or the waveforms of N20, P25, N35 and P45 are missing or the amplitude is too low, the rehabilitation effect of children is poor. Characteristics of children with flaccid cerebral palsy An obvious feature of children with flaccid cerebral palsy is dyspnea. Children's respiratory function is impaired, which always makes people feel that children's own respiratory movement is shallow and weak, and their cough is weak, which is prone to respiratory obstruction, so the incidence of respiratory diseases in such patients is relatively high. An obvious feature of children with flaccid cerebral palsy is dyspnea. Children's respiratory function is impaired, which always makes people feel that children's own respiratory movement is shallow and weak, and their cough is weak, which is prone to respiratory obstruction, so the incidence of respiratory diseases in such patients is relatively high. Children with flaccid cerebral palsy are prone to difficulties in sucking, swallowing and eating due to low muscle tone. Generally speaking, children with flaccid cerebral palsy are slow to respond to the outside world. Because of low muscle tension, low anti-gravity ability and low ability to maintain a certain posture, it is difficult for children to raise their heads and trunks and support their limbs, so most of these children like to use supine position. In supine position, his upper and lower limbs are in abduction and external rotation state, and his head leans to one side, which looks like a frog, commonly known as frog posture. Flaccid cerebral palsy is actually only a stage of special performance. Generally, after 2-3 years old, most children may turn into hand and foot peristalsis and spasms, and some may turn into ataxia. In addition, due to the lack of anti-gravity ability and low voluntary movement ability of patients with flaccid cerebral palsy, flaccid cerebral palsy has almost no function of maintaining posture, and this child's muscle tension changes greatly. When there is no external stimulus, the child is completely paralyzed; However, once the child is suddenly stimulated by the outside world or influenced by some factors, the child's muscle tension will immediately increase rapidly, resulting in hypertonia. At this time, it is mainly the extensor muscles of the back, showing a state of resisting the tension of the horn arch.