Vol.12, No 3, 2005 pp. 119 - 122
UC 616.831-009.11-053.2
THE IMPORTANCE OF EARLY DIAGNOSIS
AND EARLY PHYSICAL TREATMENT OF CEREBRAL PALSY
Lidija Dimitrijević1, Bosanka Jocić Jakubi2
1Clinic of Physical Medicine and Rehabilitation, Clinical Center, Niš, Faculty of Medicine, University of Niš
2Clinic of Mental Health and Developmental Neurology and Psychiatry, Clinical Center, Niš
  E-mail: lidijad@bankerinter.net 
Summary. Cerebral palsy (CP) refers to a group of posture and movement disorders occurring as a result of a non-progressive lesion of the developing central nervous system. CP can lead to global dysfunction but always includes motor problems. Early diagnosis of CP is extremely difficult. Often, it is impossible to diagnose CP under the age of four months and even under six months of age in slightly affected children with 'soft neurological signs'. Initially the majority of cerebral-palsied babies do not show definite signs of abnormality, but mainly those of retardation. Treatment should start only when signs of abnormal tonus and movement patterns are seen. In most babies, this happens after a 'silent' period, during which no treatment is necessary, but if suspicious signs develop, treatment must start immediately. In most cases, a very early treatment will give quicker and better results because the baby does not yet show much abnormality and therefore has little experience of abnormal movements. The VOJTA technique has decisive advantages in early physiotherapy of CP. Parents should be regarded as members of the team of therapists.
Key words: Cerebral palsy, neuromotor disorders, children, physical therapy
ZNAČAJ RANE DIJAGNOZE
I RANOG FIZIKALNOG TRETMANA CEREBRALNE PARALIZE
Kratak sadržaj: Cerabralna paraliza (CP) obuhvata poremećaje položaja i pokreta koji su posledica ne-progresivne lezije centralnog nervnog sistema u razvojnom periodu. CP izaziva opštu telesnu disfunkciju sa dominantno motornim smetnjama. Veliki je problem postaviti dijagnozu CP u prva četiri meseca života deteta. Ukoliko se radi o vrlo diskretnim oblicima sa minimalnom neurološkom simptomatologijom, dijagnozu je moguće postaviti tek nakon šestog meseca života. U najvećem broju slučajeva CP, u prvim mesecima deca ne pokazuju znake definitivnog motornog deficita, već znake motornog kašnjenja. Tretman treba započeti odmah nakon uočavanja ovih 'tihih' znakova (izmene mišićnog tonusa, abnormalna shema pokreta), jer su tada šanse za oporavak najveće. U najvećem broju slučajeva rani tretman daje najbolje rezultate i treba ga započeti dok još nije došlo do definitivne fiksacije patološke motorne sheme. Jedna od najboljih tehnika ranog fizikalnog tretmana je VOJTINA tehnika. Roditelji su najvažniji i neizostavni članovi terapeutskog tima.
Ključne reči: Cerebralna paraliza, neuromotorne smetnje, deca, fizikalna terapija