Can acute hemiplegia in children be cured?

Acute hemiplegia in children is a brain disease, mostly caused by cerebral thrombosis. Once the disease occurs, mild symptoms may cause slurred speech and unsteady gait, while severe cases may cause children to lose consciousness or have convulsions. So, can acute hemiplegia in children be cured? If parents find that their children have acute hemiplegia, they must not be too anxious. Experts say that as long as the disease is treated correctly and in a timely manner, the prognosis of this disease is still very good.

Treatment in the acute phase is mainly symptomatic and supportive. The principles of treatment are to increase cerebral blood perfusion, prevent disease progression and treat the cause.

1. Symptomatic and supportive treatment

(1) Supportive treatment should first pay attention to the overall condition, stabilize vital signs, prevent high fever, support blood pressure, correct metabolic disorders, maintain blood sugar at normal levels, improve blood circulation, and use low molecular weight dextran to expand blood volume when necessary. (2) Treatment of cerebral edema is usually obvious within 24 hours after onset. For patients with severe cerebral edema or increased intracranial pressure, dehydrating agents or diuretics such as mannitol and dexamethasone can be used. (3) For patients with severe seizures, diazepam or phenobarbital should be injected to control the seizures. If necessary, a maintenance dose should be taken orally to prevent recurrence of seizures. (4) Etiological treatment: Every possible effort should be made to find the cause and specific treatment should be given as early as possible to prevent worsening of cerebral ischemia and prevent future recurrences. (5) Other symptomatic treatments: Patients with meningitis should be given antibiotics as soon as possible; patients with traumatic intracranial hematoma, brain tumor, or cerebral vascular malformation should seek surgical consultation; patients with cerebral thrombosis caused by metabolic abnormalities should have their metabolic disorders corrected; patients with heart, blood, or autoimmune diseases should take appropriate measures.

2. Application of anticoagulants

Care should be taken in selecting indications. It should not be used in children with bleeding tendency, intracranial hemorrhage, or thrombocytopenia. It is mainly used in cases where the thrombosis process is continuing to develop, cases with multiple vascular infarctions, and when there is a possibility of recurrent infarction.

(1) Other anticoagulant drugs include heparin, etc., which should also be used with caution. (2) Low molecular weight heparin is increasingly used in children and can be used in the early stages of ischemic cerebral infarction in children. Low molecular weight heparin is safer and easier to use. It is suitable for pediatric cerebral artery infarction, dissecting aneurysm, coagulopathy, hypercoagulable state, etc. It should be used with caution in patients with renal dysfunction. After the heparin injection, blood should be drawn to test the concentration of anti-factor X-α to ensure safety.

3. Application of vasodilators

There are different opinions. Because its efficacy is uncertain, it is not recommended to be used in the acute phase. It is believed that it should be used with caution 3 weeks after onset when the cerebral vascular autoregulation function is restored. Vasodilator drugs can be selected from some Chinese medicines that promote blood circulation and remove blood stasis, or papaverine. Some studies have shown that using dextran as a volume expander to dilute the blood and increase cerebral blood flow can reduce sequelae.

4. Protect brain function

(1) Calcium channel blockers are believed to dilate cerebral blood vessels, increase cerebral blood flow, and protect brain cells when used within 12 hours of the onset of acute hemiplegia. (2) Glutamate antagonists can also reduce ischemic brain damage. (3) Brain Protective Agents In addition, there are a variety of drugs called brain protective agents that are believed to reduce brain tissue damage, such as excitatory neurotransmitter receptor blockers, inhibitory neurotransmitter enhancers, brain metabolism inhibitors, nitric oxide antagonists, etc. Their effectiveness needs further study. (4) Brain cell activators In addition, some researchers also recommend brain cell activators.

5. Recovery period

During the recovery period of acute hemiplegia in children, rehabilitation treatments such as massage, physical therapy, body therapy, and motor function training are recommended. These treatments should be started as soon as the condition stabilizes in order to maximize the compensatory potential. For those with severe paralysis, passive movements and functional exercises of each joint should be performed every day. Can be supplemented with acupuncture. Psychological support and behavioral therapy should be given, and children should be encouraged to actively participate in treatment and pay attention to the training of life skills. People with aphasia should receive language training. Rehabilitation therapy should ensure those activities that are particularly needed in daily life and those that may have an impact on future study and work. Parents of sick children should also participate in the rehabilitation process. Children with congenital or hereditary causes should receive genetic counseling.