Cerebral Palsy Overview 脑瘫概况

Cerebral palsy is an umbrella-like term used to describe a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time.脑瘫是一个总括样用来描述一组慢性疾病损害控制的运动，出现在最初几年的生活和一般不会随着时间的推移进一步恶化。 The term cerebral refers to the brain's two halves, or hemispheres, and palsy describes any disorder that impairs control of body movement.这个词是指脑大脑的两半，或半球，和脑瘫介绍任何疾病，损害控制身体运动。 Thus, these disorders are not caused by problems in the muscles or nerves.因此，这些疾病所造成的问题，肌肉或神经。 Instead, faulty development or damage to motor areas in the brain disrupts the brain's ability to adequately control movement and posture.相反，错误的发展或损坏电机领域的大脑扰乱了大脑的能力，适当地控制运动和姿态。



Symptoms of cerebral palsy lie along a spectrum of varying severity.症状脑瘫位于频谱的不同程度。 An individual with cerebral palsy may have difficulty with fine motor tasks, such as writing or cutting with scissors; experience trouble with maintaining balance and walking; or be affected by involuntary movements, such as uncontrollable writhing motion of the hands or drooling.个人脑瘫可能会遇到困难与精细动作的任务，如书面或用剪刀切割;遇到问题保持平衡，步行，或受不自主运动，如运动控制扭的手或流口水。 The symptoms differ from one person to the next, and may even change over time in the individual.不同的症状从一人到下一个，甚至可能随时间变化的个人。 Some people with cerebral palsy are also affected by other medical disorders, including seizures or mental impairment.有些人脑性麻痹也受其他医疗疾病，包括癫痫发作或精神障碍。 Contrary to common belief, however, cerebral palsy does not always cause profound handicap.相反，共同的信仰，但是，脑性麻痹并不总是导致深刻的障碍。 While a child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, a child with mild cerebral palsy might only be slightly awkward and require no special assistance.虽然孩子有严重脑性麻痹可能无法走路，需要广泛的，终身保健，儿童患有轻度脑瘫可能只略微尴尬的，不需要特殊的援助。 Cerebral palsy is not contagious nor is it usually inherited from one generation to the next.脑瘫不是传染性的，也不是通常继承一代一代传下去。 At this time, it cannot be cured, although scientific research continues to yield improved treatments and methods of prevention.在这个时候，它不能治愈，但科研产量继续提高治疗和预防方法。



How Many People Have This Disorder? 有多少人有这种病？

The United Cerebral Palsy Associations estimate that more than 500,000 Americans have cerebral palsy.美国脑性麻痹协会估计，超过500000美国人有脑性麻痹。 Despite advances in preventing and treating certain causes of cerebral palsy, the number of children and adults it affects has remained essentially unchanged or perhaps risen slightly over the past 30 years.尽管有进步，预防和治疗某些原因脑瘫的人数的儿童和成年人的影响已经基本上保持不变或略有上升，在过去30多年。 This is partly because more critically premature and frail infants are surviving through improved intensive care.这部分是因为更严重的早产儿和体弱婴儿存活通过改进护理。 Unfortunately, many of these infants have developmental problems of the nervous system or suffer neurological damage.不幸的是，许多这些婴儿发育问题的中枢神经系统或神经系统受到损害。 Research is under way to improve care for these infants, as in ongoing studies of technology to alleviate troubled breathing and trials of drugs to prevent bleeding in the brain before or soon after birth.正在进行研究，以改进照顾这些婴儿，因为在目前的技术研究，以减轻呼吸困难和考验的药物，以防止脑出血前或出生后不久。


What Are the Different Forms? 有哪些不同的形式？

Spastic diplegia, the disorder first described by Dr. Little in the 1860s, is only one of several disorders called cerebral palsy.痉挛性瘫，第一紊乱所描述的小博士在19世纪60年代，只有一个障碍的几个所谓的脑性麻痹。 Today doctors classify cerebral palsy into four broad categories -- spastic, athetoid, ataxic, and mixed forms -- according to the type of movement disturbance.今天，医生分类脑性瘫痪分为四大类-痉挛， a thetoid， a taxic，混合形式-按照类型的运动障碍。

Spastic cerebral palsy.痉挛性脑瘫。 In this form of cerebral palsy, which affects 70 to 80 percent of patients, the muscles are stiffly and permanently contracted.在这种形式的脑性麻痹，从而影响到70至百分之八十的病人，肌肉僵直和永久的合同。 Doctors will often describe which type of spastic cerebral palsy a patient has based on which limbs are affected.医生通常会描述哪种类型的痉挛性脑瘫病人基础上，四肢都受到影响。 The names given to these types combine a Latin description of affected limbs with the term plegia or paresis, meaning paralyzed or weak.姓名考虑到这些类型结合起来，拉丁美洲的说明影响肢体与长期plegia或麻痹，这意味着瘫痪或软弱。 The four commonly diagnosed types of spastic cerebral palsy are illustrated in the figure.这四个诊断类型的痉挛性脑瘫的说明了这个数字。

When both legs are affected by spasticity, they may turn in and cross at the knees.当双腿受痉挛，他们可能会在和交叉在膝盖上。 As these individuals walk, their legs move awkwardly and stiffly and nearly touch at the knees.至于这些个人走路，他们的腿行动笨拙和僵直，几乎触摸在膝盖上。 This causes a characteristic walking rhythm, known as the scissors gait.这将导致一个特点走路的节奏，被称为剪刀步态。

Individuals with spastic hemiparesis may also experience hemiparetic tremors, in which uncontrollable shaking affects the limbs on one side of the body.个人痉挛偏瘫也可能会遇到地震偏瘫，其中影响到无法控制的颤抖四肢一方的身体。 If these tremors are severe, they can seriously impair movement.如果这些地震是严重的，他们可以严重损害运动。

Athetoid, or dyskinetic, cerebral palsy. Athetoid ，或dyskinetic ，脑性麻痹。 This form of cerebral palsy is characterized by uncontrolled, slow, writhing movements.这种形式的脑性麻痹的特点是不加控制，缓慢，扭运动。 These abnormal movements usually affect the hands, feet, arms, or legs and, in some cases, the muscles of the face and tongue, causing grimacing or drooling.这些异常变动通常影响手，脚，胳膊，腿，或在某些情况下，肌肉的面部和舌头，造成grimacing或流口水。 The movements often increase during periods of emotional stress and disappear during sleep.经常运动期间增加的情绪紧张和睡眠过程中消失。 Patients may also have problems coordinating the muscle movements needed for speech, a condition known as dysarthria.患者也可能有问题协调肌肉运动所需的语音，这种情况被称为构音障碍。 Athetoid cerebral palsy affects about 10 to 20 percent of patients. Athetoid脑性麻痹影响到大约10至百分之二十的病人。

Ataxic cerebral palsy. Ataxic脑性麻痹。 This rare form affects the sense of balance and depth perception.这种罕见的形式影响到平衡感和深度知觉。 Affected persons often have poor coordination; walk unsteadily with a wide-based gait, placing their feet unusually far apart; and experience difficulty when attempting quick or precise movements, such as writing or buttoning a shirt.受影响的人往往缺乏协调;步行不稳定，拥有广泛基础的步态，把他们的脚不寻常相距甚远;和遇到困难时，企图快速或精确的运动，如书面或buttoning衬衫。 They may also have intention tremor.它们也可能打算震颤。 In this form of tremor, beginning a voluntary movement, such as reaching for a book, causes a trembling that affects the body part being used and that worsens as the individual gets nearer to the desired object.在这种形式的震颤，开始在自愿的运动，如达到一本书，用颤抖的原因，影响身体的一部分被用来进一步恶化，并作为个人获得接近理想的对象。 The ataxic form affects an estimated 5 to 10 percent of cerebral palsy patients. ataxic形式的影响，估计5至10百分之脑性麻痹患者。

Mixed forms.混合形式。 It is common for patients to have symptoms of more than one of the previous three forms.这是患者常见的症状有一个以上的前三个形式。 The most common mixed form includes spasticity and athetoid movements but other combinations are also possible.最常见的混合形式包括痉挛和athetoid运动，但其他组合也是可能的。


What Other Medical Disorders Are Associated With Cerebral Palsy? 什么其他医疗疾病都与脑性麻痹？

Many individuals who have cerebral palsy have no associated medical disorders.许多个人谁有脑性麻痹没有相关的医疗疾病。 However, disorders that involve the brain and impair its motor function can also cause seizures and impair an individual's intellectual development, attentiveness to the outside world, activity and behavior, and vision and hearing.然而，疾病，涉及的大脑和损害其运动功能也可能导致癫痫发作，并损害一个人的智力发展，认真向外部世界，经济活动和行为，以及视力和听力。 Medical disorders associated with cerebral palsy include:医学疾病与脑性麻痹包括：

• Mental impairment. •心理障碍。 About one-third of children who have cerebral palsy are mildly intellectually impaired, one-third are moderately or severely impaired, and the remaining third are intellectually normal.大约有三分之一的孩子谁有脑性麻痹是轻度智力障碍，有三分之一是中度或严重受损，其余三分之一是智力正常。 Mental impairment is even more common among children with spastic quadriplegia.心理障碍更是常见的儿童四肢痉挛。

• Seizures or epilepsy. •惊厥或癫痫。 As many as half of all children with cerebral palsy have seizures.多达一半的脑瘫患儿有癫痫发作。 During a seizure, the normal, orderly pattern of electrical activity in the brain is disrupted by uncontrolled bursts of electricity.在扣押，正常，有序的格局电活动在大脑中是打乱了失控连发的电力。 When seizures recur without a direct trigger, such as fever, the condition is called epilepsy.当发生缉获没有直接触发，如发烧，条件是所谓的癫痫症。 In the person who has cerebral palsy and epilepsy, this disruption may be spread throughout the brain and cause varied symptoms all over the body -- as in tonic-clonic seizures -- or may be confined to just one part of the brain and cause more specific symptoms -- as in partial seizures.在谁的人有脑性麻痹和癫痫，这可能会影响扩散到整个大脑，造成不同的症状所有的机构-在强直阵挛发作-或可能仅仅局限于某一部分的大脑，造成更多的具体症状-在部分性发作。

Tonic-clonic seizures generally cause patients to cry out and are followed by loss of consciousness, twitching of both legs and arms, convulsive body movements, and loss of bladder control.强直阵挛发作患者一般事业哭了，并随后意识丧失，抽搐的腿和胳膊，抽搐身体动作，和损失的膀胱控制。

Partial seizures are classified as simple or complex.部分性发作被列为简单或复杂。 In simple partial seizures, the individual has localized symptoms, such as muscle twitches, chewing movements, and numbness or tingling.简单部分性发作，个别的有局部症状，如肌肉twitches ，咀嚼运动，麻木或刺痛感。 In complex partial seizures, the individual may hallucinate, stagger, perform automatic and purposeless movements, or experience impaired consciousness or confusion.在复杂部分性发作，个人可幻觉，错开，自动完成和目的的运动，或经验，意识障碍或混淆。

• Growth problems. •生长的问题。 A syndrome called failure to thrive is common in children with moderate-to-severe cerebral palsy, especially those with spastic quadriparesis.一种综合症所谓失败兴旺是常见的儿童中度至重度脑性麻痹，尤其是那些痉挛quadriparesis 。 Failure to thrive is a general term physicians use to describe children who seem to lag behind in growth and development despite having enough food.不兴旺是一种通用术语，医生使用儿童来形容似乎谁落后的增长和发展，尽管有足够的粮食。 In babies, this lag usually takes the form of too little weight gain; in young children, it can appear as abnormal shortness; in teenagers, it may appear as a combination of shortness and lack of sexual development.在婴儿，这个滞后通常的形式太少，体重增加;幼儿，它可以出现异常急促;青少年，它可能出现的组合急促和缺乏性发展。 Failure to thrive probably has several causes, including, in particular, poor nutrition and damage to the brain centers controlling growth and development.不兴旺可能有几个原因，包括，特别是营养不良和损伤大脑控制中心的成长和发展。 In addition, the muscles and limbs affected by cerebral palsy tend to be smaller than normal.此外，肌肉和四肢受影响的脑性麻痹往往小于正常。 This is especially noticeable in some patients with spastic hemiplegia, because limbs on the affected side of the body may not grow as quickly or as large as those on the more normal side.尤其是在一些明显的痉挛患者偏瘫，肢体上，因为受影响的一方的身体可能不会增长很快或大那些比较正常的一方。 This condition usually affects the hand and foot most severely.这种情况通常会影响手和脚最严重的。 Since the involved foot in hemiplegia is often smaller than the unaffected foot even among patients who walk, this size difference is probably not due to lack of use.由于所涉及的脚在偏瘫往往是小于英尺甚至影响患者中谁走，这大小的差异可能不是由于缺乏使用。 Scientists believe the problem is more likely to result from disruption of the complex process responsible for normal body growth.科学家认为，这个问题更可能导致破坏了复杂的过程，负责正常体重的增长。

• Impaired vision or hearing. •受损的视力或听力。 A large number of children with cerebral palsy have strabismus, a condition in which the eyes are not aligned because of differences in the left and right eye muscles.大量的脑瘫儿童有斜视的条件，其中的目光都不能赞同，因为不同的左眼和右眼的肌肉。 In an adult, this condition causes double vision.在成人，这种情况的原因双重目标。 In children, however, the brain often adapts to the condition by ignoring signals from one of the misaligned eyes.在儿童，然而，大脑往往适应的条件忽视的信号之一失调的眼睛。 Untreated, this can lead to very poor vision in one eye and can interfere with certain visual skills, such as judging distance.未经处理，就可能导致非常差的远见，一只眼睛，并可能会干扰某些视觉技能，如判断距离。 In some cases, physicians may recommend surgery to correct strabismus.在某些情况下，医生可能会建议手术治疗，以纠正斜视。 Children with hemiparesis may have hemianopia, which is defective vision or blindness that impairs the normal field of vision of one eye.小儿偏瘫可能hemianopia ，这是有缺陷的视力或失明的损害了正常的视野一只眼睛。 For example, when hemianopia affects the right eye, a child looking straight ahead might have perfect vision except on the far right.举例来说，当hemianopia影响到右眼，儿童寻找直行可能有完美的视觉除在最右方。 In homonymous hemianopia, the impairment affects the same part of the visual field of both eyes.在同名hemianopia ，损害影响同一部分视野的眼睛。 Impaired hearing is also more frequent among those with cerebral palsy than in the general population.听力也更频繁地在这些脑瘫比一般人群。

• Abnormal sensation and perception. •异常感觉和知觉。 Some children with cerebral palsy have impaired ability to feel simple sensations like touch and pain.有些脑瘫患儿有能力受损觉得简单的感觉就像触摸和痛苦。 They may also have stereognosia, or difficulty perceiving and identifying objects using the sense of touch.它们也可能stereognosia ，或难以察觉和识别物体使用触觉。 A child with stereognosia, for example, would have trouble identifying a hard ball, sponge, or other object placed in his hand without looking at the object.儿童stereognosia ，例如，将无法确定一个硬球，海绵，或其他物件放在他的手不看对象。


What Causes Cerebral Palsy? 是什么原因导致脑瘫？

Cerebral palsy is not one disease with a single cause, like chicken pox or measles.脑瘫不是一个疾病的一个原因，如水痘或麻疹。 It is a group of disorders with similar problems in control of movement, but probably with different causes.这是一组疾病有类似问题的控制行动，但可能以不同的原因。 When physicians try to uncover the cause of cerebral palsy in an individual child, they look at the form of cerebral palsy, the mother's and child's medical history, and onset of the disorder.当医生试图揭示事业的脑瘫儿童的个人，他们看的形式，脑瘫，母亲和儿童的医疗历史，开始混乱。

In the United States, about 10 to 20 percent of children who have cerebral palsy acquire the disorder after birth.在美国，约10至百分之二十的儿童谁有脑性麻痹症获得出生后。 (The figures are higher in underdeveloped countries.) Acquired cerebral palsy results from brain damage in the first few months or years of life and can follow brain infections, such as bacterial meningitis or viral encephalitis, or results from head injury -- most often from a motor vehicle accident, a fall, or child abuse. （这些数字都高于不发达的国家。 ）后天脑性麻痹的结果脑损伤的头几个月或几年的生活和可以遵循大脑的感染，如细菌性脑膜炎或病毒性脑炎，或结果颅脑损伤-往往是从机动车辆事故，减少或虐待儿童。

Congenital cerebral palsy, on the other hand, is present at birth, although it may not be detected for months.先天性脑性麻痹，另一方面，本是在出生时，虽然它可能无法检测到几个月。 In most cases, the cause of congenital cerebral palsy is unknown.在大多数情况下，造成先天性脑性麻痹不明。 Thanks to research, however, scientists have pinpointed some specific events during pregnancy or around the time of birth that can damage motor centers in the developing brain.经过研究，然而，科学家已经发现了一些具体的事件在怀孕期间或前后出生时，可损害运动中心的脑发育。 Some of these causes of congenital cerebral palsy include:其中的一些原因，先天性脑性麻痹包括：

• Infections during pregnancy. •在怀孕期间感染。 German measles, or rubella, is caused by a virus that can infect pregnant women and, therefore, the fetus in the uterus, to cause damage to the developing nervous system.德国麻疹或风疹，是由病毒引起，可感染的孕妇，因此，胎儿在子宫，造成损害发展中国家中枢神经系统。 Other infections that can cause brain injury in the developing fetus include cytomegalovirus and toxoplasmosis.其他感染，可导致脑损伤胎儿的发展中国家包括巨细胞病毒和弓形虫病。 There is relatively recent evidence that placental and perhaps other maternal infection can be associated with cerebral palsy.有相对最近的证据表明，胎盘，也许其他产妇感染是可以与脑性麻痹。

• Jaundice in the infant. •性黄疸的婴儿。 Bile pigments, compounds that are normally found in small amounts in the bloodstream, are produced when blood cells are destroyed.胆汁色素化合物通常发现少量血液中，生产时，血细胞被摧毁。 When many blood cells are destroyed in a short time, as in the condition called Rh incompatibility (see below), the yellow-colored pigments can build up and cause jaundice.当许多血细胞被破坏在很短的时间，如在条件要求不相容铑（见下文） ，黄色的色素可以建立和事业性黄疸。 Severe, untreated jaundice can damage brain cells.严重，未经处理的黄疸会损害脑细胞。

• Rh incompatibility. •铑不相容的。 In this blood condition, the mother's body produces immune cells called antibodies that destroy the fetus's blood cells, leading to a form of jaundice in the newborn.在这种血，母亲的身体产生免疫细胞抗体，破坏了胎儿的血细胞，从而导致某种形式的性黄疸的新生儿。

• Severe oxygen shortage in the brain or trauma to the head during labor and delivery. •严重的氧气不足或脑外伤的头部在劳动和交付。 The newborn infant's blood is specially equipped to compensate for low levels of oxygen, and asphyxia (lack of oxygen caused by interruption in breathing or poor oxygen supply) is common in babies during the stresses of labor and delivery.新生婴儿的血液是特殊装备，以弥补低水平的氧气，和窒息（缺乏氧气所造成的中断或呼吸氧气供应穷人）是常见的婴儿在强调劳动和交付。 But if asphyxia severely lowers the supply of oxygen to the infant's brain for lengthy periods, the child may develop brain damage called hypoxic-ischemic encephalopathy.但是，如果窒息严重降低了供应氧气的婴儿的脑部长时间，孩子可能发展所谓的脑损伤新生儿缺氧缺血性脑病。 A significant proportion of babies with this type of brain damage die, and others may develop cerebral palsy, which is then often accompanied by mental impairment and seizures.有相当一部分婴儿这种类型的脑损伤死亡，以及其他可能发展脑性瘫痪，然后往往伴随着心理障碍和癫痫发作。

In the past, physicians and scientists attributed most cases of cerebral palsy to asphyxia or other complications during birth if they could not identify another cause.在过去，医生和科学家认为大多数情况下，脑性麻痹窒息或其他并发症出生如果他们无法确定另一个原因。 However, extensive research by NINDS scientists and others has shown that very few babies who experience asphyxia during birth develop encephalopathy soon after birth.然而，广泛的研究的神经科学家和其他人已经表明，极少数的婴儿谁的经验在出生窒息开发性脑病出生后不久。 Research also shows that a large proportion of babies who experience asphyxia do not grow up to have cerebral palsy or other neurological disorders.研究还表明，很大比例的婴儿窒息的经验谁没有成长为有脑性麻痹或其他神经系统疾病。 Birth complications including asphyxia are now estimated to account for about 6 percent of congenital cerebral palsy cases.分娩并发症，包括窒息，现在估计占百分之六左右的先天性脑性麻痹病例。

• Stroke. •中风。 Coagulation disorders in mothers or infants can produce stroke in the fetus or newborn baby.凝血功能障碍的母亲或婴儿能产生中风，胎儿或新生儿。 Bleeding in the brain has several causes -- including broken blood vessels in the brain, clogged blood vessels, or abnormal blood cells -- and is one form of stroke.脑出血有几个原因-包括血管破裂大脑中，阻塞血管，或不正常的血细胞-是一种形式的中风。 Although strokes are better known for their effects on older adults, they can also occur in the fetus during pregnancy or the newborn around the time of birth, damaging brain tissue and causing neurological problems.虽然中风是更好地了解他们对老年人来说，他们也可以发生在怀孕期间胎儿或新生儿在出生时，破坏脑组织和神经系统造成的问题。 Ongoing research is testing potential treatments that may one day help prevent stroke in fetuses and newborns.正在进行的研究是测试潜在的疗法，也许有一天有助于防止中风，胎儿和新生儿。

What are the Risk Factors? 什么是风险因素？

Research scientists have examined thousands of expectant mothers, followed them through childbirth, and monitored their children's early neurological development.科学家们研究了数以千计的待产母亲，随后他们通过分娩，并监督其子女的早期神经发育。 As a result, they have uncovered certain characteristics, called risk factors, that increase the possibility that a child will later be diagnosed with cerebral palsy:结果，他们发现某些特征，所谓的风险因素，增加的可能性，一个孩子将被诊断为脑性麻痹：

• Breech presentation. •臀位。 Babies with cerebral palsy are more likely to present feet first, instead of head first, at the beginning of labor.婴儿脑瘫更有可能本英尺第一，而不是头部首先，在年初的劳动力。
• Complicated labor and delivery. •复杂的劳动和交付。 Vascular or respiratory problems of the baby during labor and delivery may sometimes be the first sign that a baby has suffered brain damage or that a baby's brain has not developed normally.血管或呼吸系统问题的婴儿期间劳动和交付有时可能会成为第一个迹象，表明婴儿已遭受脑损伤或婴儿的大脑还没有发育正常。 Such complications can cause permanent brain damage.这种并发症可能会造成永久性脑损伤。
• Low Apgar score. •低Apgar评分。 The Apgar score (named for anesthesiologist Virginia Apgar) is a numbered rating that reflects a newborn's condition.该Apgar评分（命名为麻醉师弗吉尼亚州阿氏）是一个编号评级，反映一个新生的条件。 To determine an Apgar score, doctors periodically check the baby's heart rate, breathing, muscle tone, reflexes, and skin color in the first minutes after birth.要确定一个Apgar评分，医生定期检查孩子的心率，呼吸，肌张力，反射，和皮肤颜色在第一分钟后出生。 They then assign points; the higher the score, the more normal the baby's condition.然后，他们指定点;较高的评分，较正常婴儿的条件。 A low score at 10-20 minutes after delivery is often considered an important sign of potential problems.低评分在10-20分钟，分娩后往往被视为一个重要标志潜在的问题。
• Low birthweight and premature birth. •低出生体重和早产。 The risk of cerebral palsy is higher among babies who weigh less than 2500 grams (5 lbs., 7 1/2 oz.) at birth and among babies who are born less than 37 weeks into pregnancy.风险脑瘫较高的婴儿谁重量不到二千五百克（ 5磅。 ， 7 1 /二盎司）在出生时和婴儿之间谁是出生不到37周妊娠。 This risk increases as birthweight falls.这种风险增加，因为体重下降。
• Multiple births. •多胞胎。 Twins, triplets, and other multiple births are linked to an increased risk of cerebral palsy.双胞胎，三胞胎，和其他多胞胎是联系在一起的风险增加脑性麻痹。
• Nervous system malformations. •神经系统畸形。 Some babies born with cerebral palsy have visible signs of nervous system malformation, such as an abnormally small head (microcephaly).有些婴儿脑瘫有明显的中枢神经系统畸形，如异常小头（小） 。 This suggests that problems occurred in the development of the nervous system while the baby was in the womb.这表明，问题的发生发展中的中枢神经系统，而婴儿在子宫内。
• Maternal bleeding or severe proteinuria late in pregnancy. •产妇出血或严重蛋白尿在怀孕后期。 Vaginal bleeding during the sixth to ninth months of pregnancy and severe proteinuria (the presence of excess proteins in the urine) are linked to a higher risk of having a baby with cerebral palsy.阴道出血在第六至第九个月的怀孕和严重蛋白尿（在场的情况下过量的蛋白质在尿）都与高风险有一个婴儿脑瘫。
• Maternal hyperthyroidism, mental retardation, or seizures. •产妇甲状腺功能亢进症，精神发育迟缓，或癫痫发作。 Mothers with any of these conditions are slightly more likely to have a child with cerebral palsy.母亲与任何这些条件稍微更可能有一个孩子脑瘫。
• Seizures in the newborn. •缉获新生。 An infant who has seizures faces a higher risk of being diagnosed, later in childhood, with cerebral palsy.谁的婴儿已缉获面临着高风险被诊断，后来在童年，脑性麻痹。

Knowing these warning signs helps doctors keep a close eye on children who face a higher risk for long-term problems in the nervous system.了解这些警告标志有助于医生密切关注儿童谁面临较高的风险长期存在的问题中枢神经系统。 However, parents should not become too alarmed if their child has one or more of these factors.然而，父母不应该变得太震惊，如果他们的孩子有一个或一个以上这些因素。 Most such children do not have and do not develop cerebral palsy.这些儿童大多没有和不发展脑瘫。

Can Cerebral Palsy Be Prevented? 脑瘫可以预防？

Several of the causes of cerebral palsy that have been identified through research are preventable or treatable:有几个原因，脑瘫已确定通过研究预防或可治疗的：

• Head injury can be prevented by regular use of child safety seats when driving in a car and helmets during bicycle rides, and elimination of child abuse. •颅脑损伤是可以预防由经常使用儿童安全座椅时，驾驶的汽车和头盔，骑在自行车，和消除对儿童的虐待。 In addition, common sense measures around the household -- like close supervision during bathing and keeping poisons out of reach -- can reduce the risk of accidental injury.此外，常识性措施，围绕家庭-如在密切监督洗澡，保持毒药遥不可及-可以降低风险的意外伤害。
• Jaundice of newborn infants can be treated with phototherapy. •性黄疸的新生儿可光治疗。 In phototherapy, babies are exposed to special blue lights that break down bile pigments, preventing them from building up and threatening the brain.在光线，婴儿暴露于特殊的蓝灯打破了胆汁色素，阻止他们建立和威胁到大脑。 In the few cases in which this treatment is not enough, physicians can correct the condition with a special form of blood transfusion.在一些案件中，这种待遇是不够的，医生可以正确的条件下一种特殊形式的输血。
• Rh incompatibility is easily identified by a simple blood test routinely performed on expectant mothers and, if indicated, expectant fathers. •铑不相容很容易发现一个简单的血液测试就例行的待产母亲，如果表明，准爸爸。 This incompatibility in blood types does not usually cause problems during a woman's first pregnancy, since the mother's body generally does not produce the unwanted antibodies until after delivery.这不相容的血型通常不会导致问题的过程中女人的第一次怀孕，因为母亲的身体一般不会产生有害抗体，直到分娩后。 In most cases, a special serum given after each childbirth can prevent the unwanted production of antibodies.在大多数情况下，给予特殊的血清每个分娩后可以防止不必要的生产抗体。 In unusual cases, such as when a pregnant woman develops the antibodies during her first pregnancy or antibody production is not prevented, doctors can help minimize problems by closely watching the developing baby and, when needed, performing a transfusion to the baby while in the womb or an exchange transfusion (in which a large volume of the baby's blood is removed and replaced) after birth.在不寻常的情况下，例如当一个孕妇开发的抗体在她第一次怀孕或生产的抗体没有阻止，医生可以帮助尽量减少问题的密切关注发展中国家婴儿，并在必要时执行输血给婴儿，而在子宫或换血（其中大量的婴儿的血液被删除，代之以）出生后。
• Rubella, or German measles, can be prevented if women are vaccinated against this disease before becoming pregnant. •风疹，或德国麻疹，是可以预防的，如果妇女接种了这种疾病在怀孕。

In addition, it is always good to work toward a healthy pregnancy through regular prenatal care and good nutrition and by eliminating smoking, alcohol consumption, and drug abuse.此外，它始终是良好的工作朝着健康怀孕通过定期的产前护理和良好的营养和消除吸烟，饮酒和滥用药物。 Despite the best efforts of parents and physicians, however, children will still be born with cerebral palsy.尽管尽了最大努力，家长和医生，然而，孩子出生的仍然是脑瘫。 Since in most cases the cause of cerebral palsy is unknown, little can currently be done to prevent it.由于在多数情况下，导致脑瘫不明，目前很少能做到以防止它。 As investigators learn more about the causes of cerebral palsy through basic and clinical research, doctors and parents will be better equipped to help prevent this disorder.随着调查了解的原因，脑瘫通过基础和临床研究，医生和家长将得到更好的装备，以帮助防止这种疾病。

What Are the Early Signs? 的早期征兆是什么？

Early signs of cerebral palsy usually appear before 3 years of age, and parents are often the first to suspect that their infant is not developing motor skills normally.早期迹象脑性麻痹通常出现在3岁，家长往往首先怀疑，他们的婴儿是没有发展运动技能正常。 Infants with cerebral palsy are frequently slow to reach developmental milestones, such as learning to roll over, sit, crawl, smile, or walk.婴幼儿脑性麻痹往往是缓慢达到发展的里程碑，如学习翻转，坐下，检索，微笑，或步行。 This is sometimes called developmental delay.这是有时被称为发育迟缓。

Some affected children have abnormal muscle tone.一些受影响的儿童有异常的肌张力。 Decreased muscle tone is called hypotonia; the baby may seem flaccid and relaxed, even floppy.降低肌肉张力被称为肌无力;婴儿似乎松弛和放松，甚至软盘。 Increased muscle tone is called hypertonia, and the baby may seem stiff or rigid.增加肌肉张力被称为压力过高，婴儿似乎僵硬或僵化。 In some cases, the baby has an early period of hypotonia that progresses to hypertonia after the first 2 to 3 months of life.在某些情况下，婴儿有一个初期肌无力的进展，以压力过高后， 2至3个月的生活。 Affected children may also have unusual posture or favor one side of their body.受影响的儿童也可能有不寻常的姿势或有一方自己的身体。

Parents who are concerned about their baby's development for any reason should contact their physician, who can help distinguish normal variation in development from a developmental disorder.谁的父母关心孩子的发展以任何理由，应与他们的医生，谁可以帮助区分正常的发展变化从一个发育障碍。

How is Cerebral Palsy Diagnosed? 如何诊断脑性麻痹？

Doctors diagnose cerebral palsy by testing an infant's motor skills and looking carefully at the infant's medical history.医生诊断脑性麻痹测试婴儿的运动技能和仔细的婴儿的医疗记录。 In addition to checking for those symptoms described above -- slow development, abnormal muscle tone, and unusual posture -- a physician also tests the infant's reflexes and looks for early development of hand preference.除了检查这些症状上文所述-发展缓慢，肌肉张力异常，和不同寻常的姿态-一个医生还检查婴儿的反应，并期待早日发展一方面偏好。

Reflexes are movements that the body makes automatically in response to a specific cue.反射的运动，身体会自动作出响应的具体线索。 For example, if a newborn baby is held on its back and tilted so the legs are above its head, the baby will automatically extend its arms in a gesture, called the Moro reflex, that looks like an embrace.例如，如果一个新生婴儿是于背部和倾斜，使腿部高于其头部，婴儿会自动延长其武器的一种姿态，所谓的摩洛反射，看起来像一个拥抱。 Babies normally lose this reflex after they reach 6 months, but those with cerebral palsy may retain it for abnormally long periods.婴儿通常失去这个反射后，达到6个月，但这些脑瘫可以保留它的异常很长时间。 This is just one of several reflexes that a physician can check.这仅仅是其中一个反射，有一名医生可以检查。

Doctors can also look for hand preference -- a tendency to use either the right or left hand more often.医生还可以寻找手偏好-一种倾向，使用左边或右边的手更频繁。 When the doctor holds an object in front and to the side of the infant, an infant with hand preference will use the favored hand to reach for the object, even when it is held closer to the opposite hand.当医生持有的对象在前面的一侧的婴儿，婴儿的手将优先使用青睐一方面达到的目标，即使是在接近对面手。 During the first 12 months of life, babies do not usually show hand preference.在头12个月的寿命，婴儿通常不会显示手偏好。 But infants with spastic hemiplegia, in particular, may develop a preference much earlier, since the hand on the unaffected side of their body is stronger and more useful.但是，婴儿痉挛性偏瘫，特别是可能会制定一个优先要早得多，因为手头上没有受到影响一方自己的身体更强大和更有益的。

The next step in diagnosing cerebral palsy is to rule out other disorders that can cause movement problems.下一步的诊断是脑性麻痹，以排除其他疾病，可导致运动的问题。 Most important, doctors must determine that the child's condition is not getting worse.最重要的是，医生必须确定儿童的健康状况没有变得更糟。 Although its symptoms may change over time, cerebral palsy by definition is not progressive.虽然其症状可能会随着时间推移而改变，脑性麻痹的定义是没有进步。 If a child is continuously losing motor skills, the problem more likely springs from elsewhere -- including genetic diseases, muscle diseases, disorders of metabolism, or tumors in the nervous system.如果孩子正在不断失去运动技能，这个问题更可能源自其他地方-包括遗传性疾病，肌肉疾病，代谢疾病，或肿瘤的中枢神经系统。 The child's medical history, special diagnostic tests, and, in some cases, repeated check-ups can help confirm that other disorders are not at fault.儿童的医疗史，特殊的诊断测试，在某些情况下，反复检查可以帮助确认其他疾病没有过失。

The doctor may also order specialized tests to learn more about the possible cause of cerebral palsy.医生也可能为了专门测试，以了解可能导致脑瘫。 One such test is computed tomography, or CT, a sophisticated imaging technique that uses X rays and a computer to create an anatomical picture of the brain's tissues and structures.一个这样的试验是计算机断层扫描，或CT ，先进的成像技术，利用X射线和电脑创造一个解剖图片大脑的组织和结构。 A CT scan may reveal brain areas that are underdeveloped, abnormal cysts (sacs that are often filled with liquid) in the brain, or other physical problems. CT扫描可能揭示脑的地区，不发达，不正常的囊肿（囊，往往装满液体）在大脑中，或其他物理问题。 With the information from CT scans, doctors may be better equipped to judge the long-term outlook for an affected child.随着信息， CT扫描，医生可以得到更好的装备来判断的长期前景受影响的儿童。

Magnetic resonance imaging, or MRI, is a relatively new brain imaging technique that is rapidly gaining widespread use for identifying brain disorders.磁共振成像，或MRI ，是一个相对较新的脑成像技术，迅速获得广泛使用为确定大脑疾病。 This technique uses a magnetic field and radio waves, rather than X rays.这项技术采用了磁场和无线电波，而不是X射线。 MRI gives better pictures of structures or abnormal areas located near bone than CT.磁共振成像提供更好的画面结构或异常区位于骨比CT检查。

A third test that can expose problems in brain tissues is ultrasonography.第三次测试，可以揭露问题，在脑组织中的B超。 This technique bounces sound waves off the brain and uses the pattern of echoes to form a picture, or sonogram, of its structures.这种技术反弹的声波从大脑和使用的模式呼应，形成图片，或声像图，其结构。 Ultrasonography can be used in infants before the bones of the skull harden and close.超声可用于婴幼儿的骨骼之前颅骨变硬和密切。 Although it is less precise than CT and MRI scanning, this technique can detect cysts and structures in the brain, is less expensive, and does not require long periods of immobility.尽管这是不太准确的CT和MRI扫描，这一技术可以检测囊肿和结构，在大脑中，是不太昂贵，而且不需要很长时间不动。

Finally, physicians may want to look for other conditions that are linked to cerebral palsy, including seizure disorders, mental impairment, and vision or hearing problems.最后，医生可能要寻找其他条件都与脑性麻痹，包括癫痫，精神障碍，并视力或听力问题。

When the doctor suspects a seizure disorder, an electroencephalogram, or EEG, may be ordered.当医生怀疑扣押障碍，一个脑电图，或脑电图，可命令。 An EEG uses special patches called electrodes placed on the scalp to record the natural electrical currents inside the brain.使用一种特殊的脑电图补丁称为电极放在头皮上记录的自然电流的大脑内。 This recording can help the doctor see telltale patterns in the brain's electrical activity that suggest a seizure disorder.这个记录可以帮助医生看到警示模式，大脑的电活动表明扣押障碍。

Intelligence tests are often used to determine if a child with cerebral palsy is mentally impaired.智力测验常常被用来确定如果一个孩子脑瘫是精神上受到损害。 Sometimes, however, a child's intelligence may be underestimated because problems with movement, sensation, or speech due to cerebral palsy make it difficult for him or her to perform well on these tests.但是，有时孩子的智力可能被低估，因为问题的运动，感觉，或言语由于脑性麻痹，很难为他或她表现出色的这些试验。

If problems with vision are suspected, the doctor may refer the patient to an ophthalmologist for examination; if hearing impairment seems likely, an otologist may be called in.如果问题具有远见的怀疑，医生可转介病人到眼科检查，如果听力受损很可能，一个耳科医生可称为英寸

Identifying these accompanying conditions is important and is becoming more accurate as ongoing research yields advances that make diagnosis easier.确定这些附带条件是重要的和正在变得更加准确率正在进行的研究的进展，使诊断更容易。 Many of these conditions can then be addressed through specific treatments, improving the long-term outlook for those with cerebral palsy.许多这些条件就可以通过具体的处理治疗，改善长期前景对那些脑瘫。

How is Cerebral Palsy Managed? 如何管理脑瘫？

Cerebral palsy can not be cured, but treatment can often improve a child's capabilities.脑瘫不能治愈，但治疗往往可以提高儿童的能力。 In fact, progress due to medical research now means that many patients can enjoy near-normal lives if their neurological problems are properly managed.事实上，由于进展医学研究意味着，现在很多病人可以享受接近正常人的生活，如果他们的神经问题得到妥善管理。 There is no standard therapy that works for all patients.有没有标准的治疗方法，工程所有病人。 Instead, the physician must work with a team of health care professionals first to identify a child's unique needs and impairments and then to create an individual treatment plan that addresses them.相反，医生必须与一组医疗专业人员首先确定一个孩子的独特需要和障碍，然后再建立一个个人的治疗计划，以解决它们。

Some approaches that can be included in this plan are drugs to control seizures and muscle spasms, special braces to compensate for muscle imbalance, surgery, mechanical aids to help overcome impairments, counseling for emotional and psychological needs, and physical, occupational, speech, and behavioral therapy.有些办法，可以包含在这个计划是药物控制癫痫发作和肌肉痉挛，特别支撑，以弥补肌肉的不平衡，外科，机械器材，以帮助克服障碍，辅导的情感和心理需求，物理，职业，言论和行为疗法。 In general, the earlier treatment begins, the better chance a child has of overcoming developmental disabilities or learning new ways to accomplish difficult tasks.一般来说，早期治疗伊始，更好的机会一个孩子克服发展残疾或学习新的方式来完成艰巨的任务。

The members of the treatment team for a child with cerebral palsy should be knowledgeable professionals with a wide range of specialties.成员团队治疗儿童脑瘫应了解专业人士广泛的专业。 A typical treatment team might include:一个典型的治疗小组可能包括：

• a physician, such as a pediatrician, a pediatric neurologist, or a pediatric physiatrist, trained to help developmentally disabled children. •一名医生，如儿科，小儿神经科，儿科或physiatrist ，培训，以帮助残疾儿童的发育。 This physician, often the leader of the treatment team, works to synthesize the professional advice of all team members into a comprehensive treatment plan, implements treatments, and follows the patient's progress over a number of years.这医生，往往是领导者的治疗小组，工程，综合专业意见，所有团队成员成为一个全面的治疗计划，实施治疗，并遵循病人的进展，在若干年内。
• an orthopedist, a surgeon who specializes in treating the bones, muscles, tendons, and other parts of the body's skeletal system. •整形外科，外科医生谁擅长治疗骨骼，肌肉，肌腱，以及身体的其他部位的骨骼系统。 An orthopedist might be called on to predict, diagnose, or treat muscle problems associated with cerebral palsy.整形外科可能会被要求预测，诊断或治疗肌肉相关问题脑瘫。
• a physical therapist, who designs and implements special exercise programs to improve movement and strength. •物理治疗师，谁设计和实施特别工作计划，提高运动和力量。
• an occupational therapist, who can help patients learn skills for day-to-day living, school, and work. •职业治疗师，谁可以帮助病人学习技能的日常的生活，上学，工作。
• a speech and language pathologist, who specializes in diagnosing and treating communication problems. •演讲和语言病理学家，谁擅长诊断和治疗的沟通问题。
• a social worker, who can help patients and their families locate community assistance and education programs. •一名社会工作者，谁可以帮助病人和他们的家人找到社区援助和教育节目。
• a psychologist, who helps patients and their families cope with the special stresses and demands of cerebral palsy. •一名心理学家，谁可以帮助病人及其家属配合特别强调和要求的脑性麻痹。 In some cases, psychologists may also oversee therapy to modify unhelpful or destructive behaviors or habits.在某些情况下，心理学家还可以监督治疗修改无益或破坏性行为或习惯。
• an educator, who may play an especially important role when mental impairment or learning disabilities present a challenge to education. •一个教育工作者，谁可能发挥了特别重要的作用时，心理障碍或学习障碍提出了挑战教育。


Individuals who have cerebral palsy and their family or caregivers are also key members of the treatment team, and they should be intimately involved in all steps of planning, making decisions, and applying treatments.谁拥有个人脑瘫和他们的家人或照顾者也主要成员的待遇的球队，他们应该密切参与所有步骤的规划，决策，处理和应用。 Studies have shown that family support and personal determination are two of the most important predictors of which individuals who have cerebral palsy will achieve long-term goals.研究表明，家庭的支持和个人的决心是最重要的两个因素，其中有个人谁脑瘫将实现长期目标。

Too often, however, physicians and parents may focus primarily on an individual symptom -- especially the inability to walk.常常然而，医生和父母可能主要集中在个别症状-尤其是无法行走。 While mastering specific skills is an important focus of treatment on a day-to-day basis, the ultimate goal is to help individuals grow to adulthood and have maximum independence in society.虽然掌握特定的技能是一个重要的治疗重点在日常的基础上，最终目标是帮助个人长大成人，并产生最大的独立的社会。 In the words of one physician, "After all, the real point of walking is to get from point A to point B. Even if a child needs a wheelchair, what's important is that they're able to achieve this goal."用一名医生， “毕竟，真正的点是步行从A点，以点湾即使一个孩子需要坐轮椅，有什么重要的是，他们能够实现这一目标。 ”


Sources: National Institute of Neurological Disorders and Stroke资料来源：美国国立神经疾病和中风
National Institutes of Health美国国立卫生研究院