Neurological diagnoses of young children and parental fears

After the birth of a baby, parents have a lot of trouble, and inexperienced mothers and fathers are worried about the appearance in the child’s card of various diagnoses, consisting of abbreviations, mysterious and frightening. Children are still very tiny, and any deviations in their state of health, especially if it is the brain, can further result in serious developmental disorders of the baby – physical or mental. But are diagnoses and terrible letters in the card so dangerous?

Parenting experiences: real and contrived

Parents are especially concerned about diagnoses concerning the state of the child’s brain and nervous system, exposed almost immediately after childbirth. If the doctor says that something is wrong with the nervous system, parents may experience serious emotional stress. How, then, does a barely born child have neurological diagnoses and problems with the functioning of the brain – are the parents to blame for this, is it a medical omission or a congenital abnormality? The most common diagnosis in children is PEP, which stands for perinatal encephalopathy. Parents do not know what this mysterious state is, but the very name of the “disease” sounds threatening and frightening. How can it threaten a child, how can it affect his future, can affect the mental or physical development of the baby? Let us examine this problem in more detail.

Child’s brain: what diagnoses are possible?

It is important to point out the fact that the entire nervous system of a child, as well as both the spinal cord and the brain, the mechanisms of operation of all parts of the nervous system and the occurrence of various kinds of neurological diseases, have not been studied enough in medicine today. There are still many questions in pediatric neurology, and doctors do not know all the answers to them for sure. The child’s brain is still functionally immature at birth, the development of the baby and his nervous system actively continues in the first years of life. The majority of practicing pediatric neurologists, and even district pediatricians and neonatologists, doctors of other profiles, and even more so, cannot tell about the correct functioning of the nervous system under normal conditions and with pathologies. Often, with the aim of reinsurance, or partial removal of responsibility for further diseases and their possible development, which may be missed, doctors make redundant diagnoses. At the same time, all symptoms and deviations are attributed to variants of a completely normal development of the brain and the formation of its functionality.  

Newborn babies and the “fashion” for diagnoses

Today, doctors, by a set of certain symptoms and manifestations, have introduced a certain “fashion” in making diagnoses to children discharged from the maternity hospital and observed later on at the site. Thus, in the case histories, combinations of different letters appear, which terribly frighten and worry parents, but, in fact, do not speak of any particular danger. Very often in the future it becomes clear that such a practice was a “reassurance”. Children, against the background of such “diagnoses”, develop quite according to the timing and do not have any problems. However, some of the diagnoses may be confirmed over time, and it will not be superfluous for such children to follow general recommendations in the form of early swimming, physiotherapy exercises. If the pathological symptoms do not disappear, but, on the contrary, will be supplemented by others, this may serve as a reason for obtaining the opinion of another competent neurologist.

In addition, medical science and technology does not stand still, there is a constant improvement in diagnostic methods, including visual ones. As a result, doctors are getting access to such data about the brain and nervous system, which were previously unavailable several decades ago. And from here, too, overdiagnosis and various kinds of diagnoses begin to arise, which in children require more detailed research and observation for many years in order to say with precision whether this is a pathology or developmental options for a baby that correspond to completely healthy children. Approaches to diagnoses in pediatric neurology are changing, replacing outdated diagnoses of the type of MMD (which is deciphered as minimal cerebral dysfunction), which today is recognized as untenable, new ones have come – PEP, or GTP of the central nervous system (deciphering as hypoxic- traumatic damage to the central nervous system) or ADHD (translated as attention deficit hyperactivity disorder). All these sets of letters are not just frightening sounds, they are real diagnoses that children have in cards in almost every second (if not the first) case.  

Baby development and acronyms

Such “diagnoses” can be combined with each other, or occur in isolation or in combination with another “bunch” of problems, and can lead parents to think that things may not be good with the development of the baby, and perhaps he needs serious treatment. This is understandable, if there are several lines in the “diagnosis” column, even without their detailed decoding, such information seems to parents who do not have medical knowledge as a terrible problem. They think that the development of the baby is impaired, both physical and mental, and they will raise disabled children who are unable to move and live normally, lying with vegetables and seriously mentally retarded. From such a prospect, whoever wants, will fall into despondency. But, it is worth warning right away – it is too early to raise panic, as well as to evaluate the development of the baby in such a negative way.

The child and his problems: what is not referred to as pathology

In a child at an early age, immediately after birth and in the first months of life, the nervous system is still immature, this is quite normal. In the future, the nervous system is formed and matures for some time, the child is born with a set of minimal skills, and gradually trains and improves the nervous system, creates conditioned reflexes and goes through certain lines and stages of development. This reflects the degree of formation and maturation of the nervous system. The baby’s brain is still very plastic and is formed during its postpartum growth and development. That is why special manifestations, which for older children and adults would definitely mean pathology, for a child of the neonatal period will be a variant of the normal development process, and often doctors forget about these developmental features.

Usually, a child receives the most difficult and serious diagnoses after such a modern screening method as neurosonography (ultrasound of the brain through the large fontanelle). In this case, there is a visual inspection and measurement of the main structures of the brain on the screen of the apparatus with the adoption of conclusions on its structure. It is important to note that the conclusion of the ultrasound doctor, which was obtained based on the results of the study, in itself, is not a reason for making any diagnoses. This is an additional research method that excludes gross defects and developmental pathologies. If an expansion of any of the ventricles, lateral horns of the brain or even the interhemispheric fissure is found, this is not at all a reason to immediately treat the child, especially if there are no complaints and symptoms. This is just a picture of an ultrasound scan and these conclusions – this is not a cure! Also, there is no basis for the diagnosis of hyperactivity, this conclusion can be issued to children no earlier than five to seven years old, and newborns cannot be hyperactive. Infrequent and poor regurgitation after feeding is not attributed to the pathology of the nervous system – this is a normal phenomenon for children. 

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