腦麻痺

英文頁面:https://en.wikipedia.org/wiki/Cerebral_palsy

中文頁面:https://zh.wikipedia.org/wiki/%E8%85%A6%E9%BA%BB%E7%97%BA

Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. Signs and symptoms vary between people. Often, symptoms include poor coordination, stiff muscles, weak muscles, and tremors(顫抖). There may be problems with sensation(感官), vision(视知觉), hearing(听觉), swallowing, and speaking(說話). Often babies with cerebral palsy do not roll over, sit, crawl, or walk as early as other children their age. Difficulty with the ability to think or reason(認知) and seizureseach occurs in about one third of people with CP. While the symptoms may get more noticeable over the first few years of life, the underlying problems do not worsen over time.[1]

腦性麻痺形容的是在幼童時期早期出現的運[[動障礙]]之疾病統稱,徵兆與症狀都因人而異。常見的病徵包括肌肉協調性差、[[肌肉僵直]]、肌無力和出現[[顫抖]]。在[[觸覺]]、[[視覺]]、[[聽覺]]、[[吞嚥]]與[[說話]]上可能都會遭遇困難。通常患有腦性麻痺的嬰孩不會如相同年紀的幼兒般,會有翻身、坐下、爬行或走路的能力。三分之一罹患腦性麻痺的病人,可能會有[[認知]]障礙或是癲癇。雖然這些症狀可能在出生初期就開始出現,但上述的原發性病徵並不會因為年紀增長而變得更嚴重[1]

Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture.[1][2] Most often the problems occur during pregnancy; however, they may also occur during childbirth, or shortly after birth. Often the cause is unknown. Risk factors include preterm birth(早產), being a twin(雙胞胎), certain infections during pregnancy such as toxoplasmosis(弓蟲症) or rubella, exposure to methylmercury(甲基汞) during pregnancy, a difficult delivery, and head trauma during the first few years of life, among others.[1] About 2% of cases are believed to be due to an inherited genetic cause(遺傳).[3] A number of sub-types are classified based on the specific problems present. For example, those with stiff muscles have spastic cerebral palsy, those with poor coordination have ataxic cerebral palsy, and those with writhing movements have athetoid cerebral palsy. Diagnosis is based on the child’s development over time. Blood tests and medical imaging(醫學影像) may be used to rule out other possible causes.[1]

腦性麻痺是由腦部發育異常或腦部用來控制移動、平衡和姿勢的部位受損所導致[1][2]。這些問題最常出現在懷孕時,然而也可能出現在生產或剛生產完的時候。病因大多不明。風險因子包括:[[早產]]、本身是[[雙胞胎]]、懷孕時感染特定疾病如[[弓蟲症]]或[[風疹]],懷孕時暴露在[[甲基汞]]中、分娩困難及出生前幾年受到頭部創傷等等[1]。約2%的案例據信是因[[遺傳]]導致[3]。我們可以根據出現特定的病徵分類一些亞型。舉例來說,有僵硬肌肉的病人得的是[[痙攣性腦性麻痺]],協調能力差的是[[運動失調性腦性麻痺]],有扭曲動作的是[[徐動性腦性麻痺]]。診斷結果根據孩童隨時間的發育而定。血液檢驗及[[醫學影像]]可用來排除其他可能的病因[1]。

CP is partly preventable through immunization of the mother and efforts to prevent head injuries in children such as through improved safety. There is no cure for CP; however, supportive treatments, medications, and surgery may help many individuals. This may include physical therapy(物理治療), occupational therapy, and speech therapy(言語治療). Medications such as diazepam(地西泮), baclofen, and botulinum toxin(肉毒桿菌毒素) may help relax stiff muscles. Surgery may include lengthening muscles and cutting overly active nerves(神经). Often external braces and other assistive technology(輔具) are helpful. Some children have near normal adult lives with appropriate treatment. While alternative medicines(替代医学) are frequently used there is no evidence to support their use.[1]

腦性麻痺其實是可以讓媽媽接受疫苗注射來預防的,而提昇幼童安全以避免腦部受傷也是可達到預防效果。目前沒有可完全治癒腦性麻痺的方法,但支持性療法、藥物治療以及手術可多少給予不同病況的患者協助。[[物理治療]]、職能治療與[[言語治療]]都是會考慮使用的醫療手段。例如[[丹祈屏]]、[[貝可芬]]和[[肉毒桿菌素]]等藥物能幫助紓緩緊繃的肌肉。會進行的手術包含延長肌肉與切除過度活躍的[[神經]]。在很多時候,[[外矯型器]]與其他[[輔具]]皆是病人的好幫手。只要經過適當的治療,部分的病童可以擁有接近正常成年人的生活。常常會有患者選擇使用[[替代療法]],但這些療程都沒有任何研究可支持他們的實用性[1]

CP is the most common movement disorder in children.[4] It occurs in about 2.1 per 1,000 live births.[5] Cerebral palsy has been documented throughout history with the first known descriptions occurring in the work of Hippocrates(希波克拉底) in the 5th century BCE. Extensive study of the condition began in the 19th century by William John Little, after whom spastic diplegia was called "Little disease".[6] William Osler first named it "cerebral palsy" from the German "zerebrale Kinderlähmung" (cerebral child-paralysis).[7] A number of potential treatments are being examined, including stem cell therapy. However, more research is required to determine if it is effective and safe.[1]

腦性麻痺是孩童中最常見的運動失調症[4]。每1000個新生兒約有2.1個會得到這種病[5]。腦性麻痺一直以來都有歷史紀錄,最早的描述記錄在西元前5世紀[[希波克拉底]]的作品中。對此種疾病症狀的廣泛研究從19世紀的[[William John Little]]開始,痙攣性雙癱也由他的名字命名為 "Little disease"[6]。William Osler 由德文 "zerebrale Kinderlähmung"(腦性孩童麻痺) 最早將其命名為"腦性麻痺"[7]。現在正在檢視一些可能的治療方式,包括[[幹細胞療法]]。然而這種療法安全、有效與否仍需更多研究[1]。