10-B, Bul’varno Kudriavs’ka
Str., Kyiv City, Ukraine.
Mon-Fri: 8:30 a.m. – 7 p.m.
Sat: 9 a.m. – 1 p.m.
Sun: Day off
Call center
044 299 44 94
Взрослое отделение
044 272 11 81
Детское отделение
044 272 11 82

Peripheral nervous system trauma

Травма периферической нервной системы

Peripheral nervous system birth trauma is the damage of nerve roots, nerve plexus, peripheral and cerebral nerves affected by an external mechanical agent during childbirth. The force of such an impact far exceeds the endurance limit of specified anatomical formations; as a result the compression, destruction or tissue rupture may occur. All these disorders are accompanied by local or systemic circulation abnormalities, oedema, bone fractures, etc. The act of delivery is a very complex process, consisting of constriction injury, rotation, compression and traction. In case of worsening with the fetal malpresentation, large fetal sizes or midwifery forceps usage the probability of birth trauma is very high.

The types of peripheral nerves damage pathomorphological classification:

  1. Total (preganglionic) separation of the nerve root from the spinal cord;
  2. Postganglionic root rupture;
  3. Axon rupture with preservation of the myelin sheath;
  4. Nerve "Hurt" with axon preservation and myelin sheath.

The last damage type is least traumatizing and creates all the opportunities for a peripheral nerve complete recovery.

Any kind of nervous system birth trauma requires patient’s obligate examination by a neurologist. You can get a qualified consultation of an experienced physician at the "Bersenev's Medical Centre". For several decades our clinic has been specializing in spine and nervous system disease treatment, including birth trauma.

The most common are traumas of the brachial plexus, facial, diaphragmatic, radial and median nerves. Usually they occur in case of using the midwifery forceps.

The brachial plexus trauma mostly occurs when applying obstetric tools, which are used when the fetal head and shoulders are difficult to remove.

As a result of head or shoulders tractions and rotations, the upper and thoracic segments roots of the spinal cord stretch over the neck bones transverse processes.

A brachial natal plexoneuropathy was first described by scientists Duchenne (1872) and Klumpke (1885).

Obstetric paresis (brachial plexus trauma) is often observed in children born in the foot or breech presentation, with a heavy weight, contracted pelvis, excessive tractions of the fetal head, neck compression, difficulty while removing the shoulders or tilting the fetus arms.

Depending on the level of damage, brachial plexoneuropathy is divided into three main categories:

  • upper (proximal) type
  • lower (distal) type
  • total type

Erb-Duchenne palsy or upper (proximal) type

This is the most common type of birth palsy, which occurs 1 time for every 1500-2000 births and is associated with the primary fascicles of brachial plexus damage or C5-C6 cervical roots.

The clinical appearance is characterized by the fact, that the affected upper limb hangs weakly along the trunk, is unbent in all joints and turned inwards; the hand in the palmar flexion is turned back and out (a Novik's  characteristic symptom of the "doll's hand"). The shoulder is lowered. The shoulder and forearm muscles atrophy, the inability to raise the shoulder above the horizontal level, bend at the elbow joint are obserevd, i.e. the condition is characterized by a disorder of the function of proximal part of the arm; the movements in the fingers are preserved.

The head is often inclined and turned to the paretic shoulder, due to this the neck seems shortened and with a lot of transverse folds. There is also a muscle tone decrease in the proximal limb and a reflex from the biceps and triceps muscles is absent.

In some cases, the roots of C3-C4 are involved in the process, and then symptoms typical for damage to the phrenic nerve (rapid breathing, shortness of breath, hiccups, cyanosis, and asymmetry of chest movements) prevail in the clinical picture.

Déjerine-Klumpke palsy or lower (distal) type

This type of plexopathy occurs during the spinal cord trauma at C7-T1 level or middle and lower fascicles of the brachial plexus. It is much less common than the proximal (upper) type of lesion and is characterized by upper limb distal segment impairment. It is characterized by a sharp decline or complete loss of hand and fingers’ flexor muscles function. The hand hangs passively, there are no movements, and muscle tone is reduced. In some cases the hand is in the "clawed paw" position, which is associated with radial or ulnar nerves fibre damage.

Sometimes due to a median nerve involvement an "ischemic glove" symptom appears. This symptom is associated with the trophic disorders (hand skin blushing or blanching, swelling).

Total superior paraplegia (Kerer's paralysis)

The total type of trauma is noted at the spinal cord C5-T1 segment level for which the symptoms of the proximal and distal types of obstetric palsy are peculiar. This is the most difficult type of the obstetrical palsy. The complete hand immobility, muscle hypotension, trophic disorders, prolapse of reflexes, reduction of all kinds of sensitivity are being observed.

Seventh cranial nerve damage

The seventh cranial nerve damage is observed with facial presentation, a long-time head standing in the birth canal, contracted pelvis, while parotid gland compression with the obstetric forceps; in spontaneous delivery.

Statistics proves that the facial paresis in 80% of cases is associated with the forceps application.

In the clinical picture the mimic muscles hemiplegia prevails: the mouth angle is lowered, which is especially noticeable while crying; the nasolabial fold on the side of lesion is mild; the child is not able to close his/her eyes; the Kussmaul’s search reflex is reduced or absent; there are no forehead wrinkles and folds.

Lumbar plexus palsy is rare enough and appears as a result of an awkward legs extraction of the fetus.

At "Bersenev's medical centre" we apply the unique therapeutic method, which contributes to the restoration of affected nerve fibres. The metameric treatment method, which was developed and introduced into practice by doctor Bersenev, for several decades, has been fighting against central and peripheral nervous system diseases. Metameric method contributes to the peripheral nervous system regeneration due to the combination of reflexotherapy and the neurotrophic medication effect. By making an appointment for a consultation at our medical center, you will get qualified answers from neurologists and learn how to treat the peripheral nerves, roots and plexuses injuries. An individual treatment and rehabilitation program is developed for each patient in order to get optimum result.

To make an appointment for a consultation or a treatment session, please, call (044) 272-11-82 (children’s department), (044) 238-22-31 (call centre) or fill out the online form on our "Bersenev's medical centre" website.

Cost of treatment with additional services
Primary neurologic examination of a child/adolescent
Secondary neurologic examination of a child/adolescent
Individual program of home treatment for a child/adolescent
Prolongation of the individual program of home treatment for a child/adolescent
Outpatient treatment by the neurometameric reflexotherapy and metameric medicinal treatment of a child/adolescent with nervous system impairment
(1 neurological syndrome)
Outpatient treatment by the neurometameric reflexotherapy and metameric medicinal treatment of a child/adolescent with nervous system impairment
(2 neurological syndrome)
Outpatient treatment by the neurometameric reflexotherapy and metameric medicinal treatment of a child/adolescent with nervous system impairment
(3 neurological syndrome)
Our staff
Vladyslava Kulyk
Children’s department head physician,
Candidate of Medical Science,
high level certificate pediatric neurologist
Iuliia Biliuk
Pediatric neurologist,
first level certificate neurologist
Kseniia Maister
Psychologist, speech therapist,
neuropsychologist
Olena Bielievtseva
Speech therapist
Taras Zamors’kyi

Taras Zamors’kyi

Physical rehabilitation therapist,
PhD in Physical Education
Oleksandr Shevchuk

Oleksandr Shevchuk

Massage therapist
Stanislav Kurtosmanov

Stanislav Kurtosmanov

Massage therapist
Olha Andriienko

Olha Andriienko

High level certificate nurse
Zhanna Kucherenko

Zhanna Kucherenko

High level certificate nurse
Marharyta Momotiuk

Marharyta Momotiuk

Massage therapist,
second level certificate nurse
Child neurology
Никто не может вернуться назад и изменить свой старт, но каждый может стартовать сейчас и изменить свой финиш. Когда семья решает иметь ребенка, все представляют, какой  он будет красивый, умный, счастливый. Едва ли чье-то воображение   рисует будущего малыша больным, беспомощным и несчастным. К сожалению, жизнь преподносит не только приятные сюрпризы. Радость рождения, может омрачиться сообщением о болезни. Среди причин детской инвалидности лидируют заболевания нервной системы , 75%   которых возникают в период внутриутробного развития или же в процессе родов.
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Children’s department
About metameric treatment Documents for admission Questions and answers
What we treat
Consultation of a child neurologist

Child neurologist specializes in the treatment of diseases associated with the central and peripheral nervous system affliction, as well as functional disorders of children.

Usually, during the first month after the child’s birth, doctors send parents to the compulsory consultation of a child neurologist, even if the child was born completely healthy and does not have any disorders related to the nervous system. Moreover, the regular follow-up visits are also necessary during the next stages of life.

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CEREBRAL PALSY (CP)

The term “cerebral palsy” combines a group of syndromes resulting from underdevelopment or brain damage (often combined with spinal cord injury in the cervical spine) during the prenatal, intranatal and early postnatal periods.

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Perinatal CNS involvement

Perinatal involvements of the central nervous system are those pathological conditions that arise under the influence of many negative factors affecting the growth and fetus development in the perinatal period.

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Organic lesion of the central nervous system

Organic central nervous system lesions are a group of various neuropsychic disorders resulting from the influence of pathological factors upon the brain at different stages of ontogenetic development. This pathology has many behaviour options and various pathogenesis.

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Birth trauma of cervical spine

During the birth the infant experiences a great physical exertion when passing through the maternal passages. The newborn’s skeletal system is different from the adult person skeletal system – it is characterized by special flexibility in order to go through this passage without consequences. Thus the newborn babies have an increased chance of receiving a birth trauma of cervical spine during the process of delivery.

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Psychoverbal development delay

In recent decades, more and more children have a diagnosis “Psychoverbal development delay”. The statistics are inexorable. And the sooner a psychoverbal development delay or speech delay is detected, the greater the chances for child’s treating are.

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Muscle tone disorders

Muscle tone is a slight muscle tension, which is necessary for their quick inclusion in working condition. It is the level of tone that determines the readiness of the muscle complex to perform motor functions. For each period of child’s development there exist physiological standards of tonic activity.

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Spinal amyotrophy

The spinal amyotrophies are genetic disorders of an anterior horn motor neurone disease; they are characterized by the progressive muscle weakness and twitching. Spinal amyotrophies are not characterized by sensational, motion coordination and oculomotor disorders. This is due to the spinal cord motoneurons affection.

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Myopathy

Myopathies are hereditary diseases, which are based on the muscle fiber damage and, as a consequence, the emergence of a progressive musclular dystrophy (atrophy).

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Myelopathy

Myelopathy is a neurological term used to describe all kinds of spinal cord lesions. Myelopathy is usually a chronic disease.

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Neurotic disorders

Among the mental disorders that occur in childhood, neurotic disorders account for 65%. Neurotic disorders (neuropathy, neurosis, neurasthenia, childish nervousness) in children manifest themself with a wide range of clinical symptoms, among which autonomic dysfunction and emotional disorders are the first.

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Juvenile osteochondrosis

Juvenile (adolescent) osteochondrosis is a disease that is based on degenerative-dystrophic changes of intervertebral discs in adolescence. These changes are caused by the teens’ rapid growth, possible skeleton formation disorders, as well as inadequate physical activity on the growing spine. Osteochondrosis can develop in case of wearing a heavy bag on one shoulder and long sitting in an unnatural pose while studying.

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The compulsive movement syndrome

The compulsive movement syndrome is a children’s nervous system disorder, which appears as a series of simple repeating motions. Such movements include finger sucking, nibbling, frequent blinking, wiggling, rocking or turning, grinding of teeth, shoulders twitching, forehead skin wrinkling, etc.

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Psycho-Speech Delay in Genetic Diseases

With the development of a number of natural sciences (genetics, biochemistry, embryology, general biology, etc.), more and more importance is attached to genetic factors, which are considered to be the cause of more than half of cases of psycho-speech development disorders. This primarily includes the chromosome set pathology. Currently, more than 200 types of chromosomal aberrations are being described, causing psycho-speech development delay and mental retardation.

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The autonomic dysfunction syndrome

Autonomic dysfunction is the common name for all the autonomic nervous system (ANS) dysfunctions, which lead to a “failure” in the work of internal parts and body systems.

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Posture disorders in children

Posture is a natural habitual posture of a person, which depends on the spine condition, muscular-ligament apparatus, environment, general well-being, and heredity. This is a complex notion determined by a variety of factors and revealing not just the physical condition of a person, but also a psychical one.

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Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder is a quite common disease that is based on the central nervous system dysfunction (mainly the brain reticular formation).

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Autism

The autism is a child’s mental development disorder, which is characterized by a lack of communication and speech and motor disorders.

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Additional services
Speech therapist appointment

A speech is a reflection of thinking; it is a system. If there are problems with oral speech, then there will be difficulties with the thoughts formation, the ability to analyse, speculate, build logic chains, and also there will be some difficulties with reading and writing. A violation in one speech link is enough to make the whole system start to function incorrectly.

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Metameric massage

Many articles have already been written about the undoubted massage benefits, and it has long been known that this is one of healing means, along with sports and nutrition. Massage helps to recover from stress quickly and avoid diseases associated with constant nervous tension, relieves pain points, and relaxes tense muscles. It also reduces anxiety, normalizes the blocked energy flow, enhances the immune system functions, and restores a sense of calm and well-being. This is an important component of a healthy lifestyle.

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Psychologist consultation is your chance to change your life for the better

 

The spine, keeping the whole skeleton in an upright position, is the core of both the whole organism and our Personality.

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Family physician appointment

At the “Bersenev’s Medical Center” all patients can get a qualified individual consultation of the family physician Petlytska Victoria Vitaliivna, a specialist with decades of experience in this field.

Victoria Vitaliivna had gotten a special multi-field speciality training of “family medicine”.

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Infusion therapy

Infusion therapy (intravenous administration of solutions of various drugs into the body) is currently one of the most important medical measures aimed to solve a wide range of medical problems. This method of treatment exists since the 30s of the XIX century.

This method of treatment allows you to achieve a rapid therapeutic effect, as the medicine enters directly into the bloodstream, and also allows you to control its action more effectively.

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Kinesio Taping

Kinesio taping is the imposition and fixation of special elastic bands on the child’s skin for several days in order to provide physiological movements of the joints and muscles, activating the processes of recovery and movement control. Kinesio tapes are elastic cotton tapes coated with an acrylic-based hypoallergenic adhesive gel.

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Orthoses Making

In our Medical Centre you can get an expert advice from a physical rehabilitation specialist, as well as make individual ORTHOSES from Turbocast material.

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Corrective insoles making

В нашем Медицинском Центре Вы можете получить квалифицированную консультацию специалиста по физической реабилитации, а также изготовить индивидуальные ортопедические стельки.

Ортопедические стельки — это стельки, имеющие определенный рельеф, и за счет этого оказывающие лечебное воздействие. Этот вид ортезов используется для лечения и профилактики различных форм плоскостопия (продольного, поперечного, плоско-вальгусной деформации стопы), а также при других заболеваниях стоп и опорно-двигательного аппарата в целом.

 

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Metameric speech apparatus massage

Массаж артикуляционного аппарата или логопедический массаж — это метод механического воздействия, который изменяет  состояние мышц, нервов, кровеносных сосудов и тканей речевого аппарата.

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Doctor Bersenev explains
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