Children with Cerebral Palsy: A Parent's Guide（作者 Elaine Geralis ） 选段7

Chapter 1: What Is Cerebral Palsy? (4)

To understand how and why cerebral palsy affects your child as it does, it helps to understand how and why medical professionals classify cerebral palsy into different types. But before you can understand their classification systems, you may need to review how the human nervous system works.

The nervous system is made up of two parts: the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord. The peripheral nervous system consists of two sets of nerves which transmit information between the central nervous system and other body parts. Theses sets of nerves are known as sensory nerves and motor nerves. Sensory nerves carry information about senses such as pain, touch, position, and muscle tension from other parts of the body to the central nervous system. Motor nerves carry information from the central nervous system to the muscles.

For voluntary movement to occur, each element within the nervous system must work in harmony. Movement begins in the area of the brain known as the motor cortex, which is shown at the top of the figure 1. From here, the brain sends the initial signals to start a particular movement. The signals are then interpreted and modified by two other areas of the brain: the cerebellum and basal ganglia. The cerebellum helps coordinate muscle activity, maintains muscle tone, and controls balance. The basal ganglia control adjustments in posture needed during movement.

After these areas of the brain have processed the movement impulses, they travel to the spinal cord. The spinal cord, in turn, transmits the movement information to the peripheral nerves, which carry the impulses to the appropriate muscles. Upon receiving the impulses, the muscles contract and make the intended movement.

That, in a nutshell, is how people without motor disabilities move. Because children with cerebral palsy have injuries to the brain, they cannot control their movements normally. Exactly how their movement is affected depends on the location of the injury in their nervous system and the resulting type of muscle tone problem. Medical professionals sometimes classify types of cerebral palsy based on these two factors—— the type of muscle tone problem and the location of the injury. Another way they classify types is according to the parts of the body that are affected by movement problems.

If your child's early signs of cerebral palsy were quite clear-cut, you may already have been told what type she has. But if the exact nature and extent of your child's movement problems are still not clear, professionals may not yet have determined the type of cerebral palsy your child has. In neither case, you may be able to recognize some of your child's symptoms among the many types of cerebral palsy described in the next chapter.



Motor cortex- 运动皮层
Basal ganglia- 基底神经节
Parietal lobe- 顶叶
Occipital lobe- 枕叶
Cerebellum- 小脑
Pyramidal tract- 锥体束
Spinal cord- 脊髓
Frontal lobe- 大脑额叶
Peripheral nerve- 外围神经

Reference：The book “Children with Cerebral Palsy: A Parent's Guide”

译：
第一章：什么是脑瘫？（3）

当你明白了脑瘫为何以及如何影响你的孩子时，这将会帮助你理解医学人员为何以及如何将脑瘫归为不同的种类。但是在你能明白这些归类之前，你可能需要复习一下人体的神经系统是怎样运作的。

神经系统由两部分组成：中枢神经系统和外围神经系统。中枢神经系统由脑和脊髓构成。外围神经系统由两组神经构成，这两组神经在中枢神经系统和其它身体部分之间来回传输信息，被称作感觉神经与运动神经。感觉神经从身体的其它部分传递感官类的信息到中枢神经系统，如疼痛，触觉，姿态，和肌肉紧张度。运动神经则从中枢神经系统传递信息到肌肉。

为了形成自主运动，每一个神经系统中的元素互相之间都必须协调运作。运动开始于脑中一个叫运动皮层的区域， 依图1所示。从那里，脑发出了最初的信息来开始一个特定的动作。这些信息之后便被脑的另两个区域：小脑和基底神经节所理解与修改。小脑帮助调解肌肉活动，保持肌张力，以及控制平衡。基底神经节则控制运动时所需要的姿势的调节。

在这些脑的各个区域处理完运动脉冲之后，这些脉冲便会移动到脊髓。接着，脊髓会把这些运动信息传递到外围神经，然后外围神经将脉冲转移到适当的肌肉处。接收到脉冲之后，肌肉就会收缩并做出相应的动作。

简单概括来说，这，就是没有运动障碍的人们如何动作的。因为患有脑瘫的孩子脑部存在损伤，他们不能正常地控制他们的动作。具体他们的运动怎么受到影响取决于神经系统中损伤的部位和最终产生的肌张力问题的类型。医学人员有时就会按照这两个因素—— 肌张力问题的类型与损伤部位来对脑瘫类型进行分类。另一种方法是根据受到运动障碍影响的身体部分分类。

如果你孩子的脑瘫迹象相对明显，你可能已经被告知了他/她所属的类型。但是如果你孩子的运动障碍的准确性质和程度都还不清楚的话，专业人士可能还没有确定你孩子所患有的脑瘫类型。不管是哪一种情况，你或许都能够通过下一章所形容的各种脑瘫种类而识别出你孩子的某些症状。



出处：书籍《Children with Cerebral Palsy: A Parent's Guide》.