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For the first time, it was only in 1937 that the child’s behavior could be associated with changes in his brain. This idea was expressed by the American neurologist Samuel Orton ( Samuel Orton ), dealing with the problem of children’s learning. The term “minimal brain dysfunction, MMD” or “mild MD” itself appeared in 1955.

The findings were confirmed by Strauss , Werner in 1947 and Strauss , Lethinen in 1955. These doctors were engaged in observing the maturation of behavioral responses in children with a normal birth history and prematurity. Doctors have established that there is a direct relationship between the characteristics of the development of the child’s psyche and damage to his brain.

What is Minimal Brain Dysfunction

Synonyms: hyperkinetic chronic brain syndrome, minimal brain damage, mild infantile encephalopathy, mild brain dysfunction.

Research on this topic was carried out by both domestic and foreign neurologists. Statistics say that from 5 to 20% of preschool children and schoolchildren have one or another version of MMD.

The pathology is widespread. Doctors refer it to encephalopathies of the perinatal period. This term summarizes all the problems and lesions of the brain that occur during the perinatal period.

According to clinical criteria, the perinatal period is further divided into three sub -periods :

1. Prenatal or antenatal – calculated from the 7th month of gestation until the onset of labor;
2. Intrapartum or intranatal – begins with the onset of contractions and ends with the baby leaving the birth canal or from the incision during caesarean section.
3. Early neonatal is the first 7 days of an independent life of a child, when his body is forced to adapt to a changed environment.

MMD is characterized by delayed maturation of brain structures. Regulatory functions of the nervous system are also violated. This is reflected in the emotional sphere of the child, the ability to adapt, vegetative regulation, behavior.

In other words, the term MMD combines non-gross deviations in behavior and cognition, while maintaining intelligence at an acceptable level.

Such anomalies are the result of mild insufficiency of the functionality of the brain. And they arise, as a rule, as a result of one or another of his lesions.

Causes of brain dysfunctions

The main mechanism that affects the nervous tissue of the fetus, the newborn is hypoxia, oxygen deficiency.

The danger of brain hypoxia increases in late pregnancy and in the phase of childbirth. This is confirmed by data obtained from the results of EEG, computed tomography .

According to the criterion of cause and development, lesions of the nervous system in the perinatal period are divided into three types:

1. Hypoxic- ischemic. Occur due to oxygen starvation of the fetus with a deficiency of O ₂ or chronic metabolic disorders in the prenatal period ( feto -placental insufficiency). There is a danger of intranatal hypoxia, asphyxia, when the umbilical cord is infringed during childbirth or the vessels of the fetal neck are clamped.

1. Traumatic, usually caused by physical impact on the head.
2. Mixed, hypoxic -traumatic – when a combination of both of the above effects is noted.

It is noticed that in children with prematurity, subcortical structures suffer from hypoxia. Who is born at term, more at risk of damage to the cortex. Due to the anomalies that have arisen, minimal brain dysfunction (MMD) occurs. In childhood, they are regarded as encephalopathy. Manifestations in adults are explained by the weakness of the nervous system.

Below we will dwell in more detail on the factors that can cause CNS damage in the fetus and newborn.

Which period of pregnancy is more dangerous?

As you know, during the first 12 weeks, the laying, the formation of the foundation for the body of the future person takes place. Including – brain sprouts are formed. And the protection of the fetus, the placental barrier, matures by the end of the first trimester.

Therefore, in the first weeks of gestation, infections are dangerous:

1. toxoplasmosis;
2. chlamydia;
3. listerellosis ;
4. syphilis;
5. serum hepatitis;
6. cytomegalovirus infection, etc.

Pathogens from the mother’s body freely reach the fetus and disrupt the primary growth processes. The emerging brain structures are no exception.

At the stage of laying, infections lead to generalized lesions of the fetus. Due to the high sensitivity to damage, the correct formation of the nervous system is disrupted.

From the 13th week, when the placental barrier begins to work, the influence of adverse effects does not lead to gross defects. However, the risk of intrauterine malnutrition, premature birth and the birth of a child that is not yet ripe for this remains.

Factors that have a negative impact on the development and maturation of the nervous system are known. They can affect both at the time of conception (if the reproductive organs of the parents are affected), and subsequently.

Typical: ionizing radiation, alcohol, acute and chronic poisoning.

Risk factors for MMD during gestation

We list the main reasons due to which nervous tissue suffers in the perinatal period:

1. chronic and acute diseases suffered by a pregnant woman;
2. pathologically occurring pregnancy – severe toxicosis, eclampsia, the threat of interruption;
3. any sources of chronic intoxication in the body of the expectant mother;
4. unbalanced diet, inadequate diet during pregnancy;

1. the early age of the expectant mother, her immaturity;
2. hereditary pathology, metabolic disorders (diabetes mellitus, etc.);
3. negative impact of the environment;
4. environmental situation at the location of the pregnant woman – toxic damage, poisoning, the effect of ionizing radiation, certain drugs, etc .;
5. abnormal course of labor – weakness of labor activity, or vice versa – rapid labor, delivery of obstetrics (forceps);
6. prematurity and immaturity of the baby;
7. genetic anomalies ( Down’s b- n ).

miscarriage is more important . When, due to the health problems of the mother, the baby is born prematurely, immature and premature, with low body weight.

Such a child, as a rule, is not yet ready for overload during childbirth, which is why it is injured in the birth canal. Also, immature children have a higher risk of adaptation failure in the postpartum period.

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Statistics show that brain tissue anomalies that cause MMD are most often provoked by the use of alcohol by parents on the eve of conception. Or when a pregnant mother “uses”. Ethanol is a killer for immature fetal neurons, disrupts the laying and maturation of the brain.

No less harmful are strong stimulants – coffee, energy drinks. They constrict blood vessels, including the umbilical cord. Those can cause acute or chronic fetal hypoxia.

Risk factors for MMD during labor

At this stage, the born baby is at risk of being exposed to hypoxia or infection. Typical causes for brain dysfunctions in childbirth:

1. a long pause between the discharge of water and contractions;
2. insufficiency of contractions, weakness, which forces the use of stimulation of uterine contractions;
3. small opening of the pharynx of the cervix;
4. rapid childbirth;
5. the need to use obstetrics – turning the fetus, forceps;
6. entanglement with the umbilical cord, clamping of its vessels;
7. emergency caesarean section with general anesthesia;
8. excessive size and body weight of the fetus.

Children at risk for brain damage include those who are preterm and who are abnormally overweight (too large or too small).

As a rule, damaging factors during childbirth rarely directly affect the structures of the central nervous system. But the consequences of such exposure indirectly disrupt the biological and physiological maturation of the infant’s brain.

Risk factors for MMD in the early postnatal period

Immediately after birth, to get brain damage, the child risks for the following reasons:

1. neuronifections ;
2. trauma;
3. intoxication.

Combining or separately, genetic anomalies with organic lesions of the nervous tissue become the basis for the characteristics of the character and behavior of children described below.