不明原因，兩歲還未行得穩，可以點做，幫幫手

HammerMom

阿仔將近兩歲，由5個月前開始放手行路到而家仍然係行得左搖右擺，像剛學走路既小朋友，又未識講嘢。 一歲時問健康院護士同醫生點解阿仔仲係未企得穩，係咪有問題，個個都話每個細路發展有唔同，應該冇嘢，再觀察，係咁追先至寫轉介信去醫院跟進。

排期睇兒科醫生兩個月，醫生話可能個小腦有問題，要轉介去睇腦科、又轉介咗去做體智能測試、物理治療同職業治療。 腦科醫生話要照磁力共振，排期係一年後，體智能測試、物理治療同職業治療全部都係排期中。 知道阿仔有事政府又排咁耐已經即刻同佢排協康，點知都要排9個月或以上，3個月過咗都未排到做評估。 唯有出去搵私家物理治療同職業治療幫佢。

日子一日一日過，就嚟兩歲，阿仔仲係行到左搖右擺，但智能方面又完全正常，想做既嘢又因手腳協調又做得唔好令佢脾氣好差。

有冇人知係咩事，點可以幫到阿仔。 俾啲意見。

methy

回復 HammerMom 的帖子

如果係腦部問題,會唔會考慮早d照磁力共振? 我排政府都係一年,不過我覺得耐，要求去私家照,政府醫院比左轉介我,可以平d去私家照,不過政府個磁力共振期就取消排隊。不過我最後都係無做到。

我阿仔剛剛2歲,都未放手行到，未發展到,就只有等佢發展,同時間做治療加速佢發展,快d追返進度。
呢度個個問題好似好相似,其實又唔會完全一樣，你問既問題(有冇人知係咩事?),相信個個媽媽都想知。

點可以幫到阿仔?

我呢一年做過/做緊幫阿仔既野:
     物理治療(進行中)
     職業治療(已經唔使)
     言語治療(已經唔使)
     游水(進行中)
     針灸(試過,已無做)
     推拿(進行中)
     上門PST(進行中)
     S位暫託(剛開始)
     一星期一次playgroup

另外: 覆診義肢矯形造鞋墊幫下行路
         覆診遺傳科

HammerMom

Methy，多謝你，我都正喺你個POST到問你。

其實我由佢一歲半健康院寫咗轉介信就排政府同協康，知道要等咁耐就幫佢睇私人物理治療同職業治療，但物理治療師就話佢肌肉骨骼發展好好，唔知點解行成咁，職業治療就話佢發展遲咗成年，而家每星期一次訓練， 言語治療就仲排緊。

我想請問你，其實係咪要做磁力共振呢？ 做咗有冇負作用？點解你最後冇做？ 你講既義肢矯形造鞋墊係邊度做，係咪醫生話要做架？

methy

回復 HammerMom 的帖子

行路好多野配合,,,張力,肌力等(我都唔識)..

磁力共振副作用,醫生話無喇....不過我阿仔9個月時做過全身麻醉手術,吽吽豆豆左幾個月,我覺得點都有d影響。

磁力共振都係要麻醉,我預計到佢做完又會吽吽豆豆左幾個月。做左知道係咩原因,都係得過"知"字,考慮到當時1歲既阿仔進步緊,我就唔做住，如果佢無進步,又或退步,我先考慮照,睇下咩事。so 一年後既今日我都未照,阿仔亦進步緊,人人情況唔同,你問下醫生好d,做唔做既結果係點,秤下好處&壞處,再自己決定。

義肢矯形造鞋墊方面，阿仔開頭都係協康做物理治療,等左半年有政府物理治療,,做左4-5個月治療,見佢行路都唔多理想,有力,平衡都好左,梗係踏唔到幾步,同治療師傾,佢就提議轉介義肢矯形,就係咁喇,,多個專業意見咁囉。

cutejoycepig

磁力共振唔洗麻醉呀, 不過要小朋友瞓覺先做得. 姑娘會比d藥小朋友食左瞓.. 咁先開始做...不過之後個人好似成日都好想瞓咁囉.. 過一日到就冇咩事..我呀囝之前做過...

methy

回復 cutejoycepig 的帖子

我講得唔好,醫生講過照磁力共振係食藥,不過作用都係令人迷糊,so我唔想阿仔做。
阿仔好受藥物影響,呢個係我重要考慮。

QQP

回復 HammerMom 的帖子

你好, 我係一位有兩名腦退化症小朋友的媽媽. 我唔希望嚇親係, 更加唔希望你小朋友有類似的病.  不過我覺得你講的情況, 同我小朋友的情況類似, 所以希望可以分享一些個人意見給你.

1) 首先, 我覺得你仔仔在活動能力上有問題, 做一次 現行醫學最清淅的腦 mri 係好重要, 唔同類型的腦傷絕大部份都可以睇到. 如果真係唔好彩睇到有腦傷, 當然睇到唔代表西醫有得醫, 但有機會可以評估你小朋友仲會唔會有其他問題 (例如: 視力, 言語, 智力等等), 咁對小朋友未來發展定向有所幫助. 盡量叫公家寫紙你去私家盡快做咗佢.

2) 另外, 無論你 mri 睇唔睇到有問題, 都請你小心留意你小朋友係正在進步還是退步, 如果只係輕微的活動能力發展遲緩, 其實好快就會好轉過來, 但如果發覺問題越來越多, 甚至越加嚴重, 就請你盡快說服醫生 refer 你睇遺傳科, 正正因為每個小朋友發展都好唔同, 有好多穩性遺傳病初頭都冇明顯病徵, 而被誤診為輕度/原因不明 的 腦傷 或肌肉病, 但病情的嚴重性同 醫療路向就好唔同.

係香港的兒童專科(尤其係腦科), 都係公立(威記/qe)最多設備同經驗, 最好就洗盡辦法都叫你的公立醫院醫生幫你盡快搵出病因, 咁對小朋友的發展係好好好重要.  

LPYdad1

Dear Hammermom,

It is a strange and mix case.
If yr kid is walking imbalance and proven the coarse motoring is well developed by physiotherapist. In the beginning, it might be a false development in ear and ear lope which govern the balance of a person.
However, since u said that 未識講嘢 但智能方面又完全正常, the most possible suspect is the brain development skewed in cerebellum 小腦 and or basal ganglia 基底核which controls our motoring & language skills mainly the memory part. 脾氣好差 could be a result or a cause.There might be an over development in limbic system which control our emotion. Over-size of amygdala 杏仁體, and hippocampus海馬體 and even thalamus 丘腦 might lead to a person easily overreact to external threats or easily depressed. Thalamus also centralised our sensory stimuli in brain received through receptors like eye or ears. But I guess yr kid’s bad temper is more behavioral than in heritage. But be careful, always losing one’s temper could be a factor to affect the development of these brain parts in long run esp if he is young about 2 only.

Other than therapy, acupuncture, medication you might try, one thing to help is assessing your kid to have a quality & steady sleeping habit which helps him to release the intensiveness of the brain parts, esp cerebellum, amygdala and thalamus. Brain gym and child yoga are another possible methods to ease the stress of the brain since he is still young.

Hope it helps

HammerMom

TO Methy, 藥物影響正係我點解仲未俾阿仔照磁力共振既原因，佢上次照腦剩係食咗安眠藥就已經傻咗兩日，同埋行路都好似冇力，所以一直唔想佢照。  我都幫阿仔轉咗好多種唔同牌子既鞋，都係咁，等我問吓物理治療師駛唔駛着矯型鞋墊先。

To QQP， 阿仔已經做咗視力檢測，只係有輕微散光問題，醫生話有啲小朋友係咁，可能耐啲好好返或者差啲，而家都要定期去檢測。 至於智力方面就見咁多醫生都話佢正常，冇問題。 言語方面啲醫生認為佢只係遲發展，一直都唔肯轉介去言語治療師，但我就覺得佢連太空話都唔講係問題，一路都係發啲呀音，所以自已去排言語治療睇吓有咩幫到佢。
腦科醫生就係話要照磁力共振，但又話佢唔係咁嚴重可以慢慢排，睇吓佢做咗其它治療個成效先再算。
我想問轉介去遺傳學係由腦科醫生定專科醫生做。

TO LPYdad1，you spoke out my son's another big problem -> bad sleeping quality, he can wake up 3 to 5 times every night. I've tried lot of sleeping patern for him, but seems only improved a little.
Now, he only sleep one time (around 2 hours) for the whole morning and go to bed at around 9:30pm and wake up before 7am.  It seems too little sleeping time for him, but if he sleep longer in the morning, he will wake up frequently in the evening.
Any suggestion to improve the sleeping quality? And where can I find the brain gym training course?

Thz all for your comments and suggestion

QQP

回復 HammerMom 的帖子

你已經去咗咁多方面的評估/檢查, 辛苦你了.  一定好疲累, 又迷惘!
要估計你小朋友大概係咩問題圥知由咩科轉介, 不過一般原因不明的異常發展都被推斷為關個腦事, 所以我估你小朋友都要等腦科轉介, 但要醫生轉介去遺傳科係好唔容易的, 你要說服醫生相信你小朋友好有可能有遺傳病, 係需要理據去証明的, 所以我估你的情況, 最好最快的証明就係 mri.  如果發現mri 有問題, 佢哋先會進一步幫你做嘢, 如果唔係就只會被派去不同的部門兜圈慢慢等.

kikigal

我也是迷惘之人................

我個仔都係兩歲啦, 而家26個月大(更正歲數就24個月), 同樓主一樣, 小朋友未可以行得好穩... 狀況維持幾個月, 時進步時退步... 腳行到好似拐拐下, 動作生硬好似機械人... 行得少少又唔肯行.

物理治療已改為1個月一次, 因為治療師話阿仔有進步, 側頸問題已改善(0-10度側, 不穩定)... 行路問題不太嚴重(個治療師甚至話, 我阿仔唔係腦癱, 政府可以有的資源已提供比阿仔...可以做的就是等他自己發展)...............
職業治療2星期一次, 訓練小肌肉, 協調等等...
營養師3個月一次, 因阿仔出世太輕, 磅數剛好追到... 而家大概11kg.

排緊E位.

報左2月kindermusik playgroup, 希望阿仔多D群體活動, 又有音樂活動刺激下 (因阿仔好喜歡聽音樂).
-------------------------
阿仔出世時, 腦有出血, 出世前已照到左腦室比右腦室大少少, 出世後+半歲照過腦掃描, 又話無腦水腫問題, 加上行為上沒什麼跡象腦有問題(例如突然嘔, 抽搐等), file closed.

本身陀BB時我無胎水, 係真的無胎水... !!!
試過3個月時漏了些出來, 找不到原因, 找不到缺口....用盡方法...完全係捱到7個月出世...所以阿仔o係個肚裡面唔夠位活動.

另外, 出世後住了個半月初生嬰兒深切治療部, 用最好果部呼吸機好長時間... 個肺到而家都比較弱, 氣管容易敏感, 咳到要吸藥先得, 試過1次肺炎.

QQP

回復 kikigal 的帖子

咁聽落, 都算有跡可尋架o刺, 小朋友可能因為懷孕及初生時期的不順利, 有一次性損害腦部, 而影響發展. 希望在你的惜心照料下會慢慢健康成長.  不過可能會辛苦你好一段長時間. 唔好太擔心, 加油呀!

天天是晴天

我覺得職業治療和針灸對你小朋友來講應該會有幫助.

HammerMom

過了一個忙碌的週未，帶了阿仔去做言語評估，希望可以幫到佢。 評估員話佢50%係小腦問題，50%係發展遲緩，又話佢大肌差過小肌，同之前啲評估調轉，但最後都係安排職業治療俾阿仔。

睇嚟到係要同阿仔照MRI架嘞，政府排到下年，我諗都係搵私家照，有冇人知邊間好同幾錢呀？

QQP

私家自己搵醫生寫紙照要成七千蚊架, 所以你最好就係勸你的公立醫生寫紙俾你私人去照, 咁就平一半.  總之你堅持一定要即刻照, 醫生都會寫紙俾你的. 我上次去九龍法國照, 佢會問埋你出唔出e檔案, 出埋e檔案, 醫生可以在網上睇到晒你的片, 唔洗帶d片四圍去俾唔到的醫生睇.

LPYdad1

Dear Hammermon,
I heard Hip Hong had both U might try.
To improve about sleeping, this topic is vast and a bit subjective.I heard u had done a lot about sleeping pattern, perhaps let me know in details (via PM if u think it is necessary)
But let me get u some ideas.
First, Quality is the most most top priority. My subjective view refers to the fact that the importance of this substance could mean u may even overwhelm the next 2 -3 Important component ( the length & sleeping pattern)largely to regain this part. I think u heard that a person normally had a sleeping cycle for about 4 hrs (actually average is about 3 hrs 50 mins as i heard). If the quality is gd not enough, such circle is not even exist. Why the circle is important becoz after 15mins when a person passed the pre-sleep stage in sleeping cycle, a person's brain (about 60% if I am wrong about number, please do correct me) will start to rest including most of the cerebral cortex, hindbrain, midbrain, basal ganglia, thalamus and hypothalamus. Limbic system might still be in work, but of course in much less stress. This will last for 2-3 hours, the remaining 30-45 mins are in awakening stage. A person would be easily awaken from external intruder at that moment. It's ok if one is awake and perhaps went back to sleeping cycle again. Therefore, an adult should have 8 hours sleep per day for 2 cycles.
Since I dont know yr details, but no matter what u did, try to make yr kid to have at least one cycle each day (A kid from 2-3 should have about 10-12 hours. That means 2-3 cycle each day) in the top priority. A minimum of minimum of minimum case is at least a full quality cycle each day. Otherwise, the brain actually has no adequate rest, a permanent damage might be arisen. My subjective view is that u could even give up any kind of sleeping pattern or length, but in return getting yr kid to take a complete rest for a cycle or 2 cycles, ideally 3 cycle of course even his pattern is strange as it starts to sleep at 3pm or 3am, or sacrify the idea of a kid at 2 should have a 10-12 hours sleep each day. Of course, this is an extreme case, but quality is the top key. Other criteria of course is still important but my suggestion is to get this one first and then gradually get back the others asap.
Other details let me know if u are interested.

eva816

原帖由 QQP 於 12-01-13 發表
回復 HammerMom 的帖子

你已經去咗咁多方面的評估/檢查, 辛苦你了.  一定好疲累, 又迷惘!

請問甚麼是MRI 丫？

nicolelaulau

回復 eva816 的帖子

MRI--->磁力共振