Organic damage to the central nervous system in newborns. CNS damage in newborns: causes, symptoms, treatment methods, consequences

All living things cannot exist without taking into account signals from the external environment. Perceives them, processes them and ensures interaction with the surrounding nature nervous system. It also coordinates the work of all systems within the body.

Neurological disease

The central nervous system plays important role in regulating people's behavior. Diseases of the central nervous system today affect people of all ages.

Damage to the central nervous system is neurological disease. Patients with disorders of the central nervous system are monitored by a neurologist, although diseases of any other organs may be concomitant.

Disorders of the nervous system are closely intertwined with pronounced disharmony of mental activity, which provokes changes positive qualities character of a person. Damage to the central nervous system can affect the functioning of the brain and spinal cord, leading to neurological and mental disorders.

Causes of central nervous system damage

The central nervous system can be damaged as a result of the use of certain medications, physical or emotional stress, or difficult and difficult childbirth.

CNS damage can be caused by drug use and abuse alcoholic drinks, which leads to a decrease in the potential of important brain centers.

The causes of central nervous system diseases are injuries, infections, autoimmune diseases, structural defects, tumors, and stroke.

Types of central nervous system lesions

One type of disease of the central nervous system is neurodegenerative diseases, which are characterized by progressive dysfunction and cell death in certain areas of the nervous system. These include Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease, lateral amyotrophic sclerosis(ALS). Alzheimer's disease causes memory loss, personality changes, dementia and ultimately death. Parkinson's disease causes tremors, rigidity, and loss of motor control as a result of loss of dopamine. Most characteristic symptoms Huntington's diseases are random and uncontrolled movements.

Retroviral infections pose a potential threat to the central nervous system, illustrating the molecular interactions between certain viral pathogens and pathological reactions resulting from this interaction.

Viral infections of the nervous system are increasing from year to year, confirming the significant increase in global epidemics in recent years.

Disturbances in the functioning of the central nervous system in some cases occur during fetal development or during childbirth.

When the central nervous system is damaged, an imbalance occurs in all human organs, the functioning of which is regulated by the central nervous system.

A failure in the functioning of the central nervous system will in any case lead to damage or disruption of the activity of other organs.

Organic damage CNS

Defective brain activity means that an organic lesion of the nervous system has occurred, which can be congenital or acquired. Most people experience mild damage that does not require treatment. The presence of moderate to severe degrees of this disease requires medical intervention, since there is a disruption in the activity of the central nervous system.

Signs of organic damage to the central nervous system are increased excitability, rapid distractibility, urinary incontinence daytime, sleep disturbance. In some cases, the functioning of the organs of hearing and vision deteriorates, and coordination of movements is also impaired. The human immune system suffers.

Viral infections that occur in a woman who is carrying a child, the use of various medications, smoking or drinking alcohol during pregnancy affect the functioning of the central nervous system and lead to its disruption.

Organic damage to the nervous system can be observed in both children and adults.

A newborn baby has not yet fully formed organs and systems, and it takes some time to complete formation. It is during the process of the baby’s growth that his central nervous system also forms and matures. The baby's nervous system helps regulate its normal existence in the world.

In some cases, damage to the central nervous system of newborns can be diagnosed, which has recently occurred quite often. Suppression of the nervous system can cause serious consequences and leave the child disabled.

Features of the structure of the nervous system of a newborn

An infant differs from an adult not only in external differences, but also in the structure of its body, since all systems and organs are not fully formed. During the period of brain formation, unconditioned reflexes are clearly expressed in a child. Immediately after birth, the level of substances that regulate hormones responsible for the functioning of the digestive system increases. At the same time, all receptors are already quite well developed.

Causes of CNS pathology

The causes and consequences of damage to the central nervous system of newborns can be very different. The main factors that provoke disruption of the functioning of the nervous system are:

lack of oxygen, or hypoxia;
birth injuries;
disruption of normal metabolism;
infectious diseases suffered expectant mother during pregnancy.

Lack of oxygen, or hypoxia, occurs when a pregnant woman works in hazardous work, infectious diseases, smoking, previous abortions. It all breaks general circulation, as well as oxygen saturation of the blood, and the fetus receives oxygen along with the mother’s blood.

One of the factors leading to damage to the nervous system is considered to be birth trauma, since any injury can provoke a disruption in the maturation and subsequent development of the central nervous system.

Disruption of normal metabolism occurs for the same reasons as lack of air. Drug addiction and alcoholism of the expectant mother also lead to dysmetabolic disorders. In addition, taking potent medications can affect the nervous system.

Infectious diseases suffered by the expectant mother while carrying a child can be critical for the fetus. Among such infections it is necessary to highlight herpes and rubella. In addition, absolutely any pathogenic microbes and bacteria can provoke irreversible negative processes in the child’s body. Mostly, problems with the nervous system occur in premature babies.

Periods of CNS pathologies

The syndrome of damage and depression of the nervous system combines several pathological conditions arising during intrauterine development, during labor activity, as well as in the first hours of a baby’s life. Despite the presence of many predisposing factors, only 3 periods are distinguished during the disease, namely:

spicy;
restorative;
outcome of the disease.

In each period, damage to the central nervous system in newborns has different clinical manifestations. In addition, children may experience a combination of several different syndromes. The severity of each ongoing syndrome allows us to determine the severity of damage to the nervous system.

Acute course of the disease

The acute period lasts for a month. Its course directly depends on the degree of damage. With a mild form of the lesion, shuddering, increased excitability of nerve reflexes, trembling of the chin, sudden uncontrolled movements of the limbs, and sleep disturbances are observed. The child may cry very often for no apparent reason.

With moderate severity, there is a decrease motor activity and muscle tone, weakening of reflexes, mainly sucking. This condition of the baby should definitely alert you. By the end of the first month of life, existing signs may be replaced by hyperexcitability, almost transparent skin color, frequent regurgitation and flatulence. Often, a child is diagnosed with hydrocephalic syndrome, characterized by a rapid increase in head circumference, increased pressure, bulging of the fontanel, and strange eye movements.

At its most severe, coma usually occurs. This complication requires being under the supervision of a doctor.

Rehabilitation period

Damage to the central nervous system in newborns during the recovery period has the following syndromes:

increased excitability;
epileptic;
motor disorders;
mental retardation.

With prolonged violation of muscle tone, mental development delays and the presence of disorders often occur. motor functions, which are characterized by involuntary movements provoked by contraction of the muscles of the trunk, face, limbs, and eyes. This prevents the child from making normal, purposeful movements.

When mental development is delayed, the baby begins much later to hold his head up on his own, sit, walk, and crawl. He also has poor facial expressions, decreased interest in toys, a weak cry, and a delay in the appearance of babbling and humming. Such delays in the development of a child’s psyche should definitely alert parents.

Result of the disease

By about a year, damage to the central nervous system in newborns becomes obvious, although the main symptoms of the disease gradually disappear. The result of the pathology is:

developmental delay;
hyperactivity;
cerebroasthenic syndrome;
epilepsy.

As a result, the child may become disabled.

Perinatal CNS damage

Perinatal damage to the central nervous system in newborns is a collective concept that implies a disruption in the functioning of the brain. Similar disorders are observed in the antenatal, intranatal and neonatal periods.

Antenatal begins from the 28th week of intrauterine development and ends after birth. Intrapartum includes the period of childbirth, from the beginning of labor to the moment of birth of the child. occurs after birth and is characterized by the baby’s adaptation to environmental conditions.

The main reason why perinatal damage to the central nervous system occurs in newborns is hypoxia, which develops during an unfavorable pregnancy, birth injuries, asphyxia, and infectious diseases of the fetus.

The cause of brain damage is considered intrauterine infections, as well as birth injuries. In addition, there may be damage to the spinal cord that occurs due to trauma during childbirth.

Symptoms largely depend on the period of the disease and the severity of the lesion. In the first month after the birth of a child, an acute period of the disease is observed, characterized by depression of the nervous system, as well as hyperexcitability. Gradually normalizes. The degree of recovery largely depends on the degree of damage.

The disease is diagnosed in the maternity hospital by a neonatologist. The specialist conducts a comprehensive examination of the baby and makes a diagnosis based on the existing signs. After discharge from the maternity hospital, the child is under the supervision of a neurologist. To make a more accurate diagnosis, a hardware examination is performed.

Treatment should be carried out from the first hours after the birth of the child and diagnosis. In the acute form, therapy is carried out strictly in a hospital setting under the constant supervision of a doctor. If the disease is mild, treatment can be carried out at home under the supervision of a neurologist.

The recovery period is carried out comprehensively, and at the same time together with medications physiotherapeutic methods are used, such as physical therapy, swimming, manual therapy, massages, speech therapy sessions. The main goal of such methods is to correct mental and physical development in accordance with age-related changes.

Hypoxic-ischemic damage to the central nervous system

Since it is often hypoxia that provokes damage to the nervous system, each future mom should know what leads to hypoxia and how it can be avoided. Many parents are interested in what hypoxic-ischemic damage to the central nervous system is in newborns. The severity of the main signs of the disease largely depends on the duration of the child’s hypoxia in the prenatal period.

If hypoxia is short-term, then the violations are not so serious; oxygen starvation that continues for a long time is more dangerous. In this case, it may happen functional disorders brain or even death nerve cells. To prevent nervous system disorders in infants, a woman must be very attentive to her health while carrying a child. If you suspect the presence of diseases that provoke fetal hypoxia, you should immediately consult a doctor for treatment. Knowing what it is - hypoxic-ischemic damage to the central nervous system in newborns, and what the signs of the disease are, you can prevent the occurrence of pathology with timely treatment.

Forms and symptoms of the disease

Damage to the central nervous system in newborns can occur in several various forms, namely:

light;
average;
heavy.

The mild form is characterized by the fact that in the first days of a child’s life, excessive excitability of nerve reflexes and weak muscle tone may be observed. A sliding squint or irregular, wandering movement of the eyeballs may appear. After some time, trembling of the chin and limbs, as well as restless movements, may be observed.

The average form has symptoms such as lack of emotions in the child, poor muscle tone, and paralysis. Convulsions, excessive sensitivity, and involuntary eye movements may occur.

The severe form is characterized by serious disorders of the nervous system with its gradual suppression. This appears in the form of seizures, kidney failure, disturbances in the functioning of the intestines, cardiovascular system, and respiratory organs.

Diagnostics

Since the consequences can be quite dangerous, it is therefore important to diagnose disorders in a timely manner. Sick children generally behave uncharacteristically for newborns, which is why when the first symptoms of the disease appear, you should definitely consult a doctor for examination and subsequent treatment.

Initially, the doctor examines the newborn, but this is often not enough. At the slightest suspicion of pathology, the doctor prescribes a computed tomography scan, ultrasound diagnostics, as well as x-rays. Thanks to comprehensive diagnostics, it is possible to identify the problem in a timely manner and carry out treatment using modern means.

Treatment of central nervous system lesions

Some pathological processes occurring in the baby’s body may be irreversible in an advanced stage, and therefore require urgent measures and timely therapy. Treatment of newborns should be carried out in the first months of their life, since during this period the baby’s body is able to completely restore impaired brain functions.

Deviations in the functioning of the central nervous system are corrected with the help of drug therapy. It contains drugs that help improve the nutrition of nerve cells. During therapy, drugs that stimulate blood circulation are used. With the help of medications, muscle tone can be reduced or increased.

To help sick children recover faster, osteopathic therapy and physiotherapeutic procedures are used in combination with medications. To carry out a rehabilitation course, massage, electrophoresis, reflexology and many other techniques are indicated.

After stabilization of the child’s condition, an individual program of supportive care is developed. complex therapy and regular monitoring of the baby’s condition is carried out. Throughout the year, the dynamics of the child’s condition are analyzed, and other therapy methods are selected to promote rapid recovery and development of the required skills, abilities and reflexes.

Prevention of central nervous system damage

In order to prevent the occurrence of a serious and dangerous disease, it is necessary to prevent damage to the infant’s central nervous system. To do this, doctors recommend planning your pregnancy in advance, undergoing the required examinations in a timely manner and giving up bad habits. If necessary, carried out antiviral therapy, all necessary vaccinations are given, and hormonal levels are normalized.

If damage to the baby’s central nervous system does occur, then it is important to provide assistance to the newborn from the first hours of his life and to constantly monitor the baby’s condition.

Consequences of central nervous system damage

The consequences and complications of central nervous system damage in a newborn child can be very serious, dangerous to health and life, and they are expressed in the form of:

severe forms of mental development;
severe forms of motor development, cerebral palsy;
epilepsy;
neurological deficit.

Timely detection of the disease and proper therapy will help get rid of serious health problems and prevent complications from occurring.

It happens that in the maternity hospital or a little later, at an appointment with a pediatrician, a newborn child is given complex diagnoses regarding the state of the central nervous system (CNS). What is hidden behind the words “hypertensive-hydrocephalic syndrome” or “vegetative-visceral dysfunction syndrome” and how can these conditions affect the health and development of a child? Is it possible to treat CNS lesions? Child rehabilitation specialist Natalya Pykhtina, head of the clinic of the same name, tells the story.

The doctor receives the first information about the state of the central nervous system in the first minutes and hours after the baby is born, still in the delivery room. Everyone has heard about the Apgar score, which evaluates the viability of a child according to five main visible signs- heartbeat, skin color, breathing, reflex excitability and muscle tone.

Why is it important to correctly assess a baby’s motor activity? Because it provides information about the state of the spinal cord and brain, their functionality, which helps to recognize in time both minor deviations and serious pathologies.

So, greatest attention the degree of symmetry of the movements of the limbs is paid to: their pace and volume should be the same on both sides, that is, on the left arm and left leg and the right arm and leg, respectively. Also the doctor conducting initial examination newborn, takes into account the clarity and severity of unconditioned reflexes. This is how the pediatrician receives information about the activity of the baby’s central nervous system and finds out whether it is functioning within normal limits.

Damage to the central nervous system in a child occurs in two ways - in utero or during childbirth. If developmental abnormalities occur in the fetus during the embryonic stage of intrauterine development, they often turn into defects that are incompatible with life, or are extremely severe and cannot be treated or corrected.

If there was a damaging effect on the fetus after, this will not affect the child in the form of gross deformity, but it may well cause minor deviations that will have to be treated after birth. Negative Impact for the fetus in later stages - after- will not manifest itself in the form of defects at all, but can become a catalyst for the occurrence of diseases in a normally formed child.

It is very difficult to predict which specific negative factor and at what stage of pregnancy will cause irreparable damage to the fetus. Therefore, the expectant mother needs to be extremely careful and monitor her health even before the moment of conception. Preparing for pregnancy - important stage family planning, because the child’s health can be affected by both the bad habits of the mother and her chronic diseases, hard work and unhealthy psychological state.

How exactly he is born is also important for the child’s future life. It is at the moment of birth that there is a danger of damage in the second way - intranatally. Any incorrect intervention or, conversely, lack of timely assistance is highly likely to have a negative impact on the baby. At risk are premature birth, as well as birth at the scheduled time, but rapid or, conversely, protracted.

The main causes of central nervous system damage in newborns are oxygen starvation, which leads to hypoxia, and birth trauma. Less obvious and diagnosable causes are less common: intrauterine infections, hemolytic disease of the newborn, malformations of the brain and spinal cord, hereditary metabolic disorders or chromosomal pathology.

Doctors identify several syndromes of central nervous system pathology in newborns.

Hypertensive-hydrocephalic syndrome- This is an excessive accumulation of cerebrospinal fluid in the ventricles and under the membranes of the brain. To identify this syndrome in an infant, an ultrasound scan of the brain is performed and data on increased intracranial pressure are recorded (according to echoencephalography - EEG).

In pronounced severe cases of this syndrome, the size of the brain part of the skull increases disproportionately. As is known, children are born with mobile bones of the skull, which fuse during development, therefore, with a unilateral pathological process of this syndrome there will be a divergence of cranial sutures, thinning of the skin in temporal lobe and increased venous pattern on the scalp.

If a child has increased intracranial pressure, he will be restless, irritable, easily excitable and whiny. Also, the baby will sleep poorly, roll his eyes and throw his head back. Graefe's symptom (a white stripe between the pupil and the upper eyelid) may occur. In more severe cases, there may also be a symptom of the so-called “setting sun”, in which the iris of the eye, like the sun at sunset, is half submerged under the lower eyelid. Also sometimes convergent appears.

With reduced intracranial pressure, on the contrary, the child will be inactive, lethargic and drowsy. In this case, muscle tone is unpredictable - it can be either increased or decreased. The baby may stand on tiptoes when supported, or cross his legs when trying to walk, while the baby’s support, crawling and walking reflexes will be reduced. Seizures can also often occur.

Muscle tone disorders

Movement disorder syndrome- pathology of motor activity - is diagnosed in almost all children with intrauterine abnormalities in the development of the central nervous system. Only the severity and level of damage varies.

When making a diagnosis, the pediatrician must understand what the zone and location of the lesion is, whether there is a problem in the functioning of the brain or spinal cord. This is a fundamentally important question, since treatment methods differ radically depending on the identified pathology. Also great importance To make a diagnosis, a correct assessment of the tone of various muscle groups is necessary.

Violation of tone in various groups muscles leads to a delay in the appearance of motor skills in the baby: for example, the child later begins to grasp objects with the whole hand, finger movements are formed slowly and require additional training, the child later stands on his feet, and the cross lower limbs interferes with the formation of correct walking.

Fortunately, this syndrome is treatable - most children experience a decrease in muscle tone in the legs, and the child begins to walk well. In memory of the disease, only high vault feet. This does not interfere with normal life, and the only difficulty remains choosing comfortable and well-fitting shoes.

Autonomic-visceral dysfunction syndrome characterized by a violation of thermoregulation in a child (body temperature rises or falls for no apparent reason), exceptional whiteness of the skin associated with impaired vascular function, and gastrointestinal disorders(regurgitation, vomiting, tendency to constipation, insufficient weight gain compared to indicators accepted as the norm).

All these symptoms are most often combined with hypertensive-hydrocephalic syndrome and are directly related to disturbances in the blood supply posterior sections the brain, where all the main centers of the autonomic nervous system are located, which controls the life-supporting systems of the body - digestive, thermoregulatory and cardiovascular.

Convulsive syndrome

The tendency to have seizures in the first months of a child’s life is due to immaturity of the brain. Convulsions occur only in cases where the spread or development of a disease process in the cerebral cortex occurs, and have many different causes.

In each specific case, the cause convulsive syndrome must be determined by a doctor. Effective assessment often requires a number of studies and manipulations: instrumental studies of brain function (EEG), brain circulation (Dopplerography) and anatomical structures (brain ultrasound, computed tomography, NMR, NSG), as well as biochemical blood tests.

From the point of view of localization, cramps are not the same - they can be generalized, that is, covering the entire body, and localized, which are associated with individual muscle groups.

The convulsions are also different in nature: tonic, when the child seems to stretch out and freeze on a short time in a certain fixed position, and clonic, in which twitching of the limbs and sometimes the entire body occurs.

Parents should carefully monitor their child in the first months of life, because... convulsions in children can be the beginning if you do not immediately contact a specialist and do not carry out proper treatment. Careful observation and detailed description occurrence of seizures on the part of parents will significantly facilitate the doctor’s diagnosis and speed up the selection of treatment.

Treatment of a child with central nervous system damage

Accurate diagnosis and timely correct treatment of CNS pathology is extremely important. Children's body is very susceptible to external influences at the initial stage of development, and timely procedures can radically change the future life of the child and his parents, allowing for the most early stages with relative ease get rid of problems that can become quite significant in later life.

As a rule, children with early age pathologies are prescribed drug therapy in combination with physical rehabilitation. Therapeutic exercise (physical therapy) is one of the most effective non-drug methods of rehabilitation of children with central nervous system lesions. A properly selected course of exercise therapy helps restore the child’s motor functions, using the adaptive and compensatory capabilities of the child’s body.

Comment on the article "CNS lesions in children: what are they?"

organic damage to the central nervous system - in all my children. Everyone develops differently. IMHO, taking a child from a child care center means being prepared for behavior problems, poor academic performance, theft, damage and loss of things, hysterics.....I don’t know if you can find someone healthy in the full sense of the word in a child care center...

Discussion

organic damage to the central nervous system in all my children. Everyone develops differently. IMHO, taking a child from a child care center means being prepared for behavior problems, poor academic performance, theft, damage and loss of things, hysterics.....I don’t know if you can find someone healthy in the full sense of the word in a child care center. They get there either because of their health, or because of health (both physical and mental) bio.... Defeat is different from defeat - he walks, sees, hears, understands... this is already not bad. What is amenable to education, will be brought up, what is not amenable to falling in love) how difficult? - exactly as much as you are ready, as far as you can accept (or not accept) it in any way

10/03/2017 21:46:24, also here

Discussion of issues of adoption, forms of placing children in families, raising adopted children, interaction with guardianship, training at school for adoptive parents. Section: Adoption (diagnosis g96.8 in a child, decoding). Tell me about the diagnoses.

Discussion

G96.8 - may not mean anything at all. If by the age of 4 they still haven’t clarified what was affected there...
In general, just look at the child. Because this diagnosis means “there may be something wrong with the nerves”.....

I took a baby with a diagnosis of “perinatal damage to the central nervous system”, among others, which was expressed in very weak muscle tone, the left half of the body was generally like a rag, some doctors said that the child would not sit up, then - that it would not go... 4 courses of massage, general strengthening measures - he runs around, you’ll catch up with him, he thinks better than me already))) but I think we’ll still have problems with speech therapy.
A 4 summer child can already show itself: motor development, speech, and thinking - everything can already be studied. So pay attention to how he moves, how he speaks, talk to the teachers, what they say about mental development girls.

Tell me, if the orphanage is specialized for children with organic damage to the central nervous system and mental disorders, are there only children with serious diagnoses? Conclusion of custody in hand. On Friday, God willing, we will go to such an orphanage (just by acquaintance).

Discussion

We have Sevastyan from such a DR. He is a foundling, apparently someone imagined something in the hospital, where he was immediately sent. Well, or I don't know.
The only diagnosis was speech delay, which was severe.

As far as I know, there are no non-specialized DRs... They are paid a premium for their “specialization”. So read the map. My daughter was in the DR with the same specialization, although her cardiology is semi-fake. It’s just that this is the only DR in that city)))

My child has an organic lesion of the central nervous system. It is expressed in a mild form of cerebral palsy and some difficulties in learning. But he studies at a regular school and plays sports. And my child was diagnosed with an organic lesion of the central nervous system, paraparesis, and has been disabled since he was one and a half years old.

Discussion

Well, it looks like we're doing an MRI tomorrow. And on Friday - a psychiatrist and neurologist. The DD gave me a lot of blame - why do you need to do this, what kind of checks are these, etc., etc. I'm stupid - on my own. Thank you from the bottom of my heart girls. I myself did not expect such support and was very touched. I will write how and what as soon as something new.

I'm not a doctor. At all. Therefore, my reasoning is completely philistine. So: in my opinion, residual organic damage is a very general diagnosis. Manifestations should depend on the extent and location of the lesion. And they can range from “he doesn’t understand anything, he’s drooling” (sorry for the incorrectness) to “nothing is noticeable at all.” The first option clearly no longer threatens the girl. The child is adequate, obedient, reads poetry, role-playing games plays... So, I think, everything that could have happened has already manifested itself in this “bad student.” Is this critical for you? What if it is difficult to study? What if he doesn't go to university? If in fact as a last resort will he study in correction?
This is, in principle, a real prospect for many adopted children. It’s not a fact; a child taken at a younger age will not get the same problems at school.
In general, since my child is almost like this (he studies with difficulty, after 1st grade he couldn’t do anything), but he is wonderful and beloved, I feel bad for the girl. Somehow in the discussion they almost put an end to it. :(She’s a good girl. Although, of course, it’s up to you to decide.

Inorganic lesions of the central nervous system in young children (from 0 to 2 years) (beginning). Section: Adoption (ROP CNS with hypertension in children, treatment prognosis). So the question is: residual organic damage to the central nervous system - what is it, what are the prognosis and what...

Discussion

depends on the background, and even more on the perspective. any child, whether sick or healthy, in a favorable psycho-social environment has a much greater chance of growing up as a good person than under poor initial conditions. Children with health problems bring no less, and maybe even more, joy than healthy children. unless, of course, you completely dissolve in worries, problems and searches for the best solutions.

Just like on the Internet - from nothing terrible to vagrancy, suicidal tendencies, etc. Look at the children. If anything worries you, contact a specialist. Sorry for the diagnosis on the Internet, but in my opinion, your children look good.

damage to the central nervous system. Medicine/children. Adoption. Discussion of issues of adoption, forms of placement of children in families, education. Please tell me what damage to the central nervous system is without damage to the psyche. I found on the Internet only about perinatal damage to the central nervous system. this is one and...

Discussion

The benefits of swimming are undeniable.

But... if the child is predisposed to allergies, coughs, or there is a hint of asthma, then I would not bother.
Products that are thrown into water for disinfection:
1. They are not beneficial in themselves, they are absorbed through the skin, enter the body through the nose or mouth, etc.
2. Combining with organic matter, they form carcinogens, which also enter the body from water.

Those. look at the child. Water itself and swimming are very useful. Ideal for the sea and for the whole summer.

There are benefits, but the child must have a comfortable temperature. Therefore, if you mean the Lestgaf Institute (I’m not sure if you wrote it correctly), then they wrote that their children are cold. We go to the clinic, where it’s very easy to add hot water. Exercises we are passive, but at one year I think you can still induce reflex swimming movements of the arms and legs, mine in the bathtub only moved on their own after 3 months of daily swimming, then we were 10 months old.

I agree with Ilyusha’s mother. If there is no strong head growth, then it is better to do without diacarb, it greatly disrupts mineral metabolism. In addition, there is a lot of data about an increase in ICP on Cavinton and head growth when taking it (we also had this :-()) So the first scheme is good, I wouldn’t change it. It’s just that Kinder Biovital is a little confusing for such a small child, but if there are none allergic reactions, then let's have it too.

Organic damage to the central nervous system. Girls, here in the conference there are more children with cerebral palsy, autism and others like them. Is there anyone with organics? (organic brain damage) If there is, please tell us what you did for the child, what changes there were, who could at least somehow really help.

Discussion

There is a brain institute where they teach using the Bronnikov method. I’m not an expert at all, a friend studied there and told me what wonderful results there are. I can ask if it is worth going there if you have problems. Or maybe you already know about them?

Well, we can assume that we also have an organic lesion, after a cerebral hemorrhage and subsequent hydrocephalus, hypoplasia of the corpus callosum occurs, diffuse lesion white matter etc. I don’t know about others, but for us official medicine could not offer anything except standard vascular therapy and light nootropics in the hope that the remnants of the affected areas would “sort out on their own,” redistribute functions, etc. This process was somewhat stimulated by the treatment of the Koreans on the street. ak. Pilyugin, by the way, I saw children with them who also had problems with the cerebellum, there was some progress, but it’s all individual. What city do you live?

damage to the central nervous system. My friend was born as a result of placental abruption premature baby(32nd week); suffered severe hypoxia, they even say that some lobules in the brain (I don’t understand what they mean) died.

Lecture XIV.

Residual organic lesions of the central nervous system

Consequences of early residual organic damage to the central nervous system with cerebrasthenic, neurosis-like, psychopath-like syndromes. Organic mental infantilism. Psychoorganic syndrome. Childhood hyperactivity disorder with attention deficit. Mechanisms of social and school disadaptation, prevention and correction of residual effects of residual organic cerebral insufficiency and childhood hyperactivity syndrome.

Clinical illustrations.

^ EARLY RESIDUAL ORGANIC CEREBRAL INSUFFICIENCY in children - a condition caused by persistent consequences of brain damage (early intrauterine brain damage, birth trauma, traumatic brain injury in early childhood, infectious diseases). There are serious reasons to believe that in recent years the number of children with consequences of early residual organic damage to the central nervous system has been increasing, although the true prevalence of these conditions is not known.

The reasons for the increase in residual effects of residual organic damage to the central nervous system in recent years are diverse. These include environmental problems, including chemical and radiation contamination of many cities and regions of Russia, malnutrition, unjustified abuse medicines, untested and often harmful dietary supplements, etc. The principles of physical education of girls - expectant mothers, whose development is often disrupted due to frequent somatic diseases, a sedentary lifestyle, restrictions on movement, fresh air, feasible homework or, on the contrary, excessive activities professional sports, as well as early initiation of smoking, drinking alcohol, toxic substances and drugs. Poor nutrition and heavy physical labor of a woman during pregnancy, mental experiences associated with an unfavorable family situation or unwanted pregnancy, not to mention the use of alcohol and drugs during pregnancy, disrupt its normal course and negatively affect the intrauterine development of the child. The result of imperfect medical care, primarily the lack of any representation from the medical contingent antenatal clinics about a psychotherapeutic approach to a pregnant woman, full-fledged patronage during pregnancy, informal practices of preparing pregnant women for childbirth and not always qualified obstetric care, are birth injuries that violate normal development child and subsequently affecting his entire life. The introduced practice of “birth planning” is often brought to the point of absurdity, turning out to be useful not for the mother and newborn, but for the maternity hospital staff, who have received the legal right to plan their rest. Suffice it to say that in recent years, children are born not at night or in the morning, when they are supposed to be born according to biological laws, but in the first half of the day, when tired personnel are replaced by a new shift. Excessive enthusiasm also seems unjustified caesarean section, in which not only the mother, but also the baby receives anesthesia for quite a long time, which is completely indifferent to him. The above is only part of the reasons for the increase in early residual organic lesions of the central nervous system.

In the very first months of a child’s life, organic damage to the central nervous system manifests itself in the form of neurological signs that are detected by a pediatric neurologist and everyone familiar with external signs: trembling of the arms, chin, muscle hypertonicity, early holding of the head, tilting it back (when the child seems to be looking at something behind his back), anxiety, tearfulness, unjustified screaming, interrupted night sleep, delayed development of motor functions and speech. In the first year of life, all these signs allow the neurologist to register the child for the consequences birth trauma and prescribe treatment (Cerebrolysin, cinnarizine, Cavinton, vitamins, massage, gymnastics). Intensive and properly organized treatment in non-severe cases, as a rule, provides positive action, and by the age of one year the child is removed from the neurological register, and for several years a child raised at home does not cause any particular concern for parents, with the possible exception of some delay in speech development. Meanwhile, after placement in kindergarten, the child’s characteristics begin to attract attention, which are manifestations of cerebrastia, neurosis-like disorders, hyperactivity and mental infantilism.

The most common consequence of residual organic cerebral insufficiency is cerebrasthenic syndrome. Cerebrasthenic syndrome is characterized by exhaustion (inability to concentrate for a long time), fatigue, mood instability associated with minor external circumstances or fatigue, intolerance to loud sounds, bright light, and in most cases is accompanied by a noticeable and long-term decrease in performance, especially with significant intellectual load. Schoolchildren show a decrease in memorization and retention of educational material in memory. Along with this, irritability is observed, taking the form of explosiveness, tearfulness, and capriciousness. Cerebrasthenic conditions caused by early brain damage become a source of difficulty in developing school skills (writing, reading, counting). A mirror character of writing and reading is possible. Speech disorders are especially common (delayed speech development, articulatory deficiencies, slowness or, conversely, excessive speed of speech).

Frequent manifestations of cerebrasthenia may be headaches that occur upon awakening or when tired at the end of classes, accompanied by dizziness, nausea and vomiting. Often such children experience transport intolerance with dizziness, nausea, vomiting, and a feeling of lightheadedness. They also do not tolerate heat, stuffiness, and high humidity well, reacting to them with a rapid pulse, an increase or decrease in blood pressure, and fainting. Many children with cerebrasthenic disorders cannot tolerate merry-go-round rides and other spinning movements, which also lead to dizziness, lightheadedness, and vomiting.

In the motor sphere, cerebrovascular disease manifests itself in two equally common variants: lethargy and inertia or, on the contrary, motor disinhibition. In the first case, children look lethargic, they are not active enough, they are slow, they take a long time to get involved in work, they need much more time than ordinary children to comprehend the material, solve problems, do exercises, and think about answers; the mood background is most often reduced. Such children become especially unproductive in activities after 3-4 lessons and at the end of each lesson, when tired, they become drowsy or tearful. They are forced to lie down or even sleep after returning from school, in the evenings they are lethargic and passive; with difficulty, reluctantly, and take a very long time to prepare homework; Difficulty concentrating and headaches worsen when tired. In the second case, fussiness, excessive motor activity, and restlessness are noted, which prevents the child not only from engaging in purposeful educational activities, but even from games that require attention. At the same time, the child’s motor hyperactivity increases with fatigue and becomes more and more disordered and chaotic. It is impossible to involve such a child in consistent play in the evenings, and in school years - in preparing homework, repeating what has been learned, or reading books; It is almost impossible to put him to bed on time, so from day to day he sleeps significantly less than he should for his age.

Many children with the consequences of early residual organic cerebral insufficiency exhibit features of dysplasia (deformation of the skull, facial skeleton, ears, hypertelorism - widely spaced eyes, high palate, abnormal growth of teeth, prognathism - protruding forward upper jaw and etc.).

In connection with the disorders described above, schoolchildren starting from the first grades in the absence individual approach in their learning and routine, they experience great difficulties in adapting to school. They sit through lessons more than their healthy peers and are even more decompensated due to the fact that they need longer and more complete rest than ordinary children. Despite all their efforts, they, as a rule, do not receive encouragement, but, on the contrary, are subjected to punishment, continuous comments and even ridicule. After a more or less long time, they stop paying attention to their failures, interest in studying drops sharply and a desire for easy pastime appears: watching all television programs without exception, playing active games on the street and, finally, a craving for the company of their own kind. In this case, direct skimping already occurs school activities: absenteeism, refusal to attend classes, escapes, vagrancy, early drinking, which often leads to home theft. It should be noted that residual organic cerebral insufficiency significantly contributes to the rapid emergence of dependence on alcohol, drugs and psychoactive substances.

^ Neurosis-like syndrome in a child with residual organic damage, the central nervous system is characterized by stability, monotony, stability of symptoms, and its low dependence on external circumstances. In this case, neurosis-like disorders include tics, enuresis, encopresis, stuttering, mutism, obsessive symptoms- fears, doubts, concerns, movements.

The above observation illustrates cerebrasthenic and neurosis-like syndromes in a child with early residual organic damage to the central nervous system.

Kostya, 11 years old.

Second child in the family. Born from a pregnancy that occurred with toxicosis in the first half (nausea, vomiting), threat of miscarriage, edema and increased blood pressure in the second half. Childbirth 2 weeks premature, born with a double entanglement of the umbilical cord, in blue asphyxia, screamed after resuscitation measures. Birth weight 2700. Weaned to the breast on the third day. He sucked sluggishly. Early development with a delay: began to walk at 1 year 3 months, pronounces individual words from 1 year 10 months, phrasal speech - from 3 years. Until the age of 2, he was very restless, whiny, and suffered from colds a lot. For up to 1 year, he was observed by a neurologist for trembling of the hands, chin, hypertonicity, convulsions (2 times) at high temperatures against the background of an acute respiratory disease. He grew up quiet, sensitive, sedentary, awkward. He was overly attached to his mother, did not let her go, took a very long time to get used to kindergarten: he did not eat, did not sleep, did not play with the children, cried almost all day, refused toys. Until the age of 7, he suffered from bedwetting. He was afraid to be alone at home, fell asleep only by the light of a night light and in the presence of his mother, was afraid of dogs, cats, sobbed, resisted when he was taken to the clinic. When under emotional stress, colds, troubles in the family, the boy had blinking and stereotypical shoulder movements, which disappeared when small doses of tranquilizers or sedative herbs were prescribed. Speech suffered from incorrect pronunciation of many sounds and became clear only by 7 years after speech therapy sessions. I went to school at the age of 7.5, willingly, quickly got to know the children, but hardly spoke to the teacher for 3 months. He answered questions very quietly, behaved timidly and uncertainly. I was tired by the 3rd lesson, “lying” on my desk, could not learn educational material, ceased to understand the teacher’s explanations. After school he went to bed himself and sometimes fell asleep. He taught his lessons only in the presence of adults, and often complained in the evenings of a headache, often accompanied by nausea. I slept restlessly. I could not stand riding in a bus or car - I experienced nausea, vomiting, turned pale, and began to sweat. Felt bad on cloudy days; At this time, I almost always had a headache, dizziness, decreased mood, and lethargy. In the summer and autumn I felt better. The condition worsened under high loads, after illnesses (acute respiratory infections, tonsillitis, childhood infections). He studied at “4” and “3”, although, according to others, he was distinguished by high intelligence and good memory. He had friends and walked alone in the yard, but preferred quiet games at home. He began studying at a music school, but attended it reluctantly, cried, complained of fatigue, was afraid that he would not have time to do his homework, and became irritable and restless.

Starting from the age of 8, as prescribed by a psychiatrist, twice a year - in November and March - he received a course of diuretics, nootropil (or Cerebrolysin in injections), Cavinton, a mixture with citral, a sedative mixture. If necessary, an additional day off was assigned. During the treatment, the boy's condition improved significantly: headaches became rare, tics disappeared, he became more independent and less fearful, and his academic performance improved.

In this case we're talking about about pronounced signs of cerebrasthenic syndrome, appearing in combination with neurosis-like symptoms (tics, enuresis, elementary fears). Meanwhile, with adequate medical supervision, correct treatment tactics and a gentle regime, the child has fully adapted to the conditions of school.

Organic damage to the central nervous system can also be expressed in psychoorganic syndrome (encephalopathy), characterized by a greater severity of disorders and containing, along with all the above-described signs of cerebrastia, decreased memory, weakened productivity of intellectual activity, changes in affectivity (incontinence of affect). These signs are called the Walter-Bühel triad. Incontinence of affect can manifest itself not only in excessive affective excitability, inappropriately violent and explosive expression of emotions, but also in affective weakness, which includes a pronounced degree emotional lability, emotional hyperesthesia with excessive sensitivity to everything external stimuli: minute changes situations, an unexpected word cause the patient to have irresistible and uncorrectable violent emotional states: crying, sobbing, anger, etc. Memory impairments in psychoorganic syndrome vary from mild weakening to severe mnestic disorders (for example, difficulties in remembering momentary events and current material).

In psychoorganic syndrome, the prerequisites for intelligence are, first of all, insufficient: decreased memory, attention and perception. The amount of attention is limited, the ability to concentrate decreases, absent-mindedness, exhaustion and satiety increase intellectual activity. Violations of attention lead to a violation of the perception of the environment, as a result of which the patient is not able to grasp the situation as a whole, capturing only fragments, individual aspects of events. Impaired memory, attention and perception contribute to weak judgment and inference, which makes patients appear helpless and clueless. There is also a slowdown in the pace of mental activity, inertia and rigidity of mental processes; this manifests itself in slowness, getting stuck on certain ideas, and difficulty switching from one type of activity to another. Characterized by a lack of criticism of one's capabilities and behavior with a careless attitude towards one's condition, loss of a sense of distance, familiarity and familiarity. Low intellectual productivity becomes apparent with additional workload, but unlike mental retardation the ability to abstract is preserved.

Psychoorganic syndrome may have a temporary, transitory nature(for example, after a traumatic brain injury, including birth trauma, neuroinfection) or be a permanent, chronic personality trait in long term organic damage to the central nervous system.

Often, with residual organic cerebral insufficiency, signs appear psychopath-like syndrome, which becomes especially obvious in prepubertal and puberty. Children and adolescents with psychoorganic syndrome are characterized by the most serious forms of behavioral disorders caused by a pronounced change in affectivity. Pathological character traits in this case are mainly manifested by affective excitability, a tendency to aggression, conflict, disinhibition of drives, satiety, sensory thirst (desire for new impressions, pleasures). Affective excitability is expressed in a tendency to excessively easy occurrence violent affective outbursts, inadequate to the cause that caused them, in attacks of anger, rage, passion, accompanied by motor agitation, thoughtless, sometimes dangerous for the child or others, actions and, often, narrowed consciousness. Children and adolescents with affective excitability are capricious, touchy, overly active, and prone to unbridled pranks. They shout a lot and get angry easily; Any restrictions, prohibitions, remarks cause violent protest reactions in them with viciousness and aggression.

Together with the signs organic mental infantilism(emotional-volitional immaturity, uncriticality, lack of purposeful activity, suggestibility, dependence on others) psychopathic-like disorders in a teenager with residual organic damage to the central nervous system create the preconditions for social disadaptation with criminal tendencies. Offenses are often committed by them in a state of alcohol intoxication or under the influence of drugs; Moreover, for a complete loss of criticism or even amnesia (lack of memory) of the criminal act itself, a relatively small dose of alcohol and drugs is enough for a teenager with residual organic damage to the central nervous system. It is necessary to note once again that children and adolescents with residual organic cerebral insufficiency develop dependence on alcohol and drugs faster than healthy ones, leading to severe forms of alcoholism and drug addiction.

The most important means of preventing school disadaptation in residual organic cerebral insufficiency is the prevention of intellectual and physical overload by normalizing the daily routine, correct alternation of intellectual work and rest, and eliminating simultaneous classes in general education and special schools (music, art, etc.). Residual effects of residual organic damage to the central nervous system in severe cases are a contraindication for admission to a specialized school (with in-depth study of a foreign language, physics and mathematics, gymnasium or college with an accelerated and extended curriculum).

In this type of mental pathology, to prevent educational decompensation, it is necessary to timely introduce an adequate drug course of therapy (nootropics, dehydration, vitamins, mild sedatives, etc.) constant monitoring psychoneurologist and dynamic electroencephalographic, craniographic, pathopsychological control; early start pedagogical correction taking into account the individual characteristics of the child; individual lessons with a defectologist; socio-psychological and psychotherapeutic work with the child’s family to develop the right attitudes towards the child’s capabilities and his future.

^ HYPERACTIVITY IN CHILDREN. There is also a definite connection with residual organic cerebral insufficiency in childhood. hyperactivity, which occupies a special place, first of all, in connection with the pronounced school disadaptation caused by it - educational failure and (or) behavioral disorders. Motor hyperactivity is described in child psychiatry under different names: minimum brain dysfunction(MMD), motor disinhibition syndrome, hyperdynamic syndrome, hyperkinetic syndrome, childhood attention deficit hyperactivity syndrome, active attention disorder syndrome, attention deficit syndrome (the last name corresponds to the modern classification).

The standard for assessing behavior as “hyperkinetic” is a complex the following signs:

1) physical activity is excessively high in the context of what is expected in this situation and in comparison with other children of the same age and intellectual development;

2) has an early onset (before 6 years);

3) long duration (or constancy over time);

4) is detected in more than one situation (not only at school, but also at home, on the street, in the hospital, etc.).

Data on the prevalence of hyperkinetic disorders vary widely - from 2 to 23% of the child population. Hyperkinetic disorders that occur in childhood, in the absence of preventive measures often lead not only to school maladaptation - poor academic performance, repetition, behavioral disorders, but also to severe forms of social maladaptation, far beyond the limits of childhood and even puberty.

Hyperkinetic disorder usually manifests itself in early childhood. In the first year of life, the child shows signs of motor excitement, constantly fidgets, makes a lot of unnecessary movements, which makes it difficult to put him to sleep and feed him. The formation of motor functions occurs in a hyperactive child faster than in his peers, while the development of speech does not differ from normal periods or even lags behind them. When a hyperactive child begins to walk, he is distinguished by speed and an excessive number of movements, uncontrollability, cannot sit still, climbs everywhere, tries to get different objects, does not respond to prohibitions, does not sense danger or edges. Such a child very early (from 1.5-2 years old) stops sleeping during the day, and in the evening it is difficult to put him to bed due to the chaotic excitement that grows in the afternoon, when he is completely unable to play with his toys, do one thing, and is capricious. , plays around, runs. Falling asleep is disrupted: even when physically restrained, the child continuously moves, tries to slip out from under the mother’s arms, jump up, and open his eyes. With severe daytime arousal, deep night sleep with long-lasting enuresis may occur.

However, hyperkinetic disorders in infancy and early preschool age are often regarded as ordinary liveliness within the framework of normal child psychodynamics. Meanwhile, restlessness, distractibility, satiation with the need for frequent changes of impressions, and the inability to play independently or with children without persistent organization of adults gradually increase and begin to attract attention. These features become obvious in older preschool age, when the child begins to prepare for school - at home, in the preparatory group kindergarten, in preparatory groups of secondary schools.

Starting from grade 1, hyperdynamic disorders in a child are expressed in motor disinhibition, fussiness, inattention and lack of perseverance in performing tasks. At the same time, it is often observed elevated background moods with overestimation of one's own capabilities, mischief and fearlessness, insufficient persistence in activities, especially those requiring active attention, a tendency to move from one activity to another without completing any of them, poorly organized and poorly regulated activity. Hyperkinetic children are often reckless and impulsive, prone to accidents and disciplinary action due to infractions. They usually have disrupted relationships with adults due to a lack of caution and restraint, and a low sense of self-worth. Hyperactive children are impatient, do not know how to wait, cannot sit still during a lesson, are in constant undirected movement, jump up, run, jump, and if necessary to sit still, constantly move their legs and arms. They are usually talkative, noisy, often good-natured, constantly smiling and laughing. Such children need a constant change of activity and new experiences. A hyperactive child can consistently and purposefully engage in one activity only after significant physical exertion; At the same time, such children themselves say that they “need to unwind”, “reset their energy.”

Hyperkinetic disorders appear in combination with cerebrasthenic syndrome, signs of mental infantilism, pathological personality characteristics, expressed against the background of motor disinhibition to a greater or lesser extent and further complicating the school and social adaptation of a hyperactive child. Often hyperkinetic disorders are accompanied by neurosis-like symptoms: tics, enuresis, encopresis, stuttering, fears - long-lasting common childhood fears of loneliness, darkness, pets, white coats, medical manipulations or quickly occurring obsessive fears based on a traumatic situation. Signs of mental infantilism in hyperkinetic syndrome are expressed in play interests characteristic of an earlier age, gullibility, suggestibility, subordination, affection, spontaneity, naivety, dependence on adults or more self-confident friends. Due to hyperkinetic disorders and traits of mental immaturity, the child prefers only play activity, but it does not captivate him for a long time: he constantly changes his opinion and direction of activity in accordance with who is near him; He, having committed a rash act, immediately repents of it, assures adults that “he will behave well,” but, finding himself in a similar situation, again and again he sometimes repeats harmless pranks, the outcome of which he cannot foresee or calculate. At the same time, because of his kindness, good-naturedness, and sincere repentance for his deeds, such a child is extremely attractive and loved by adults. Children often reject such a child, since it is impossible to play productively and consistently with him because of his fussiness, noisiness, desire to constantly change the conditions of the game or move from one type of play to another, because of his inconsistency, variability, and superficiality. A hyperactive child quickly gets acquainted with children and adults, but also quickly “changes” friendships in the pursuit of new acquaintances and new experiences. Mental immaturity in children with hyperkinetic disorders determines the relative ease of occurrence in them of various transient or more persistent deviations, disruption of the process of personality formation under the influence unfavorable factors- both micro-social-psychological and biological. The most common in hyperactive children are pathological character traits with a predominance of instability, when the lack of volitional delays, dependence of behavior on momentary desires and drives, increased subordination to outside influence, lack of ability and reluctance to overcome the slightest difficulties, interest and skill in work come to the fore. The immaturity of the emotional-volitional personality traits of adolescents with an unstable variant determines their increased tendency to imitate forms of behavior of others, including negative ones (leaving home, school, foul language, petty theft, drinking alcoholic beverages).

Hyperkinetic disorders in the vast majority of cases are gradually reduced by the middle of puberty - at 14-15 years. It is impossible to wait for the spontaneous disappearance of hyperactivity without taking corrective and preventive measures due to the fact that hyperkinetic disorders, being a mild, borderline mental pathology, give rise to severe forms school and social disadaptation, leaving an imprint on the entire future life of a person.

From the very first days schooling the child finds himself in conditions of the necessary fulfillment of disciplinary norms, assessment of knowledge, manifestation of his own initiative, and the formation of contact with the team. Due to excessive physical activity, restlessness, distractibility, and satiation, a hyperactive child does not meet the requirements of school and in the coming months after the start of school becomes the subject of constant discussion in teaching staff. He receives comments and diary entries every day, he is discussed at parent and class meetings, he is scolded by teachers and school administration, he is threatened with expulsion or transfer to individual education. Parents cannot help but react to all these actions, and in the family a hyperactive child becomes the cause of constant discord, quarrels, disputes, which gives rise to an education system in the form of constant penalties, prohibitions and punishments. Teachers and parents are trying to restrain his physical activity, which in itself is impossible due to physiological characteristics child. A hyperactive child disturbs everyone: teachers, parents, older and younger brothers and sisters, children in the classroom and in the yard. His successes, in the absence of special correction methods, never correspond to his natural intellectual abilities, i.e. he studies significantly below his capabilities. Instead of the motor relaxation that the child himself talks about to adults, he is forced to sit for many hours, completely unproductively, preparing his homework. Rejected by family and school, a misunderstood, unsuccessful child sooner or later begins to openly skimp on school. Most often this happens at the age of 10-12, when parental control weakens and the child gets the opportunity to use transport independently. The street is full of entertainment, temptations, new acquaintances; the street is diverse. It is here that a hyperkinetic child never gets bored; the street satisfies his inherent passion for a continuous change of impressions. Here no one scolds or asks about academic performance; here peers and older children are in the same position of rejection and resentment; new acquaintances appear here every day; Here, for the first time, the child tries the first cigarette, the first glass, the first joint, and sometimes the first injection of a drug. Due to suggestibility and subordination, lack of momentary criticism and the ability to predict the near future, children with hyperactivity often become members of an antisocial company, commit criminal acts or are present at them. With the layering of pathological character traits, social disadaptation becomes especially deep (even to the point of being registered in the children's room by the police, judicial investigation, and a colony for juvenile offenders). In prepubertal and pubertal ages, almost never being the initiators of a crime, hyperactive schoolchildren often join the criminal ranks.

Thus, although the hyperkinetic syndrome, becoming especially noticeable already in early preschool age, is significantly (or completely) compensated for during adolescence Due to a decrease in motor activity and improved attention, such adolescents, as a rule, do not achieve a level of adaptation corresponding to their natural abilities, since they are socially decompensated already at primary school age and this decompensation can increase in the absence of adequate correctional and therapeutic approaches. Meanwhile, with correct, patient, constant therapeutic, preventive and psychological-pedagogical work with hyperactive child it is possible to prevent deep forms of social disadaptation. IN mature age in most cases, signs of mental infantilism, mild cerebrasthenic symptoms, pathological character traits, as well as superficiality, lack of purposefulness, and suggestibility remain noticeable.

Misha, 10 years old.

Pregnancy with mild toxicosis in the first half; delivery at term, with a long anhydrous period, with stimulation. Born weighing 3300, he screamed after being spanked. Early development of motor functions is advanced (for example, he began to sit at 5 months, stood independently at 8 months, walks independently from 11 months), speech - with some delay (phrasal speech appeared by 2 years 9 months). He grew up very active, he grabbed everything around him, climbed everywhere, not afraid of heights. Until he was a year old, he repeatedly fell out of the crib, hurt himself, and was constantly covered in bruises and bumps. He had difficulty falling asleep; he had to be rocked to sleep for hours, while at the same time holding him so that he would not jump up. From the age of 2 he stopped sleeping during the day; in the evening he became more and more agitated, noisy, constantly moving, even when he was forced to sit. At the same time, he completely stopped playing with toys, couldn’t find something to do, “lounged around” with nothing to do, played pranks, and disturbed everyone. In kindergarten - from 4 years old. I got used to it right away, playing only with boys, not singling out any of them in particular; The teachers complained about his excessive mobility, senseless mischief, and pugnacity. In the preparatory group, attention was drawn to restlessness, many unnecessary movements even in relative peace, reluctance to study, lack of curiosity, and distractibility. He was affectionate towards his parents and loved his younger sister, which did not stop him from constantly bullying her, provoking scandals and fights. He repented of his pranks, but could then thoughtlessly repeat the mischief. He started attending school at the age of 7. During lessons he could not sit still, he constantly fidgeted, chatted, played with toys brought from home, made airplanes, rustled papers, not always fulfilling the teacher’s assignments. Distinguished by his good memory, he studied poorly - mostly with grades “3”; From the 5th grade, my academic performance deteriorated even more; I did not always learn home lessons, only under the constant supervision of my parents and grandmother. During lessons, he was constantly distracted, whining, looking with empty eyes, not absorbing the material, asking extraneous questions; left alone, he immediately found something to do - played with the cat, made airplanes, drew “horror stories” directly on notebooks, etc. He preferred to spend his time on the street, came home later than the appointed time, promising every day to “get better.” Remained excessively mobile and did not feel danger. Twice diagnosed with a concussion (at the age of 7 he was hit on the head by a swing, at the age of 9 he fell from a tree) and once due to a broken arm (8 years old) he was in the hospital. I got to know both children and adults very quickly, but there were no permanent friends. He did not know how to play one game, even an active one, for a long time, he disturbed the children or left in search of other entertainment. I tried smoking since I was 8 years old. From the 5th grade he began to skip classes, did not spend the night at home several times for three days; after the police found him, he explained that he was afraid to go home after receiving several bad marks, fearing punishment. Sometimes he spent time in the boiler room, where he met adults, and spent the night there when he disappeared from home. At the insistence of his parents, he began to attend sports sections and clubs at school several times, but stayed there for a short time - he abandoned them without explaining the reasons and without informing his loved ones. After consulting a psychiatrist (at the age of 11), he began receiving phenibut and small doses of neuleptil, and was enrolled in a folk dance school. After a few months, he became calmer and more focused in his studies, first under the supervision of adults, and then on his own, without missing a beat, he attended dance school, was proud of his successes, participated in competitions, and went on tour with the group. Academic achievement and discipline in secondary schools have improved significantly.

The present case is an example of hyperdynamic syndrome in childhood, in which it was possible to avoid severe social disadaptation thanks to treatment and correct actions parents.

When determining preventive tactics in relation to a child with hyperactivity, first of all, you need to think about the organization of the living space of a hyperactive child, which should include all the opportunities for the implementation of his increased physical activity. For such a child, the morning hours preceding school or kindergarten should be filled with increased physical activity - running in the air, fairly long morning exercises, and training on exercise machines are the most appropriate. As practice shows, after 1-2 hours of sports activities, hyperactive children sit more calmly in class, are able to concentrate, and learn the material better. Most adequate in junior school organizing the first two physical education lessons for such children. Unfortunately, in fact, this practice is not used in any school institution due to difficulties with the class schedule. Parents who understand the child’s characteristics sometimes organize physical exercises themselves, running in the fresh air before classes begin, which immediately has a positive effect on the child’s academic performance and discipline. Having dozens of children suffering from hyperkinetic disorder in one school, in order to predict school and social disadaptation in the future, the administration of each school is able to provide hyperactive children with the opportunity for adequate physical activity during breaks and after classes. To do this, it is advisable to install exercise equipment, trampolines, a wall bars, etc. in a gym or other fairly spacious room (perhaps even in recreational corridors) and allow hyperactive children, under the control of one teacher on duty, to carry out recess in such a room. Along with organizing increased physical activity during breaks, such children are also recommended to increase physical activity during physical education lessons at school. In addition, for children with motor disinhibition, exercise in sports sections, which require a lot of physical effort and movement and at the same time plasticity, attention, and fine motor actions, is also useful for developing perseverance; however, they are not recommended power types sports The earlier sports activities are introduced, the higher positive effect, affecting primarily the academic performance of a hyperactive child. The educational role of the coach is very important: if both the sport itself and the personality of the coach appeal to the child, then the coach has the power to gradually and consistently demand that the student improve his performance. The psychiatrist must explain to the parents the characteristics of their child, the origin of his excessive motor activity, lack of attention, inform them of the possible social prognosis, convince them of the need for proper organization of living space, as well as the negative effect of forcible restriction of movements.

Among non-drug forms of preventing social maladjustment in children with hyperkinetic disorders, psychotherapy is also possible. The preferred approach in this case is behavioral psychotherapy. Considering wide range family problems that are involved in the pathoplasty of disorders and that arise in response to them, family psychotherapy is indicated. After completing the course, supportive psychotherapy is advisable, also including the child and family. The presence of medical and psychological services makes it possible to include in the assistance system work with teachers and educators, aimed at their ability to support the child. If there are signs of maladaptation in children's institutions and schools, the preferred psychotherapeutic approach is psychodynamic. It allows you to work with manifestations individual reactions on school and emotional attitudes. Behavior therapy addresses changing the problem behavior of the child himself. Cognitive therapy applicable to older schoolchildren and is aimed at reorganizing their understanding of the school situation and existing difficulties.

When hyperkinetic disorders are combined with cerebrasthenic disorders and signs of increased intracranial pressure, the prevention of educational decompensation requires the timely introduction of adequate drug course therapy (nootropics, diuretics, vitamins, sedative herbs, etc.) with constant monitoring by a psychiatrist and neurologist and dynamic electroencephalographic, craniographic, pathopsychological control.

LITERATURE:

1. V.V. Kovalev. Psychiatry childhood. - Moscow. "Medicine". - 1995.

2. Guide to psychiatry. Edited by A.V. Snezhnevsky. - Moscow. - Medgiz. - 1983, T. 1

3. G.E. Sukhareva. Clinical lectures on childhood psychiatry. - vol. I. - Moscow. "Medgiz". - 1955.

4. Handbook of psychology and psychiatry of childhood and adolescence. - St. Petersburg - Moscow - Kharkov - Minsk. - Peter. - 1999.

5. G.K. Ushakov. Child psychiatry. - Moscow. "Medicine". - 1973.

QUESTIONS:

1. What psychopathological disorders are characteristic of early residual organic damage to the central nervous system?

2. What is the difference between cerebrovascular disease and encephalopathy?

3. Please name the basic principle of correcting the behavior of a hyperactive child.

The central nervous system is responsible for the functioning of all organs. Brain dysfunction leads to irreversible consequences, resulting in loss of control over the body. Mild organic damage to the central nervous system can occur in anyone, but only severe stages require proper treatment.

Organic damage to the central nervous system in adults

Making such a diagnosis indicates the inferiority of brain function. Its damage is the result of long-term use of medications, alcohol abuse and drug use. In addition, the causes of the disease are:

injuries received;
Availability cancerous tumor;
infection;
excessive physical exercise;
exposure to stress.

Symptoms of organic damage to the central nervous system

During development pathological processes apathy, decreased activity, and loss of interest in life are observed. Along with this, indifference to one’s appearance and sloppiness arises. However, sometimes the patient, on the contrary, becomes too excitable, and his emotions become inappropriate.

The following signs are also identified:

forgetfulness, difficulty remembering names and dates;
deterioration of intellectual abilities (impaired writing and counting);
loss of previous speech functions, manifested in the inability to link words into sentences;
hallucinations and delusions are possible;
during the daytime;
decreased visual and hearing acuity.

As the disease progresses, there is significant deterioration protective properties the body, therefore, consequences of organic damage to the central nervous system may occur, such as:

meningitis;
neurosyphilis;
and other serious infections.

As a rule, the disease progresses and subsequently becomes the cause of social exclusion and dementia.

Diagnosis of organic damage to the central nervous system

Timely detection of the disease allows you to begin treatment and stop its further development. The patient undergoes a brain tomography. If vascular damage is detected and cognitive impairment is simultaneously manifested, a diagnosis is made.

Treatment of organic damage to the central nervous system

No specific treatment for the disease has been developed. Basically, the fight against symptoms is carried out, during which the patient is prescribed drugs to normalize blood flow in the brain and eliminate depression. Mental work is restored by changing lifestyle and diet, which is especially necessary for certain liver diseases, atherosclerosis and alcoholism.