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 the signals of the external environment. Perceives them, processes and provides 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 under the supervision of 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 psychiatric disorders.

Causes of CNS damage

The central nervous system can be affected as a result of the use of certain drugs, physical or emotional overload, difficult and difficult childbirth.

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

CNS diseases are caused by trauma, infection, autoimmune diseases, structural defects, tumors, and stroke.

Types of CNS damage

One of the varieties of diseases of the central nervous system are 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 eventually death. Parkinson's disease causes tremors, rigidity, and impaired movement control as a result of loss of dopamine. Most characteristic symptoms Huntington's disease is random and uncontrolled movements.

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

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

Disorders in the work of the central nervous system in some cases occur during fetal development or during childbirth.

With damage to the central nervous system, an imbalance occurs in all human organs, the work of which is regulated by the central nervous system.

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

organic defeat CNS

Inadequate brain activity means that an organic lesion of the nervous system has occurred, which can be congenital or acquired. Most people develop mild lesions that do not require treatment. The presence of a moderate to severe degree of this disease requires medical intervention, as there is a violation of the activity of the central nervous system.

Signs of an organic lesion of the central nervous system are irritability, rapid distractibility, urinary incontinence daytime, sleep disturbance. In some cases, the work of the organs of hearing and vision worsens, and coordination of movements is also disturbed. 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 child has not yet fully formed organs and systems, and it takes some time to complete the formation. It is in the process of the growth of the baby that his central nervous system is also formed and matures. The nervous system of the baby helps to regulate its normal existence in the world.

In some cases, damage to the central nervous system of newborns can be diagnosed, which has recently been encountered quite often. Depression of the nervous system can provoke serious consequences and leave the child disabled.

Structural features 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 formation of the brain, the child has pronounced unconditioned reflexes. Immediately after birth, the level of substances that regulate hormones responsible for the functioning of the digestive system rises. At the same time, all receptors are already quite well developed.

Causes of the pathology of the central nervous system

The causes and consequences of lesions of the central nervous system of newborns can be very different. The main factors provoking disruption of the functioning of the nervous system are:

• lack of oxygen, or hypoxia;
• birth trauma;
• violation of normal metabolism;
• infectious diseases suffered future mother during pregnancy.

Lack of oxygen, or hypoxia, occurs when a pregnant woman works in a hazardous industry, with infectious diseases, smoking, previous abortions. All this violates general circulation, as well as blood oxygen saturation, and the fetus receives oxygen along with the mother's blood.

Birth trauma is considered one of the factors leading to damage to the nervous system, since any injury can provoke a violation of the maturation and subsequent development of the central nervous system.

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

Critical for the fetus can be infectious diseases suffered by the expectant mother while carrying a child. Among such infections, herpes and rubella should be distinguished. In addition, absolutely any pathogenic microbes and bacteria can provoke irreversible negative processes in the child's body. Most problems with the nervous system occur in premature babies.

Periods of pathologies of the central nervous system

Syndrome of damage and depression of the nervous system combines several pathological conditions that occur during fetal 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 course of the disease, namely:

• spicy;
• restorative;
• outcome of the disease.

In each period, CNS lesions in newborns have different clinical manifestations. In addition, children may have a combination of several different syndromes. The severity of each ongoing syndrome allows you 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, startle, increased excitability of nervous reflexes, trembling of the chin, sharp 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. By the end of the first month of life, the existing signs may be replaced by hyperexcitability, an almost transparent skin color, frequent regurgitation and flatulence. Often, a child is diagnosed with a hydrocephalic syndrome, characterized by a rapid increase in head circumference, increased pressure, bulge of the fontanel, and strange eye movements.

At the most severe degree, coma usually occurs. Such a complication requires a stay under the supervision of a doctor.

rehabilitation period

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

• increased excitability;
• epileptic;
• movement disorders;
• mental retardation.

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

With a delay in the development of the psyche, the baby begins much later to hold his head on his own, sit, walk, crawl. He also has insufficiently good facial expressions, reduced interest in toys, a weak cry, a delay in the appearance of babbling and cooing. Such delays in the development of the child's psyche should definitely alert parents.

The result of the disease

By about a year, CNS damage in newborns becomes apparent, although the main symptoms of the disease gradually disappear. The result of the course of the pathology is:

• developmental delay;
• hyperactivity;
• cerebroasthenic syndrome;
• epilepsy.

As a result of this, there may be a disability of the child.

Perinatal CNS damage

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

Antenatal begins from the 28th week of intrauterine development and ends after birth. Intranatal includes the period of childbirth, starting from the onset of labor and until the birth of the child. occurs after birth and is characterized by the adaptation of the baby to environmental conditions.

The main reason why perinatal CNS damage occurs in newborns is hypoxia, which develops during an unfavorable pregnancy, birth trauma, asphyxia, and infectious diseases of the fetus.

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

Symptoms largely depend on the period of the course of the disease and the severity of the lesion. In the first month after the birth of a child, an acute period of the course 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 hospital by a neonatologist. The specialist conducts a comprehensive examination of the baby and, based on the available signs, makes a diagnosis. 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 the diagnosis. In the acute form, therapy is carried out strictly in a hospital under the constant supervision of a doctor. If the disease has a mild course, then treatment can be carried out at home under the supervision of a neurologist.

The recovery period is carried out in a complex, and at the same time, together with medications physiotherapeutic methods are applied, such as physiotherapy exercises, swimming, manual therapy, massages, speech therapy classes. The main goal of such methods is the correction of mental and physical development in accordance with age-related changes.

Hypoxic-ischemic CNS injury

Since it is often hypoxia that provokes damage to the nervous system, each future mom should know what causes hypoxia and how it can be avoided. Many parents are interested in what is hypoxic-ischemic CNS damage 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 such a case, there may be functional disorders brain or even death nerve cells. To prevent a disorder of the nervous system in an infant, a woman during childbearing should be very attentive to her state of health. 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 are the signs of the disease, it is possible to prevent the occurrence of pathology during timely treatment.

Forms and symptoms of the course of the disease

CNS damage 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 can be observed. There may be a sliding strabismus or irregular, wandering movement of the eyeballs. After some time, trembling of the chin and limbs, as well as restless movements, may be observed.

The middle form has symptoms such as lack of emotion in the child, poor muscle tone, and paralysis. There may be convulsions, excessive sensitivity, involuntary eye movement.

The severe form is characterized by serious disorders of the nervous system with its gradual suppression. This appears in the form of convulsions, renal failure, disorders of the intestines, the cardiovascular system, and the respiratory system.

Diagnostics

Since the consequences can be quite dangerous, it is therefore important to diagnose violations 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 an examination and subsequent treatment.

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

Treatment of CNS lesions

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

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

In order for sick children to be able to recover faster, osteopathic therapy and physiotherapy procedures are used in combination with medications. For the rehabilitation course, massage, electrophoresis, reflexology and many other techniques are indicated.

After the stabilization of the child's condition, an individual program of supportive care is developed. complex therapy and regularly monitor the condition of the baby. Throughout the year, the dynamics of the child's condition is analyzed, other methods of therapy are selected that contribute to the speedy recovery and development of the required skills, abilities and reflexes.

Prevention of CNS damage

In order to prevent the occurrence of a serious and dangerous disease, it is necessary to carry out the prevention of lesions of the central nervous system of the baby. For this, doctors recommend planning a pregnancy in advance, undergoing the required examinations in a timely manner and giving up bad habits. Conducted if necessary antiviral therapy, all necessary vaccinations are made, and hormonal levels are normalized.

If the defeat of the central nervous system of the baby did occur, then it is important to help the newborn from the first hours of his life and to constantly monitor the condition of the baby.

Consequences of damage to the central nervous system

The consequences and complications of CNS damage in a newborn child can be very serious, dangerous to health and life, and they are expressed as:

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

Timely detection of the disease and well-conducted therapy will help get rid of serious health problems and prevent complications.

It happens that in the maternity hospital or a little later, at a pediatrician's appointment, 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? Natalya Pykhtina, a specialist in pediatric rehabilitation, is the head of the clinic of the same name.

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, even in the delivery room. Everyone has heard about the Apgar scale, according to which the viability of the child is assessed according to five main visible signs- heartbeat, skin coloration, respiration, reflex excitability and muscle tone.

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

So, most attention the degree of symmetry of the movements of the limbs is given: their pace and volume should be the same on both sides, that is, the left arm and left leg and the right arm and leg, respectively. Also the doctor who conducts initial inspection newborn, takes into account the clarity and severity of unconditioned reflexes. So the pediatrician receives information about the activity of the baby's central nervous system and finds out whether it functions within the normal range.

Damage to the central nervous system in a child occurs in two ways - in utero or during childbirth. If developmental abnormalities arose in the fetus during the embryonic stage of intrauterine development, then they often turn into defects that are incompatible with life, or extremely severe and not amenable to treatment and correction.

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

It is very difficult to predict which specific negative factor and at what period 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 - milestone family planning, because the mother’s bad habits, as well as her chronic diseases, hard work and unhealthy psychological state, can affect the child’s health.

It is important for the future life of the child and how exactly he will be born. It is at the time of childbirth that there is a danger of damage in the second way - intranatally. Any improper intervention or, conversely, the lack of timely assistance is highly likely to negatively affect the baby. At risk are premature births, as well as births at the scheduled time, but rapid or, conversely, protracted.

The main causes of CNS 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 distinguish several syndromes of CNS pathology in newborns.

Hypertension-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 of the brain is performed and data on an increase in intracranial pressure are recorded (according to echoencephalography - EEG).

In pronounced severe cases with this syndrome, the size of the cerebral part of the skull disproportionately increases. As you know, children are born with movable bones of the skull, which grow together in the process of development, therefore, with a unilateral pathological process this syndrome there will be a divergence of the 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 tearful. Also, the baby will not sleep well, goggle and tilt his head back. Perhaps the manifestation of a symptom of Graefe (a white strip between the pupil and the upper eyelid). 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 immersed under the lower eyelid. Also sometimes appears convergent.

With reduced intracranial pressure, on the contrary, the child will be inactive, lethargic and drowsy. Muscle tone in this case is unpredictable - it can be either increased or decreased. The baby can stand on tiptoe when supported, cross the legs when trying to walk, while the reflexes of support, crawling and walking in the baby 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 differ.

When making a diagnosis, the pediatrician must understand what the area and localization 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 the methods of treatment differ radically depending on the established pathology. Also great importance for the diagnosis is a correct assessment of the tone of various muscle groups.

Violation of tone in various groups muscles leads to a delay in the appearance of motor skills in an infant: for example, the child later begins to take objects with the whole brush, finger movements are formed slowly and require additional training, the child later gets up on his feet, and the cross lower extremities hinders proper walking.

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

Syndrome of vegetative-visceral dysfunctions characterized by impaired 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 in comparison with the indicators taken as the norm).

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

convulsive syndrome

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

In each specific case, the cause convulsive syndrome must be identified by a physician. An effective assessment often requires a number of studies and manipulations: an instrumental study of the brain (EEG), cerebral circulation (Dopplerography) and anatomical structures (ultrasound of the brain, computed tomography, MRI, NSG), as well as biochemical blood tests.

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

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 there is a twitching of the limbs, and sometimes the entire body.

Parents should carefully monitor the 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 competent treatment. Careful observation and detailed description the occurrence of seizures on the part of the parents will greatly facilitate the doctor's diagnosis and speed up the selection of treatment.

Treatment of a child with CNS damage

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

As a rule, children with pathologies of early age are prescribed drug therapy in combination with physical rehabilitation. Therapeutic exercise (exercise therapy) is one of the most effective non-drug methods for the rehabilitation of children with CNS lesions. A properly selected course of exercise therapy helps to 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 lesion of the central nervous system - in all my children. Everyone develops differently. IMHO, taking a child from DD means being prepared for behavioral disorders, poor study, theft, damage and loss of things, tantrums ..... I don’t know if you can find a healthy DD in the full sense of this ...

Discussion

organic damage to the central nervous system in all my children. Everyone develops differently. IMHO, taking a child from DD means being prepared for behavioral disorders, poor study, theft, damage and loss of things, tantrums ..... I don’t know if you can find healthy in the DD in the full sense of the word. They get there either because of their health, or because of their health (both physical and mental) bio... What lends itself to education, is brought up, what does not lend itself - fall in love) how difficult? - exactly as much as you are ready, as far as you can accept (or not accept) it with any

03.10.2017 21:46:24, alsohere

Discussion of adoption issues, forms of placing children in families, raising foster children, interaction with guardianship, teaching foster parents at school. Section: Adoption (diagnosis g96.8 in a child decoding). Prompt for diagnoses.

Discussion

G96.8 - may not mean anything at all. If before the age of 4 they did not specify what was struck 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 CNS damage", among others, expressed in a very weak muscle tone, the left half of the body was like a rag, some doctors said that the child would not sit down, then - that it would not go ... 4 massage courses, general strengthening measures - running, you’ll catch up with hell, he thinks better than me already))) but, I think, we will still have problems with speech therapy.
A 4 summer child can already show itself: motor development, speech, and thinking - everything can already be investigated. 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 lesions of the central nervous system and with mental disorders, are there only children with serious diagnoses? Conclusion of guardianship. On Friday, God willing, we will go to such a children's home (just an 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. Or, I don't know.
Of the diagnoses, there was only a delay in the development of speech, it is severe.

As far as I know, there are no non-specialized DRs ... They are paid a premium for "specialization". So read the map. My daughter was in the DR with the same specialization, although her cardiology is semi-fake. It's just 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 goes to a regular school, goes in for sports. And my child was diagnosed with an organic lesion of the central nervous system, paraparesis, and a disability from a year and a half.

Discussion

Looks like we're doing an MRI tomorrow. And on Friday - a psychiatrist and a neurologist. In DD they gave me a lot of guilt - 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 am not a doctor. At all. Therefore, my reasoning is completely philistine. So: in my opinion, residual organic lesion is a very general diagnosis. Manifestations should depend on the extent and localization of the lesion. And they can be from "does not understand anything, drools" (sorry for the incorrectness), to "nothing is noticeable at all." The first option is clearly no longer a threat to 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 "poor study." Is it critical for you? What if it's hard to study? What if he doesn't go to university? If in the very last resort will study in correction?
This is, in principle, a real prospect for many adopted children. Not a fact, a child taken at a younger age, you will not get the same problems at school.
In general, since my child is almost like this (studies with difficulty, after grade 1 he couldn’t do anything), but wonderful and beloved, I feel sorry for the girl. Somehow, in the discussion, they almost put an end to it. :(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 (CNS with hypertension in children treatment prognosis). So the question is: residual-organic lesion of the central nervous system - what is it, what are the forecasts and what ...

Discussion

depends on the background, and even more on the perspective. any child, sick or healthy, in a favorable psycho-social environment has a much better chance of growing up to be 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, completely dissolved in worries, problems and the search for the best solutions.

Just like on the Internet - from nothing terrible to vagrancy, suicidal tendencies, etc. Look at the children. If something is bothering you, contact the experts. Sorry for the internet diagnosis, but I think your kids look good.

CNS damage. Medicine / children. Adoption. Discussion of adoption issues, forms of placement of children in families, education Please tell me what is a CNS lesion without a psychic lesion. in an Internet has found only about perinatal damage of TsNS. it's one and...

Discussion

The benefits of swimming are undeniable.

But... if the child is predisposed to allergies, coughs, there is a hint of asthma, then I would not be zealous.
Means that are thrown into the water for disinfection:
1. Not useful on their own, 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 sea and for the whole summer.

There are benefits, but there should be a comfortable temperature for the child. Therefore, if you mean the Lestgaf Institute (I’m not sure if I wrote it correctly), then they wrote here that it’s cold for children. We go to the clinic, it’s very easy to add hot water there. we are passive, but in a year I think you can still cause reflex swimming movements of the arms and legs, mine in the bath only after 3 months of everyday swimming began to stir on their own, 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 on the increase in ICP on Cavinton and the growth of the head when taking it (we also had this :-() So the first scheme is good, I would not change it. It’s just that Kinder biovital is a little embarrassing for such a small child, but if there are none allergic reactions then let's have it too.

Organic damage to the CNS. Girls, there are more children with cerebral palsy, autism and others like them in the conference. 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 according to the Bronnikov method. I’m not special at all, a friend studied there, told me what wonderful results there are. I can ask if it's worth it for your problems to go there. 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, there is hypoplasia of the corpus callosum, diffuse lesion white matter etc. I don’t know how others, but we official medicine she could not offer anything except standard vascular therapy and light nootropics in the hope that the remnants of the affected areas would "sort themselves out", redistribute functions, etc. This process was somewhat stimulated by the treatment of Koreans on the street. ak. Pilyugin, by the way, I saw children with them who also have problems with the cerebellum, there was some progress, but this is all individual. What city do you live?

CNS damage. My friend had a birth due to placental abruption premature baby(32nd week); suffered severe hypoxia, they even say that some lobules in the brain (I don’t understand well what is meant) have died.

Lecture XIV.

Residual organic lesions of the CNS

Consequences of early residual-organic lesions of the central nervous system with cerebrasthenic, neurosis-like, psychopathic-like syndromes. Organic mental infantilism. Psychoorganic Syndrome. Attention deficit hyperactivity disorder in children. Mechanisms of social and school disadaptation, prevention and correction of residual effects of residual organic cerebral insufficiency and child 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 injuries in early childhood, infectious diseases). There are serious reasons to believe that in recent years the number of children with the consequences of early residual organic lesions of the central nervous system has become more and more, although the true prevalence of these conditions is not known.

The reasons for the increase in the 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 disturbed due to frequent somatic diseases, a sedentary lifestyle, restrictions on movement, fresh air, feasible homework or, conversely, excessive exercise professional sports as well as early initiation of smoking, alcohol consumption, toxic substances and drugs. Improper nutrition and hard physical labor of a woman during pregnancy, emotional experiences associated with an unfavorable family situation or unwanted pregnancy, not to mention the use of alcohol and drugs during pregnancy, disrupt its proper course and adversely affect the intrauterine development of the child. The result of imperfect medical care, primarily the lack of any representation of the medical contingent antenatal clinics about the psychotherapeutic approach to a pregnant woman, full-fledged patronage during pregnancy, informal practice of preparing pregnant women for childbirth and not always qualified obstetric care, are birth injuries that violate normal development child and affect later on throughout his life. The introduced practice of “birth planning” is often brought to the point of absurdity, turning out to be useful not for the woman in labor and the newborn, but for the staff of the maternity hospital, who have received the legal right to plan their vacation. 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 a new shift takes over from tired staff. 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 not 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, an organic lesion of the central nervous system manifests itself in the form of neurological signs that are detected by a pediatric neuropathologist, and all familiar external signs: trembling of the hands, 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, intermittent night sleep, delay in the formation 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 injury and prescribe treatment (cerebrolysin, cinnarizine, cavinton, vitamins, massage, gymnastics). Intensive and properly organized treatment in non-severe cases, as a rule, has positive action, and already by the age of one, the child is removed from the neurological register, and for several years a child brought up at home does not cause much concern for parents, with the possible exception of some delay in speech development. Meanwhile, after being placed in a kindergarten, the child's characteristics begin to attract attention, which are manifestations of cerebral palsy, neurosis-like disorders, hyperactivity and mental infantilism.

The most common consequence of residual organic cerebral insufficiency is cerebrosthenic syndrome. Cerebrosthenic 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 prolonged decrease in working capacity, especially with significant intellectual stress. Schoolchildren have a decrease in memorization and retention of educational material in memory. Along with this, irritability is observed, taking the form of explosiveness, tearfulness, capriciousness. Cerebrosthenic conditions caused by early brain damage become a source of difficulty in developing school skills (writing, reading, counting). The mirror character of writing and reading is possible. Speech disorders are especially frequent (delay in the development of speech, articulatory deficiencies, slowness or, conversely, excessive speed of speech).

Frequent manifestations of cerebrosthenia may be headaches that occur upon awakening or when tired at the end of lessons, accompanied by dizziness, nausea and vomiting. Often, such children have transport intolerance with dizziness, nausea, vomiting, and a feeling of lightheadedness. They also do not tolerate heat, stuffiness, high humidity, reacting to them with a rapid pulse, an increase or decrease in blood pressure, and fainting. Many children with cerebrovascular disorders cannot tolerate merry-go-rounds and other rotational movements, which also result in dizziness, lightheadedness, and vomiting.

In the motor sphere, cerebrosthenia 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 get involved in work for a long time, they need much more time than ordinary children to comprehend the material, solve problems, do exercises, 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 whiny. They are forced to lie down or even sleep after returning from school, in the evenings they are lethargic, passive; with difficulty, reluctantly, for a very long time preparing homework; difficulty concentrating and headaches are aggravated by fatigue. In the second case, fussiness, excessive motor activity, and restlessness are noted, which prevents the child from not only engaging in purposeful educational activities, but even playing a game that requires attention. At the same time, the child's motor hyperactivity increases with fatigue, becomes more and more disorderly, chaotic. It is impossible to involve such a child in the evenings in a consistent game, and in school years - in preparing homework, repeating the past, reading books; he almost fails to get to bed on time, so that from day to day he sleeps much less than his age.

Many children with the consequences of early residual organic cerebral insufficiency have features of dysplasia (deformation of the skull, facial skeleton, auricles, 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 of individual approach in training and mode, they experience great difficulties in adapting to school. They are more than their healthy peers, sit through the lessons and even more decompensated due to the fact that they need a longer and more complete rest than ordinary children. Despite all efforts, they, as a rule, do not receive encouragement, but, on the contrary, are subjected to punishments, continuous remarks and even ridicule. After a more or less long time, they stop paying attention to their failures, interest in learning drops sharply and a desire for an easy pastime appears: watching all television programs without exception, outdoor games and, finally, craving for the company of their own kind. In this case, direct skimming is already taking place. schoolwork: absenteeism, refusal to attend classes, runaways, vagrancy, early drinking, which often causes home theft. It should be noted that residual organic cerebral insufficiency greatly contributes to the rapid emergence of dependence on alcohol, drugs and psychoactive substances.

^ neurosis-like syndrome in a child with a residual organic lesion of the central nervous system, it 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, fears, movements.

The above observation illustrates cerebrasthenic and neurosis-like syndromes in a child with early residual-organic lesion of the CNS.

Kostya, 11 years old.

The second child in the family. He was born from a pregnancy that proceeded with toxicosis of the first half (nausea, vomiting), the threat of miscarriage, edema and increased blood pressure in the second half. Delivery 2 weeks premature, born with double cord entanglement, in blue asphyxia, screamed after resuscitation. Birth weight 2700. Attached to the breast on the third day. He sucked sluggishly. Early development with a delay: he began to walk at the age of 1 year 3 months, utters individual words from 1 year 10 months, phrasal speech - from 3 years. Until the age of 2, he was very restless, whiny, and had a lot of colds. Up to 1 year, she was observed by a neuropathologist for trembling of the hands, chin, hypertonicity, convulsions (2 times) at high temperature against the background of acute respiratory disease. He grew up quiet, sensitive, inactive, awkward. He was overly attached to his mother, did not let her go from him, got used to kindergarten for a very long time: he did not eat, did not sleep, did not play with children, cried almost all day, refused toys. Until the age of 7, he suffered from nighttime urinary incontinence. He was afraid to be alone at home, fell asleep only by the light of a night lamp and in the presence of his mother, was afraid of dogs, cats, sobbed, resisted when he was taken to the clinic. With emotional stress colds, troubles in the family, the boy had blinking and stereotyped shoulder movements, which disappeared with the appointment of small doses of tranquilizers or sedative herbs. Speech suffered from the incorrect pronunciation of many sounds and became clear only by 7 years after speech therapy classes. I went to school from the age of 7.5, willingly, quickly got acquainted with the children, but almost did not talk to the teacher, for 3 months. He answered questions very quietly, behaved timidly, uncertainly. Tired by the 3rd lesson, "lying" on the desk, could not absorb educational material, ceased to understand the explanations of the teacher. After school he went to bed and sometimes fell asleep. Lessons taught only in the presence of adults, often in the evenings complained of a headache, often accompanied by nausea. Slept restlessly. He could not stand the ride in the bus and the car - nausea, vomiting were noted, he turned pale, covered with perspiration. Felt bad on cloudy days; at this time, the head almost always hurt, dizziness, decreased mood, and lethargy were noted. In summer and autumn I felt better. The condition worsened at high loads, after diseases (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, walked alone in the yard, but preferred quiet games at home. He began to study at a music school, but attended it reluctantly, cried, complained of fatigue, was afraid that he would not have time to do his homework, became irritable, 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, and a sedative mixture. If necessary, an additional day off was assigned. In the process of 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 are talking about pronounced signs of cerebrasthenic syndrome, acting in combination with neurosis-like symptoms (tics, enuresis, elementary fears). Meanwhile, with adequate medical supervision, the correct treatment tactics and a sparing regimen, the child fully adapted to the conditions of the school.

Organic damage to the CNS can also be expressed in psychoorganic syndrome (encephalopathy), characterized by a greater severity of disorders and containing, along with all the signs of cerebrosthenia described above, a decrease in memory, a decrease in the productivity of intellectual activity, a change in affectivity (affect incontinence). These features are called the Walter-Buhel triad. Affect incontinence can manifest itself not only in excessive affective excitability, inappropriately violent and explosive manifestation of emotions, but also in affective weakness, which includes a pronounced degree emotional lability, emotional hyperesthesia with excessive sensitivity to all external stimuli: the smallest changes situations, an inadvertent word causes irresistible and uncorrectable stormy emotional states in the patient: crying, sobbing, anger, etc. Memory impairment in psychoorganic syndrome varies from its slight weakening to severe mnestic disorders (for example, difficulties in remembering momentary events and current material).

With a psychoorganic syndrome, the prerequisites for intelligence are insufficient, first of all: a decrease in 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 cover the situation as a whole, capturing only fragments, separate aspects of events. Violations of memory, attention and perception contribute to the weakness of judgments and inferences, which is why patients give the impression of helpless and stupid. There is also a slowdown in the pace of mental activity, inertness and rigidity of mental processes; this manifests itself in slowness, stuck on certain ideas, in the difficulty of switching from one type of activity to another. Characterized by the lack of criticism of their abilities and behavior with a careless attitude to their 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 remains.

The 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 remote period organic damage to the CNS.

Often, with residual-organic cerebral insufficiency, signs appear psychopathic syndrome which becomes especially evident in prepubertal and pubertal age. For children and adolescents with psychoorganic syndrome, the most serious forms of behavioral disorders are characteristic, due to 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 (the desire to receive new experiences, pleasures). Affective excitability is expressed in a tendency to excessive easy onset violent affective outbursts, inadequate to the cause that caused them, in fits of anger, rage, impatience, accompanied by motor excitement, thoughtless, sometimes dangerous for the child himself or those around him and, often, narrowed consciousness. Children and adolescents with affective excitability are capricious, touchy, overly mobile, prone to unbridled pranks. They shout a lot, get angry easily; any restrictions, prohibitions, remarks cause them violent reactions of protest with malice and aggression.

Together with symptoms organic mental infantilism(emotional-volitional immaturity, uncriticality, lack of purposefulness of activity, suggestibility, dependence on others) psychopathic disorders in a teenager with residual organic damage to the central nervous system create the prerequisites 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 the complete loss of criticism or even amnesia (lack of memory) of the criminal act itself, a relatively small dose of alcohol and drugs is sufficient for a teenager with residual organic damage to the central nervous system. It should be noted once again that in children and adolescents with residual organic cerebral insufficiency, addiction to alcohol and drugs develops faster than in healthy children, leading to severe forms of alcoholism and drug addiction.

The most important means of preventing school maladaptation in residual organic cerebral insufficiency is the prevention of intellectual and physical overload by normalizing the daily routine, the correct alternation of intellectual work and rest, and the exclusion of 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 type of school (with in-depth study of a foreign language, physics and mathematics, gymnasium or college with an accelerated and expanded curriculum).

With this type of mental pathology, for the prevention of educational decompensation, it is necessary to timely introduce adequate drug course therapy (nootropics, dehydration, vitamins, light sedatives, etc.) constant surveillance psychoneurologist and dynamic electroencephalographic, craniographic, pathopsychological control; early start pedagogical correction taking into account the individual characteristics of the child; classes with a defectologist on an individual basis; 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 CHILDHOOD. A certain connection with residual-organic cerebral insufficiency in childhood is also 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, attention deficit hyperactivity disorder in children, active attention disorder syndrome, attention deficit syndrome (the latter name corresponds to the modern classification).

The standard for evaluating behavior as "hyperkinetic" is the 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 in time);

4) is found in more than one situation (not only at school, but also at home, on the street, in a 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 disadaptation - poor progress, repetition, behavioral disorders, but also to severe forms of social disadaptation, far beyond childhood and even puberty.

Hyperkinetic disorder, as a rule, manifests itself already in early childhood. In the first year of life, the child shows signs of motor excitation, constantly spins, makes a lot of unnecessary movements, because of which it is difficult to put him to bed and feed him. The formation of motor functions in a hyperactive child occurs faster than in his peers, while the formation of speech does not differ from the usual terms or even lags behind them. When a hyperactive child begins to walk, he is characterized by speed and an excessive number of movements, unrestraint, cannot sit still, climbs everywhere, tries to get different objects, does not respond to prohibitions, does not feel danger, 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 cannot play with his toys at all, do one thing, is naughty , playing around, running. Falling asleep is disturbed: even when physically restrained, the child constantly moves, tries to slip out from under the mother's arms, jump up, open his eyes. With pronounced daytime arousal, there may be a deep night's sleep with long-term incessant enuresis.

However, hyperkinetic disorders in infancy and early preschool years are often regarded as ordinary vivacity within the framework of normal child psychodynamics. In the meantime, restlessness, distractibility, satiety with the need for frequent changes of impressions, the inability to play alone or with children without the persistent organization of adults gradually increase and begin to attract attention. These features become already apparent in the senior preschool age, when the child begins to prepare for school - at home, in the preparatory group kindergarten, in the preparatory groups of a comprehensive school.

Starting from the 1st grade, hyperdynamic disorders in a child are expressed in motor disinhibition, fussiness, inattention and lack of perseverance when performing tasks. At the same time, it is often observed elevated background moods with overestimation of one's own abilities, mischief and fearlessness, lack of perseverance 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 violations of the rules of conduct. They usually have broken relationships with adults due to the lack of caution and restraint, low self-esteem. Hyperactive children are impatient, do not know how to wait, cannot sit during the lesson, are in constant non-purposeful movement, jump up, run, jump, if necessary, sit still, constantly move their legs and arms. They are, as a rule, talkative, noisy, often complacent, constantly smiling, laughing. Such children need a constant change of activity, new experiences. A hyperactive child can consistently and purposefully engage in one thing only after significant physical exertion; at the same time, such children themselves say that they "need to discharge", "discharge energy."

Hyperkinetic disorders act in combination with cerebrosthenic syndrome, signs of mental infantilism, pathological personality traits, 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-term common childhood fears of loneliness, darkness, pets, white coats, medical manipulations or rapidly emerging obsessive fears based on a traumatic situation. Signs of mental infantilism in hyperkinetic syndrome are expressed in the game interests inherent in an earlier age, gullibility, suggestibility, submissiveness, affection, spontaneity, naivety, dependence on adults or more self-confident friends. Due to hyperkinetic disorders and features of mental immaturity, the child prefers only gaming activity, but even she does not capture him for a long time: he constantly changes his mind and direction of activity in accordance with those who are near him; he, committing a rash act, immediately repents of it, assures adults that "he will behave well," but, getting into a similar situation, again and again repeats sometimes harmless pranks, the outcome of which he cannot foresee, calculate. At the same time, because of affection, good-naturedness, sincere repentance for what he has done, such a child is extremely attractive and loved by adults. Children, on the other hand, often reject such a child, since it is impossible to play productively and consistently with him because of his fussiness, noisiness, the desire to constantly change the conditions of the game or move from one type of game to another, because of his inconsistency, variability, superficiality. A hyperactive child quickly becomes 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 the occurrence of various transient or more persistent deviations in them, violations of the process of personality formation under the influence adverse factors- both microsocial-psychological and biological. The most common in hyperactive children are pathological character traits with a predominance of instability, when the lack of volitional delays, the dependence of behavior on momentary desires and inclinations, increased subordination to outside influences, lack of skill and unwillingness 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 the forms of behavior of others, including negative ones (leaving home, school, foul language, petty theft, drinking alcohol).

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 whole future life of a person.

From the very first days schooling the child finds himself in the conditions of the necessary fulfillment of disciplinary norms, the assessment of knowledge, the manifestation of his own initiative, the formation of contact with the team. Due to excessive physical activity, restlessness, distractibility, satiety, a hyperactive child does not meet the requirements of the school and in the coming months after the start of studies becomes the subject of constant discussion in teaching staff. Every day he receives comments, diary entries, he is discussed at parent and class meetings, he is scolded by teachers and the school administration, he is threatened with expulsion or transfer to individual education. Parents cannot 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 a system of education 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 interferes with everyone: teachers, parents, older and younger siblings, children in the classroom and in the yard. His success in the absence of special methods of correction never corresponds to his intellectual natural data, i.e. he learns much worse than his abilities. Instead of motor discharge, which the child himself tells adults about, he is forced to sit for many hours completely unproductively preparing lessons. Rejected by family and school, misunderstood, unsuccessful child sooner or later begins to frankly 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 on his own. The street is full of entertainment, temptations, new acquaintances; street is varied. It is here that the hyperkinetic child is never bored, the street satisfies his inherent passion for a continuous change of impressions. Here no one scolds, no one asks about academic performance; here peers and older children are in the same position of rejection and resentment; new acquaintances appear daily here; here for the first time the child tries the first cigarette, the first glass, the first joint, and sometimes the first shot of the drug. Due to suggestibility and subordination, the 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 (up to registration in the children's room of the police, judicial investigation, 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 at a younger preschool age, is significantly (or completely) compensated during adolescence due to a decrease in motor activity and improved attention, such adolescents, as a rule, do not reach the level of adaptation corresponding to their natural data, since they are socially decompensated already at primary school age, and this decompensation can increase in the absence of adequate corrective and therapeutic approaches. Meanwhile, with proper, patient, constant treatment-and-prophylactic and psychological-pedagogical work with hyperactive child it is possible to prevent deep forms of social disadaptation. AT adulthood 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 with a weight of 3300, cried after spanking. Early development of motor functions with advance (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 mobile, grabbed everything around, climbed everywhere, not being afraid of heights. Up to a year, he repeatedly fell out of the crib, hurt himself, constantly walked in bruises and bumps. He fell asleep with difficulty, he had to be rocked for hours, 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, did not find an occupation for himself, "lost about" idle, was naughty, interfered with everyone. In kindergarten - from 4 years. I got used to it right away, played only with the boys, not particularly singling out any of them; educators complained about his excessive mobility, senseless mischief, pugnacity. In the preparatory group, attention was drawn to restlessness, a lot of unnecessary movements even in relative peace, unwillingness to study, lack of curiosity, and distractibility. He was affectionate towards his parents, loved his younger sister, which did not prevent him from constantly bullying her, provoking scandals and fights. He repented of his pranks, but then thoughtlessly he could repeat the mischief. He started going to school at the age of 7. At the lessons he could not sit still, constantly fidgeting, chatting, playing with toys brought from home, making airplanes, rustling papers, not always fulfilling the teacher's tasks. Distinguished by a good memory, he studied poorly - mainly at "3"; from the 5th grade, academic performance worsened even more, he did not always teach home lessons, only with the vigilant control of his parents and grandmother. During the lessons he was constantly distracted, whined, looked with empty eyes, not absorbing the material, asked extraneous questions; left alone, he immediately found something to do - played with a cat, made airplanes, drew "horror stories" directly on notebooks, etc. He preferred to spend time on the street, came home later than the appointed time, every day promising to "correct". Remained overly mobile, did not feel the danger. Twice with a diagnosis of "brain concussion" (at the age of 7 he was hit on the head by a swing, at 9 years old he fell from a tree) and once due to a broken arm (8 years old) he was in the hospital. He quickly got acquainted with both children and adults, but there were no permanent friends. He did not know how to play one, even an outdoor game for a long time, interfered with the children or left in search of other entertainment. I have been smoking since the age of 8. From the 5th grade, he began to skip classes, several times did not spend the night at home for three days; after the police found him, he explained that he was afraid to go home after receiving several twos, fearing punishment. Sometimes he spent time in the boiler room, where he met adults, and spent the night there when he disappeared from the house. At the insistence of his parents, he began to attend sports sections and circles at school several times, but stayed there for a short time - he left them without explaining the reasons and without informing his relatives. After consulting a psychiatrist (at the age of 11), he began to receive phenibut and small doses of neuleptil, and was assigned to a folk dance school. A few months later he became calmer, more focused in his studies, at first under the supervision of adults, and then on his own, without missing, attended a dance school, was proud of his success, participated in competitions, and went on tour with the team. Achievement and discipline in the general education school have improved significantly.

The present case is an example of hyperdynamic syndrome in childhood, in which gross social disadaptation was avoided due to treatment and right action parents.

When determining preventive tactics in relation to a child with hyperactivity, first of all, it is necessary to think about the organization of the living space of a hyperactive child, which should include all the possibilities for the implementation of his increased physical activity. The morning hours preceding classes at school or attending a kindergarten, such a child should be filled with increased physical activity - the most appropriate running in the air, a fairly long morning exercise, training on simulators. As practice shows, after 1-2 hours of sports activities, hyperactive children sit more calmly in the classroom, are able to concentrate, and better learn the material. Most appropriate for elementary school organizing the first two lessons of physical education 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 characteristics of the child sometimes organize physical exercises themselves, running in the fresh air before the start of classes, 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 school. To do this, it is advisable to put simulators, trampolines, 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 make changes in such a room. Along with the organization of increased physical activity during breaks, such children are also recommended increased physical activity during physical education classes at school. In addition, for children with motor disinhibition, for the development of perseverance, classes in sports sections are also useful, requiring great physical tension and movement and, at the same time, plasticity, attention, and fine motor actions; while not recommended power types sports. The earlier sports are introduced, the higher positive effect, affecting primarily the performance of a hyperactive child. In this case, the educational role of the coach is very important: if both the sport itself and the personality of the coach impress the child, then it is in the power of the coach to gradually and consistently demand that the student improve academic performance. A psychiatrist should explain to parents the characteristics of their child, the origin of his excessive motor activity, lack of attention, inform them of a possible social prognosis, convince them of the need for a proper organization of living space, as well as the negative effect of forcible restriction of movements.

Among non-drug forms of prevention of social disadaptation in children with hyperkinetic disorders, it is also possible to conduct psychotherapy. The preferred approach in this case is behavioral psychotherapy. Considering wide range family problems involved in pathoplasty disorders and arising in response to them, family therapy is indicated. After the end of the course, supportive psychotherapy, also including the child and the family, is advisable. The presence of medical and psychological services makes it possible to include work with teachers and educators in the assistance system, aimed at the possibility of supporting the child on their part. With signs of disadaptation 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. Behavioral therapy addresses the problem behavior of the child himself. Cognitive Therapy applicable to older students and is aimed at reorganizing the understanding of the school situation and the existing difficulties.

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

LITERATURE:

1. V.V. Kovalev. Psychiatry childhood. - Moscow. "The medicine". - 1995.

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

3. G.E. Sukharev. 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. "The medicine". - 1973.

QUESTIONS:

1. What psychopathological disorders are typical for early residual organic lesions of the CNS?

2. What is the difference between cerebral palsy 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 CNS damage can occur in everyone, but only serious stages require proper treatment.

Organic CNS damage in adults

Such a diagnosis indicates the inferiority of the brain. Its damage is the result of long-term medication, alcohol abuse and drug use. In addition, the cause of the disease are:

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

Symptoms of organic damage to the central nervous system

With the development pathological processes apathy, decrease in activity, loss of interest in life are observed. Along with this, there is indifference to their appearance and slovenliness. However, sometimes the patient, on the contrary, becomes too excitable, and his emotions become inappropriate.

Also distinguish the following signs:

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

With the development of the disease, there is a significant deterioration protective properties organism, therefore, such consequences of an organic lesion of the central nervous system as:

• meningitis;
• neurosyphilis;
• and other serious infections.

As a rule, the disease progresses and becomes a further cause of social decapitation and dementia.

Diagnosis of organic lesion of the central nervous system

Timely detection of the disease allows you to start treatment and stop its further development. The patient undergoes a tomography of the brain. Upon detection of vascular damage and the simultaneous manifestation of cognitive impairment, a conclusion is made about the diagnosis.

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 with a change in lifestyle, diet, which is especially necessary for certain liver diseases, atherosclerosis and alcoholism.