A method of treating tempo delay of mental development in children
(57) Abstract:The invention relates to medicine, more precisely, neurology, and can be used to treat the side effects of perinatal lesions of the Central nervous system. Establish the extent of the backlog of the child from age norms and depending on this, assign pharmacokineti within 2-3 weeks. Then spend megametre, specifying the severity of Central disorders. If levels of omega-potential below -20 mV or more than -40 mV, conduct transcranial micropolarization (TCMP) current strength of 0.03 to 0.08 mA in the form of sessions of 15-20 minutes each not more than 1 time per week 2 of the electrode imposed as follows: cathode on the lower parts of the occipital region of the left hemisphere, the anode during the first 3-6 sessions on the border signalone region and anterior superior temporal gyrus, then in 2-3 sessions on the projection of the motor cortex of the left hemisphere. Throughout the course TCMP continue supporting neurometabolic therapy and speech therapy classes. The method allows to obtain a stable therapeutic effect and reduce the treatment time. 1 C.p. f-crystals. The invention relates to medicine, more specifically to a neuro who.Tempo delay of mental development, as one of the types of dysontogenesis, characterized by multiformato clinical manifestations of damage or partial hypoplasia of the brain systems regulating adaptive behavior and higher mental functions, including speech. In accordance with modern ideas on the basis of tempo delay of mental development there are multiple factors of complications in early ontogenesis, including hypoxic (intrauterine hypoxia, complications in childbirth, and others), toxic (toxicosis of pregnancy and other types of poisoning), infectious type of lesion in the embryonic period, the mechanical (instrumental benefits in childbirth, rapid delivery, and so on)
According to the MOH of Russia complications ante-, peri - and early postnatal periods of ontogenesis in the form of tempo delay of mental development are found in 60-75% of children. Close connection violations in the individual development of these children and their adaptation to the surrounding world. Disorders of the Central mechanisms of perception, attention, associative memory and speech functions are among the fundamental factors limiting poznavatelnogo group of children.Manifestations tempo delay of mental development on residual organic background are common symptom zerebrasteniceski violations of hemodynamic, autonomic, and emotional-volitional disorders neurotic level, deficienct motor functions (including motor function of the tongue), reduced motivation and cognitive activity, curiosity, focus action. Reduction of self-control and predict the actions of such children significantly below age norms. Higher mental functions, they show impaired phonemic hearing, the weakening of the oral-aural memory, cognitive decline and limited information about the world; takes place later development of phrase speech, underdevelopment of the logico-grammatical structures, poor vocabulary, difficulty in retelling read and seen, in violation of the syllabic structure of words, the distortion of sound pronunciation.As a consequence of perinatal CNS damage, such violations require correction in the early stages of their manifestation, i.e., in children of primary and pre-school age.The present invention concerns this is Aulnay age with the consequences of perinatal CNS lesions.Currently, the most widely used method of correction of these violations is a combination of drug therapy with psychotherapy, teaching and speech therapy methods [Pathogenetic approaches to integrated treatment of speech disorders in children and adolescents with effects of organic lesions of the Central nervous system. Methodological manual for doctors MH RF, M, 2001]. This method is closest to the proposed and taken as a prototype. The method consists in applying a dehydration and resolving the funds attributable to cerebroprotective, antiprotection, heatprotection, vitamin products and their analogues, as well as means of regulating emotional and behavioral reactions, if necessary anticonvulsants. Offer medicines prescribed courses from 1-2 months to 1-2 years or more in combination with psychotherapy. This method allows to achieve a marked positive effects of treatment in more than 50% of children with tempo delay of mental development. It should be noted that this effect is achieved, as noted by the authors, when treatment for a very long time (up to several nastojashego of the invention is to reduce treatment time due to the additional use of schema therapeutic effects of transcranial micropolarization.This result is achieved in that additionally at least 1 times 10 days perform megametre and when values of omega-potential to -20,0 MB and more -40,0 mV spend transcranial micropolarization current strength of 0.03 to 0.08 mA sessions 15-20 minutes through 2 electrodes, applying a cathode on the lower parts of the occipital region of the left hemisphere, the anode - within 3-6 sessions on the border signalone region and anterior superior temporal gyrus of the same hemisphere, and after 1-2 weeks 2-3 sessions consecutively on the projection of the motor cortex of the same hemisphere, the first session of transcranial micropolarization spend 2-3 weeks after the start of pharmacotherapy, further not more than 1 time a week, and drug therapy and speech therapy sessions continue throughout the course of treatment.Suitable as drug use antioxidant, antihypoxic and antihypertensives, and micronutrients, amino acids and enzymes.Engaged for many years in the treatment of patients with diseases of the Central nervous system, we used in our practice not only medicines, but also a wide variety of biophysical methods for correction of pathology, depression we used various modifications of the method of transcranial electrical effects. Particularly effective, in our opinion, were transcranial micropolarization (TCMP). This agreed well with the literature data, in particular, with the famous research D. Y. Pinchuk [Clinical and physiological study aimed transcranial micropolarization in children with dysontogenetic CNS pathology. Abstract. of thesis...doctor, honey. Sciences. SPb, 1997], using transcranial micropolarization for the treatment of cerebral palsy and other manifestations dysontogenetic CNS lesions. Known also use TCMP with good effect in the treatment of logoneurosis (stuttering) [Patent 2147447].Based on the previously accumulated experience, as well as with the accounting described in the literature, the results of the use TCMP, we tried to include this treatment in children of primary and pre-school age tempo delay of mental development in the scheme of the complex medical and logotherapie. At the first stage we attempt has been made use of generally accepted modes TCMP and location of the electrodes. However, and more than 100 µa and the duration of its exposure more than 20 min for toddlers and preschool age (from 2 to 7 years) with the consequences of perinatal CNS damage and tempo delay of mental development during the first session TCMP was detected deepening asthenia with a sharp increase of excitability, anxiety and emergence of aggressiveness in some cases and, conversely, the appearance of lethargy, sleepiness in others. And in fact, in both cases it took more medication correction and a break in the continuation on this background, pedagogical and speech training. It was decided to minimize the current and to reduce the duration of exposure current, and change the location of the conductive electrodes based on the results of a comprehensive diagnostic examination.Earlier we (on the basis of the results of basic research role of slow physiological processes - frequency band from 0 to 0.5 Hz in the mechanisms regulating normal and pathological human conditions) developed a method of omegametry used for diagnostics of the level of alertness and emotional disorders at the neurotic level [Ilyukhin C. A. and other Method mehmetli in the practice of hygienic research. Ministry of health guidelines of the RSFSR, M., 1986; omega-capacity in newborn infants and its application in clinical practice. The issues of motherhood and childhood, 1987, T. 32, 1; non-Invasive method of diagnosis of conditions and adaptive responses by way of omegametry in healthy children and balneation indicators in children with tempo delay of mental development we have found: (a) violation stem mechanisms of regulation of wakefulness (in the form of mitigation, a sharp increase, destabilization); b) violation newsegments mechanisms of autonomic and hemodynamic provision of wakefulness manifested symptom of vegetative-vascular dystonia; C) violation of cortical-subcortical mechanisms of regulation of emotions and adaptive behavior.Omega-potential in lead vertex-tenor at rest was measured at the first stage of complex diagnostics (in combination with EEG, REG, neurointervention). Data EEG confirmed the presence of this group of children dysfunction of the median non-specific structures of the brain stem (mainly mesencephalic level), usually with a predominance of its timing effects have been reported cortical immaturity biorhythms, increased convulsive readiness of the Central nervous system, aggravated by hyperventilation, that was one more sign of a hypoxic condition in the brain. A sharp decrease in the duration of an arbitrary threshold apnea when the sample Rod (20) in combination with the peculiarities of manifestations of vegetative-vascular dystonia was further confirmation of the presence oxygendependent energy shortage on respiratory, hemodynamic, or slavickova energy shortage, violations stem mechanisms of regulation of wakefulness, dysfunction of the median non-specific structures of the brain stem, violations newsegments mechanisms of autonomic and hemodynamic provision of wakefulness and cortical-subcortical mechanisms of regulation of emotions and higher nervous activity for 2-3 weeks before using TCMP all children, we conducted additional drug therapy aimed at improving energy potential, which continued during a course of treatment using TCMP. Extra carrying the omegametry proved to be the most informative for rapid (within 10 min) determining the level of wakefulness, his autonomic and hemodynamic support, and the nature of psycho-emotional disorders (emotional lability, psychopathological disorders of neurotic level, emotional rigidity) immediately before each session. The beginning of the course TCMP and each subsequent session TCMP was administered only if found dramatically increased wakefulness, when omega-potential was more -40,0 mV or sharply reduced level of vigilance when Megaco our patients the violation tempo delay higher mental functions was a major factor in the limitations of adaptive behaviour and social adaptation, it was decided to conduct medical TCMP on the left hemisphere is responsible for analytical and synthetic and thought processes, as well as spoken motor functions.Used longitudinal electrodes, and the cathode was placed randomly on the most remote from the anode a distance and place it in the lower sections of the occipital region. The location of the anode was chosen on the basis of comparison of results of trial TCMP different areas of the left hemisphere. The best effect was obtained when applying it to the border signalone region and anterior superior temporal gyrus, which was shown directly after the first session and was expressed in the "spasmodic" positive effect in improving mental health in the classroom with a speech therapist, acceleration of the rate of assimilation of new material, the emergence of interest in studies and curiosity. Use for TCMP projections of the motor cortex contributed to the reduction of the lag of the rate of formation of motor skills from the accelerated pace of development of intellectual and cognitive function, which was observed during TCMP with the anode located on the border signalone region and ECENA 3-6 sessions on the border signalone region and anterior superior temporal gyrus and then 2-3 sessions per motor cortex contributed to the harmonization of accelerated development as mental, and motor functions.The current strength was determined we also empirically and ranged from 0.03 to 0.08 mA. The number of sessions and the interval between them was determined according to the omegametry, the results of neurological and speech therapy examination.The use of pharmacotherapy for 2-3 weeks before the TCMP has helped reduce the severity Serebryanicheskaya syndrome and cerebral symptoms that reduced the potential effect of depletion with TCMP. Further medical therapy, ongoing during the entire course of treatment, as we have shown, supported and strengthened achieved by TCMP positive effect by optimizing cellular metabolism.Conducting speech therapy practice at the background of the TCMP with drug maintenance therapy was objectivesyou accelerated formation recanatini functions and adaptive behavior of the child.The method consists in the following.The child tempo delay of mental development on the basis of neurological and speech therapy surveys establish the extent of the backlog from age norms and depending on this, on arnosti Central violations. If levels of omega-potential below -20,0 mV or more -40,0 mV, carry out TCMP current strength of 0.03 to 0.08 mA in the form of sessions of 15-20 minutes each not more than 1 time per week 2 of the electrode, applying a cathode on the lower parts of the occipital region of the left hemisphere, the anode - first, for 3-6 sessions, on the border signalone region and anterior superior temporal gyrus, then in 2-3 sessions on the projection of the motor cortex of the left hemisphere. Transcranial micropolarization was performed using serial medical device FLOW-1 (included in the State Register of medical equipment) in the constant current mode. Used two standard metal disk electrode with a diameter of 27 mm, which were placed on the skin of the head through 6-8 layers of moist flannel lining. The electrodes were fixed on the head with a rubber helmet on the coordinates of the scheme Kronlein used to Refine the projections of the intracerebral reference points on the head surface. Throughout the course TCMP continue supporting neurometabolic therapy in the form of antioxidant, antihypoxic agents, trace elements, amino acids and enzymes, as well as speech therapy classes.The essence of the method with a diagnosis of Minimal brain dysfunction in residual organic background due to perinatal CNS lesions. The General underdevelopment of speech. Motor alalia.From the anamnesis: the Pregnancy of the mother proceeded with toxemia second half. Delivery is urgent, anhydrous long period. The baby was born full-term. Birth weight 3550, At birth, on the basis of neurological examination, diagnosed with Perinatal encephalopathy syndrome musculoskeletal disorders, congenital cleft hard and soft palate. Was seen by the neurologist to 1 year. Motor development: sitting with 7 months., went in 2 years. Underwent surgery for congenital pathology of maxillofacial area under General anesthesia (10.1997).In clinical neurological examination at the time of admission: hydrocephalic Head form, the syndrome Graefe (+), syndrome Huasteca (+). Determined by diffuse alopecia symptoms residual Genesis. Muscle tone is uniformly reduced, distancey. Tendon reflexes resistant, high on the legs is relatively higher, with filevych tendons marked stable clones. The spine is unstable, fine motor skills poor. Coordinating sample performs blurred. Ascension, there is a decrease in body weight, tissue turgor, sleep disorders, sleep long, sleep prodolzhitelnyh tones, respiratory arrhythmia, functional systolic murmur. Pale skin, pink dermographism HELL 90/65 mm RT. Art. (D=S); HR 108 beats./min, BH - 18 ex/min. Marked asymmetry of the vibration of the soft palate when zvukoproiznositelinoi, a decrease in the amplitude of vibration of the soft palate. Rough speech delay (lack of word formation, onomatopoeia). Turned it understands. The reduction of the emotional background. Reduction of communicative functions (bad comes in contact with your doctor).Speech therapy examination: the Child does not come in contact with. General motor clumsiness, awkwardness, discoordinated movements. The greatest difficulties were noted in the small movements and articulatory motor: not held the pencil, and could not squeeze the hand could not hold the line. Did not feel the articulation of language, could not repeat the pattern of articulatory posture. Impaired phonemic hearing. Understood addressed speech, showed the familiar grammatical categories, did not differentiate singular and plural (the doll - doll), is an affectionate diminutive suffixes (table-chair), did not understand the number of verbs (sing - sing). Vocabulary is poor, consisted of some vowel sounds and onomatopoeia. Does not know colors, broken elemei. Lagomarsino lessons were taught according to the traditional scheme - 3 classes a week for 35 minutes in the first half of the day. At the first class was passive, he did not come into contact until used. There was no interest in the lessons, which created difficulties in learning. In the six months before admission to outpatient treatment in the Institute of human brain RAS and before TCMP) during speech therapy sessions very slowly work progressed on the formation of motor co-ordinate of the vocal apparatus. With great difficulty and only with mechanical assistance could be switched from one articulatory posture to another. An elaborate pose quickly lost. He walked slowly working on the expansion of active and passive vocabulary, not automated set sounds. We encountered difficulties in the development of fine motor skills. Dynamics of development for six months is insignificant. Functional diagnosis prior to the appointment of a complex therapy with the inclusion of TCMP:
Electroencephalography: Background EEG unstable polymorphic, synchronized, vysokotemperaturno with a predominance of diffuse medlennovolnovoj activity in combination with low-voltage beta rhythm and sharp waves without a clear preferential localization. Periodically observed SPONTA the (mid-back) and occipital regions. Rhythmic photic stimulation and hyperventilation increase diffuse epileptiform activity.Thus, when the cortical immaturity biorhythms marked instability of the functional state of the Central nervous system, dysfunction of the median non-specific structures of the brain stem (mainly mesencephalic level) dominated his clock influences. Has increased convulsive readiness of the Central nervous system, especially when functional loads.Data REG: Detected a decrease in the amplitude of the pulse of the blood in the vertebro-basilar pool (bilateral in 50% below the age norm). Revealed moderately expressed vertebral influence compressive in nature (reduction of AOM on turning his head to 25-35% of the initial level). In General, there angiopathies violations of mild and moderate severity, increased vascular tone arterioles bed, unstable signs of difficulty of venous outflow (from mild to moderately expressed).Clinical diagnosis of Minimal brain dysfunction in residual organic background, hypertension-hydrocephalic syndrome I-II century, zerebrasteniceski syndrome, secondary cardiopathy, the background of instability of the spine, the General underdevelopment of speech, motor alalia, the state after uranoplasty (1997) congenital cleft palate.On the basis of the survey is assigned a comprehensive treatment, including pharmacotherapy, lagomarsino classes, massage and transcranial micropolarization.- Pharmacotherapy: glutamic acid 0.25 g 1 per day; glycine 0.1 1 g once a day (at night); Riboxin 0.2 g 1 per day; Essentiale-Forte 1 caps. daily (lunch); sedative calming tea at night; vitamin B12/m 400 µg through day 15; solcoseryl 2% 2 ml/m 15 oligovit 1/2 table. 1 time per day; methionine 0.25 g daily (lunch), mersilene-Forte 1 capsule 1 time a day, solcoseryl 200 mg daily for 15 days, phenibut 0.25 g 2 times a day, Magne-B6 1 tab. daily diuretic tea in the morning. This pharmacotherapy held within 3 weeks.- Lagomarsino classes were held on schedule 3 times a week for 35 minutes in the morning during the whole course of treatment.- Before starting the course TCMP were conducted additional surveys of the level of wakefulness (using the method of omegametry), autonomic and hemodynamic support (based on vegetative and hemodynamically what I (background values of omega-Potentilla alone -4,3 mV D=S), and emotional instability (positive omega-potential to a plateau of 33.0 mV). In the study of the vegetative status detected expressed sympathicotonia (Vegetative Index Cargo 58,0 D=S) and the error term vegetative ensure interaction between the cardiovascular and respiratory systems (coefficients. Hildebrant 5,2 at the rate of 2.8 to 4.9). Data of complex psychophysiological examination testified: (a) expressed in the human stem mechanisms of regulation of wakefulness type sharp decline; b) a violation of newsegments mechanisms of autonomic regulation functions (type hyperactively sympathoadrenal effects); (C) involvement in the pathological process of the formations of the limbic system, which was manifested severe emotional lability.Transcranial micropolarization started 3 weeks after the initiation of pharmacotherapy. Duration of one session of 15 min, the interval between sessions 2 weeks. TCMP was conducted in the afternoon.The first session TCMP was held in the afternoon. The location of the anode at the junction signalone region and anterior superior temporal gyrus of the left hemisphere; the cathode is on the lower sections of the occipital region of the same hemisphere. Omega-potential in lead vertec what it was tense, showed no interest in his surroundings. The procedure was well tolerated, any discomfort is not felt, the negative reaction was not. Immediately after the session behaved naturally. The emotional background is positive.After 3 days after TCMP, under the supervision of a therapist, he first developed an interest in the practice (began to show interest in toys on the table, books, consider the objects in the room). Spontaneously in speech first appeared consonant "M", have an interest in their own articulation, began to repeat articulation exercises.During the week TCMP field, according to the observations of parents, there is General emotional excitement, the child has become more dexterous (independently climbs on a chair). First began to listen to long stories.After 2 weeks, held the second session of the TCMP. Before a session of omega-potential alone -9,8 mV, D=S. the location of the anode and cathode of the former. The parameters of the current of 0.05 mA (including the preservation of Serebryaniy), the duration of the session 15 minutes Before the session had no complaints. Neurologically stable. The procedure was tolerated well. Immediately after the session visible changes in the status of no.According to the observations of therapist, after 3 days after the second Soglassye sounds "p", "beat", began to make pictures of 2 - 3 parts (constructional praxis), appeared the counting operation within 3 agriculture Began to hold a pencil, hold straight lines. Articulation without significant changes. Maintaining a reduced level of alertness and clinical manifestations asthenia decided to keep the interval between subsequent sessions TCMP in 2 weeks with continued drug maintenance therapy, aimed at increasing the energy potential with holding against this background, the speech training scheme.Subsequent sessions TCMP 3, 4, 5 continued while maintaining the same modes. Side effects were not observed. During the course of treatment in the neurological status was observed a positive trend in the form of disappearance of symptoms increased convulsive readiness, reduce the appearance of Serebryaniy (gained weight, improved appetite, normalized sleep), decreased functional abnormalities of the cardiovascular system. According to the dynamic measurement of omega-potential prior to each subsequent session revealed a gradual increase of its values accordingly to -14,0 mV before the 3rd session; to -17,5 mV before 4 session and to -18,8 mV pennvalley activity; began to notice small details of the items appeared podrazdelennosti, watching with interest the cartoons.According to the observations of speech therapist speech became clearer. Improved cognitive processes. Saves the intonational pattern of the word, appeared emotional statement, mastered age generalizing concepts began to retell small tests, seen cartoons, learns heroes of fairy tales in the pictures (improving associative functions) mastered direct account within 10, the counting operation within 5 knows geometric shape that defines the shape of the object. With significant improvement in the recovery of higher mental functions marked preservation of discoordination articulatory movements, there is no significant dynamics of motor activity in the distal hand.In order to improve motor activity decided to hold sessions TCMP with the location of the anode on the motor cortex of the left hemisphere in the projection of the center of movement of the facial muscles and the upper extremities; the cathode is on the lower sections, the occipital region of the same hemisphere. Before a session of omega-potential -18,3 mV, D=S. the constant current of 0.08 mA, session duration 15 minutes Spent 2 such session with inteli. No adverse effects were observed. Throughout the course TCMP continued selected for a child pharmacotherapy.After the last session of TCMP, according to the observations of parents and the data of the speech therapist, become more agile, fine motor skills have improved markedly (draws circles, strokes, stroke, folds small simple mosaic), jumping on one leg, catches the ball.In connection with pronounced positive effect of the treatment was completed.At follow-UPS of child one month after the end of treatment using TCMP, according to the neurologist, psychologist and speech therapist, the positive dynamics of General mental development and adaptive behavior of the child. Increase the positive effect is confirmed by the results of the complex psychophysiological examination. According to the omegametry found keeping optimal level of wakefulness (omega-potential -34,43,6 mV) while maintaining emotional lability. According to EEG revealed the disappearance of signs of increased convulsive readiness. According to REG decreased amiodaronesee manifestations. Vegetative indicators disappeared misalignment vegetative provision den in correctional group kindergarten, before treatment he was visited by a group from the coarse delay of mental development (for mentally retarded children).Example 2. Patient N., 7 years old, was admitted to outpatient treatment February 2, 2001 with a diagnosis of mental retardation. Dyslalia.From the anamnesis: the Pregnancy of the mother proceeded with the toxicity of 1-St and 2-nd half of pregnancy. During pregnancy had impaired transplatzentarnogo circulation. The baby was born in a period of asphyxia secondary degree. In the first year of life was seen by the neurologist diagnosed with Perinatal nervous system damage hypoxic-ischemic Genesis. Tempo delay of psychomotor development up to the age of three. In subsequent years, were treated by a neurologist about the delay of mental development. Received long-term pharmacotherapy (nootropics, vascular equipment, amino acids and other) with no effect. Long-term (2 years) worked with the speech therapist without a positive effect to the recommendation of the teaching in the secondary school.In clinical neurological examination at the time of admission: child slow with ill-formed motor skills (motor clumsiness and awkwardness). Clear stabilny (more in the sixth division). There are signs of pyramidal insufficiency. Planovalgus installation stop. Tendon reflexes decreased, quickly fading. The symptom Gref (+), symptom Huasteca (). Hyperhidrosis. Sleep disorders (difficult falling asleep, segoviana). Night terrors. Physical and mental asthenia (fatigued, loss of memory, attention, and learning difficulties. Obesity Art. I Heard functional systolic murmur, the lability of the pulse.Speech therapy examination: Passive perception of information, lack of curiosity and motivation cognitive activity. Prevalent gaming activities. The weakening of all kinds of memory. Reduced ability to involuntary memorization. Limited vocabulary. Agrammatism in the grammatical system of speech. The inability of the proper use of a number of grammatical categories in the active speech does not emit the main idea of the text. Can't tell what he heard, because it does not understand the meaning of the story. Does not remember the characters of letters and numbers. Difficulties in the assimilation of age training programs. No "R"sound.Functional diagnosis prior to the appointment of a complex therapy with the inclusion of TCMP:
Electroencephalography: fo is aktivnosti alternate with phases of decreasing amplitude and disritmia, mainly in the frontal and Central-parietal regions, while maintaining permanent high-amplitude epileptiform activity in posterior temporal and occipital areas. Against this background, spontaneously arise common high-amplitude paroxysmal synchronized slow (theta) waves with greater intensity in fronto-Central regions. Functional load exacerbate existing violations b.A. Data EEG indicate pronounced diffuse changes B. A., the cortical immaturity of jet lag, instability of the functional state of the CNS in severe dysfunction of the median non-specific structures of the brain stem, with a predominance of his clock influences. The presence of common paroxysmal of espectively without a clear preferential localization, apparently, has a hypoxic Genesis.Data REG: With mild signs of difficulty of venous outflow and amiodarone have expressed compressive stresses on the vertebral arteries and restrict blood flow, more to the left.Clinical diagnosis: Tempo delay of mental development on residual organic background. Hypertensive the syndrome is s syndrome. Secondary cardiopathy (FSS). Obesity I senior General speech underdevelopment of the third level of speech development.Based on the results of the survey are assigned complex treatment, including pharmacotherapy, lagomarsino classes, massage and transcranial micropolarization.- Pharmacotherapy: glycine 0.1 g daily (at night), methionine 0.25 g of 1 times a day, solcoseryl 200 mg 1 time per day, Riboxin 0.2 g of 1 times a day, Essentiale-Forte 1 caps. daily (lunch), phenibut 0.25 g 2 times a day, Magne-B6 1 tab. daily diuretic tea in the morning daily. This pharmacotherapy were installed on the entire course of treatment.- Lagomarsino lessons are conducted on an individual plan, 3 sessions per week for 35 min in the morning during the whole course of treatment.- Before starting the course TCMP was conducted megametre. According to the omegametry in lead vertex-tenor revealed dramatically increased, sustained wakefulness (background values of omega-potential alone -51,8 mV), indicating that the voltage of the mechanisms of regulation of wakefulness and psycho-emotional stress. In the study of the vegetative status detected expressed sympathicotonia (Vegetative Indian systems (coefficients. Hildebrant 5,1).Transcranial micropolarization was conducted with a duration of one session of 15 min, interval between sessions 1 week. TCMP conducted in the second half of the day.The first session TCMP: the location of the anode is on the border signalone region and anterior superior temporal gyrus of the left hemisphere; the cathode is on the lower sections of the occipital region of the same hemisphere. Omega-potential in lead vertex-tenor -51,8 mV. Parameters postoyanno current of 0.08 mA, duration of the session 15 minutes Before the session had no complaints, indifferent to the world around them. The procedure was well tolerated, discomfort and no side effects were.Later, 3 days after the first session TCMP, by the observation of a speech therapist, the observed increase in muscle tone, changed gait, have become more dexterous hand movements (began to collect small mosaic, buckles and lacing), there was interest in the environment.During the week, parents noted the emergence of interest to the surrounding objects at home and on the street, was the first to substitute the chair and get the items from cabinets and top shelves to climb over the barriers. In the neurological examination, the positive dynamics in the form of significant sleduushie sessions TCMP 2 - 4 continued at intervals of 1 week while maintaining the same modes. During the session TCMP side effects were not observed. After four sessions TCMP significantly decreased symptoms of astheno-neurotic syndrome, night terrors stopped, significantly improved motor activity and orientation in space. The child was diligent, attentive, motivated by cognitive activity, increased vocabulary, began to form study skills, began to retell short texts. Because, according to the speech therapist, during the sessions continued difficulties in fine movements of the fingers, in the formation of the grammatical structure of speech, elementary mathematical concepts, continued instability attention (rapid otvlekaemost), noted poor absorption of symbols, letters and numbers, learning difficulties of writing and reading, it was decided to hold sessions TCMP with the location of the anode on the motor cortex of the left hemisphere (the representation of the upper extremities) and the cathode is on the lower sections of the occipital region of the same hemisphere. When measuring the omega-potential before 5 session identified expressed his agility at average values -45,7 mV and -42,3 mV before 6 session. Parameters DC and duration of sessions are not izmeneniya effects were absent. During the entire course TCMP continued pharmacotherapy.Upon completion of the course TCMP, according to clinical neurological and speech therapy examination, significant improvement of cognitive functions (comparison, generalization, analysis and synthesis), improved themagicke ear marked improvement in the grammatical system of speech, the child began to remember the letters, numbers, begins to read the first skill of writing, writes the elements of letters, focuses on a sheet of paper, performs a counting operation within ten, came forward and backward count to twenty. Improved constructive praxis and gnosis. Appeared the "R" sound. Significantly improved coherent speech. Significantly decreased fatigue, improved cognitive abilities. Motor function was closer to the age norm. Well come into contact with children and adults. When you achieve therapeutic effect, the course of complex therapy was completed.A monitoring study of the child, 2 months, experienced a dramatic acceleration in the rate of mental development, the opportunity of training in remedial class with the subsequent transition to secondary school, when the original recom is tan in joint research staff of the Laboratory of physiology States Institute of human brain RAS, Department of emergency medicine, SPb maps MZ the Russian Federation and the St. Petersburg city center on treatment of children with congenital disorders of the maxillofacial region and has been tested in 98 children aged 2 to 7 years with tempo delay of mental development on residual organic background due to perinatal CNS lesions with a positive result.The proposed method is compared with the known has a number of advantages:
1) reduction of term achieve a positive therapeutic effect of up to 2-3 months, while the known methods require to achieve the effect of a longer time to 1-2 years or more;
2) minimization of pharmacokineti excluding psychotropic drugs and only drugs that improve cellular metabolism;
3) use of low-impact modes TCMP (known how they are orders of magnitude above) virtually eliminates the effects of depletion of regulatory mechanisms of the examined group of children;
4) sustainability of the achieved effect the stepwise extension of the adaptive capacity of the child and further increase the effectiveness of speech therapy correction of those children, Logotherapy have praagh children with neurological and speech therapy examination followed by pharmacotherapy and speech training, characterized in that additionally at least 1 times 10 days perform megametre and when values of omega-potential to -20,0 mV and more than -40 mV spend transcranial micropolarization current strength of 0.03 to 0.08 mA sessions 15-20 minutes through 2 electrodes, applying a cathode on the lower parts of the occipital region of the left hemisphere, the anode - within 3-6 sessions on the border signalone region and anterior superior temporal gyrus of the same hemisphere, and after 1-2 weeks 2-3 sessions consecutively on the projection of the motor cortex of the same hemisphere, the first session transcranially of micropolarization spend 2-3 weeks after the start of pharmacotherapy, the next - not more than 1 time a week, and drug therapy and speech therapy sessions continue throughout the course of treatment.2. The method according to p. 1, characterized in that pharmacotherapy includes antioxidant, antihypoxic funds, as well as trace elements, amino acids and enzymes.
SUBSTANCE: method involves carrying out pulsating Doppler echocardiographic examination. Mean pressure is determined in pulmonary artery. Mean pressure in pulmonary artery being less than 13 mm of mercury column, no cardiac rhythm disorders risk is considered to take place. The value being greater than 13 mm of mercury column, complex cardiac rhythm disorder occurrence risk is considered to be the case.
EFFECT: accelerated noninvasive method.