[Tactics of management of preschool children with different variants of speech delay].

OBJECTIVE: To study the efficacy of neurometabolic treatment in dependence of different variants of speech delay (SD), general underdevelopment of speech (GUDS) type, in preschool children. MATERIAL AND METHODS: The study included 130 children, aged 4-6 years, with SD, GUDS type, Most of children were boys (74%). Clinical and psychological characteristics and efficacy of neurorehabilitation were studied in 3 parallel groups. RESULTS AND СONCLUSION: The results demonstrate the heterogeneity of disorders of speech development depending on the clinical and neurological SD variant. Authors have identified characteristics that allow to determine the amount of corrective actions for children with associated pathology and improve rehabilitation actions.

[Acute toxic hepatitis at mushroom poisoning of the young child].

The example of clinical observation shows nonspecific clinical picture of acute mushroom poisoning in the young child as a late manifestation of symptoms of acute gastroenteritis. The severity of hepato-biliary system, defeat followed with a long period of recovery and severity of residual effects.

[Hydrocephaly in newborns with perinatal brain damage of moderate severity].

A prospective examination of 103 newborns with hypoxic damage of the central nervous system of moderate severity was conducted on the 4-7, 10-14 and 21-28 days after birth and included clinical examination, neurosonographic study with dopplerography of great brain arteries and biochemical study of venous blood and urine. Children with ventriculomegalia were treated with diacarb. A control group included 15 newborns without signs of survived hypoxia. Ventriculomegalia was found in 29% of children in the main group and remained till the end of neonatal period in 15%, with moderate and large dilatation in 63,5% and mild dilatation of anterior horns of lateral ventriculars in 36,5%. The markers of development and long remaining ventriculomegalia are specified as follows: the morphofunctional immaturity of the brain (RR=1,7; 95%CI 1,16-2,45), absence of compensatory reduction of resistance index (RI) in anterior brain arteries on 4-7 days of life (RR=3,03; 95%CI 2,11-4,31), metabolic acidosis - the bicarbonate level in the venous blood less than 21 mmol/l (RR=2,9; 95% CI 1,66-5,02), carbanhydrase activation - bicarbonate concentration in the urine less than 5 mmol/mcmol of creatinine on 4-7 days of life (RR=3,81; 95%CI 2,87-5,02). Diacarb in ventriculomegalia should be prescribed only in case of disturbance of the organism compensatory reaction because it causes the significant increase of compensatory reduced RI. The drug has a nephrotoxic effect and causes metabolic acidosis.

[Minimal brain dysfunction in childhood]. / Minimal'naia disfunktsiia mozga v detskom vozraste.

Minimal (minor) dysfunction of brain (MDB) is the peculiar form among other consequences of perinatal damages of nervous system. The problems of organization of medical care for children with MDB at preschool age are very important. 106 patients with MDB aged 3-8 years were examined. Detailed clinical-neurological, neuropsychological, instrumental and some other forms of examinations were performed including data about postnatal development. It is demonstrated that MDB may be considered as a diffuse cerebral dysregulation, conditioned by a delay of maturation of some connections between different CNS regions. Leading levels of maximal dysregulation are identified. A necessity was emphasized of early revelation, prolonged follow-up and purposeful rehabilitation of such patients.

[The epileptic variant of enuresis in children]. / Epilepticheskii variant énureza u detei.

Clinical, neuropsychological and instrumental examinations were conducted in enuresis children aged 5-7. All of them suffered from minimal brain dysfunction (MBD). The authors found that in MBD mediobasal frontal regions and lower stem portions are involved. This contributes to formation of congestive excitement foci in the deep frontal regions responsible for paroxysm onset, epileptic enuresis, in particular.