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DEVELOPMENTAL DISORDERS IN CHILDREN WITH COGNITIVE EPILEPTIFORM DISINTEGRATION
Abstract
The research is determined by the increase of the quantity and changes in qualitative characteristics of developmental disorders in children with cognitive epileptiform disintegration. According to the definition of K.Yu.Mukhin, cognitive epileptiform disintegration (CED) is considered as a symptomatic complex of acquired disorders of higher mental functions (HMF) in children associated with severe epileptiform activity on the EEG in the absence of epileptic seizures. There are several actual problems connected with CED nowadays: a) timely detection of CED, for which it is necessary to make an EEG video sleep monitoring a routine examination if there are any developmental disorders in a child; at the present moment in Russian Federation it is not included into basic diagnostic protocols; b) creation of linguistically and psychologically valid instruments for evaluation of HMF in children according to their age as well as personalized programs for habilitation and rehabilitation of children relevant to their cognitive profiles; c) effective treatment of patients with CED taking into account the fact that standard antiepileptic therapy is not effective in many cases. During the period from August 2016 till April 2017 we observed 42 children aged 2-6 with developmental disorders caused by epileptiform activity which was revealed on the EEG. All children were assessed with 19-channel EEG, synchronized with a video-monitoring system. Recording time was 1-2 hours. The occurrence of severe cognitive (especially speech) impairment was much more common with diffuse epileptiform activity than with the regional, but among regional the most severe consequences we can find in cases of frontal and temporal predominance of activity both in left and in right hemisphere (most children have ambidextrous profile of lateral organization). We used neuropsychological tests to assess the cognitive functions in these children. They included 25 specific subtests adapted to pre-school children worked out in the laboratory of Clinical linguistics (KFU). In 100% of children from the observed group we registered speech disorders (different stages of severity), such as: a) total absence of speech, both expressive and impressive; b) disorders of impressive speech; c) echolalia; d) logorrhea; e) non-communicative speech; f) delayed answers to the questions. 95,2% demonstrated autism-like behavior: a) non-stable response to the name; b) verbal and non-verbal communication disorders; c) autism-like games; d) stereotype behavior; e) disorders of the emotional sphere; f) absence of index gesture. 73,8% of these children had the severe retardation of HMF development. In 59,5% there was a high index of hyperactivity and attention deficit. 76,2% showed the deficit of planning and regulation of activity. The retardation of HMF development in 26,2% of children was accompanied by deficit of major motor skills and in 85,7% – by low level of self-care skills.
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