Tserebrastenichesky syndrome at children – the nonspecific neurologic simptomokompleks caused by immaturity, an arrest of development of the central mechanisms of nervous regulation. It is shown by an adynamy: increased fatigue, exhaustion of mental and physical activity, drowsiness, decrease in concentration of attention, irritability, headache. Diagnostics is based on kliniko-neurologic inspection, is supplemented with tool researches of a brain, psychological testing, laboratory analyses. Treatment is complex, includes reception of medicines, physical therapy and psychocorrection.
Tserebrastenichesky syndrome at children
The word of "tserebrastenicheskiya" in literal translation means "weakness, powerlessness of a brain". Synonymous names of a syndrome – a tserebrasteniye, an adynamy, an asthenic syndrome, an asthenic state. Prevalence among children makes 3%. As the main characteristic of a tserebrasteniya is violation of adaptation and adaptive mechanisms, the syndrome is more often diagnosed during the stressful periods of life of the child – at receipt in kindergarten, school. Epidemiological peaks are defined aged 3-4 and 6-7 years. The symptomatology is more expressed in off-season – in the spring, in the fall. Gender and geographical factors do not influence prevalence of pathology.
The reasons of a tserebrastenichesky syndrome at children
Tserebrasteniya develops at organic damage of a brain. The reasons of a syndrome can become:
- Pregnancy complications. The negative impact on TsNS of a fruit is exerted by heavy toxicosis, a hypoxia, a Rhesus factor conflict, intoxications, pre-natal infections. The high risk of a tserebrasteniya exists at influence of harmful factors on late terms of a gestation.
- The complicated childbirth. Damages arise at asphyxia, blood losses, injuries of the natal period. Are shown by ischemic, hypoxemic violations, vertebralno-bazilyarny insufficiency.
- Neuroinfections. Damage of the central nervous system is observed at meningitis, encephalitis, poliomiyelita, miyelita. The adynamy develops as a symptom, long time remains after recovery.
- Craniocereberal injuries. Asthenic violations are defined at 88% of children in the remote period of ChMT. Expressiveness depends on weight and prescription of a trauma.
- Somatic diseases. Symptoms are noted at insufficiency of cerebral blood circulation. Pathologies of cardiovascular system, a gipovolemiya (reduction of volume of blood), a gipoksemiya (decrease in oxygen in blood) against the background of diseases of kidneys, shock and other serious conditions are the reason.
- Stressful factors. Unexpected intensive load of an organism can become the trigger of a tserebrastenichesky syndrome. Symptoms arise after long emotional pressure or a shock, in the period of age physiological crisis, at violation of the day mode, frequent change of time zones.
The Tserebrastenichesky syndrome develops against the background of hypoxemic, ischemic, infectious, traumatic damages of a brain. The main manifestations – weakness, bystry fatigue, irritability, headaches – arise because of insufficient intake of oxygen to fabrics, reductions in the rate of nervous transfer, emergence of the pathological centers. The neurologic scattered microsymptomatology is explained by the increased intra cranial pressure, easy violations of a likvorodinamika, changes of electric activity of a brain on residual integrally type. The regreduated course, a reduction of clinical manifestations is peculiar to Tserebrasteniya. The decompensation periods provoked by somatic diseases, stressful situations, age crises are possible.
Symptoms of a tserebrastenichesky syndrome at children
Tserebrasteniya is shown by physical weakness, bystry fatigue, drowsiness, vegetative dysfunctions. Babies are uneasy, often cry, sleep much in the afternoon, are awake at night. The appetite reduced a set of weight slow, the general lag in development is defined. At children of early age interest in toys is reduced. They do not love outdoor games, badly adapt to an unfamiliar situation. At closeness, heat, cold, sharp sounds the health worsens, the child asks on hands, is capricious. Does not love trips, driving on attractions, a swing.
Children of preschool age are disturbing, have fears (darkness, monsters, height). Frequent symptoms are night enuresis, meteodependence, the increased perspiration or a chill. Emotions of a labilna, are unstable – patients easily are upset, cry, are angry, quickly calm down. Seldom participate in games, are insufficiently inquisitive. Stressful situations lead to functional physiological violations – vomiting, a diarrhea, tachycardia, dizzinesses.
At school students symptoms of a physical indisposition remain, signs of cognitive deficiency act more distinctly. The carelessness, the reduced stability of attention, inability to remember a training material is noted. At letter lessons the child passes letters, interchanges the position of them, does not manage to write down from dictation, asks again. At oral answers hardly builds a monologue, long is at proper words, remembers information. Daily dynamics of working capacity is noticeable: lessons since morning are given much easier, by the evening there comes exhaustion.
The Tserebrastenichesky syndrome at children leads to lag in physical and mental development. Babies, children master 1-3 years later movement and household skills, the speech. Preschool children, school students are given the training program heavier, school poor progress often develops. Complications of the emotional sphere – the increased uneasiness, a depression, fears, phobias. In hard cases training at home or in special educational institutions for somatic the weakened children is necessary. At teenagers on the basis of an asthenic syndrome organic frustration of the personality is formed.
Diagnostics of a tserebrastenichesky syndrome includes clinical, fizikalny, tool and laboratory methods. Need of broad inspection is explained by not specificity of symptoms – immunological, infectious, hematologic and other diseases have to be excluded. The following methods are applied:
- Clinical. Detailed poll, collecting the anamnesis, a katamnez is held by the therapist, the neurologist, the psychiatrist. Each expert builds a conversation according to estimated diagnoses, appoints additional objective inspections.
- Fizikalny. The therapist carries out the general survey, at complaints to work of internals estimates work of lungs, hearts, digestive tract. The neurologist checks formation, symmetry, adequacy of reflexes, reactions to light and a sound, reveals lags in development.
- Psychodiagnostic. The psychologist uses methods of a research of cognitive functions – attention, memory, thinking. Decrease in attentivno-mnestichesky processes, the bystry exhaustion which is shown deterioration in indicators from the beginning by the end of inspection is characteristic of a tserebrasteniya.
- Tool. EEG, REG, MRT of a brain, UZDG of the head and a neck is carried out. At an asthenic syndrome vascular inferiority, a deviation of values of bioelectric potential, an imbalance of nervous impulses is defined.
- Laboratory. The general and biochemical blood test is appointed. The infections, anemias, diabetes and other diseases capable to cause weakness, fatigue, dizzinesses are by results excluded.
Treatment of a tserebrastenichesky syndrome at children
Treatment of a tserebrasteniya at children – a complex action. Methods of therapy are selected individually taking into account age and expressiveness of clinical manifestations. The general scheme looks as follows:
- Reception of medicines. The drugs improving the blood supply and metabolic processes of a brain removing nervous tension, normalizing the dream wakefulness mode are appointed. Nootropa, antianginalny medicines, vitamins of group B, amino acid (methionine, lecithin, glycine, a glutamine) are shown.
- Physical therapy. Medical massage, a balneoterapiya improve blood circulation, promote neuromuscular relaxation. UVCh, a svetoterapiya increase permeability of vessels, stimulate blood circulation, exchange processes.
- Psychocorrection. To children 4-5 years are more senior occupations with the psychologist, the psychotherapist are shown. Correction is aimed at the development of informative functions, restoration of emotional steadiness.
Forecast and prevention
At the correct medical and psychology and pedagogical care the forecast of a tserebrastenichesky syndrome at children favorable. Clinical manifestations become less expressed, to teenage age disappear. For the prevention of development of a syndrome and its aggravations it is necessary to watch health of the child carefully: at early stages to reveal increased fatigue, to define the reason of day drowsiness, headaches, school poor progress. It is important to create a favorable, quiet situation in a family, to avoid the conflicts, quarrels. It is worth adhering to the correct day regimen: to provide to the child a full-fledged dream at night (not less than 8 hours), to 6-8-year age – a day dream, to alternate the periods of intellectual and physical work, to walk daily in the fresh air.