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21.09.2005:
   21.09.2005

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USE OF AMINO ACID COMPOUNDS IN THE TREATMENT OF MENTAL RETARDATION IN INFANTILE CEREBRAL PALSY (ICP) PATIENTS.

S.A. Parkanova, neuropathologist
1997

INTRODUCTION

It is known from the literature that marked mental deficiency is indicative of massive brain impairment. Children with cerebral paralyses often show insufficiency of a number of nervous-mental functions that are largely due to involvement of the motor sphere (4). First of all, this concerns speech disorders that are greatly attributed to the deficient motor component of speech. The main disturbance is dysarthria of different nature and manifestation. Retarded development of the motor speech component, of correct pronunciation, delayed uttering of first words and phrase speech as well as slow enlargement of the vocabulary are recorded. In more severe cases of speech disorders motor alalia combined with general speech deficiency is noted (1). Mental subnormality also includes spatial gnosia deficiency that is associated with involvement of parietal regions of the brain (2). Children have difficulties in forming shape perception and deficient awareness of their own body scheme. Devel

Most of therapeutic drugs used hitherto in the treatment of infantile cerebral palsy produced a symptomatic effect and caused some side reactions and complications. In the treatment of mental subnormality health care institutions used drugs that overexcited children thus exacerbating still further neurotic and neurosis-like disturbances. Such drugs included, for instance, gamalon and aminalon. Frequent use of drugs, such as encephabol and cerebrolysin lead to endocrine deviations in the child organism. Year-long therapy employed did not bring about essential changes in the clinical picture of the disease since it was clearly aimed at correcting the disturbed pathogenic links of nosology concerned.

The objective of the present study was to assess the therapeutic efficacy of new drugs of pathogenic therapy, in particular, amino acid compounds.

MATERIAL AND STUDY METHODS

To conduct the study, a group of children with different forms of infantile cerebral palsy (53 patients) and a group of children with an intranatal, postnatal and perinatal pathology history (28 patients) was selected. Their age ranged from 1 year and 1 month to 5 years.

The first signs of a perinatal CNS lesion in children emerged already in the neonatal period. The medical history of 14 children (30%) recorded the diagnosis: 1st- 2nd degree of cerebral circulation impairment; 10% of children sustained asphyxia. In 11 newborn infants a CNS depression syndrome dominated and their general condition was found to be severe (weak cry, pale skin, superficial breath with frequent apneas, depression of tendon reflexes, hypotonicity). In 3 cases hemolytic disease of newborns generated postnatal CNS involvement.

During examination deviations in the psychoneurologic status in children under 5 years of age were identified. The hypertensive syndrome was prevalent; nervous hyperexcitability, capriciousness, bad appetite, superficial sleep, sweating, motor disinhibition, fears and speech retardation were recorded. In severe cases of CNS involvement the absence of emotional or motor responses in patients was reported.

STUDY RESULTS

A careful analysis of clinical findings of a 2-year use of amino acids in the treatment of encephalopathic patients has allowed the conclusion on the possibility of a rapid recovery of the somatic status and emotional-speech indices (Table 2, 1).

In the group of children under study with encephalitic mental-speech retardation positive changes following the intake of amino acid compounds occurred within shorter time periods and covered an increase of play activity and arrest of neurosis-like disorders (Table 2).

In the first course of treatment of hemiplegic and mixed ICP only sounds and syllables appeared. Children with ICP (spastic diplegia) more rapidly achieved similar results after the 4th week of treatment and mastered simple phrase speech of predominantly daily life nature. Sufferers with hyperkinetic ICP form acquired phrase speech in the 3rd-4th treatment week. Single words and prattling speech emerge as a result of amino acid compound treatment in the 4th week in children with atonic-astatic ICP form. The dynamics of speech output and of the emotional-somatic condition depends on the form of ICP and the age of the sick child. A long-acting clinical effect was achieved in practically all the children (Table 2).

As can be inferred from the data presented, time required to eliminate pathology in children is different, but likelihood of phrase speech by the end of the first treatment course is obvious. The rate of adaptative mechanisms accelerated, earlier fears and neurosis-like disorders were stopped that prevented the child over years to get to know the environment. Two weeks after the start of a treatment with amino acid compounds the speech disorder in the form of dysarthria disappeared in the great majority of cases.

The above-mentioned pathologic disorders were abolished within the time indicated in children aged 5-6 years. In elder children the therapeutic process lasted longer.

CONCLUSION

The clinical studies stretching over 2 years have enabled the suggestion that amino acid compounds were basic preparations in the treatment of children with ICP, mental subnormality and speech retardation of different genesis. The use of these preparations makes it possible to eliminate neurologic deficiency within short periods of time.

REFERENCES (in Russian):

Badalyan, L.O. Child neurology. Meditsina, Moscow, 1975.

Isayev, I.A. Mental subnormality in children. Meditsina, Leningrad, 1982.

Kaverina, Ye.K. Speech development in children of the first two years of life . Medgiz, Moscow, 1950.

Kovalyov, V.V. Psychiatry of child age. Meditsina, Moscow, 1978.

Tsuker, M.B. Fundamentals of neuropathology in child age. Medgiz, Moscow, 1961.

Table 1

Time of recovery of speech deficiency and somatic condition on the background of amino acid compound treatment in different ICP forms (in weeks)


ICP, hemiplegia
ICP,

mixed form
ICP, hyper-kinetic form
ICP, atonico-astatic form
ICP, spastic diplegia

 

Understanding of speech

II

III

 

Sounds, syllables

IV

III

II

II-III

II

 

Babbling, single words
I
VI

 

Phrasal speech

III-V

IV

 

Interest in toys and play

III

II

I

III

 

Improvement of the somatic status

II

III

 

Sleep

I

II

II

 

Affect

II

I

II

IV


 

Table 2

Time of recovery of speech deficiency and somatic condition on the background of amino acid compound treatment in different forms of mental retardation (in weeks)

Coarse

mental-speech

retardation

Mental-speech

retardation

 

Understanding of speech

I

 

Sounds, syllables

I

I

 

Babbling, single words

III-II

I-III

 

Phrasal speech

III-V

 

Play with toys

IV

III

 

Completed subject play

IV-VI

 

Sleep, affect

II

III-IV

 

Neurosis-like disorders

V

III-IV

 

Self-help

VI


 
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