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Options for the recovery of mental activity in children after acute brain damage

Published online by Cambridge University Press:  13 August 2021

Y. Sidneva ,
A. Zakrepina ,
M. Bratkova  and
S. Valiullina
Y. Sidneva*
Affiliation:
The Department Of Rehabilitation; Psychiatric Research Group, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma; N.N.Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
A. Zakrepina
Affiliation:
The Department Of Rehabilitation; Laboratory Of Psychological And Pedagogical Research And Technologies For Special Education Of Persons With Intellectual Disabilities, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma; The Federal State Budget Scientific Institution “Institute of Special Education of the Russian Academy of Education”, Moscow, Russian Federation
M. Bratkova
Affiliation:
Institute Of Special Education And Psychology Institute Of System Projects Institute Of Lifelong Learning Directorate Of Educational Programs Institute Of Education Content, Methods And Technology, Moscow City University; Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
S. Valiullina
Affiliation:
Department Of Rehabilitation, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST), Moscow, Russian Federation
*
*Corresponding author.

Abstract

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Introduction

Children with acute brain damage make up a large group of patients who require multi-stage rehabilitation. Rehabilitation requires the creation of special conditions for psychiatric care and psychological and pedagogical correction of the consequences of severe damage to the nervous system.

Objectives

To identify the options for mental activity during the restoration of the level of consciousness in children after acute severe brain damage.

Methods

210 children under the age of 18 with severe brain damage (traumatic brain injury, hypoxia, hydrocephalus). Clinical-psychopathological, pedagogical methods were used; additionally diagnostic scales, questionnaires.

Results

4 groups were formed: 1st 37 (18%) patients had manifestations of mental activity with physical, cognitive and social capabilities in the minimal consciousness “+” (a- / hyperkinetic mutism with emotional reactions, understanding of addressed speech); 2nd 67 (32%) - manifestations of physical and cognitive abilities with minimal consciousness “-” (a- / hyperkinetic mutism without reactions); 3rd 95 (40%) - only the manifestation of physical capabilities at the exit from the vegetative status. 4th 11 (10%) - a low manifestation of mental activity in the form of physical capabilities with a vegetative status.

Conclusions

4 variants of mental activity in children after acute severe brain damage have been identified: from minimal involuntary reactions or their absence in vegetative status to voluntary actions according to the instructions of an adult in minimal consciousness “+”. Taking into account the variability of mental activity helps to differentiate the methods of psychiatric and psychological-pedagogical assistance in the recovery of children already in the early stages of rehabilitation.

Keywords

recovery of mental activityrehabilitation of childrenminimal consciousnessvegetative status
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S245
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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