Comparative features of the medical history of young children with neurodevelopmental disorders and cerebral palsy who underwent rehabilitation in a children’s rehabilitation center

Authors:

Ivanova Violetta Andreevna – Head of the Department of Medical Rehabilitation of the Children’s Rehabilitation Center of the Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: abstraction@yandex.ru.

Annotation:

Introduction. The progressive increase in the number of children with neurodevelopmental disorders in recent years requires a search for possible etiological factors influencing this process. The neurological status of children with neurodevelopmental disorders often contains diffuse microsymptoms, which, in combination with anamnesis data at the stage of clarifying the diagnosis, in some cases makes it possible to classify these disorders in the structure of unspecified encephalopathy with a violation of certain higher mental functions and motor skills, coordination, speech, intelligence and behavior.

Aim. Analysis of anamnestic, neurophysiological and clinical data of patients undergoing rehabilitation in a children’s rehabilitation center, identifying features for drawing up a rehabilitation route.

Materials and methods. Materials: results of studying anamnesis, parental questionnaires, clinical examination and advisory opinions of specialists. Methods: data copying, expert assessments, statistical, analytical.

Results. In a study conducted on the basis of the Children’s Rehabilitation Center of the Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation of the Ministry of Labour of Russia in 20192024, 194 preschool children, from 2 to 8 years old, participated. The average age of the children was 4 years, the gender distribution in all groups was 1:3 with a predominance of boys. Group 1 included 100 children with severe pervasive deficits in social interaction, limited interests, and repetitive behavior. Group 2 included 53 children with predominantly expressive and receptive speech disorders, minor impairments in social communication without stereotypical behavior and interests. Group 3 consisted of 41 children with gross motor disorders in the structure of cerebral palsy or other specified pathology of the central nervous system. The following parameters were assessed: birth order, the natural nature of pregnancy, the presence of a threat of miscarriage in the first second and third trimester, the presence of stress and infections during pregnancy, the presence of gestational diabetes mellitus during pregnancy, arterial hypertension, hypo- and hyperthyroidism, blood clotting disorders, gestosis of the first and second half, oligohydramnios and polyhydramnios. The order and nature of childbirth, gestational age, and complications of the early postpartum period were assessed. In all three groups, statistically significant differences in the assessed parameters were revealed.

Discussion. All three groups presented were comparable in gender and age. The following statistically significant differences were revealed in the groups: threats of miscarriage at all stages, signs of early and late gestosis, premature birth, low Apgar score, breathing disorders after birth, the need for oxygen supply and artificial ventilation of the lungs, the presence of structural pathology on neuroimaging and the need for neurological treatment were significantly more common in the group patients with movement disorders. Infections during pregnancy were more common in group 1 relative to the other two groups. Gestational diabetes mellitus and a long anhydrous period were equally common in groups 1 and 3; this parameter was absent in group 2. For the remaining parameters compared, no statistically significant differences were found.

Conclusion. Data obtained from the analysis of early anamnesis allow us to identify risk factors for the development of movement disorders and some risk factors for the formation of pathology of higher mental functions.

List of cited literature:

1. Zabirova KR, Gamirova RG, Gorobets EA, Gaynetdinova DD et al. Osobennosti nevrologich-eskogo statusa u detej s rasstrojstvami autistichesk-ogo spektra [Features of neurological status in children with autism spectrum disorders]. Rossiyskiy Vestnik Perinatologii i Pediatrii [Russian Bulletin of Perinatology and Pediatrics]. 2022;67(5):153-57. DOI: 10.21508/1027-4065-2022-67-5-153-157. (In Russian).

2. Autism Diagnostic Observation Schedule Second Edition (ADOS -II) Available at: https://www. wpspublish.com/ados-2-autism-diagnostic-observation-schedule-second-edition. (accessed 25.09.2024).

3. Oprosnik rasstroistv autisticheskogo spectra [Checklist for autism spectrum disorders]. Available at: http:// osrussia.com/ru/products1/диагностика-аутизма/ casd/. (accessed 25.09.2024).

4. Narkevich AN, Vinogradov KA. Vybor metoda dlya statisticheskogo analiza medicinskih dannyh i sposoba graficheskogo predstavleniya rezul’tatov. [Choosing a method for statistical analysis of medical data and a method for graphically presenting the results]. Social’nye aspekty zdorov’ya naseleniya [setevoe izdanie]. [Social aspects of public health [online publication], 2019;65(4):4-9. DOI: 10.21045/20715021-2019-65-4-9. (In Russian).

5. Rasstroistva autisticheskogo spektra. Klinicheskie rekomendatsii. 2020, peresmotr 2024. [Autism spectrum disorders. Clinical recommendations. Approval year 2020, revision 2024]. Available at: https://cr.minzdrav.gov.ru/recomend/594_1. (accessed 25.09.2024).

6. Ponomarenko GN. Fizicheskaya i reabilitatsionnaya meditsina: fundamental’nye osnovy i klinicheskaya praktika [Physical and rehabilitation medicine: fundamental principles and clinical practice]. Fizioterapiya, bal’neologiya i reabilitatsiya [Physiotherapy, balneology and rehabilitation]. 2016;15(6):284-9. DOI: 10.18821/1681-3456-2016-156-284-289. (In Russian).

7. Ponomarenko GN. Principy’ dokazatel’noj mediciny’ v fizioterapii [Principles of evidence-based medicine in physiotherapy]. Voprosy’ kurortologii, fizioterapii i lechebnoj fizicheskoj kul’tury’ [Problems of balneology, physiotherapy and exercise therapy]. 2004;2:46. (In Russian).