The concept of residual encephalopathy in children, signs, diagnostic and therapeutic measures

Treatment methods

For treatment to be effective, one should take into account the reasons that led to the development of the pathology, the main signs and the severity of their manifestation.
Therefore, therapy is selected individually in each specific case. There are several treatments for residual encephalopathy:

• Surgical intervention.
• Drug therapy.
• Physiotherapy.
• Manual therapy.
• Physiotherapy.
• Massage.
• Acupuncture.

Drug treatment is used to improve metabolic processes and blood supply to the brain.

It includes the use of the following tools:

• hormonal and non-steroidal anti-inflammatory drugs;
• drugs to improve cerebral blood flow;
• vitamin complexes;
• anticonvulsants.

Surgery is not used very often, since it involves additional trauma to brain tissue. The operation is performed only if its risk is lower than refusing such intervention.

Similar manipulations are carried out in case of brain injuries in order to restore blood supply. Sometimes they are indicated for the development of tumors.

Adjuvant therapy

Osteopathy, massage techniques, physical therapy, and acupuncture can be classified as means of rehabilitation, but often it is these means that play the main role in the treatment of residual encephalopathy.

Folk remedies are also used to alleviate the human condition. To improve blood flow and cleanse blood vessels, a herbal balm is used.

In order to prepare this remedy, you need to make three infusions - based on propolis, red clover, Caucasian dioscorea. All these products are mixed in equal proportions and taken after meals, diluted with water. This balm should be drunk for two months.

Psychotherapy, a rational rest regimen, and adequate sleep are of no small importance. People suffering from this disease need to give up bad habits; they are advised to take walks in the fresh air and relax in a sanatorium.

In children

Treatment of residual encephalopathy in children is carried out over long courses.

The following medications are used:

• phenotropil;
• pantogam;
• stugeron;
• Cerebrolysin;
• Cavinton;
• glutamic acid;
• glycine.

Physiotherapeutic procedures, manual therapy, osteopathy, and acupuncture are also indicated. With the help of herbal medicine, it is possible to eliminate the symptoms of the perinatal form of the disease.

Of course, healing herbs cannot completely cure pathology, but they can minimize its health consequences.

To treat the disease, teas from St. John's wort, oregano, knotweed, lemon balm, lingonberry, mint, etc. are actively used. Essential oils are also used to treat encephalopathy in children. Oils of geranium, lavender, rosemary, and ginger are especially useful. It is recommended to engage in physical therapy and take a contrast shower.

Methods of therapy

Treatment for residual encephalopathy is aimed at eliminating the symptoms of the pathology, improving the patient’s standard of living, and restoring normal functions. For migraines, anti-migraine medications such as Amigrenin and Sumatriptan are prescribed. To get rid of insomnia and stabilize the psycho-emotional state, adaptogens and antidepressants are indicated.

To improve brain activity, neurometabolic stimulants and drugs that increase the metabolism of carbohydrates in brain tissue (Glycine, Mildronate, Phezam, etc.) are prescribed. Diuretics for increased ICP, and for dizziness - Betaserc or its analogues. Hormonal, anticonvulsant drugs, and vitamin complexes may also be prescribed.

To increase muscle tone, improve blood circulation, and restore coordination of movements, doctors prescribe physical therapy and massages. You will also need additional consultation with a psychotherapist and physiotherapeutic procedures. Osteopathy and herbal medicine are prescribed as additional treatment.

In especially severe cases, surgery is used. The main indication is the development of tumors in the brain.

During therapy, traditional methods are also used. Herbal balm is considered especially effective. It helps get rid of dizziness, cleanse brain vessels, and improve blood circulation.

To prepare such a remedy, you will need three different tinctures: red clover flowers, propolis, and Caucasian dioskerea rhizomes.

Equal parts of the resulting tinctures are mixed. Take the prepared balm three times a day after meals, 5 ml, after diluting with 50 grams of water. The course of such treatment is 60 days. After which a 14-day break is taken.

You should not self-medicate or take medications without first consulting a specialist. Any mistake, even the smallest one, can damage your health even more and lead to serious consequences, including disability.

Causes of RE

Most often, residual encephalopathy is observed after the perinatal form of this disease.

What is residual encephalopathy in children? It occurs for various reasons.

Reasons for RE:

• perinatal (more often appears due to hypoxic brain damage, as well as trauma during childbirth);
• residual organic (formation of a focus of cerebral palsy (cerebral palsy) or epileptic damage);
• traumatic (post-traumatic) – incorrect assistance during childbirth, use of obstetric forceps, vacuum extractor, rapid labor, incorrect position of the fetal head, traction on the head;
• dysontogenetic pathological conditions (hydrocephalus with the development of hypertension syndrome);
• infectious (tick-borne encephalitis, meningoencephalitis of various origins);
• operations (surgical interventions that do not lead to recovery or additionally injure brain tissue);
• idiopathic.

The most common cause of RE is hypoxia. Hypoxia is oxygen starvation of brain tissue. It can occur in utero, as well as during childbirth. Hypoxia during gestation can develop with strong uterine tone that persists throughout pregnancy. A hypoxic state also occurs with fetoplacental insufficiency (FPI). With this pathology, blood flow in the vessels of the placenta slows down. What causes hypoxia and delayed fetal development.

Placental insufficiency during pregnancy often leads to fetal hypoxia

FPN can occur if the mother has diabetes mellitus, severe uterine tone, threat of miscarriage, kidney disease, gestosis, viral infections (ARVI, influenza). Preeclampsia provokes damage to the blood vessels of the placenta due to increased pressure and other factors. Viral respiratory infections can provoke destruction of the vascular bed, since viral agents are tropic (specific) not only to the mucous membrane of the respiratory tract, but also to the vascular wall. With diabetes, blood vessels become brittle and are unable to transport blood normally. This happens with severe diabetes mellitus.

When the umbilical cord is entwined around the neck, asphyxia may develop. As the baby passes through the birth canal, the umbilical cord begins to tighten. If the obstetrician-gynecologist delivering the baby does not remove the loop in time (especially if it is double entangled), the child may die.

Hypoxia is provoked by prolonged labor. In this case, the child remains in the birth canal for a long time. The reason for a very long labor may be the weakness of labor forces, as well as a large fetus or a narrow pelvis.

Prolonged labor can lead to fetal hypoxia

Injuries during childbirth can be caused by very fast labor. If the process is rapid, the child’s skull does not have time to adapt to the size of the birth canal, and severe compression occurs. During rapid labor, displacement of the periosteum is possible with the formation of a cephalohematoma. In this case, the brain can also be damaged.

When using obstetric forceps (not used now), sometimes the bones of the skull can break due to their softness. The brain is also strongly compressed with forceps. A vacuum extractor is not used, since there is a strong redistribution of blood into the area of ​​its suction. A hematoma often forms.

Residual encephalopathy in children may occur due to hydrocephalus. The child has no outflow of cerebrospinal fluid from the ventricles of the brain. Increasing pressure inside the ventricles leads to compression and damage to brain tissue.

A diagnosis of PEP was made. What to do?

First of all, stop panicking and re-read the article carefully. The main idea is that perinatal encephalopathy can be successfully corrected. In many cases it is cured.

The first thing you need to do is contact a good neurologist and undergo a full examination, which will reveal the mechanism and cause of the occurrence of PEP in the child. The fact of the disease should not be denied.

Next, you should independently study the features of this pathology in order to navigate all the procedures that await the child during the treatment process. Adhere to the diet, sleep, and treatment regimen prescribed by your doctor.

It is worth making acquaintances with parents of children with the same problems, sharing experiences and providing (as well as receiving) support.

Follow all the doctors’ recommendations, knock on all doors one by one and try all common sense ways to help the child. Go through this period with your baby, support him and show him in every possible way that he is loved and needed.

Regularly undergo follow-up examinations. Keep a diary of your child’s health, in which you note daily the symptoms that arise, the therapy performed, and the response to treatment. This will help parents properly organize care, and the doctor will help monitor the dynamics of the child’s health.

Visit a psychotherapist and/or medical psychologist for psychocorrectional work. Do not limit the child’s social contacts, but promote their emergence.

The main thing is to remember that the PEP is not a sentence.

Residual encephalopathy in adults and children

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Encephalopathy is a lesion of the brain structure that was formed under the influence of various pathological processes of a non-pathological nature. Residual encephalopathy is those changes in the structure and function of the brain that remain after acute or chronic damage.

It often happens that this form of encephalopathy does not manifest itself for a long time. This continues until a certain stimulating factor or group of factors arises.

Causes

Encephalopathy can be acquired and congenital (perinatal).

Reasons for the development of acquired encephalopathy:

• Brain injuries;
• Intoxication of the body - the effect of various external (alcohol, salts of heavy metals) and internal (for liver and kidney diseases) toxins;
• Vascular changes (cerebral stroke);
• Diseases such as diabetes, atherosclerosis, arterial hypertension;
• Tumor processes;
• Exposure to ionizing radiation.

Photo MRI of brain encephalopathy

As for perinatal encephalopathy, it develops when the child is in the womb.

The causes of perinatal encephalopathy in children can be:

• Complications of pregnancy and childbirth (hypoxia (oxygen starvation), birth trauma, infection);
• Various metabolic disorders of the mother’s body, due to which internal toxins affect the fetus;
• Taking alcohol, toxic drugs;
• Smoking.

Development of the pathological process

As a result of the action of one or a group of damaging factors, over time, some nerve cells die, others lose communication with each other. Ultimately, there is an increase in the number of damaged areas, which leads to disruption of brain function. Vivid clinical symptoms develop.

Most often this happens in old age, when a large number of structural disorders accumulate.

However, if the effect of the damaging factor becomes significant, then acquired residual encephalopathy of the brain develops much earlier. An example is an increase in bilirubin in liver pathology from exposure to alcohol.

With adequate treatment of newborns and with not too significant brain damage, the disorders are quickly compensated. However, years later, a relapse may occur. Then we have to talk about residual encephalopathy.

In children

common signs of the development of residual encephalopathy in children may be:

• rage and aggression;
• poor performance at school;
• sleep and memory disturbances;
• headache;
• slow thinking.
• trembling of the chin, arms, legs (after 3 months);
• walking on tiptoes, curling toes in a standing position;
• difficulty holding objects, speech disorder.

diagnostics

Diagnosis of residual encephalopathy is a difficult task due to the frequent lack of medical documentation (for congenital encephalopathy) or difficult contact with an adult patient (specificity of pathology).

A detailed survey of the patient (his parents) to find out data about the onset of the above manifestations, about the presence of possible causes of the development of the disease:

• How long has your blood pressure been elevated, and is the patient taking antihypertensive medications?
• Does the job involve exposure to various toxins?
• Does the patient use or have previously abused alcohol?

A general examination can provide information about the pathology due to which encephalopathy developed: icterus of the sclera, the smell of ammonia.

Laboratory research to identify the effect of toxic substances and the presence of organic pathology: clinical and biochemical blood tests, urine analysis, cerebrospinal fluid analysis.

Instrumental examination to clarify the nature of the disease: electroencephalography; computer and magnetic resonance imaging, ultrasound and vascular angiography.

Encephalogram of the brain

Forecast and consequences

The prognosis of encephalopathy largely depends on when it is detected. If detected early and treated, the disease can be eliminated or at least its progress can be stopped.

The consequences of this disease for an adult, when diagnosed late, are expressed in a significant decrease in the quality of life.

If encephalopathy is detected late in children, the consequences can be catastrophic and lead to the development of hydrocephalic syndrome, cerebral palsy, epileptic seizure, mental retardation, and dementia.

Symptoms of the disease

The severity of the symptoms of this pathology and their combination depend on:

• on the age of the child and the degree of maturation of the nervous system;
• on the location and extent of damage to brain tissue and its glial structures;
• on the causative factor and the duration of its effect on brain cells;
• from the presence of concomitant diseases that can aggravate the pathological effect of the main etiological factors (intoxication, metabolic or vascular disorders).

Common signs and symptoms of encephalopathy in children are:

• frequent headaches, anxiety, moodiness, constant screaming (in young children);
• hyperactivity, uncontrollability, disinhibition, obsessive states;
• sleep disorders, which are manifested by drowsiness during the day and insomnia at night;
• neuroses in the form of behavioral disorders or phobias in the form of panic fear of any objects, obvious or imagined, as well as environmental phenomena;
• decreased memory (usually impaired short-term memory for remembering words, numbers or names of objects), cognitive activity and intelligence of the child;
• hearing and vision impairment;
• development of hydrocephalic syndrome (in children of the first year of life).

Parents need to remember that in the absence of diagnosis and timely treatment, there is a progression of diffuse changes in brain cells, the breakdown of connections between neurons and their death lead to significant deviations in the functioning of the central nervous system.

In this case, the symptoms become permanent with worsening signs of encephalopathy in children, the following are noted:

• frequent fainting;
• dizziness;
• asthenia;
• deterioration of attention and memory;
• changes in motor coordination;

• movement disorders (flaccid paralysis, paresis);
• mental and vegetative disorders;
• significant decrease in intelligence;
• behavioral disorders;
• developmental delay.

What is residual encephalopathy

This form of encephalopathy is essentially a residual phenomenon, which often manifests itself over a long period of time after brain damage. This is why this disease can be very difficult to diagnose.

Encephalopathy can be congenital or acquired. Thus, the congenital form of the disease is also called perinatal. The main feature of this pathology is that it is associated with pathologies during pregnancy and childbirth. This may be fetal hypoxia, traumatic injuries during childbirth, neuroinfections, etc.

If signs of brain damage in a child do not appear immediately, but after some time, then we are talking about residual encephalopathy. In children, it often occurs as a result of organic brain damage and manifests itself many years later (residual organic encephalopathy).

Adults suffer from an acquired form of encephalopathy. Various factors can lead to the development of this pathology - injuries, high blood pressure, infections, inflammatory processes.

That is why the following types of acquired encephalopathies are distinguished:

• post-traumatic;
• toxic;
• vascular;
• radial;
• metabolic;
• discirculatory.

Residual encephalopathy (RE) is not defined in ICD-10, but the term has been used in neurology since 1960.

Reasons for the development of residual mental retardation

ZPR of residual organic origin are disorders that can be caused by:

• injury or disease affecting brain tissue;
• chemical or hormonal disorders;
• exposure to toxic materials;
• neurological disorders or abnormal changes associated with aging;
• diseases of the liver, kidneys or thyroid gland;
• vitamin deficiency.

Concussions, blood clots, or bleeding in or around the brain from injury can lead to organic brain syndrome. Low oxygen levels in the blood, high amounts of carbon dioxide in the body, strokes, brain infections and heart infections can also lead to organic mental disorder.

Degenerative disorders such as Parkinson's disease, Alzheimer's disease, Huntington's disease and multiple sclerosis may also be contributing factors.

Types of encephalopathy

According to the classification, childhood encephalopathy is practically no different from its adult form in terms of etiological (damaging factor), but congenital encephalopathy, which developed as a result of the influence of damaging agents on the child’s brain while still in the womb, stands out as a separate form.

It can appear immediately after birth (perinatal encephalopathy) or in older children (residual perinatal encephalopathy).

Encephalopathy of the brain in children is a multi-etiological disease, but depending on the main cause, several types of this pathology are distinguished:

• discirculatory encephalopathy – diseases associated with impaired outflow of venous blood with prolonged stagnation in the brain tissue;
• vascular encephalopathy - pathology is associated with congenital anomalies of cerebral vessels or acquired vascular diseases, causing impaired blood supply and ischemic changes in the brain;
• perinatal encephalopathy is associated with intrauterine exposure to a damaging factor on the fetal brain from the 28th week of pregnancy to the 7th day of life in full-term babies, and up to 28 days in premature babies;
• toxic encephalopathy is associated with the effect on the brain of various toxic compounds - most often it is bilirubin encephalopathy as a result of a malignant course of hemolytic disease or other types of jaundice in newborns (toxoplasmosis, sepsis, abnormalities of the liver and gallbladder, blood diseases) with damage to cells and structures of the brain (kernicterus )
• post-traumatic encephalopathy occurs as a result of head trauma (birth or traumatic brain injury), which is accompanied by a large volume of damaged neurons;
• residual encephalopathy - symptoms and signs appear in children after three years of age as a result of neuroinfections, injuries or exposure to other active damaging agents on brain cells in the perinatal or postnatal period;
• hypertensive encephalopathy more often develops in adolescents as a result of neuronal damage with a systematic increase in blood pressure due to primary arterial hypertension, pathology of the kidneys or adrenal glands with a malfunction in the regulation of the renin-angiotensin system (chronic glomerulonephritis, interstitial nephritis).

Less common:

• leukoencephalopathy of vascular origin develops due to impaired blood supply and nutrition of nerve cells with a pronounced disruption of connections between brain neurons as a result of the development and progression of demyelinating diseases (multiple sclerosis);
• small focal leukoencephalopathy, which has a progressive course - changes in neurons occur after meningitis, encephalitis or as a result of immunopathological processes due to a significant malfunction of the immune system
• Wernicke encephalopathy is associated with impaired nutrition of neurons and their death as a result of a significant lack of B vitamins.

ICD code

When compiling the International Classification of Diseases, EC was not included in its list, as it has many causes. To make a diagnosis, code G93.4 is often used - encephalopathy of unspecified origin. In addition to this formulation, code G93.8 is used - other specified brain damage (it is more often suitable for radiation damage to brain tissue). If the cause of RE is traumatic, use code T90.5, T90.8 (consequence of intracranial and consequence of other specified head injury).

The ICD code is determined depending on the etiological cause. The doctor must conduct a complete examination. This will help make the correct diagnosis.

Treatment methods and drugs

Several treatment methods are used in the treatment of residual encephalopathy. To normalize brain function, the child is prescribed special medications.

At the second stage of therapy, procedures are used that consolidate the results of medications (physiotherapy, physical therapy, therapeutic massage, etc.). If there are complications, a small patient may need surgery.

Treatment of residual encephalopathy uses the following drugs:

• vitamin complexes appropriate for the child’s age;
• anticonvulsants;
• medications to improve cerebral circulation;
• non-steroidal anti-inflammatory drugs;
• hormonal drugs;
• means to accelerate the regeneration of brain tissue.

A child suffering from residual encephalopathy needs developmental activities

When correcting mental disorders, it is very important to train memory and attention. In case of severe developmental delay, home schooling is recommended for school-age children

Making a diagnosis of residual encephalopathy can be very difficult if the first symptoms appear quite a long time after the brain has been exposed to factors that could cause damage.

Sometimes residual encephalopathy of the brain can acquire signs of other diseases, so the diagnosis may not be made accurately.

Diagnostic methods include the following:

1. The main role in diagnosing the disease is the testimony of the patient himself. He must clearly explain the reasons that could cause the collapse of brain cells.
2. An electroencephalography procedure is mandatory for all patients. It is carried out with the aim of accurately analyzing the functioning of the entire brain and its cells in particular. Allows you to identify even pathological diseases.
3. Computed tomography is necessary to study the patient's internal organs using X-rays.
4. Nuclear magnetic resonance is performed to look at the biochemical processes that occur inside the tissues and cells of the body.
5. Magnetic resonance imaging is also necessary to study processes occurring at the cellular level in body tissues.
6. The main role in diagnosis lies with urine and blood tests, which will show the full picture of the disease.

Find out whether the drug Diacarb is suitable for treating children - instructions for use and reviews of which are discussed in our article. Meningioma of the brain is a curable, most often benign brain tumor. Timely treatment increases the patient's chances of recovery.

Prognosis for cure

Most manifestations and symptoms of the disease are reversible. With early detection and proper treatment, the prognosis is favorable; a third of young patients and children with residual encephalopathy are completely cured.

The prognosis directly depends on two main factors - the severity of the disease and the time of its detection. Such a disease in a child is a blow for parents, but there is no need to give up prematurely. About a third of patients are completely cured, and most achieve good results with treatment. Only a small percentage have permanent problems and disabilities.

If the disease is detected early, there is a good chance of a full recovery, which is why it is so important to be attentive to your child. With your participation, you can save him from an unfulfilling life!

The consequences can be terrible - residual brain dysfunction, vegetative-vascular dystonia with lesions of the vascular system, hydrocephalic disorders, cerebral palsy, epilepsy, severe mental development disorders. Thus, the main thing is to pay attention to alarming symptoms in time and take action.

The subsequent prognosis after diagnosis depends on the severity of brain damage and the time that has passed since the discovery of encephalopathy. When the right treatment is chosen, a person has a chance of recovery. For perinatal encephalopathy diagnosed in a child after birth, modern methods of therapy will help to recover in infancy.

When patients do not seek medical help, consequences may occur:

• cerebral paralysis;
• hydrocephalic syndrome;
• vegetative-vascular dystonia;
• residual brain dysfunction;
• Parkinson's disease;
• cerebral hypertension;
• epilepsy.

If residual encephalopathy was detected on time, and the doctor carried out the appropriate high-quality treatment, then all the symptoms will go away over time, and there is practically no reason for concern.

But if the disease begins to be treated at the last stage, then such treatment will not bring positive results, since the brain simply will not recover completely.

Treatment of encephalopathy in children

Encephalopathy is a serious diagnosis that requires immediate medical attention. Self-medication in this case is not only inappropriate, but can also lead to irreversible consequences. Only a specialist will select an individual treatment - at home or in hospital - depending on the age, anthropometric data of the child, the severity of the pathology and the severity of its symptoms, which will not suppress a number of important brain functions.

Medicines

Drug therapy is based on taking the following main groups of drugs:

• Nootropics, or neurometabolic stimulants. Activate the work of nerve cells and improve blood flow. These include: Piracetam, Vinpocetine, Pantogam, Phenotropil, Actovegin, Cerebrolysin (we recommend reading: instructions for using Pantogam syrup for children).
• Vasodilators, or vasodilators. They expand the lumen of blood vessels, normalizing blood flow. Among them are Papaverine and Vinpocetine.
• Psycholeptics, or sedatives. Aimed at relieving increased excitability. These include Citral, Valerianahel, Elenium.
• Analgesics, or painkillers. The purpose of their use is to relieve severe pain. This is Aspirin, Ibuprofen.
• Anticonvulsants, or antiepileptic drugs. Aimed at reducing epileptic activity and stopping seizures of any origin. Among them are Valparin, Phenobarbital.

In addition to these medications, the doctor may prescribe antispasmodics and centrally acting muscle relaxants. Physiotherapy procedures such as electrophoresis and amplipulse therapy have proven themselves as part of inpatient treatment. For bilirubin encephalopathy, treatment with phototherapy is appropriate.

Recommendations

To effectively combat the consequences of perinatal or acquired encephalopathy, medications alone are not enough. Parents should be patient and focus on the physical and mental recovery of their child. To do this, you should establish a regime of wakefulness and rest for the baby, provide his diet with food rich in vitamin B, and regularly conduct physical therapy classes and massage sessions.

As the child grows up, if necessary, it is recommended to involve correctional teachers - speech therapists, defectologists. They provide assistance in social adaptation, the formation of positive motivation and draw up a development plan using the necessary methods, tools and techniques that take into account the age, individual and psychological characteristics of the baby.

Symptoms

Residual organic encephalopathy is manifested by persistent neurological deficit caused by disease or adverse external influences. EC is often combined with other syndromes and diseases of the nervous system, which makes it difficult to make a differentiated diagnosis. Symptoms of residual encephalopathy in adults:

1. Deterioration of cognitive abilities (memory, mental activity).
2. Pain in the head area.
3. Dizziness, difficulty maintaining balance.
4. Depressive, neurotic disorders.
5. Irritability, emotional lability.
6. Increased fatigue.

Signs of residual encephalopathy include pyramidal insufficiency of the reflex type (impairment of complex, fine voluntary movements), paresis, confusion, vegetative-vascular dystonia (pain in the heart, a feeling of lack of air, shortness of breath, rapid heartbeat, paresthesia in the extremities, sleep disturbance, fainting) .

RE can manifest itself as convulsive seizures of the myoclonic type - generalized seizures, often short-term, characterized by short, involuntary twitching, muscle contractions in the area of ​​the whole body or its parts (limbs, head). Residual encephalopathy is often accompanied by hydrocephalic, hypertension syndrome and immunological disorders. The main syndromes that are observed with EC in children:

• Epileptic.
• Psychovegetative.
• Focal neurological symptoms.

The pathology often manifests itself with general cerebral symptoms, which in children include pain in the head area, dizziness, nausea, accompanied by bouts of vomiting. Cephalgia in the initial stages of the disease is paroxysmal in nature, later it is permanent. Cephalgia is most often localized in the frontal, frontotemporal, frontoparietal, and occipital zones.

Nausea and vomiting often occur at the peak of a hypertensive-hydrocephalic crisis. Attacks of vomiting in some cases bring relief to the patient, in others they are repeated without signs of improvement in well-being. Dizziness may be accompanied by tinnitus and spontaneous nystagmus (frequent, involuntary, oscillatory movements of the eyeballs). Neurasthenic disorders:

Frequent mood changes. Inability to concentrate. Narrowing the range of interests. Apathy, indifference to the surrounding reality.

Residual encephalopathy is a pathology that in the acute period can manifest itself with mild meningeal signs (stiff neck, Kernig and Brudzinski symptoms), which indicates irritation of the meninges. Focal symptoms:

1. Stem. Paresis of the third oculomotor nerve, impaired visual perception (color and twilight vision), nystagmus.
2. Cerebellar. Impaired motor coordination - unsteadiness of gait, adiadochokinesis (inability to alternately perform movements opposite in direction at a fast pace), instability of the body in the Romberg position, asynergia (impaired ability to perform combined movements).
3. Hemispheric. Pyramidal insufficiency (asymmetry of tendon reflexes, pathological foot and hand reflexes - Jacobson-Lask, Hoffman, Babinsky, Oppenheim, convulsive syndrome accompanied by impaired perception and disorder of automatic motor activity), cranial nerve paresis (VII-facial, XII-hyoid), visual , auditory dysfunction.

Damage to the nerve endings innervating the speech apparatus leads to disruption of speech formation, which indicates residual encephalopathy with hemispheric focal symptoms.

TBI is one of the common causes of disability, death and the development of post-traumatic EC. Neurological symptoms are caused by atrophic, scarring, degenerative changes that have occurred in the medulla as a result of injury. Symptoms include cerebrovascular disorders. A decrease in cerebral blood flow leads to an imbalance between the brain's needs and the amount of oxygen supplied, which provokes the development of oxidative stress. Other signs:

1. Asthenia (weakness, decreased performance).
2. Post-traumatic epilepsy.
3. Disorder of cerebrospinal fluid dynamics.
4. Mental and behavioral disorders.

Intoxication with neurotoxicants is manifested by disturbances in sensory, motor, and higher cortical functions, as well as changes in emotional status. Neurotoxicants primarily affect the activity of neurotransmitters and synaptic transmission of nerve impulses.

Diagnostic measures

Diagnosis of residual encephalopathy is aimed at identifying its causes and confirming diffuse damage to the brain substance.

For this use:

• physical examination to clarify the neurological status;
• laboratory tests (clinical blood and urine analysis, biochemical blood test, blood sugar test, thyroid hormones);
• EEG to identify epileptogenic foci;
• neurosonography in children under one year of age, since their large fontanel is not yet closed;
• Echo-ES is also an ultrasound method that can help identify signs of hydrocephalus;
• Doppler ultrasound, duplex or triplex scanning of the vessels of the head and neck - to clarify pathology and abnormalities in the development of the circulatory system that can lead to brain hypoxia;
• CT or MRI - these neuroimaging technologies make it possible to detect foci of ischemia, changes in the ventricles and subarachnoid space, and clarify the cause of the observed clinical picture.

The list of diagnostic measures is compiled only by the attending physician after a detailed examination. This will help in some cases to avoid a tomography, since young children will have to be under anesthesia to perform the procedure.