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The level of consciousness and mental reactions of children after acute brain injury (interdisciplinary rehabilitation)

Published online by Cambridge University Press:  13 August 2021

A. Kamelkova ,
D. Martyshevskaya ,
A. Zakrepina  and
Y. Sidneva
A. Kamelkova*
Affiliation:
Department Of Rehabilitation, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST), Moscow, Russian Federation Laboratory Of Psychological And Pedagogical Research And Technologies For Special Education Of Persons With Intellectual Disabilities, The Federal State Budget Scientific Institution “Institute of Special Education of the Russian Academy of Education”, Moscow, Russian Federation
D. Martyshevskaya
Affiliation:
Department Of Rehabilitation, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST), Moscow, Russian Federation Laboratory Of Psychological And Pedagogical Research And Technologies For Special Education Of Persons With Intellectual Disabilities, The Federal State Budget Scientific Institution “Institute of Special Education of the Russian Academy of Education”, Moscow, Russian Federation
A. Zakrepina
Affiliation:
Department Of Rehabilitation, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST), Moscow, Russian Federation Laboratory Of Psychological And Pedagogical Research And Technologies For Special Education Of Persons With Intellectual Disabilities, The Federal State Budget Scientific Institution “Institute of Special Education of the Russian Academy of Education”, Moscow, Russian Federation
Y. Sidneva
Affiliation:
The Department Of Rehabilitation, Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST), Moscow, Russian Federation Psychiatric Research Group, N.N.Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
*
*Corresponding author.

Abstract

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Introduction

The process of recovery of mental reactions in children after acute traumatic brain injury is determined by complex methods with an interdisciplinary approach. Studies of emotional, communicative and behavioral reactions are based on an assessment by a psychiatrist and a teacher-defectologist.

Objectives

To study mental reactions and identify predictors of positive recovery of consciousness after acute brain injury in children in early rehabilitation.

Methods

48 children (14–36 months) with acute severe traumatic brain injury who were admitted for treatment and rehabilitation (in CRIEPST). Methods: psychiatric and pedagogical examinations; also - neuroimaging data and others.

Results

Three groups of children were identified, depending on the different severity of emotional, communicative and behavioral indicators: Group 1 (11%): The level of consciousness is minimal positive. Reactions: stable gaze fixation; emotional reaction to sound (smile) and the face of an adult; short-term tracking of the gaze of the object; the ability to touch an object and hold it; sits himself. Group 2 (33%): The level of consciousness is minimal positive / negative, with an advantage of positive. Reactions: unstable gaze fixation; emotional reaction and involuntary movements to sound; reflex seizure of an object; sits with support. Group 3 (56%): The level of consciousness is minimal negative. Reactions: no emotional reactions, low motor and sensorimotor activity.

Conclusions

Predictors of emotional-communicative and behavioral indicators of recovery of the level of consciousness were identified: sensory and motor, cognitive and socially-oriented. These predictors are the basis for choosing a rehabilitation program with interdisciplinary support and a treatment strategy.

Keywords

interdisciplinary approachchild rehabilitationmental recoveryminimal consciousness
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S502
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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