儿童脑瘫偏瘫型患者的认知和语言障碍

N. G. Asilova
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摘要

的目标。目的探讨脑瘫患者的认知和语言功能及其与病灶位置和性别的关系。材料和方法。我们检查了125名7-9岁的儿童,最终诊断为脑瘫偏瘫形式(G80.2)。根据半球病灶的位置将患者分为两组。第一组为左侧偏瘫(LHP)患者72例,其中女生33例,男生39例。第二组为53例右侧偏瘫(RHP)患者,其中女孩23例,男孩30例。对照组为30例健康儿童,男16例,女14例,无神经系统病变,平均年龄7.3±1.5岁。结果和讨论。LHP患儿在语速和韵律特征上更容易出现障碍(43.7%)。言语障碍发生率为33.8%,叙事性言语障碍发生率为14.1%。这些疾病被称为“右半球皮质构音障碍”。4.2%的儿童存在计数障碍。在RHP组中,违反表达性语言的情况是:“单一”占88.7%,“对话”占86.8%,“自动”占17.0%,不流利的占66.0%,缓慢的占64.2%。研究结果表明,言语障碍和认知功能受损与偏瘫的严重程度和脑MRI结构变化高度相关。这些结果与相应的指标有显著差异,这取决于偏瘫的侧面和性别。认知诱发电位的测定可以获得脑瘫患者认知状态的额外信息,这取决于病变的偏侧程度。
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Cognitive and speech disorders in patients with hemiparetic form of childhood cerebral palsy
Aim. To assess cognitive and speech functions in patients with cerebral palsy and their relationship with the location of the pathological focus and gender.Material and methods. We examined 125 children aged 7-9 years with a final diagnosis of cerebral palsy, hemiplegic form (G80.2). The patients were divided into 2 groups depending on the location of the hemispheric focus. Group I consisted of 72 patients with left-sided hemiparesis (LHP), 33 girls and 39 boys. Group II consisted of 53 patients with right-sided hemiparesis (RHP), 23 girls and 30 boys. The control group included 30 practically healthy children (16 boys and 14 girls) without neurological pathology with an average age of 7.3±1.5 years.Results and discussion. Children with LHP more often had disturbances in the tempo and prosodic characteristics of speech (43.7%). The rate of speech was disturbed in 33.8% of children, narrative speech - in 14.1%. These disorders are called "right hemispheric cortical dysarthria". Counting disorders were noted in 4.2% of children.In the group with RHP, violations of expressive speech were stated: "monologic" - in 88.7%, "dialogical" - in 86.8%, "automated" - in 17.0% of patients, not fluent speech - in 66.0%, slow - in 64.2%.Conclusion. The results of the study indicate a high degree of correlation of speech disorders and impaired cognitive functions with the severity of hemiparesis and structural changes on MRI of the brain. These results significantly differ from the corresponding indicators depending on the side of hemiparesis and sex. Determination of cognitive evoked potentials makes it possible to obtain additional information about the cognitive status of patients with cerebral palsy, depending on the lateralization of the lesion.
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