Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental Neurology2075-54732409-2533Research Center of Neurology83310.54101/ACEN.2022.1.3UnknownRehabilitation of young children with movement disorders and epilepsy: rational approach and efficacyBukreevaElena A.<p>Head, Department of physiotherapy exercises, assistant, Department of rehabilitation and physiotherapy, Faculty of additional professional education</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0001-7660-4933SednenkovaTatyana A.<p>physician, Department of physiotherapy exercises, assistant, Department of rehabilitation and physiotherapy, Faculty of additional professional education</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0001-6089-2045KalyuzhnyAleksander V.<p>physiotherapy doctor, Russian Children's Clinical Hospital</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0002-2222-449XOsipovaGayane A.<p>neurologist</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0001-6453-0930SokolovPavel L.<p>D. Sci. (Med.), leading researcher</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0002-0625-1404SergeenkoElena Yu.<p>D. Sci. (Med.), Prof., main researcher, Scientific department, Dean, Faculty of continuing professional education, Head, Department of rehabilitation and physiotherapy</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0001-7882-1317ChebanenkoNatalya V.<p>Cand. Sci. (Med.), Associate Professor, Department of pediatric neurology</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0002-7231-0249LayshevaOlga A.<p>D. Sci. (Med.), Prof., Department of rehabilitation, sports medicine and physical education, Head, Medical Rehabilitation Center, Russian Children's Clinical Hospital</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0002-8084-1277Scientific and Practical Center for Specialized Assistance for Children named after N.V. Voyno-YasenetskyPirogov Russian National Research Medical UniversityRussian Medical Academy of Continuous Professional EducationRussian Children's Clinical Hospital, Pirogov Russian National Research Medical University Moscow1501202216124312603202226032022Copyright © 2022, Bukreeva E.A., Sednenkova T.A., Kalyuzhny A.V., Osipova G.A., Sokolov P.L., Sergeenko E.Y., Chebanenko N.V., Laysheva O.A.2022<p><strong>Introduction.</strong> Epilepsy is one of the most common chronic nervous system disorders. Epilepsy in a child requiring physical, psychological and speech therapy significantly reduces its scope and decreases the likelihood of recovery.</p>
<p>The <strong>aim</strong> of the study was to assess the efficacy and safety of a rehabilitation programme for young children with movement disorders and concomitant epilepsy.</p>
<p><strong>Materials and methods.</strong> Simple randomization was used to divide 123 children aged 924 months into four groups: three main groups and one comparison group. Patients in group 1 received traditional massage, excluding the cervical region, as their rehabilitation. Patients in group 2 received kinesiotherapy (Vojta therapy) in addition to traditional massage. Children in group 3 participated in a comprehensive programme, including traditional massage and kinesiotherapy (Vojta therapy). Children in the control group did not receive rehabilitation.</p>
<p><strong>Results.</strong> A statistically significant improvement in the psychomotor development parameters was observed after a course of medical rehabilitation. It was more significant when the epileptic focus was localized in the right hemisphere or the patient had generalized epilepsy. The outcome was less favourable in multifocal epilepsy and when the epileptic focus was present on the convex surface of the left hemisphere. The third group noted a statistically significant improvement in the GMFCS scores by the end of the comprehensive rehabilitation course. There were no epileptic seizures seen on repeat EEG recordings during the medical rehabilitation and one month after its completion.</p>
<p><strong>Conclusion.</strong> A comprehensive approach to planning a course of rehabilitation ensures its efficacy. The location of the epileptic focus and the distribution of epileptic activity along the convex surface of the brain determines the outcome of medical rehabilitation. An increased epileptiform activity index on EEG without signs of clinical deterioration requires more careful patient monitoring but, nevertheless, is not a reason to completely cancel rehabilitation measures.</p>epilepsymedical rehabilitationchildrenmassageэпилепсиямедицинская реабилитациядетимассаж[Batysheva T.T., Platonova A.N., Bykova O.V Epileptic syndromes in child-ren with cerebral palsy. Epilepsia i paroksizmalʹnye sostoania. 2011;3(2):10–14. (In Russ.)][Murtazina T.K. Epilepsy. Modern rehabilitation measures and their impact on the vital activity of sick and disabled people. Thesis dis. ... Cand. Sci. (Med.). St. Petersburg, 2013.][Batysheva T.T., Platonovа A.N., Bykova O.V. et al. The physical rehabilitation of children with movement disorders associated with epileptic seizures. Detskaya i podrostkovaya reabilitatsiya. 2016;(1):12–16. (In Russ.)][Sokolov P.L. Cerebral palsy — disontogenesis and rehabilitation. Moscow, 2012. 158 p. (In Russ).][Kenzhegulova R.B. Rehabilitation problems for children with epilepsy. Kazakh Journal of Physical Medicine & Rehabilitation. 2020;(1):17–24. (In Russ). DOI: 10.52889/2708-4167-2021-1-34-23-30.][Mukhin K.Yu., Petrukhin A.S., Mironov M.B. Epileptic syndromes. Diagnosis and therapy. Reference guide for physicians. Moscow, 2008. 223 p. (In Russ.)][Accardo P.J., Capute A.J. The capute scales: Cognitive Adaptive Test and Clini- cal Linguistic Auditory Milesetone Scale (Cat/Clams). Baltimore, 2005. 115 p. DOI: 10.1177/0883073807300318.][Capute A.J., Accardo P.J. The infant neurodevelopmental assessment: a clini- cal interpretive manual for CAT-CLAMS in the first two years of life, part 1. Curr Probl Pediatr. 1996;26(7):238–257. DOI: 10.1016/s0045-9380(06)80061-7. PMID: 8889388.][Bykova O.V., Platonova A.N., Balkanskaya S.V., Batysheva T.T. Cerebral palsy and epilepsy — approaches to treatment and rehabilitation. Zh Nevrol Psikhiatr Im S S Korsakova. 2012. (7 Pt 2):64–70. PMID: 23330195. (In Russ.)][Bukreeva E.A., Ayvazyan S.O., Laisheva O.A. Complex method of therapeutic gymnastics in children at an early age age with epilepsy, accompanied by impaired the function of movement. Detskaya bol’nitsa. 2012;(2):46–51. (In Russ.)]