26 children at the age of 1.5 to 4 with delayed psychoverbal development (DPVD) without movement disorders were examined. All children were born full-term, had cerebral ischaemia of the 1st and 2nd degrees, were observed by a neurologist during the 1st year of life and were further observed according to their place of residence.
The complex of examination included: video-EEG monitoring of the daytime sleep, brain MRI, transcranial dopplerography (TCDG) and consultation of a psychologist, logopedist, endocrinologist and geneticist.
The data of psychological testing revealed mental retardation of a different level and character: immaturity of emotional regulation, skills of communicative behaviour and cooperative activity as well as partial delay of cognitive development against the background of general speech underdevelopment, delay of sensorimotor development (12), intellectual deficiency of cerebral-organic genesis with neurodynamic disorders (10) and traits of autistic behaviour (4).
As a result of logopedist’s examination it was revealed that more than 1/3 of children had alalia, 2 children had dysarthria and 15 children had dyslalia.
According to the data of video-EEG 13 children had decrease of functional lability of cortical processes, 6 children had paroxysmal activity, 2 children had epiactivity in the form of ‘peak-slow wave’ complexes, 5 children had delay in the basic rhythm formation that conformed to the presence of organicity as per the data of brain MRI in the form of periventricular gliosis and allowed to consider DPVD of cerebral-organic type.
As a result of complex examination the following clinical entities were revealed: subclinical hypothyroidism (2), syndrome of cognitive epileptiform disintegration (2), autism (3), organic lesion of central nervous system (5), encephalasthenia (7) and syndrome of minimal brain dysfunction (9).
The analysis of results revealed different variants of DPVD: dysontogenetic variant due to immaturity, encephalopathic variant against the background of minor organic lesion of CNS, secondary DPVD against the background of hypothyroidism that determined the initial approach and amount of therapy as well as further prognosis for the disease.