Online ISSN: 2515-8260


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Ya.N.Madjidova, U.T. Babajanova, V.K.Abdullaeva, Sh.A.Shirmatov, Khalilova A.A


Abstract: Introduction. Affective-respiratory paroxysm (ARP) or breath-holding spells is a common phenomenon that occurs in children from 6 months to 6 years. Up to 90% of children experience ARP for the first time before the age of 18 months. The mechanism of the condition is still unclear. Scientists have found that children with breath-holding spells are much more likely to be diagnosed with iron-deficiency anemia and, perhaps, it contributes to the development of pathology. 20-35% of children have a burdened family history. Some families have a dominant type of inheritance. Materials and Methods. The algorithm for examining children included: general clinical, neurological and psychological examination of children, conducting laboratory research, registration of an electroencephalogram, according to indications, conducting an echocardiographic study. We examined 50 children with ARP aged 6 months to 6 years. Research was carried out in the clinic of the Tashkent Pediatric Medical Institute. The diagnosis of ARP was established based on the history provided by mothers and observations of seizures. Paroxysms were defined as stopping the baby's breathing at exhalation after deep inhalation during crying. Paroxysms were classified as cyanotic, pale, and mixed. Results. A detailed study of the passage of the ante-, intra- and postnatal periods made it possible to determine the significance of various unfavorable factors such as anemia (p <0.05), toxicosis (p <0.01), acute respiratory infections (p <0.1), stress, use of obstetric aids (p <0.05) and birth trauma. (p <0.1). In addition to perinatal risk factors, 13 (28%) children were found to have a hereditary predisposition to ARP and 4 children (8%) to epilepsy. In most cases, seizures began at 6–12 months of age (38%). According to our observations, the main provoking factors of seizures were: anger, inability to get what you want - 70%, pain - 18%, fear - 12%. At clinical and neurological examination in children, ARP of neurotic nature (82%) prevailed over affectively provoked syncope (10%) and "epileptic" ARP (8%). The seizures in most cases were characterized by a typical course, medium duration and high frequency. When assessing psychoemotional and behavioral characteristics, children with ARP were more sensitive, intense, persistent, active, less distracted, and differed in mood variability compared to healthy children. According to the indicators of the functional state of the autonomic nervous system in children of the main group, the initial autonomic tone was characterized by sympathicotonia, normal autonomic reactivity was recorded significantly less than in the control group (p <0.05). According to the results of laboratory studies, anemia (88%) and hypocalcemia (82%) were significantly more common in children with ARP. Analysis of electroencephalographic data revealed: signs of age norm - in 14 (28%) children, signs of dysfunction of nonspecific midline structures of the brain - in 6 (12%) children, general cerebral changes. - in 3 (6%)children, signs that reduce the threshold of convulsive readiness - in 20 (40%) children, epileptiform activity - in 6 (12%) children. Conclusion. The use of Pantogam in combination with basic therapy in children with moderate seizures was justified. Already after 3 months of therapy, the psychoemotional status of the majority of children improved, neurotic seizures decreased, seizures were stopped, and indicators of the bioelectric activity of the brain improved. Basic therapy with the inclusion of Konvuleks has also been shown to be effective in the treatment of children with severe seizures and epileptiform activity. The efficacy was less significant than in the other two groups, so epileptiform activity was still retained from short-term use. In general, positive dynamics was observed in all 3 groups, which was reflected in the reduction of seizures and improvement in the condition of children.

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