Child neurology in Russia: development of the traditions

Abstract

The child is the future of society because he is the parent of the children of tomorrow. However, children are also the products of our societies. This is why the United Nations promulgated in 1989 the International Convention on the Rights of Children. Health-care for children, and especially child neurology, plays a very important role in promoting their harmonious development. According to the data of World Health Organization, every 20th child has some disturbances in his development, requiring special medical and educational measures. Child neurology in Russia has long lasting history and traditions, dating back to the end of the 19th century. The outstanding neurologists V.M. Bekhterev, A.Y. Kojevnikov, V.K. Rot, S.I. Rossolimo, V.A. Muratov, L.S. Minor, and others, made their contribution to the foundation of child neurology in Russia. Some famous pediatricians, including N.F. Filatov and others, also promoted the development of child neurology. It is difficult to overestimate the contribution of the world-famous psychologists and physiologists L.S. Vygotsky, A.R. Luria, P.K. Anokhin, I.A. Arshavsky, A.A. Volokhov, and others, to the research of nervous-system functioning in children and higher cortical functions development in ontogenesis. At the end of the last century, neurology experienced an early period of accumulation of separate facts and observations and description of the separate forms of nervous diseases. It was found that the main forms of nervous-system diseases also affected children, and some illnesses were linked mainly to childhood. The epidemics of poliomyelitis and encephalitis in Russia affected many children, often leaving irreversible neurological deficits. It became obvious that nervous-system diseases in children require closer attention by virtue of their peculiarities and consequences. There were two large neurological schools in Russia by that time, in Moscow and St. Petersburg. The Moscow Neurological Center was organized under Alexey Kojevnikov’s (1836–1902) management; V.K. Rot, G.I. Rossolimo, V.A. Muratov, L.S. Minor and others were among its representatives. Kojevnikov graduated from the Medical Faculty of Moscow University – where nervous-system diseases in children constituted a large part of a special course on child diseases – in 1858, and began to work in obstetric clinic. Then he worked as an assistant in a therapeutic clinic, where, in 1866, he defended the doctoral thesis on his clinical and anatomical investigations on Duchenne disease and received the Doctor of Science degree. In 1869, Kojevnikov became the director of the specialized neurological clinic, which was the first not only in Russia, but in the world. A new clinical campus, which was attached to the Moscow University and consisted of a psychiatric clinic, a clinic for nervous diseases, a shelter for chronic patients and a neurological museum, was arranged under his management. Kojevnikov was interested in clinics and pathomorphology of poliomyelitis and expressed his opinion about its inflammatory nature in 1883. In 1894, Kojevnikov distinguished a special form of epilepsy, characterized by constant clonic convulsions in the hemiplegic hand and leg. They were observed in patients without any progression, but periodically transformed into extended epileptic fits. This form of epilepsy was named ‘epilepsia partialis continua’. Kojevnikov considered encephalitis to be its cause. Grigory Rossolimo (1860–1928) from 1890 to 1911 managed the neurology department of Novo-Ekaterininsky Hospital, simultaneously being the Assistant Professor of Moscow University. In 1917, Rossolimo was elected Head of the Neurology Department and Director of the Neurology Institute in Moscow University. His scientific investigations were devoted to nervous-system anatomy and physiology, clinical and surgical treatment of nervous diseases, child psychoneurology, and medical psychology. Rossolimo studied thoroughly a special form of relapsing hypertrophic polyneuritis in children (1899) which was given his name. Rossolimo was among the founders of child psychoneurology. He was especially interested in diseases of nervous system in childhood, education and peculiarities of mental activity of children, psychotherapy for sick children, disturBrain & Development 20 (1998) 543–546