Abstract
Psychoemotional and cognitive impairments are an integral part of the recovery of consciousness of patients with severe brain lesions. The adequacy and timeliness of psychо-correcting methods in the process of restoring higher mental functions play an important role. The paper presents the results of rehabilitation treatment of 220 patients with post-comatose long-term impairment of consciousness as a result of traumatic brain injury at the stages of reintegration of consciousness, of which - 138 at the stage of confusion, 72 - at the stage dismnesic syndrome. Neuropsychiatric rehabilitation was carried out using the following techniques: cognitive rehabilitation, cognitive-behavioral therapy (psychological rehabilitation with psychotherapeutic techniques); neuro-sensory and neurodynamic correction (psychostimulation); psychopharmacotherapy. As a result of neuropsychiatric rehabilitation, all patients showed positive dynamics of consciousness of varying severity, and in 46 of them, consciousness regained completely, and only 14 patients stopped at the stage of dysmnesic syndrome, but at the same time became as socially integrated as possible. When analyzing the effectiveness of the methods, it was shown that in the process of neurorehabilitation the neuropsychiatric correction should have an integrated approach, and the methods cover the influence on the patient’s recovery process from the reintegration of basic reflexes to the correction of hemispheric interaction, kinesthetic praxis and cognitive cognitive sphere. At each of the stages of restoration of consciousness, it is important to use adequate psychopharmacocorrection depending on the clinical manifestations and dynamics of psycho emotional reactions. Thus, as a result of the study, the importance of an integrated approach to psychoneurological correction at all stages of the neurorehabilitation process and the use of adequate psycho-pharmacotherapy at each of the stages of recovery of consciousness, depending on the clinical manifestations, major syndromes and the dynamics of psychoemotional reactions, was confirmed. The dependence of the speed and quality of the recovery of consciousness on the peculiarities of mental processes has been revealed.
Highlights
Психоемоційні та когнітивні порушення є важливою складовою відновлення свідомості хворих із тяжкими ураженнями головного мозку
На кожній зі стадій відновлення свідомості важливим є використання адекватної психофармакокорекції у залежності від клінічних проявів та динаміки психоемоційних реакцій
Summary
Психоемоційні та когнітивні порушення є важливою складовою відновлення свідомості хворих із тяжкими ураженнями головного мозку. При аналізі ефективності методик показано, що в процесі нейрореабілітації психоневрологічна корекція повинна мати комплексний підхід, а методики охоплювати вплив на хід відновлення пацієнта від реінтеграції базових рефлексів до корекції міжпівкулевої взаємодії, кінестатичного праксиса та когнітивної сфери.
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