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目的 探讨综合康复治疗对小儿病毒性脑炎继发性癫痫伴重度痴呆完全性失语的价值和意义。方法 2 0 0 2 -0 1～2 0 0 2 -10收治 1例病毒性脑炎继发性癫痫伴重度痴呆完全性失语患儿 ,在抗癫痫、益脑开窍、活血化瘀中西药物治疗基础上采用针刺头部百会、四神聪、运动区、足运感区及语言区等穴位 ,配合按摩、中频电疗、高压氧、以Bobath、Vojta方法为主的运动疗法、作业疗法 ,并注重平衡练习、行走练习、认知训练、语言治疗。结果 经综合康复治疗 1个月后 ,抽搐发作消失 ,步态不稳改善。治疗 9个月后 ,步态基本恢复正常 ,大小便能控制 ,吃饭基本自理 ,意识、协调控制、认知功能基本恢复正常 ,言语功能明显改善 ,能说出简单语句。MMSE评分 2 6分 ,神经功能缺损程度评分 1分。此后指导继续家中言语训练 ,于 2 0 0 3 -12复诊 ,患儿已能流畅地作日常交流 ,表情自然 ,发音清楚。结论 综合康复治疗措施对小儿病毒性脑炎继发性癫痫伴重度痴呆完全性失语患者具有积极意义
Objective To investigate the value and significance of comprehensive rehabilitation therapy on complete aphasia of secondary viral epilepsy with severe dementia in children with viral encephalitis. Method 2 0 0 2 -0 1 ~ 2 0 0 2 -10 admitted to a case of viral encephalitis secondary epilepsy with severe dementia children with complete aphasia, antiepileptic, beneficial brain resuscitation, blood circulation and blood stasis based on the basis of drug treatment On the acupuncture head with Baihui, Sishencong, sports area, foot sports area and language area and other points, with massage, intermediate frequency electrotherapy, hyperbaric oxygen, Bobath, Vojta method based exercise therapy, homework therapy, and Focus on balance exercises, walking exercises, cognitive training, language therapy. Results After 1 month of comprehensive rehabilitation, the seizures disappeared and the gait instability improved. After 9 months of treatment, the gait basically returned to normal, the size of the urine can be controlled, the basic self-care eating, consciousness, coordinated control, the basic cognitive function returned to normal, significantly improved speech function, can speak simple sentences. MMSE score 26, neurological deficit score 1 point. Since then, he has been instructed to continue speech training in his home. At the referral of 2002-03, his children have been able to communicate routinely and smoothly with a natural expression and clear pronunciation. Conclusion The comprehensive rehabilitation measures have positive effects on children with viral encephalitis secondary to epilepsy and severe dementia with complete aphasia