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Apallic Syndrome in Children: Development and Prognosis

Publication at Second Faculty of Medicine |
2002

Abstract

The apallic syndrome (AS) occurs in 10-14% of all severe cerebral injuries, after hypoxic or metabolic affections of the brain and in degenerative brain diseases. For the apallic syndrome the state of "wakeful unconsciousness" with preserved functions of the brain stem and disintegration or suppression of cortical functions is typical.

It is a dynamic state comprising the initial stage, the transitional stage into the apallic syndrome proper and the stage of remission which occurs within the fi'amework of gradual reintegration. In this study 46 children with apallic syndrome were included who were hospitalized at the Clinic of Child Neurology, Faculty Hospital Motol where the resulting state was evaluated after a ca 3-year follow-up.

In 91.3% children in the course of the apallic syndrome the mother was hospitalized with the child and then an opportunity was created for application of intuitive interactional rehabilitation. On discharge ft-om the Clinic the apallic syndrome persisted in 26%, in 56.5% significant improvement occurred.

After 3 years 63% were sent to educational facilities. The investigation confirmed experience described in the literature, i.e. of a more favourable prognosis of apallic syndrome in children, in particular after injury.

Relatively good results as regards the long-term prognosis support the hypothesis on the importance of the continual presence of the mother during the phase proper of AS.