Синдром Геллера – редкое, но очень серьёзное детское психическое расстройство. При нём ребёнок почти полностью утрачивает все свои ранее сформированные навыки.
Чаще всего патология фиксируется у 2-3 годовалых детей, однако отмечались случаи, когда расстройство возникало и в возрасте 8-10 лет.
Патогенез
Он неясен. Врачам удалось лишь выявить лишь некоторые закономерности, на основании которых происходит развитие заболевания. До его начала никаких тревожных отклонений в психическом развитии не наблюдается. Ребёнок понимает речь, разговаривает, социально адаптирован.
Главные симптомы расстройства
Латентное течение болезни проявляется в повышении капризности, агрессивности и тревожности ребёнка. Параллельно с этим он перестаёт интересоваться ранее любимыми играми и занятиями, не выносит даже минимальное их усложнение.
Симптомы, характерные именно для синдрома Геллера, начинают проявляться только через несколько месяцев. Они включают:
- Резкое уменьшение словарного запаса ребёнка. Он прекращает говорить сложными фразами, употребляет лишь самые примитивные речевые конструкции типа «да», «нет», «иди», «принеси». Особенно ярко этот симптом проявляется у детей старше 5-ти летнего возраста;
- Падение интереса к обстановке, людям, развлечениям. Ребёнок полностью равнодушен ко всему, что происходит вокруг;
- Потеря ранее сформированных физических навыков: умения одеваться, пользоваться столовыми приборами, собирать игрушки и т. д. На завершающей стадии расстройства ребёнок теряет способность к удержанию мочи и кала.
Осложнения
Через 12 месяцев заболевание перестаёт прогрессировать. Осложнений не наблюдается, но ребёнок находится уже в таком состоянии, что о его социальной адаптации, как правило, и речи быть не может. Больному требуется постоянный уход. В самых благоприятных случаях он может смениться контролем. Интеллектуальное развитие хоть и идёт, но очень медленно.
Диагностика
Она начинается с посещения педиатра и невролога. Ребёнка обследуют на наличие эпилепсии, опухоли, травмы головного мозга. Когда эти заболевания исключены, его направляют к психиатру. Диагностика у этого врача включает:
- Беседу с родителями, выяснение у них характера течения болезни, того, какие навыки нарушаются, регресса более чем двух сфер;
- Наблюдение. Врач фиксирует симптомы латентной или уже начавшейся активной стадии заболевания;
- Психологическое тестирование. Используются тесты пирамидка, прогрессивные матрицы Равена, «коробка форм» и др.
Лечение синдрома Геллера
Используется комплексный подход включающий:
- Развивающие и коррекционные мероприятия. Они проводятся специалистами разных профилей и состоят из попыток восстановить речевые функции ребёнка, сформировать у него социальные навыки, скорректировать эмоциональные нарушения;
- Психотерапию, семейное консультирование. Родителей обучают уходу за ребёнком, информируют их об особенностях заболевания, организуют психотерапевтическую помощь;
- Социальную реабилитацию. Она нацелена на выработку у больного таких практических навыков, как умение одеваться, умываться, пользоваться столовыми приборами и др. Параллельно идёт коррекция поведенческих отклонений и эмоциональных нарушений. Развиваются способность к концентрации внимания и усидчивость.
Прогноз и профилактика
Потерянные навыки восстанавливаются очень медленно и не полностью. Только 20% пациентов при условии ранней и интенсивной терапии обретают способность к самообслуживанию, проявлению социальной активности и изъяснению простыми фразами.
Профилактика заболевания невозможна. Обусловлено это тем, что пока не выяснена его причина.
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