Mental retardation

Mental retardation (synonym: maloma, mental subnormality) is a group of painful condition characterized by congenital or acquired during early childhood intellectual defect that throughout later life is not growing. When the mental retardation deviate and physical development: the growth delay, irregularity physique, malformations of the internal organs and senses (vision, hearing), delay or premature sexual development. Movement of the poor, deprived of smoothness, accuracy, committed with excessive speed, or the opposite, with the slowness. Expression monotonous and inexpressive.
The etiology and pathogenesis of a variety of mental retardation. Cause of mental retardation can be different harmful factors influencing sexual cells of the parents (for example, alcohol), on the embryo, the foetus , or the child in the first months - years of life.
Such hazards are also a variety of infectious diseases of pregnant women and children; intoxication and injuries pregnant, starvation and malnutrition during pregnancy; birth trauma; different endocrine disorders, and genetic factors (see down the disease). According to the degree of underdevelopment of the psyche with mental retardation allocate idiocy, imbecile and debilnosti.

Mental retardation (oligophrenia; from the Greek. oligos - small and phren - mind) - maloma, mental subnormality.
Different etiology and pathogenesis of congenital or acquired early morbid state of the United group of oligophrenia based on a common characteristic - they are the clinical manifestations of impaired brain development (and sometimes of the whole body).
Mental retardation is characterized by two features: the presence of early intellectual defect and the lack of progression.
Although mental retardation and a strong state, but the manifestation is changing under the influence of external and internal influences. An important factor determining the dynamics of the clinical picture of O. is the age evolution of the patient, the value of which is especially great at a young age. As the patient gets older and his Central nervous system is being improved in terms of functionality, develop adaptive and compensatory mechanisms and may increase the level of intellectual development. The dynamics of the patients O. depends on the degree of intellectual defect, environmental conditions and upbringing of the child, early treatment and medical-pedagogical work. Along with the improvement in patients with oligophrenia possible deterioration in connection with decompensation, occurring more frequently in the transitional phase of development, sometimes under the influence of additional hazards (physical and mental traumas, infections, etc).
Etiology. Cause of mental retardation are various harmful factors influencing the generative cells parents, to an embryo, fetus or baby during the first months (years) life. These hazards include: 1) infectious, in particular viral, and parasitic diseases of pregnant women and child - rubella, measles, pertussis, influenza, malaria, syphilis, toxoplasmosis, laterales; special importance infection, affecting the brain of the child in early childhood (meningitis or meningoencephalitis); 2) intoxication pregnant: autointoxication - diabetes, diseases of liver and kidneys, cardiovascular system, toxemia; antitoxical - alcohol, lead, podozrevaemye funds; 3) injuries (bruises) pregnant; 4) effect on pregnant radial energy (atomic radiation, x-rays); 5) starvation and malnutrition during pregnancy, particularly Hypo - and the reason that fasting child and debilitating disease in the first months of life; 6) endocrinopathies mother and defeat endocrine apparatus of the fetus (violation of the activity of the thyroid, pituitary, adrenal);
7) the incompatibility between the blood of the mother and fetus; 8) birth trauma; 9) early postnatal injury of the Central nervous system of the child.
The question of the role of pathological heredity in the origin of the mental retardation is still under study. By genetic analysis of family name and twin method was installed dominant or recessive nature of inheritance of some forms of O. Identified clinical forms due to congenital hereditary enzyme deficiency, disorders of different types of metabolism (phenylketonuria, galactosemia, Secretaria and others), and special ways of O. associated with chromosomal aberration (syndrome disease, syndromes Cline-filter, Shereshevsky - Turner and others).
Classification. Through experimental studies and clinical observations, it was proved that the manifestation of the disease development in General and mental retardation in particular depends not only on the quality and seriousness of etiological factors, but mainly on what stage of ontogenesis of the body was damaged. In this regard, the mental retardation is classified on the basis of two criteria: the time of damage to the brain and the quality of the pathogenic effect.
Depending on the time of exposure to allocate three groups Acting with the further division of each of them in accordance with the quality of harmfulness (in cases when unknown etiology,clinical picture).
The first group - the mental retardation endogenous nature (damage to the generative cells parents).
A. down's disease (see).
B. True microcephaly (see).
B. Enzimaticski form with mental retardation disorders of different types of metabolism (protein, carbohydrate, lipid): 1) phenylpropanolamine O., which is characterized by the violation of intermediate metabolism of phenylalanine; most authors consider this form of O. hereditary associated with recessive gene; 2) Acting associated with galactosemia; 3) Acting associated with secretaries and procesoriai.
, Clinical forms O. characterized by a combination of dementia with disease of the skin, bones: 1) xerodermia O., when combined with dementia defects of the skin - with ichthyosis (syndrome Ore), muscle hypertension (Sjogren syndrome - Larsson); 2) isostatically mental retardation, when combined with dementia defects bone system; there are several variants of these forms O.: arachnodactyly (Marfan syndrome), a disease Crotona, or craniofacial desotos.
The second group of embryopathy (see) and fetopathy (see): 1) Acting caused by the rubella transferred by the mother in the first three months of pregnancy (robertma embryopathy); 2) mental retardation associated with toxoplasmosis; 3) Acting due to congenital syphilis; 4) Acting caused by hemolytic disease of newborns due to incompatibility between the blood of the mother and fetus on RH factor.
To the group of embryo - and fetopathy include a range of clinical forms O. caused by a toxic agent in the prenatal period (x-ray irradiation pregnant, chemical contraceptives, diabetes, hyperthyroidism, cardiovascular disorders, kidney failure, starvation, Hypo - and avitaminosis mother and so on). However, the clinical features of these forms has not been sufficiently studied.
The third group is the mental retardation associated with various hazards during birth and in early childhood (infection, intoxication, trauma of the cranium and others).
To include atypical forms of O. associated with progressive hydrocephalus, local defects of the brain, endocrine disorders.
This classification reflects mainly the etiology and pathogenesis of disease. Within each group is classification on a degree of intellectual disability. In accordance with this criterion O. divided into the idiocy, the imbecile, debilnosti.

The clinical picture of mental retardation is caused by various manifestations of mental underdevelopment, among which the leading role is played by the violation of cognitive activity. The most typical symptom is Acting underdevelopment of the complex functions of thinking - generalization, education concepts, establishing the cause-effect relationships. It is completely absent, or in more or less immature (phonetics and speech defects, poor vocabulary, primitive build phrases and others). In the sphere of feelings prevail primitive emotions and desires, more complex differentiated emotions underdeveloped. Characterized by extreme poverty of imagination, weakness initiatives, most pokazatelno, suggestibility, the tendency to monotonous automatic operation. However, full parallelism between the degree of intellectual defect and the emotional-volitional failure not. Depending on the peculiarities of temperament patients behavior may be different:
from the engine block, peticesti (torpid patients) before extraordinary mobility, fussiness and often elevated mood (eroticheskie).
Abnormalities are observed in the physical development: stunting, dispassionate physique, structural abnormalities of the skull malformations of internal organs and senses (sight and hearing). Sexual development is often delayed (rarely happens premature). Motor sphere is underdeveloped. Disrupted the pace, smooth, smooth and precise movements. Notes synkinesia and stereotyped movements. Mimicry monotonous and inexpressive. Neurological symptoms and signs of endocrine dysfunction of different depending on the pathogenesis of mental retardation.
The degree of underdevelopment psyche when Acting may be different.