الثلاثاء، 10 يوليو 2012

Asperger’s disorder

This topic has been prepared by committees of medical doctors network one of the networks of the center of the specialized medical advice, Kingdom of Bahrain, this information is only for education and not for treatment, and is treated better than the doctor. Copyright, in the case of quotation, please refer to the network. http://www.medicalcom.net/
Asperger syndrome is characterized by the presence of ill qualities Touhdih the child, is one of 5 types of problems that affects the child and affect her mental, behavioral, and is called Pervasive developmental disorder, namely:

    
1. Autism Autism.
    
2. Ill rite Rett's disorder.
    
3. Ill Asperger Asperger's disorder.
    
4. Poor separation childish disintegrative Childhood disorder.
    
5. Widespread problems of growth and non-specific. PDD NOS (1)
Introduction:Characterized by ill Asperger Asperger's disease the existence of qualities and behaviors resembling a child with autism and mild but with a degree, without any delay in growth and mental skill is remarkable, but can be affected by the impact of a simple phenomenon. (2)
Rate of occurrence:There are no specific figures for the proportion of patients, but there is evidence to suggest higher incidence of diseases anchoritic other. (2)
Reasons:Still the causes of the disease so far unknown, but there is evidence to suggest the emergence of cases in families with children with autism. (2)
Symptoms:The disease is diagnosed as ill Asperger when you see a certain set of symptoms the patient, which is defined as approved by the American Psychiatric Association to diagnose the disease in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and is :

    
A. The existence of a distinct lack of ability to communicate with others, where the child is suffering from at least two offers from the following four symptoms:

    
1. Inability to communicate with others to seduce others through the eyes or facial expressions or body language.
    
2. Inability to form social relationships and friendships with others.
    
3. Indifference configured to engage in friendships or social relationships with others or participate in various activities, lack of enthusiasm to do anything.
    
4. Lack of interaction with social events and empathy with the circumstances.

    
B. Repeat a particular behavior or activity of interest one, and hurt his thinking on one thing and return it repeated, such as:
    
1. Keeping busy with one abnormally and inappropriate for the idea or the degree of attention.
    
2. Follow a certain routine and do not accept change this routine for any reason, whether the habits or function entrusted to it every day.
    
3. Stereotyping certain repetition of movement such as waving the hand or the movement of the body with a certain insistence on repeating this movement.
    
4. Attachment to certain things such as abnormal fan, etc. ........... Office.
    
C. Clearly the delay in education, skills and other concerns.
    
D. Be natural to speak to a large extent, without delay, such as the pronunciation of a word at the age of two years, simple sentences at the age of 3 years.
    
E. Not affected by some cognitive skills Cognitive development other than the school level, where level is affected by the school, but can still be skilled in something else, such as drawing, for example.
    
. F symptoms experienced by the child does not apply to any other disease in terms of the appearance of some symptoms with anchoritic not affected by the language and the level of intelligence and some of the skills, the opposite of what is Metzqa of a delay in the level of intelligence of autistic children. (3)
Tests:There are many tests to be carried out is not to diagnose, but denied the existence of any organic causes for symptoms, while the same disease are diagnosed by medical history and symptoms are apparent to the child, and these tests:

    
1. Laboratory tests:
    
Measuring the ratio of hormones to stimulate the secretion of thyroid hormones Thyroid - stimulating hormones (TSH) ß, to denied the existence of a decrease in the secretion of thyroid hormones has led to delays intellectual Hypothyroidism.
    
Measure the level of lead blood Lead level ß where lead poisoning leads to a behavior disorder.
    
Measure the percentage of creatine phosphofructo Kanez Creatine phosphokinase ß denied the existence of ill muscular dystrophy Muscular dystrophy, which was accompanied by his presence behavioral disorders.
    
Measure the proportion of some amino acids in the blood Plasma amino acid, and the proportion of ammonia in the blood Serum ammonia ß denied the existence of a defect in the metabolism of food, where most of the leading diseases defect also food to behavioral disorders due to brain growth failure due to lack of food.
    
Measure the proportion of some fatty acids in the blood Fatty acids, lactate and pyruvate and Lactate / Pyruvate ß denied the existence of a defect in the metabolism of food, where most of the leading diseases defect also food to behavioral disorders due to brain growth failure due to lack of food.
    
Work of the chromosomal analysis of the genetic material DNA ß and so to detect the presence of any chromosomal defect or syndrome caused by the presence of these symptoms.
    
2. Rays:
    
Magnetic resonance radiation action on the brain MRI.
    
Work on the brain CT scan CT.
    
Ultrasonic testing provocative work Positron - emission topography (PET), by an influential audio or visual recording of the brain's response influential by drawing a stroke.
    
Work with the CT scan provoked a wave
    
Single - photon computerized tomography (sPECT) and is a way of
    
Modern diagnosis of the brain.
    
3. Other tests:
    
The work of drawing brain Electroencephalography (EEG) ß, where a growing proportion of children with focal point of activity between brain circuit plus 100% of children ill rite.
    
Scale work heard Hearing test ß to make sure that the delay in the talk is not a result of weakness in the hearing.
    
Work of psychological tests Psychological & neuropsychological testing ß and to identify the symptoms carefully and make sure that these symptoms are not schizophrenia.
    
Sonograms work on the heart ECHO and functions of breathing Pulmonary function test and chest X-ray Chest X-Ray to check on the rest of the organs of the body. (4)
Note: Not all of these tests is required for each child, but the physician determines what is required of them by symptoms that appear on every child, the doctor doubted the existence of a particular disorder.
Treatment:

    
1. Special education Special education: There was consensus that education in the early and properly suitable for the situation of children through the schools with the special nature of the most important things that help to improve the situation, so the diagnosis and early intervention is the most important things at all.
    
2. Drug therapy Pharmacological:
    
A. For symptoms of hyperactivity, violence and impulse, agitation and nervousness, the anti-schizophrenia, such as haloperidol Haloperidol, Alrespridon Resperidone (Resperidal), Alawlenzben Olanzepine (Zyprexa), lead to calm the movement and behavior of the child effectively.
    
B. The use of antidepressants that increase the quality of the ratio blood serotonin SSRIs such as fluoxetine Fluoxetine Prozac Prozac and the situation has improved a lot.
    
C. For lack of focus and attention deficit, the methyl Vinadat such as Ritalin Methylphenidate Retalin increase the concentration of the child, although more than a little violence of the symptoms.
    
D. The use of lithium, and beta channels Mglqat Beta blockers and antispasmodics improve the troubled mood of the child.
    
E. Some argue that the use of Alrivia (Opioid antagonists (eg naltroxone [Revia] allay aggressive behaviors and self Amae and reduces symptoms anchoritic of the child, although the subject was still under probation.
    
3. Psychological treatment Psychological:
     
The role of individual therapy for the child to be little, but psychotherapy is an effective treatment and mass treatment of prisoners:
    
1. Family therapy Family therapy: where the role of family therapist in collaboration with the physician and psychologist to try to teach the child.
    
2. Group therapy Group therapy: where a group of mentally handicapped children from the social work activities, music and graphic representation and works of art which strengthens social cohesion and the ability to communicate with others. (5)
New in Version:

    
In a recent study conducted on children with Asperger ill found that most had a family of first degree relatives of schizophrenia, depression or autism, indicating that the disease and genetic background. (6)
    
Found that there are some people with Asperger ill suffer from problems such as the personal: Gender identity disorder, and found that behavioral therapy and psychotherapy in these cases comes very good results. (7)
    
Proved that the treatment technique using EEG Biofeedback, reduced stress and psychological Anxiety pen when a lot of patients, leading to much improvement in the situation when patients are large and that the subject was still under study. (8)
Reference:

    
1. Center of autism & related disabilities, fact sheet 7, revised 9/2003
    
2. J. Sodack, Virginia A Sodack, Kaplan & sodack's pocket handbook of clinical psychiatry, 3rd edn, 2002, pervasive developmental disorder, P: 289 -290.
    
3. American psychiatric association, diagnostic and statistical manual of mental disorders, text revised, 4th edn, Washington DC, American psychiatric association, 2000
    
4. Sufen Chiu, MD, Pervasive Developmental Disorder, work up, eMedicine Specialties> Pediatrics> Developmental & Behavioral Last Updated: May 20, 2005
    
5. J. Sodack, Virginia A Sodack, Kaplan & sodack's pocket handbook of clinical psychiatry, 3rd edn, 2002, pervasive developmental disorder, P: 290 -291.
    
6. Ghaziuddin M
    
A family history study of Asperger syndrome.
    
J Autism Dev Disord (United States), Apr 2005, 35 (2) p177-82
    
7. Kraemer B, Delsignore A, Gundelfinger R, et al.
    
Comorbidity of Asperger syndrome and gender identity disorder.
    
Eur Child Adolesc Psychiatry (Germany), Aug 2005, 14 (5) p292-6
    
8. Scolnick B
    
Effects of electroencephalogram biofeedback with Asperger's syndrome.
    
Int J Rehabil Res (England), Jun 2005, 28 (2) p159-63

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