Head of Department: Elena S. Ilyina, Cand. Sci. (Med.).

Department of Psychoneurology No. 2 was opened on August 19, 1991. The decision to open a separate department of psychoneurology and epilepsy was dictated by the necessity of organizing specialized medical help for young children with pathologies of the nervous system. A division for treatment of epilepsy is operating within the department.
Our department is part of the Russian Center for Nervous System Pathologies affiliated with the Russian Children's Clinical Hospital (the center is headed by Prof. A.V. Banin, Dr. Med.). It is also one of the clinical bases of the Chair of Nervous Diseases at the Pediatric Department of the Russian State Medical University. Medical students, registers, and interns from the Chair of Nerve Diseases and Chair of Clinical Pharmacology (Russian State Medical University) have classes at this department.
In the last few years, the proportion of disabled children has been increasing in Russia. The leading causes of child disability are pathologies of the nervous system. This is why it is important for us to provide not only timely diagnosis and treatment of developmental problems in early-age children but also preventive measures: if we know the correct diagnosis, the birth of another ill child in this family can be prevented in most cases. When we examine a patient with neurological disorders, we should not confine ourselves only to specialized examinations (CT, EEG, etc.). Each patient needs a combined examination (involving specialists from other departments) and a multitude of laboratory tests.

The following directions are of predominant importance:

* Epilepsy and early-age epileptic syndromes

The majority of patients at our department have various resistant forms of epilepsy, such as West syndrome, early child-age epileptic encephalopathies, Lennox-Gasteau syndrome, frontal lobe epilepsy. The main contents of the National Program for Treatment of Patients with Epilepsy have been developed on the basis of our department together with the Chair of Nerve Diseases, Pediatric Department, Russian State Medical University.

* Paroxysmal conditions in early childhood

At the department, we develop new approaches to diagnosis and treatment of nonepileptic paroxysmal conditions in children. The opening of a special division for treatment of epilepsy and the use of EEG monitoring made it possible to clearly differentiate epileptic syndromes from paroxysmal conditions of other origins. This distinction determines different therapeutic tactics for such patients.

* Hereditary metabolic disorders, hereditary degenerative disorders

Due to accumulated practical experience of diagnosis and treatment of nervous system disorders, it has become possible to confirm that many congenital metabolic disorders are the actual reason for neurological problems in early-age children. Hereditary metabolic problems have been thoroughly discussed in literature; genetic markers have been developed for many of them; and prenatal diagnosis is possible for some diseases. This is important for prevention of child disabilities. In 2001, in close cooperation with the Laboratory of Hereditary Metabolic Disorders (State Scientific Center, Russian Academy of Medical Sciences), we started working on the diagnostic algorithm of examination of children with nervous system disorders and possible metabolic disorders. This joint work enabled us to perform clinical and laboratory confirmation of numerous rare diseases: GM1 gangliosidosis, GM2 gangliosidosis, neuronal ceroid lipofuscinosis, metachromatic leukodystrophy, globoid cell leukodystrophy, glutaric aciduria, some forms of mitochondrial disorders.
The following diagnoses were established for the first time in Russia according to international standards (enzymatic diagnosis, DNA diagnosis): Canavan leukodystrophy, biotinidase deficiency, neuronal ceroid lipofuscinosis type 2, multiple deficiency of acyl-CoA-dehydrogenases of fatty acids.

* Perinatal pathology of the nervous system and its consequences

We examine and treat children with hypoxic ischemic and hypoxic traumatic encephalopathies, prenatal infections and their consequences, prenatal CNS anomalies, chromosomal syndromes.

* Psychomotor retardation of various origins

Psychomotor retardation can be encountered in various pathologies of the nervous system. The cause of the disorder often remains unknown; this impairs the quality of treatment and does not allow us to predict the development of the disease for the parents. At our department, we have developed an integrated approach to examination of such patients using the laboratory and diagnostic facilities available at the hospital and other medical institutions in Moscow.