Develop. Med. Child Neurol. 1979, 21, 539-540

Letter to the Editor Paediatric Neurology SIR-We have read with interest Dr. Gordon’s annotation (DMCN, 20, 670), which underlines the importance of paediatric neurology being a separate speciality. Here in the USSR we have no doubts with regard to paediatric neurology-it has existed in our country for quite some time. We realize, of course, that each country has its own path for paediatrics and its branches, including that of paediatric neurology. Our experience (over 25 years) in a large children’s hospital with various departments has convinced us that there are two main categories of neurological problems which require the attention of paediatric neurologists. One of them comprises ‘hard core’ neurological conditions such as epilepsy, hydrocephalus, palsies and muscular dystrophies, which always have been admitted to neurological departments and treated and followedup by neurologists. The other is represented by various neurological lesions and dysfunctions in patients who are admitted to paediatric wards: these patients are normally treated and otherwise managed and followed-up by paediatricians under the consultation of paediatric neurologists. We consider the participation of neurologists in the management of such cases to be important both for collection of data on such disorders and for training paediatricians in neurological ways of thinking. In the USSR, although paediatric neurology is not yet formally considered as a speciality in the official nomenclature of medical specialities, several hundreds of paediatric neurologists are working both in inpatient and outpatient departments. There is also postgraduate training in departments of paediatric neurology at postgraduate institutes in Moscow, Kasan and Tashkent, as well as in some medical colleges. Although paediatric neurology has been recognized in the USSR for a long time, we cannot state that its functions are clearly delineated, in particular the demarcation between it and psychiatry: traditionally, learning disabilities, disorders of speech development and mental retardation are cared for by psychiatrists. Paediatric neurologists in our country tended for some time to concentrate on major neurological disorders, but lately they have increasingly recognized the importance of neurological syndromes and symptoms (in many cases not too clearly defined) in general paediatric practice. We believe that paediatric neurologists have an important r61e to play in the management of all neurological disorders at all stages of treatment, rehabilitation and follow-up. This is of particular importance for pe .inatal neurological conditions. In many territories of our country an arrangement is made for paediatric neurologists to consult all symptomatic neonates while they are still in the maternity homes. If needed, children can be followed-up by the same specialist in the polyclinic or in special neonatal neurological inpatient wards which are being opened as part of larger children’s hospitals. Such departments can, and in fact do, serve as a training institution for both paediatric neurologists (in addition to their training in ‘conventional’ departments for ‘major’ neurology) and paediatricians. 539

DEVELOPMENTAL MEDICINE AND CHILD

NEUROLOGY. 1979, 2 1

We think that what we have said above does not contradict the idea of a team approach: special teams for rehabilitative establishments, management of metabolic disorders, etc., must include neurologists, some of whom might further specialise for these purposes. It is important, however, that paediatric neurologists become what could be termed ‘psychoneurologists’, to be able to handle psychiatric and psychological problems in children with neurological disorders. PROFESSOR B. LEBEDEV Chief, Paediatric Neurology Dept. PROFESSOR V. TATOCHENKO, Chief, Infectious Diseases Dept.

Institute of Paediatrics, Academy for Medical Sciences, Lomenosovsky Pr. 2, Moscow.

Notices Specific Management Problems in Cerebral Palsy Cambridge, England, 24th-28th September 1979 THEMedical Education and Information Unit of the Spastics Society is organizing the above meeting at Sidney Sussex College, Cambridge. Subjects to be discussed include positional deformity; the management of windswept hips; minimal brain dysfunction; the clumsy child; the hand in cerebral palsy; programming for the whole child; living with handicap; communication between therapies; operant conditioning; speech delay and its management; and dribbling (drooling). Participation is limited to 70 people, and cost (seminar fee, accommodation and all meals) is f 7 0 sterling. Please write, giving name, address and present employment, to Miss Dian Coley, Organiser, Medical Education and Information Unit, 5A Netherhall Gardens, London NW3 5RN.

Fifth Annual Meeting of Paediatric Neurology Society Berlin, 19th and 20th November 1979 THEFifth Annual Meeting of the Paediatric Neurology Society will be held in West Berlin on 19th and 20th November 1979. Themes will include brain tumours, cerebral palsy, neurotoxicity and therapy-resistant petit mal. Further information from Prof. Dr. F. Hanefeld, Universitats Kinderklinik, Kaiserin Auguste Victoria Haus, Heubnerweg 6, 1000 Berlin 19, West Germany.

British Institute of Mental Handicap FROM 1st June 1979, the Institute of Mental Subnormality has changed its title to the British Institute of Mental Handicap. The aim of the Institute will continue to be to raise standards of treatment, care and management of mentally handicapped people, but, with the change of name, an expansion of the Institute’s activities is envisaged. Details about the services of the Institute, including its national education programme, its publications and its various information services for interested professionals and families of the handicapped are available from the British Institute of Mental Handicap, Information and Resource Centre, Wolverhampton Road, Kidderminster, Worcs. DY 10 3PP (tel.: (0562) 850251). 540

Paediatric neurology.

Develop. Med. Child Neurol. 1979, 21, 539-540 Letter to the Editor Paediatric Neurology SIR-We have read with interest Dr. Gordon’s annotation (DMCN,...
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