Encephalopathy - Causes, Symptoms and Treatment .MF .
Encephalopathy (encephalopathia, Anat encephalon brain + Greek pathos suffering, disease, Synonym:.. Psevdoentsefalit, cerebropathia, entsefaloz) - a syndrome of diffuse brain damage, which is based on the mechanismischemia (impaired blood flow), hypoxia (lack of oxygen) brain tissue and, as a result, the phenomenon of the death of nerve cells caused by various diseases and pathological conditions.
There are congenital and acquired encephalopathy.Congenital encephalopathy can be caused by genetic defects in the metabolism, abnormal brain development or associated with exposure to damaging factors in the perinatal period, especially such as cerebral hypoxia and intracranial birth trauma.
acquired encephalopathies are caused by exposure to brain damaging factors in the postnatal period.Depending on the etiology and pathogenesis of several types of acquired encephalopathies.Post-traumatic encephalopathy - a recent or long-term effects of traumatic brain injury.Toxic encephalopathy - a c
encephalopathy can develop when water retention in the body, reducing the osmotic pressure and hyponatremia due to increased release of antidiuretic hormone in various tumor diseases, bleeding, trauma, diseases of the lungs.When encephalopathy caused by hyperthermia, marked dysfunction of the hypothalamus with subsequent metabolic changes.
separate group consists of so-called vascular encephalopathy, etiologically associated with chronic disorders of cerebral blood flow.Encephalopathy may develop in atherosclerosis (atherosclerotic encephalopathy), hypertension (hypertensive encephalopathy), violations of cerebral venous outflow (venous encephalopathy).Acute hypertensive encephalopathy is observed in malignant course of hypertension, secondary hypertension, occurring in various diseases of the kidneys and kidney disease during pregnancy.Acute development of metabolic encephalopathy observed in hypoxia-induced pulmonary ventilation disorders, circulation, tissue metabolism, such as the long-term reduction in blood pressure during cardiac surgery, major blood vessels.An example of hypoxic encephalopathy is postresuscitation encephalopathy.
The basis of the mechanism of any kind encephalopathy most often is hypoxia of the brain, which is a consequence of the deterioration of its blood supply, venous plethora, edema, as well as mikrogemorragii, the impact on the brain of endogenous and exogenous toxins that aggravate disorders of the brain metabolism.The presence of common (along with specific) pathogenetic mechanisms encephalopathy causes similar morphological changes of varying degrees.This diffuse brain atrophy with fewer neurons and degenerative changes in them, necrosis and small foci of demyelination of white matter in the proliferation of glial cells, brain edema, brain mikrogemorragii in matter, sometimes with signs of blood stasis, edema and hyperemia of the meninges.The features of the different types and severity of encephalopathy are the predominant localization of lesions, the predominant loss of white and gray matter of the brain, the degree of cerebral blood flow.
Encephalopathy - the common name of a brain disease characterized by degenerative changes in it.
Encephalopathy azotemicheskaya acute psychotic (ie azotaemica psychotica acuta.) - See Delirium acutum..
anoxic encephalopathy (. E anoxica;. Syn hypoxic encephalopathy) - encephalopathy, occurs on the basis of hypoxia caused by pulmonary ventilation disorders, circulation, tissue metabolism, for example, as a result of prolonged hypotension during surgery on the heart and large vessels.
arteriosclerotic encephalopathy (e arteriosclerotica.) - Encephalopathy with diffuse cerebral atherosclerosis, manifested focal neurological disorders and decrease the level of mental activity.
bilirubin encephalopathy (e bilirubinica.) - Encephalopathy in severe jaundice due to a toxic effect of bile pigments and acids in the cells of the basal nuclei of the brain.
venous Encephalopathy (e venosa.) - Encephalopathy in the elderly, especially with symptoms of cardio-respiratory failure caused by a violation of the venous outflow from the brain.
congenital encephalopathy (e congenita.) - The common name of encephalopathies caused by abnormal brain development.
hypertensive encephalopathy (e hypertonica.) - Encephalopathy with hypertension, especially in the malignant form, which manifests itself throbbing headache, focal, predominantly pseudo-bulbar, symptoms.
hypoglycemic encephalopathy (e hypoglycaemica.) - Encephalopathy due to chronic hypoglycemia in patients with lesions of the pancreas, pituitary or adrenal.
hypoxic encephalopathy (e hypoxica.) - See anoxic encephalopathy..
diabetic encephalopathy (e diabetica.) - Encephalopathy in diabetes, manifesting migraine headaches, asthenic syndrome, often focal neurological symptoms, reduced vision.
circulatory encephalopathy (. E dyscirculatoria;. Syn vascular encephalopathy) - encephalopathy due to chronic disorders of cerebral blood flow, such as atherosclerosis, hypertension;It characterized by a combination of brain and focal symptoms.
Encephalopathy Ray (. With radialis) - encephalopathy, due to the influence on the organism of ionizing radiation;It characterized by asthenic disorders, and in more severe lesions - the different manifestations of the depth of organic psihosindroma.
hepatic encephalopathy (e hepatica.) - See Gepatargiya..
portosystemic encephalopathy (e portosystemica.) - See Gepatargiya..
postanoksicheskaya Encephalopathy (e postanoxica.) - See Encephalopathy resuscitative-conditioned..
traumatic encephalopathy (e posttraumatica) - see Traumatic Encephalopathy..
Encephalopathy resuscitative-conditioned (. Syn E. postanoksicheskaya) - anoxic encephalopathy, which developed after intensive care;the nature and extent of brain damage caused by the duration of the period of clinical death.
Vascular Encephalopathy (e vascularis.) - See circulatory encephalopathy..
toxic encephalopathy (e toxica.) - Encephalopathy developing in a systematic exposure to neurotropic substances.
traumatic encephalopathy (.. E traumatica; syn traumatic encephalopathy) - encephalopathy, developing as late or long-term complication of traumatic brain injury;appears Chap.astenovegetative way or hypertensive syndrome, seizures.
traumatic encephalopathy boxers (syn .: boxers dementia, Martlanda syndrome) - encephalopathy, occurs in boxers after repeated head injuries (KO);organic psihosindromom shown in conjunction with neurological disorders in Parkinson's type.
symptoms of encephalopathy
encephalopathy Clinical manifestations are diverse.Early signs of encephalopathy are decrease in mental performance, memory (especially recent events), difficulty in changing activities, sleep disturbance, drowsiness during the day, general fatigue.Frequent complaints or diffuse headaches, tinnitus, general weakness, unstable mood, irritability.Neurological examination can reveal nystagmus, decreased visual acuity and hearing, increased muscle tone and tendon reflexes, pathological pyramidal and oral reflexes, impaired coordination, autonomic disorders.These disorders can progress with the development of the underlying disease, which is accompanied by encephalopathy.In such cases, the later stages are identified distinct neurological syndromes: parkinsonian, pseudobulbar (see Pseudobulbar palsy, Dementia.).Some patients may experience a mental disorder.
In severe generalized brain damage, significant violations of microcirculation, cerebral edema may develop acute clinical picture of encephalopathy;general anxiety, severe headache, often in the occipital region, nausea, vomiting, visual disturbances, dizziness, staggering, sometimes numb the tips of the fingers, nose, lips, tongue.Then the anxiety gives way to apathy, and sometimes dizziness.Disorders of consciousness, and sometimes seizures may occur in acute renal, hepatic, pancreatic encephalopathy.Acute encephalopathy with an intense headache, nausea, vomiting, nystagmus, paresis, mental illness, seizures less frequently observed in pulmonary thromboembolism, infarction pneumonia, in some cases, an exacerbation of chronic pneumonia.
For diagnosis of encephalopathy and defining its shape are important data history: perinatal pathology, intoxication, traumatic brain injury, inherited or acquired disorders of metabolism, pronounced atherosclerosis, hypertension, kidney disease, liver, pancreas, lung,, exposure to ionizing radiation.
When electroencephalography (EEG) recorded disorganization basic rhythms, the emergence of abnormal slow waves, signs of epileptic activity.
When computed tomography (CT) and MRI signs of diffuse brain atrophy: the expansion of the brain ventricles, subarachnoid space, brain deepening furrows.Signs melkoochagovogo diffuse lesions can be detected by imaging by nuclear magnetic resonance (NMR).
Biochemical studies of blood, urine, cerebrospinal fluid, detection of toxic substances allow to clarify the etiology and pathogenesis of encephalopathy.
Complex treatment of encephalopathy is aimed at both the underlying disease that caused encephalopathy, and the common elements of the pathogenesis and symptoms.In acute encephalopathy use various support systems: hemodialysis, mechanical ventilation (ALV), hemoperfusion, prolonged parenteral nutrition.Often necessary measures to reduce intracranial pressure, elimination of seizures.Subsequently prescribe drugs that improve brain metabolism: nootropic core (piriditol, piracetam), amino acids (cerebrolysin alvezin, methionine, glutamic acid), lipotropic compound (Essentiale, lecithin), vitamins A, E, group B, ascorbic and folic acid:on the testimony - angioprotectors (cinnarizine, ksantinola nicotinate, parmidin, cavinton, Sermion), antiplatelet agents (pentoxifylline), biostimulants (aloe, vitreous).Drugs administered in combination, repeated courses of a duration of 1-3 months.
as adjuvant treatment using physical therapy and reflexology (acupuncture), walking, exercise breathing exercises (qigong, breathing Strelnikova, Buteyko), meditation and more.Only without overload.Everything is very individual.From drug treatment at the same time can not refuse.
determined by the dynamics of the underlying disease, the degree of brain damage, the possibility of specific therapy;in some cases it is possible to provide only the stabilization of the patients.
Consequences of encephalopathy
Consequences of encephalopathy is essentially the same as its symptoms and are specific to each type of encephalopathy.Particularly serious consequences observed with encephalopathy, leading to severe irreversible brain damage, such as toxic encephalopathy.
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