Syncope. What is it in neurology in children, adolescents, adults, pregnancy, causes IRR, classification, first aid, clinical guidelines

Syncope - is loss of consciousness due to the non-epileptic nature dystrophic reduce brain metabolism, triggered by short-term blood circulation. Such a state is there because of the different pathologies in the body.

What is syncope?

Sudden hypoxia tissue with a drop in muscle tone, resulting in the common carotid artery cannulation is called syncope crisis.

Fainting is expressed:

• pale skin;
• increased sweating;
• a decrease of biological functions of the brain;
• drop in blood pressure;
• rare oscillations of arterial walls;
• incorrect breathing.

After losing consciousness the body recovers quickly enough, but there is a lack of physical strength and energy. In a swoon after more mature age people can temporarily lose their memory.

The causes of syncope

Hypoxic brain tissue exposed to people of all ages - children, teenagers and adults. Syncope occurs due to acute circulatory disorders in the body. The causes of such a state may be various changes in the organism.

Childhood:

• violation of protein synthesis red blood particles due to iron deficiency which manifested anemia;
• lack of sleep;
  
• prolonged lack or absence of receipt of essential nutrients in the body, for maintaining a liquid state of the blood;
• Disorder in the glands and chromaffin body, synthesizing hormones;
• psychomotor activity in a loud voice signals;
• a sudden sense of fear;
• violation of the department in the nervous system that regulates the activity of internal organs;
• pathological processes in the system, which provides blood circulation in the body;
• prolonged lack of rest.

teens:

• emotional overload;
• weakening of the forces;
• fatigue;
• lack of sleep;
• stuffy room;
• heatwave;
• unbalanced diet;
• increase or decrease of signal generating chemical organic compounds body cells, which affect the organism;
• failure in the liquid iron-containing protein of connective tissue;
• neoplasms of the central nervous system;
• cardiovascular disease;
• a disorder of the autonomic nervous system;
• elevated blood glucose;
• vasospasm;
• malnutrition tissue of intervertebral discs;
• brain injury.

Adults:

• acute circulatory disorder in the myocardium;
• acute blood loss volume;
• interruptions in the contraction of the heart;
• violation of sinus rhythm;
• liquid volume reduction of connective tissue;
• long flowing pathology of cerebral arteries;
• closing more guys artery in the neck;
• vasoconstriction;
• decrease in muscle tone of the vascular wall;
• orthostatic hypotension;
• irritation of the expansion of the common carotid artery;
• flowing acute inflammatory process in the gall bladder;
• trigeminal neuralgia;
• no inflammation of the 9th cranial nerves;
• the use of certain pharmacological agents;
• impaired function and structure of cells liquid connective tissue;
  
• inflammatory diseases of the respiratory system.

stage

Syncope - is (a disturbance in the body can not be ignored) functional disruptions of the CNS that have certain stages and manifestations:

A preliminary breakdown:

• mental and physical discomfort;
• growing lack of strength and energy;
• vomiting reflex;
• unsteadiness of gait;
• sudden darkening of the organ of vision;
• hearing the noise and the sound;
• pastoznost;
• extremities cold snap;
• respiratory disorders;
• lowering blood pressure;
• hypotonia;
• unstable arterial contraction.

Amentia - lack of orientation in the surrounding area:

• Intermittent fainting;
• disorientation;
• slow the formation of associations;
• immobility;
• lack of conversation;
• dilated pupils;
• poor filling of heart;
• hypotension;
• lack of muscle tone.

Return to the previous state:

• the resumption of consciousness occurs within a few minutes, sometimes a little longer;
• lack of energy holds for a couple of hours.

Classification of syncope

Short-term disturbances of consciousness with loss of postural muscle tone classified by the change in the physiological functions of the body.

Syncope is divided into several types:

types of syncope	Aggravating factors
neurogenic	sudden vasodilation; irritation of the carotid sinuses; convulsive breath wheezing; hypotension; pain in the internal organs; rhabdomyolysis; postprandial state; 9 hemilesion pair cerebral nerves; rigeminalnaya neuralgia.
Vertical	perifericheskoyinervnoy damage structures in the system; resistant hypotension provoked by drugs and environmental factors; decrease the liquid circulation of the connective tissue in the body.
myocardio	tachycardia; mixed type of arrhythmia; Short syndrome; violation of the electrical impulse from the atria to the ventricles; Atrial fibrillation and ventricular; fusion flaps of the aortic valve; thickening of the left ventricular wall; protrusion of the aortic wall; narrowing of the output of the right ventricular outflow tract; pulmonary hypertension; violation of diastolic blood flow from the left atrium into the left ventricle; a benign tumor on the wall in the myocardium.
Vascular	occlusion of the proximal part of the subclavian artery.
Nesinkopalny	elevated blood glucose; seizures; toxins poisoning the body; ischemic attack; myotonia; psychosomatic disorders; attacks of severe anxiety; hysterical mental disorder.

symptomatology

Modified tone of blood vessels carrying CNS diet, lack of sufficient liquid provokes the connective tissue to the brain and appears syncope.

Fainting has certain symptoms:

• uncertainty in the determination of its position in space;
• float before my eyes;
• vagueness and ambivalence of objects;
• lack of physical strength;
• condition in which the ears can hear different sounds;
• rash;
• a sense of the preceding vomiting;
• mydriasis;
• hyperventilation;
• uneven heartbeat;
• the desire to sleep;
• hypotension;
• unsteadiness of gait;
• pain in the abdomen;
• reduced muscle tone;
• dry mouth;
  
• change in skin color.

The more dangerous fainting

Syncope - is (a short-term change in the body can adversely affect the health of the body), loss of consciousness.

For syncope can hide a large number of diseases.

If syncope occurs repeatedly, you should visit a general practitioner to exclude vascular, neurological and cardiac disorders.

vasodepressor syncope

Vasovagal syncope begins because of the increased voltage of the body and manifest reduction of total parallel resistance vascular networks of the systemic circulation, the expansion of the vascular lumen in muscles.

Aggravating factors of vasodepressor syncope is:

• being in a space of buildings with a large number of people;
• long vertical position;
• severe pain;
• the process of making the finished food.

Start fainting episode appears:

• extreme fatigue;
• lack of power;
• a sense of the preceding vomiting;
• abdominal cramping.

Loss of consciousness occurs only in the standing position. The main pathological changes in the body, which are the instigators of syncope - a violation of the regulation of the nervous and mental disorders.

orthostatic state

Postural hypotension - a sharp decrease in blood pressure when standing. Fainting of this type are not an independent process.

Pathology has a number of medicinal agents of:

• diuretics;
  
• angiotensin converting enzyme inhibitors;
• receptor blockers mediators adrenaline group;
• organic compound is glycerol trinitrate;
• antiparkinsonian drugs;
• heterocyclic sulfur and nitrogen;
• psychotropic drugs.

With this type of syncope, loss of consciousness can provoke:

• malarial crisis phase;
• pressosensitive reflex insufficiency;
• decrease in stroke volume and reduced perfusion;
• dilation of superficial venous vessels in the lower limbs;
• diabetic defeat of the capillary network;
• inflammation of the spinal cord.

Orthostatic condition manifests a sense of lack of energy, blurred eyes, unsteadiness. Postural syncope above symptoms characteristic held in the horizontal position of the body.

hypoglycemic syncopations

Syncope - is (such a phenomenon happens quite often), syncope, provoked changes in the body. Loss of consciousness, which is caused by a decrease in the level of glucose in the fluid coupling of the blood is called hypoglycemia. The fall of blood sugar amount below 2.0 u / l provokes syncope.

Fainting due to lower glucose levels usually happen:

• in patients with diabetes;
• when the genetic manifestations of intolerance monosaccharides;
• in patients with a variety of tumors in the body;
• with pathologically increased secretion of pancreatic hormone and malnutrition.

For hypoglycemic syncope is characterized by sudden weakness, desire something to eat, rash, involuntary trembling of the whole body. Loss of consciousness may be accompanied by involuntary muscle contractions, defeat pyramidal pathway, the long absence of consciousness.

hysterical syncope

Syncope, provoked a nervous disease, manifested in seizures, irritability, convulsive laughter with tears called hysterical syncope.

The variety of loss of consciousness need provocation in the form of spiritual experiences, feelings and fast elements spectators.

Hysterical syncope can last a few minutes or a few hours. Body Functions for fainting is not violated. After recovery of consciousness patient's condition is normal.

hyperventilation

Syncope, which occurs due to frequent shallow breathing, known as hyperventilation.

Provoking factor fainting - a reduction of carbon dioxide concentration in the liquid connective tissue. Loss of consciousness occurs due to the increase of carbon dioxide tension in blood, which together with the dependence oxyhemoglobin dissociation degree of carbon dioxide partial pressure value influences the saturation oxygen receptacles in the CNS.

A feature of hyperventilation syncope is prolonged preliminary disorder that combined with the inexplicable, painful attacks of anxiety accompanied by an irrational fear, which leads to fainting. Loss of consciousness is manifested fast or respiratory failure. This type of fainting, as a rule, does not last long.

carotid sinus syncope

Syncope, provoked by abnormal influence on the part of the arterial bed in the general bifurcation sleepy vessel, which causes a decrease in heart rate and speed hypotension, called the carotid sinus fainting. Fainting occur with this type of turns of the head, the load on the cervical spine, as well as wearing tight clothing in the neck area.

Any pressure on the carotid sinus can lead to loss of consciousness.

A feature of the carotid sinus syncope is the prevalence of sinus rhythm disturbances and reduction in blood pressure without the arrhythmia. Stop an attack to be by introducing anticholinergic plant alkaloid.

Nikturicheskie fainting

The difficulty of liquid inflow connective tissue abdomen provokes nikturichesky syncope. This form of syncope occurs in people, which often arise, not quite woken up in the toilet. The main difference between this form of syncope - is that at night is hard at work the vagus nerve, which is responsible for breathing, heart rate and a decrease in motility.

If you wake up in a dream, the activities of the 10th cranial nerve affects the blood flow to the muscle fibers during straining and emptying of the bladder or intestine, which entails a reduction in the cavity volume stomach. In this case an additional liquid redistribution of connective tissue in the body ends syncope.

Neuralgia glossopharyngeal nerve

Syncopal crisis, which is not caused by inflammatory lesions of the 9th cranial nerves - it glossopharyngeal faint. Such a state provokes a sharp pain in the tonsil, extending to the cervical spine and the lower the bone structure of the mouth.

Unbearable sensation, lasting a few minutes, results in a loss of consciousness. Fainting may be accompanied by involuntary contraction of one or more muscle groups. Syncope of the variety subject to the representative of a strong half of which are more than 55 years.

cough syncope

Fainting, which occur when a convulsive expiratory wheezing, called cough syncope. Provoke their attacks pathology of respiratory and cardiovascular system, manifested by forced exhalation through the mouth, which is caused by muscle contraction.

This type of syncope is not pre-disorder and occurs when straining during coughing, provoking violation of blood flow in the small circle of blood circulation, which leads to loss of consciousness. Attack may be accompanied by sudden muscle spasm.

swallowing

Pathological effect on 10-th pair of nerves emanating from the central nervous system to the abdominal cavity and the charge of the motor, sensory and autonomic system pharyngeal syncope occur.

Loss of consciousness occurs when the channel diseases that connects the mouth to the esophagus, as well as in pathological processes in the peritoneum.

Syncope accompanied by short-term cessation of cardiac activity with the disappearance of the bioelectric activity.

somatogenic

Fainting due to diseases of any organ or system, called somatogenic. Pathological conditions provoke circulatory disorders in the CNS.

When syncope of this type there is a certain set of symptoms and syndromes:

• bluish color of the skin;
• excessive accumulation of fluid in the extracellular tissue spaces and organs;
• more frequent and spasmodic contraction of the heart muscle;
• poor circulation of the internal organs;
• urticaria;
• anemia;
• pathology of the hepatobiliary system;
• asthenic syndrome;
• infection;
• hyperthermia.

This type of syncope can not be ignored, because loss of consciousness can be triggered by serious illnesses.

unknown etiology

Syncope (this is the pathological manifestations in the body) in many cases, require a serious diagnosis to find out the causes of loss of consciousness. The source of many of syncope is very difficult to establish. Therefore, in medicine called such manifestations of syncope of unknown etiology.

This kind of negative process should necessarily investigate using organic systems activity analysis method on the basis of registration of biopotentials, ECG Holter and diagnostic status of an organism, based on measurements at specific points in the nervous system.

Syncope unknown etiology may occur when turning the head, raising the abdominal pressure, intensive muscular work. The main feature of this species is the lack of syncope violations heart rate and blood pressure changes.

Many patients with syncope of unknown etiology disorder have a history of congenital abnormalities in the internal organs and systems, and neurological disorders.

First aid for syncope syndrome

Fainting - is not a disease, but a manifestation of pathological changes in the body. As a rule, unconscious man himself comes to his senses.

But there are situations when in violation of blood circulation in the brain should help:

• put the victim on his back and slightly raise the lower limbs;
• unfasten the belt, buttons in the cervical area, any squeezing clothes items;
• on the forehead to put a piece of damp, cool cloth;
• if you suspect the approaching gag reflex, the patient must be deployed on the side, facing down;
• If syncope lasts longer than a couple of minutes, you need to call an ambulance emergency care;
• when the crisis will pass, and the victim will return to consciousness should not take the vertical position;
  
• If possible, give the man a drink a hot drink.

Diagnostics

When repeatedly occurring attacks of syncope should consult your doctor, physician to determine the cause of a pathological condition.

After interviewing the patient, experts have concluded and will appoint a number of surveys, which include:

• laboratory blood tests;
• Clinical urine analysis;
• liver and kidney samples;
• UZGD cerebral vessels;
• hormonal status;
• if necessary, an MRI of the head and heart;
• encephalography;
• glucose test.

If in the course of studies have found changes therapist assigns consultation related specialists - a neurologist, cardiologist, hematologist, an endocrinologist and psychiatrist.

Treatment

Therapy syncopal episodes should be aimed at improving brain blood circulation and the quality of life of the patient.

To recover from syncope following groups of drugs must be used:

• neyrometabolicheskie stimulants;
• medication to improve resistance to harmful influences;
• vitamin complexes;
• angioprotectors.

The patient should give up alcohol, nicotine, to avoid stressful situations. If necessary to lose weight, a balanced diet and do yoga.

Syncope during pregnancy

Many women know what faint during pregnancy.

The main features of this life period must include:

• hormonal changes that manifest hypotension or hypertension;
• hypervolemia, which is triggered by physiological changes in the body;
• lowering of red blood cells connective tissue in the liquid;
• lowering glucose levels because of the constant nausea.

To prevent syncope during gestation pregnancy should be:

• not stay long in the crowded and stuffy places;
• monitor rises from the bed;
  
• eat food in small portions;
• adhere to the management of fluid intake;
• to wear clothes according to the season;
• to avoid long-term stay in one position;
• full sleep;
• Avoid heavy physical labor.

In the event of impending loss of consciousness should:

• as soon as possible to adopt a sitting position, it is desirable to have knees above the pelvis;
• with frequent fainting be worn with an aqueous ammonium hydroxide solution;
• go out accompanied by another person.

complications

Syncopal attacks can have complications:

• body injuries from falling;
• memory problems;
• modifications vessels in the CNS;
• pathological processes in cardiac muscle;
• emotional stress;
• due to long anoxia death of brain cells;
• fatal outcome.

Syncopal attack - a pathology that can not be ignored. When multiple episodes of such conditions should consult a doctor to determine the causes of provocateurs.

Registration of the article: Lozinski Oleg

Video of syncope

3 cause of syncope and how to help the victim: