Hypothalamic syndrome - a complex symptom that develops in the defeat of the hypothalamus and characterized by endocrine, autonomic, metabolic and trophic disorders.
Hypothalamic syndrome affects people aged 31 - 40 years. The percentage of patients with this syndrome among women is much higher than the percentage of men with hypothalamic syndrome.
Hypothalamic syndrome is widespread, but not diagnosed immediately, as the symptoms can masquerade as symptoms of other diseases.
The hypothalamus is located in the brain and is responsible for the homeostasis (constancy of the internal environment) exchange processes, thermoregulation, the condition of blood vessels and internal organs, as well as for food, sexual and psychological behavior. In the pathology of the hypothalamus disturbed periodicity any function that is manifested in the form of vegetative crisis or paroxysm.
Kinds
Depending on the prevalence of certain signs of the disease are the following forms of hypothalamic syndrome:
- vegetovascular;
- disorders of thermoregulation;
- hypothalamic (diencephalic) epilepsy;
- Neurotrophic;
- neuromuscular;
- violation of motivation and drives (including sleep and wakefulness disorders);
- neuroendocrine metabolic disorders;
- psevdonevrastenicheskaya or psychopathology.
In adolescence, hypothalamic syndrome occurs with a delay or acceleration of sexual development (puberty syndrome).
By degree of severity of the disease is isolated mild, moderate and severe.
Downstream distinguish progressive course of the disease, stable, regressing, relapsing.
Causes
The following factors may lead to violations of the function of the hypothalamus with the development of hypothalamic syndrome:
- Brain tumors that compress the area of the hypothalamus;
- craniocerebral trauma injury to the hypothalamus;
- chronic cerebral intoxication (drug addiction, alcoholism, drug addiction, work in hazardous environments, impaired ecology, etc.);
- vascular diseases, cerebral stroke, cervical osteochondrosis;
- viral and bacterial CNS (malaria, Influenza, meningitis, Infectious jaundice, rheumatism, chronic tonsillitis);
- chronic stress, mental tension;
- hormonal changes during pregnancy;
- chronic and endocrine disorders (bronchial asthma, Hypertension, gastric ulcer, obesity);
- constitutional deficiency of the hypothalamus.
The symptoms of hypothalamic syndrome
Manifestations of hypothalamic syndrome depend on which department (front or rear) of the hypothalamus is damaged. Symptoms of the syndrome may occur immediately after the hypothalamus damage or delayed (a few days, weeks or even years).
Vegetovascular form
In the development of vegetative-vascular form of hypothalamic crisis play the role of dysfunction of the autonomic nervous system (sympathetic and parasympathetic divisions). It manifested in the form of this form of crises.
1. During sympathoadrenal crisis patients complain
- heart palpitations,
- general weakness and lethargy
- agitation, anxiety manifests itself,
- the fear of death.
there
- numbness and coldness of hands and feet,
- pale skin,
- exophthalmos (bulging eyes)
- dry mouth,
- thirst, chills,
- general tremor,
- blood pressure rise to 150/100 - 180/110 mm Hg. Art.,
- raising the temperature to 38 degrees.
Provoke a crisis can change the weather, menstruation, emotional stress, pain. Paroxysm duration is 15 minutes - 3 hr.
2. Vagoinsulyarnye crisis is characterized by
- suffocation,
- feeling of lack of air,
- headache
- hot flashes to the face.
Also, patients appear
- weakness, lethargy, drowsiness,
- excessive sweating,
- salivation,
- dizziness, tinnitus,
- nausea,
- lowered blood pressure
- It slows the heartbeat,
- join bowel disorder symptoms (flatulence, diarrhea) and urinary bladder (excessive urination).
Allergic reactions in the form of urticaria or angioedema. It continues to attack 1 - 2 hours.
violation of thermoregulation
Hypothalamic syndrome with impaired thermoregulation characterized subfebrile long (up to 38 degrees) with its body temperature periodic increase (up to 40 degrees).
This form is more common in children and adolescents.
Along with the rise in temperature takes place signs sympathoadrenal or mixed crisis (vegetovascular form).
The temperature rises in the morning and in the evening back to normal. There are no obvious signs of inflammation. Changes in thermoregulation directly related to emotional and physical stress (eg, in children thermoregulation changes appear in the classroom in the school and disappear during the holidays).
Characteristic signs of violation of thermoregulation are constant chilliness, fear of drafts and cold weather.
Violation of the motivations and drives
For this form of hypothalamic syndrome characterized by emotional and personality disorders (various phobias - fear, gain or loss of sexual desire, abnormal sleepiness or insomnia, frequent and sudden change mood).
neuroendocrine form
Such disorders are characterized by a violation of a protein, carbohydrate, fat and water exchange Nightingale, polyphagia (bulimia) or anorexia (Not eating), thirst.
Often, neuroendocrine disorders accompanied syndromes Cushing, diabetes insipidus, early menopause, acromegaly and thyroid disorders.
Neurotrophic form
Characterized trophic changes (allergic rash, trophic ulcers, Itching and dryness of the skin, bedsores, Change of pigment metabolism), it is possible osteomalacia (softening of the bones), or hardening of bone appearance of ulcerations in the esophagus, stomach, duodenum.
Diagnostics
Due to the numerous symptoms of hypothalamic syndrome diagnosis it presents certain difficulties.
Various tests are used for diagnosis
- definition of sugar with the load curve: measuring fasting blood sugar and upon receiving the 100 c. glucose with the definition of sugar every 30 minutes,
- A three-day urine sample for Zimnitskiy,
- body temperature measurement in three locations: in both armpits and in the rectum,
- electroencephalography.
shown
- appointment MRI of the brain (identification increased intracranial pressure and tumor)
- Hormone Research (testosterone, prolactin, cortisol, estradiol, LH, FSH, TSH, T4, Adrenocorticotropic hormone levels 17-ketosteroids in urine),
- Ultrasonography of the adrenal and thyroid
- MRI of the adrenal glands or computed tomography.
hypothalamic syndrome treatment
hypothalamic syndrome treatment is long, in most cases, lifelong. Treatment depends on the symptoms and the leading cause of the hypothalamic syndrome.
Treatment of patients with this disease are engaged endocrinologist, neurologist and gynecologist (for women).
The first stage of treatment involves the elimination of causative factors: the appointment of antibiotic treatment or antiviral therapy, trauma therapy, brain tumors, and so on.
In the case of exposure to the toxic syndrome treat hypothalamic factor disintoxication therapy (gemodez, sodium thiosulfate, glucose, saline i.v.).
Recommended restorative therapy, vitamins, means of improving brain blood circulation (cavinton, piracetam, Cerebrolysin), amino acids (glycine, aktovegin), calcium supplements. The complex treatment includes physiotherapy, physiotherapy, reflexology (acupuncture).
In order to prevent sympathoadrenal krizov appointed Bellataminalum, pirroksan, Grandaxinum, antidepressants (amitriptyline).
When neuroendocrine disorders (disorders of fat and carbohydrate metabolism) recommended diet, inhibiting or stimulating hormones (ACTH - ACTH and glucocorticoid prednisolone, dexamethasone).
Forecast
The prognosis of this disease is relatively benign.
However, as a rule, hypothalamic syndrome results in reduced work capacity. Such patients assigned to third, less common Group 2 disability. They are contraindicated in night work, physical and mental strain.
Hypothalamic syndrome puberty passes to 20-25 years with proper correction.