Encephalopathy called dystrophic lesions of brain tissue common character as a result of various factors - infection, intoxication, disorders in the metabolism.
Causes
The main cause of encephalopathy - a chronic brain hypoxia resulting from various pathological factors.
Hypoxia or oxygen deficiency - leads to disruption of normal metabolism of brain tissue disruption in the power supply and death of nerve cells, disabling operation of certain areas of the brain.
Kinds
All encephalopathy can be divided into two large groups - congenital and acquired.
Congenital forms may occur as a result of genetic metabolic disruptions due to defects brain development or the impact of damaging factors during pregnancy (hypoxia, infection) or during childbirth (birth trauma, bruises, hemorrhage).
Acquired encephalopathy occur throughout life from infancy to old age, can be caused by different factors, they are divided into several groups.
- traumatic - are the consequences of traumatic brain injury, open and closed fractures skull
- toxic encephalopathy, arising as a result of brain damage neurotropic toxins (alcohol, methyl alcohol, chloroform, lead)
- toxic and infectious - brain damage by bacterial toxins (tetanus, botulism)
- beam, resulting in lesions of brain tissue to ionizing radiation
- metabolic, in hepatic or renal insufficiency, diabetes diabetes due to oscillations of glucose
- encephalopathy due to violation of the water-salt balance (due to cerebral edema or dehydration), acute blood loss
- vascular, due to chronic disorders of blood circulation (causes could be atherosclerosis, arterial hypertension, Venous stasis)
- Medicinal encephalopathy, toxic alternatively, overdose or poisoning by medicaments.
The symptoms of encephalopathy
Manifestations of encephalopathy can be extremely diverse, depending on the cause of its occurrence. The degree of symptoms scrolled on the depth and extent of brain damage, disease duration and sopustvuyuschih health disorders.
Most early signs of encephalopathy may include:
- decrease in mental abilities, IQ coefficient
- difficulty in performing intellectual tasks, brainteasers, which previously handled the patient easily
- loss of memory as a short-term (forgot where he was going) and long (can not remember the events of past years)
- there can be significant difficulties in performing multi-tasks
- difficulty in changing the activity where you need to think fast and act
- sleep disturbances and its depth, insomnia, daytime sleepiness, nightmares, snogovorenie, sleep walking
- daytime fatigue even when the usual activity
- exhaustion with stress
- general fatigue under all load conditions.
Often, when encephalopathy there are complaints of persistent headaches diffuse nature of the noise in the ears seizures, malaise, irritability for no reason, constantly depressed mood.
Patients often say to the doctor, they have double vision, reduced vision and hearing, especially in the evening or in the during loading, can be detected episodes toning muscles of the body and limbs, enhanced tendon reflexes (especially knee).
When encephalopathies can be detected irregularities in the limbs, disorders of the cerebellum work as a violation gait instability, especially with eyes closed, there may be problems with speech - slurred, feeling Zapletal language.
Can join autonomic disorders - heart attacks with shortness of breath and a feeling of lack of air pressure fluctuations, severe sweating, pallor, syncope and marbling of the skin, disorders thermoregulation.
encephalopathy manifestations may be progressive and not progressive, in the later stages may develop parkinsonism or brain damage cores with a sharp violation of basic life support functions (breathing problems, paralysis).
Most of the patients with encephalopathy accompanied by mental disorders in the form of hallucinations, delusional disorders, depression, etc.
Symptoms of acute encephalopathy
Separately allocated acute encephalopathy - they occur resulting heavy, massive and significant brain damage, circulatory disorders and cerebral edema.
Acute encephalopathy manifests severe headache in the neck and general anxiety, nausea with vomiting, vision problems, dizziness, numbness of fingers and toes, face, tongue. As progressirvaniya going oppression of consciousness, lethargy, can be convulsions, paresis.
Diagnostics
The basis of diagnosis in suspected encephalopathy - is the original state of health - data that have chronic disease, diabetes, toxic, etc.
Supplemented with data examination of a neurologist with the definition of neurological symptoms, disorders in the motor area, the sensitivity and the higher nervous activity.
If you suspect that encephalopathy is needed:
- examination ophthalmologist to determine the state of the fundus
- clinical tests - blood, urine, biochemistry Blood on the testimony, with the identification of inflammatory, toxic, allergic and other nature of the lesion
- conducting diagnostic tool
When electroencephalography may be detected abnormal wave epileptic activity rhythms and disorganization. In carrying out CT and magnetic resonance scan revealed signs of brain atrophy.
In secondary encephalopathy that occurs as a symptom of other diseases that must be specific examination of the main disease.
encephalopathies treatment
Treatment encephalopathy engaged neurologists together with specialists in those diseases that caused it (endocrinology, urologists, gastroenterologists, cardiologists, pediatricians).
First of all, in the treatment, there are two directions - the elimination of the causes of encephalopathy, and the fight against manifestations.
In acute encephalopathy requiring hospitalization in intensive care with hemodialysis, mechanical ventilation, detoxification. Conducted combat brain swelling, seizures, and vascular disorders.
With the improvement of prescribers that improve brain function - nootropnye (Piracetam, Nootropilum), amino acid (glutamic gistota, glycine), Essentiale, lecithin, and vitminy metabolites.
If necessary, appointed by the cardiovascular drugs pikamilon, cavinton, cinnarizine.
The tendency to thrombosis is used antiplatelet agent (pentoksifilin aspirin) and stimulators - aloe.
Courses of treatment lasting up to three months in a row.
Complications and prognosis
Encephalopathy can be complicated by development of coma, seizures, stroke, and mortality in the future may remain with organic lesions movement disorder, muscle tone and speech.
Prognosis depends largely on the causes of encephalopathy, and the degree of brain damage. In most cases, you can only stabilize, but does not completely eliminate the effects.
