Somatoform disorder (autonomic dysfunction)
Somatoform disorder (autonomic dysfunction), which occurs on the background of the body's endocrine rearrangements in adolescence, is clinically inadequate vegetative regulation. Typical manifestations of the smatoform disorder syndrome (autonomic dysfunction) - is the vegetative disturbances on the background light or expressed by endocrine disorders, blood pressure fluctuations, orthostatic syndromes or fainting, emotional instability, disorders of thermoregulation). Women during menopause smatoform disorder (autonomic dysfunction) manifests emotional dysfunction with characteristic tides, hot flashes and profuse sweating may occur, and autonomic-vascular paroxysms.
When somatoform disorder (autonomic dysfunction) in the first place as the most labile and vulnerable, suffering cardiovascular system. The clinical picture of irregularities in somatoform disorders (autonomic dysfunction):
- pain in the left side of chest
- sleep disorder
- paresthesia (tingling or itching) in the limbs
At the same time can be autonomic skin disorders, dyskinetic syndrome, gastro-intestinal tract and breach of thermoregulation (cold hands and feet from sweating).
The objective symptoms of somatoform disorder (autonomic dysfunction) are: the lability of heart rate (tachycardia with little physical exertion), a tendency to increase (hypertonic type) or decrease (hypotonic type) blood pressure lability vasomotors (persistent red, or, on the contrary, white dermographism, sharply positive Inverse or orthostatic test), cold hands and feet.
In addition, there may be a so-called "respiratory syndrome", which is a feeling of "respiratory corset," shortness of breath, shallow breathing with a restriction inhalation. Hypertensive type of somatoform disorder (autonomic dysfunction) is characterized by a rise in blood pressure of 140 / 90-170 / 95 mmHg. Art. and often expressed paroxysmal tachycardia, prevalence sympathoadrenal reactions, and hypotonic type of somatoform disorder (autonomic dysfunction) (neurocirculatory or dystonia) - reduction in blood pressure to 100 / 50-90 / 45 mm Hg. Art. with a predominance of vago-insular reactions.
The clinical picture of somatoform disorder (autonomic dysfunction) complement fatigue, decreased performance, fainting, and the presence of paroxysms (attacks). One of the major factors in the pathogenetic mechanism of somatoform disorder (autonomic dysfunction) - is excessive formation of catecholamines and lactic acid. Accumulation of the latter plays a major role in the development of cardiac syndrome and attacks (paroxysms) somatoform disorder (autonomic dysfunction).
It is considered more legitimate to consider somatoform disorder (autonomic dysfunction) within less independent form of the disease as a syndrome. Factors causing disease somatoform disorder (autonomic dysfunction), it's best to group as follows:
- constitutional nature
- endocrine reorganization
- primary lesion of visceral organs
- primary disease of the peripheral endocrine glands
- organic lesion of the brain
Somatoform disorder syndrome (autonomic dysfunction) constitutional nature manifests itself in early childhood and is characterized by instability of the autonomic parameters. Patients are noted:
- rapid change of skin color
- fluctuations in heart rate and blood pressure
- gastrointestinal pain and dyskinesias
- tendency to subfebrile condition
- poor tolerance of physical and mental stress
Often these disorders in somatoform disorders (autonomic dysfunction) are family-hereditary character, and with the right upbringing of patients with age reach the famous compensation, although life remain vegetative asthenic.
Types of manifestations in somatoform disorder (autonomic dysfunction)
Sympathoadrenal (sympathetic) crisis in the somatoform disorder (autonomic dysfunction) develops suddenly, there are pains in the heart or headaches, sometimes feeling of shock, heart beat, feeling cold, fever, a deadly anxiety. Objectively marked pallor and dryness of skin, tachycardia, increased blood sugar, body temperature and predominantly systolic blood pressure. At the height of the attack (paroxysmal) somatoform disorder (autonomic dysfunction) - numbness, chills, seizure ends polyuria and release of large amounts of urine with low light density, at the end of the attack (paroxysmal) somatoform disorder (autonomic dysfunction) - general weakness, the duration of which corresponds to its severity.
Vagoinsulyarnyh (parasympathetic) crisis at the somatoform disorder (autonomic dysfunction) begins with a sense of bated breath, nausea, chest tightness, shortness of breath, dizziness, falling through, feeling the heat. Objectively, when osmtotre patient with somatoform disorder (autonomic dysfunction) marked hyperemia, humidity, and red spots on the skin, heart rate slows down and becomes weak, blood pressure is lowered. During the attack in the somatoform disorder (autonomic dysfunction) enhanced intestinal peristalsis, in the end - the urge to defecate. Mixed crises in somatoform disorders (autonomic dysfunction) are distinguished succession of symptoms characteristic of sympathoadrenal and vago-insular crises.
Somatoform disorder syndrome (autonomic dysfunction) in the primary lesion of the internal organs include gall and kidney disease, chronic pancreatitis and appendicitis, diaphragmatic hernia. Mechanisms causing autonomic disorders, reduced irritation autonomic receptors that exist in the internal organs. In the case of chronic disease somatoform disorder (autonomic dysfunction) appear first local reflex, and then generalized autonomic disorders. Cure the underlying disease of the internal organ is often linked to improvements in or disappearance of autonomic dysfunction.
Somatoform disorder syndrome (autonomic dysfunction) in primary diseases of the peripheral endocrine glands (thyroid, adrenal glands, ovaries, hormonally active parts of the pancreas) - increased or decreased secretion of these glands results in a violation of the autonomic-endocrine equilibrium. Increased blood levels of hormones (thyroxine, catecholamines, steroids, insulin) or decrease their secretion is a factor contributing to the emergence of autonomic disorders.
Somatoform disorder syndrome (autonomic dysfunction) at an allergy — at an allergy autonomic nervous system is involved in the pathogenesis of autonomic disorders. The well-known role in this regard belongs sympathoadrenal influences. Portion is formed allergy accompany distinct autonomic dysfunction in the form of detailed sympathoadrenal paroxysms.
Somatoform disorder syndrome (autonomic dysfunction) in the pathology of the segmental apparatus of the autonomic nervous system is observed in case of defeat parasympathetic and sympathetic nuclear formations of the brainstem, the lateral horn of the spinal cord, the sympathetic chain, pre- and postganglionic fibers, prevertebral and intramural ganglia. The most common process involves preganglionic fibers at the level of the anterior roots of the spinal cord in spinal osteochondrosis and vegetative plexus of vertebral artery (posterior cervical sympathetic nerve) with cervical osteochondrosis and defeat the sympathetic chain (ganglionitis, truntsity, sympathetic-ganglionitis) due to influenza infection, chronic tonsillitis, malaria, in addition, with cervical lymphadenitis.
Somatoform disorder syndrome (autonomic dysfunction) under organic brain damage — any form of cerebral pathology escorted autonomic disorders. They are most pronounced in lesions of deep structures: stem, hypothalamus and limbic brain.
At caudal parts of the brain stem lesions often determined vegetatively-vestibular crises that start with vertigo, in the paroxysm of dominate vago-nsulyarnye manifestations.
In the case of brain intermediate structures pathology which are in topographical and in close proximity to a functional connection with the hypothalamus, the main syndromes are:
- neuroendocrine (excluding the primary lesion of the peripheral endocrine glands)
- motivational (hunger, thirst, libido)
- thermoregulatory dysfunction
- abnormal sleepiness (paroxysmal)
- vegetative-vascular crises (most sympathadrenalic)
Damage of the limbic brain (the internal division of temporal lobe) is manifested by primarily temporal lobe epilepsy syndrome. Autonomic dysfunction in this case may be part of the aura. The most characteristic abdominal (pain and discomfort in the epigastric region) or cardiovascular (unpleasant sensations in the heart, arrhythmias) state. Autonomic disorders are often subjective, their symptoms similar to that in the vago-insular paroxysms.
Somatoform disorder syndrome (autonomic dysfunction) in neuroses — special relationship of vegetative and emotional spheres noticed by a person for a long time. This is reflected in the characteristic of psycho-vegetative syndrome. Formation of the psycho-emotional conflict entails neurotic disorders, the most common manifestations of which - vegetative, sleep and emotional disorders.
Autonomic disorders in hysterical, phobic, neurotic neurosis obligate, undifferentiated. They are reflected in all functional systems (cardiovascular, respiratory, digestive, urinary, and others.). Feature of autonomic disorders - polysystemic. React, usually several systems, depending not only on the shape of neurosis, but also on the individual patient. Against the background of the permanent violations often occur, and autonomic-vascular paroxysms expanded character. Dominated sympathadrenalic and mixed, rarely observed parasympathetic.
Often, however, somatoform disorder (autonomic dysfunction) serves not as a syndrome, but as an independent nosological form with various features of the flow. In contrast to the syndrome, this form has no intimate connection with etiotropic factors and its development is more conducive to an innate inferiority of the autonomic nervous system. In many cases, revealed several factors: some of them - predisposing, others - realize the disease.
Clinical symptoms of somatoform disorder (autonomic dysfunction) are diverse, characterized by a predominance of subjective manifestations over the objective.
Somatoform disorder (autonomic dysfunction) diagnosis
Minimally Invasive Neurosurgery Clinic, the only clinic that offers a unique method of complex treatment of somatoform disorder (autonomic dysfunction). To help you, we set ourselves the task of finding and treating the causes of vegetative-vascular dystonia. Therefore, treatment in our clinic brings results. Treatment of somatoform disorder (autonomic dysfunction) involves two steps: diagnostic and therapeutic.
Syndrome somatoform disorders (of vegetative dysfunction) in neuroses occurs in 50% of cases. Neurosis as a disease related to border states and are the competence of psychiatrists. Meanwhile, patients with somatoform disorder (of vegetative dysfunction), especially during the first call, visit a neurologist, who should promptly and properly solve the question of ownership of the syndrome somatoform disorder (autonomic dysfunction) to a specific disease, including the form of neurosis.
Somatoform disorder (autonomic dysfunction) diagnosis consists of three stages:
1. Complete neurological examination and psychotherapeutic and evaluation of previous studies carried out by you, if any were made.
2. During the treatment, it will be held diagnostics of functional systems of the body, which allows you to: determine the level of reserves and the cardiovascular, of vegetative and central regulation, as well as to evaluate the deviation of these parameters from the norm during somatoform disorder (autonomic dysfunction):
- evaluate the level of compensation of energy resources of the body at different levels of regulation
- evaluate the effectiveness of various therapies during medical and preventive measures
- give a comprehensive medical report and recommendations when necessary somatoform disorder (autonomic dysfunction)
- choose a plan and optimize various treatments
- monitoring and forecast of the functional state during rehabilitation
- identify patients who need further clinical examination in specialized medical institutions
- identification of cancer patients, including those in the early stages of the disease
- monitoring and forecast of a psychophysical condition in a neuro-emotional stress and repetitive work
- Individual choice of optimum agents of regeneration at overwork and chronic overstrain: vitamin balance, normalization of sleep, etc.
- evaluate the level of self-regulation of the body during somatoform disorder (autonomic dysfunction)
3. Psychotherapist consultation.
We strive to reduce the costs of our patients, but do not save on diagnostic and therapeutic procedures, if they are really necessary.
If you have the following symptoms:
- dry skin or sweating
- paroxysmal states and crises
- "panic attacks" followed by palpitations, difficulty inhaling / exhaling
- unmotivated rise in blood pressure
- pale skin
- a strong sense of fear
- feeling of suffocation
- sleep disorder
- syncope, followed by hot flashes, nausea, slow heartbeat, change in blood pressure, red spots on the skin, et al., then you should consult a neurologist and psychotherapist.
Somatoform disorder (autonomic dysfunction) treatment
Patients with somatoform disorders (of vegetative dysfunction) under the supervision of a therapist or a neurologist, endocrinologist or psychiatrist, depending on the leading syndrome and defeats the relevant authorities. One person must be considered a major, others - consultants.
Somatoform disorder (autonomic dysfunction) treatment is carried out in complex: etiological, pathogenetic and symptomatic. Glucocorticoids, antibiotics, sulfonamides and other antimicrobial drugs is shown only at the beginning of the disease, when it is possible to establish a direct connection with the transfer of general infection (ARI, influenza, etc.) Or after exacerbations of chronic hearth (tonsillitis, otorinogennye processes, cholecystitis, etc.).
Somatoform disorder (autonomic dysfunction) treatment should be carried of short duration courses. In the residual period of use of these drugs is inappropriate. With traumatic brain injury (in acute and remote periods) should be used dehydrating and absorbable.
The importance of the treatment of somatoform disorder (autonomic dysfunction) is a rational therapy. It must be an individual and aimed at freeing the patient from the excitement of his fortune, to overcome feelings of "doom" and fear. In addition, the patient should acquaint with the methods of autogenous training, general hardening the psychophysical exercise, self-massage.
To eliminate the polymorphic vegetative-vascular disorders, prescribe tranquilizers. The positive effect of somatoform disorder (autonomic dysfunction) give amphotropic means normalizing function. Due to the high meteosensitivity patients with somatoform disorder (autonomic dysfunction) it is recommended to take stugeron (cinnarizine) having antiserotoninovym effect.
At cardialgia and respiratory syndrome advisable to appoint valokordin, validol, valerian, tinctures lily of the valley, hawthorn, adonis. Showing a small dose of beta-blockers and medium-therapeutic doses of antidepressants. They help to improve sleep, mood, reduce hyperexcitability.
In the complex treatment of somatoform disorder (autonomic dysfunction) should include physiotherapy:
- exercise therapy
- electrotherapeutic sleep therapy and others.