Encephalopathy is a diagnosis that is causing well-founded concern for the man he was exposed. Especially true this statement is in relation to the parents of the child whose card appears the word "encephalopathy".
The content of the article:
What is encephalopathy?Encephalopathy is a syndrome that can be caused by many diseases. When encephalopathy affected brain cells, resulting in impaired functioning. Encephalopathy often has a slow progression and responded well to therapy. A fundamental factor in successful treatment is the effect on the cause that led to the violations. Although not every encephalopathy ends happily. So, hepatic, diabetic or toxic its shape can result in coma and death of patient.
The brain after 6 minutes after submission to him of oxygen ,begins to die. Also, this organ is very sensitive to the toxic influence of any pathogenic factors. On the background of acute or chronic lack of oxygen its cells begin to die, which affects the functioning of the brain.
Anoxia may be caused by the following factors:
- The cessation of the heart.
- Discontinuance of the lungs.
- The cerebral circulation for a long time.
Factors leading to toxic effects on the brain:
- The intake of substances that contribute to intoxication. It can be alcohol or drugs.
- Production of toxins by the body, for example, against diseases of the liver, kidneys, severe infections.
Negative impact on the functioning of the brain is capable of any factors resulting in the failure in the body.
There are several forms of encephalopathy:
Hypoxia, which develops when there is insufficient supply of brain with oxygen. Hypoxic encephalopathy includes the following subtypes: postoperative, perinatal and efficicency encephalopathy.
Toxic, which develops on the background of poisoning the body with toxic substances, alcohol, drugs.
Vascular, which develops on the background of circulatory disorders in the vessels of the brain. It includes the following subtypes: hypertensive encephalopathy, atherosclerotic encephalopathy, venous encephalopathy.
Toxic-metabolic, which develops when the intoxication of the brain by the breakdown products of metabolism. It distinguished the following subtypes: bilirubin (triggered hemolytic disease in newborns), liver (triggered by cirrhosis or hepatitis of the liver), uremic (triggered by renal insufficiency), hyperglycemic and hypoglycemic (triggered by diabetes).
PTSDthat develops on the background of brain damage. It can be delayed in time.
Radiationthat develops after the person has suffered exposure to ionizing radiation.
Perinatal encephalopathy in children (PEP)PEP or ischemic encephalopathy is characterized by impaired functioning of the brain, which occurs due to the influence of negative factors on the foetus from 28 weeks of pregnancy or during childbirth or in the first 8-10 days of baby's life.
There are three degrees of severity of PEP: heavy, medium and light.
Depending on the timing of recovery are distinguished: the acute phase (up to months), early recovery period (3-4 months) and late recovery period (12-24 months).
Statistics vary widely, according to information received from various sources, such diagnosis is put up 30-70% of newborns.
Causes of perinatal encephalopathy
Causes of AEDs in a child:
During fetal development he has been under the influence of negative factors. It can be a chronic disease of the mother, such as diabetes, kidney inflammation, heart disease , etc. the Negative impact of past infectious diseases (tuberculosis, influenza, rubella), the presence of harmful habits in women, a strong emotional shock. Encephalopathy can develop in children,whose mothers suffered from early or late toxicity from chronic placental insufficiency. It is possible that the fetus is exposed to infection during fetal development, or had a threatened miscarriage.
- The child was influenced by negative factors for yourself during birth. In this respect, the danger is birth asphyxia, prolonged residence time of the fruit without water, infection of amniotic fluid, the penetration of amniotic fluid into the respiratory tract of the baby, prolonged or too rapid labor, early detachment of the placenta.
- The child was subjected to negative influences in the early postpartum period. It could be an infection of a baby, surgery, hemolytic disease of the newborn.
Symptoms of perinatal encephalopathyThat baby develops encephalopathy, will specify the following symptoms:
Mild encephalopathy: irritability, prolonged and frequent crying spells, refusal of the chest, short sleep, frequent awakenings and regurgitation, increased or decreased muscle tone, strabismus.
- Moderate: impaired motor function, depression of the nervous system, increased muscle tone, hydrocephalus, convulsions. All these symptoms may be presented as a package, or separately. Muscle tone first will be low, and then rises, the baby will always keep his hands close to the body. Often the children have strabismus, outward bulging fontanel, excessive pallor of the skin, the sleep is disturbed by sklikivanie, a baby crying a long, shrill and monotonous.
- Severe: the baby is in a coma or precomatose condition.
Immediately after the birth of each child examined by a neurologist and a optometrist. It is also possible to examination by a neurosurgeon, but only if they have reason.
Tests that allow to confirm, probe:
- Lumbar puncture with a fence of cerebrospinal fluid.
- KOS – blood acid-base state
- Blood gas composition.
- Duplex scanning of vessels of the head.
- Skull x-rays.
- CT or MRI of the brain.
Naturally, a full range of diagnostic procedures is not possible, carry them out as necessary.
When the baby is discharged home from the hospital after 2 months, it will be examined by the neurologist. Later the growing child will be speech therapist, psychologist and psychiatrist. Although, if the encephalopathy is mild, the need for taking these professionals out.
Treatment of perinatal encephalopathyIf the child revealed PEP, the treatment should be commenced without delay, it is reduced to the following activities:
The child is administered anticonvulsant drugs, drugs to improve the metabolic processes in the brain, the removal of intoxication. It can be drugs such as: Pantogamum, Cinnarizine, Solkoseril, Phenibut, Actovegin, Piracetam, etc.
To reduce intracranial pressure prescribe the following drugs: Diakarb, Mannitol.
When the acute encephalopathy is resolved, perhaps the passage of physiotherapy. Good effect gives massage, therapeutic exercise, manual therapy, swimming, acupuncture.
What is dangerous AEDs?
If encephalopathy was mild, it goes unnoticed for a child. Perhaps the development of hyperactivity, increased distraction, difficulty focusing, and so the symptom is called SGD or syndrome of hyperactivity and attention deficit.
If encephalopathy was leaking hard, it is possible that a backlog of child mental and psychomotor development, the formation of asthenic-vegetative disorders.
The most dangerous and severe consequences of encephalopathy are: hydrocephalus, epilepsy and cerebral palsy.
Long-term effects of AEDs. If a child at an early age moved encephalopathy, then in the future he may develop vascular dystonia. It is not excluded migraines, epilepsy. All these effects are manifest in adolescence.
PEP can be felt in adulthood, high risk of the development of early stroke.
The diagnosis of vascular encephalopathy may also sound like DEP or discirkulatorna encephalopathy. Revealed this condition most often in people of senile age. People who reach 70 years, face DEP very often. Almost every 5 man on reception at the doctor indicates the characteristic symptoms.
To vascular encephalopathy can lead to various causes, among which are:
In 60% of cases atherosclerosis of carotid arteries and atherosclerotic disease of the aorta contributes to the formation of atherosclerotic forms of encephalopathy.
Consistently high blood pressure is a prerequisite for the development of hypertensive encephalopathy.
- Venous thrombosis, pulmonary disease cardio-pulmonary insufficiency – all these pathologies become the basis for the formation of venous encephalopathy.
Combined form of vascular encephalopathy develops after the transferred stroke, chronic heart failure, disorders of cardiac rhythm, on the background of cervical degenerative disc disease or diabetes.
Symptoms of DEPDepending on how long the patient develops vascular encephalopathy, the symptoms will vary:
At an early stage of development of encephalopathy, this syndrome is disguised as fatigue. A person usually begins to get tired and faster, becoming more irritable, his mood swings. Day so sick I want to sleep, and at night they can't relax, suffering from insomnia. Memory worsens, it becomes difficult to focus their own attention, recurring dizziness, before the eyes can appear small outbreaks.
- Progression of encephalopathy, neurologic symptoms manifest more strongly. The gait becomes shaky, loss of stability, during the movement of the man begins shuffling feet, joined by a hand tremor, muscle are increased tone. Urination becomes impossible to control. Mental disorders are expressed in the increased tearfulness and resentment, perhaps aggression. The memory of the patient is disturbed, which affects the quality and volumeperformed mental work.
- The last stage of encephalopathy is reflected in the fact that the patient loses the ability to navigate in space and time, severely affecting the mental development, there are gross violations of the psyche. A person loses the ability to work can not independently to care for themselves.
Diagnosis of DEPTo make the correct diagnosis the doctor prescribes the patient the following tests:
The blood General and biochemical analysis determination of level of sugar and cholesterol in the blood.
- The delivery of urine for General analysis.
- The holding REG for information about the vascular system of the brain.
- An ECG and heart ultrasound.
- Performing duplex scanning of the carotid arteries, intracranial arteries and veins.
- MRI of the cervical spine, radiography of the spine.
- MRI of the brain.
Treatment of DEPThe treatment of vascular encephalopathy begins with identification of the causes of the disease.
To lower blood pressure shown drugs such as Concor, Hartel, Prestarium, etc.
To reduce the level of cholesterol in blood, a dose of Atorvastatin, Rosuvastatin, etc.
As diuretics medicines used Diakarb, Lasix, Indapamide.
If the patient has diabetes, he shows the diet and holding insulin.
To improve cerebral blood circulation it is necessary to apply such preparations, as: Cavinton, Cinnarizine. Contribute to the improvement of metabolic processes in the brain such drugs as Piracetam, Nootropil, Pantogram, Narox, Cerepro, etc. To maintain the health take antioxidants Actovegin, Mexidol, vitamin E, Solkoseril, vitamin C and e Therapy may continue for several months.
Encephalopathy on the background of the injuryTraumatic brain injury can lead to the development of encephalopathy, and it does not depend on age or gender. It can develop as soon, and after a few months oreven years after the incident. Encephalopathy in varying degrees manifests itself in 80% of people who received a concussion or some injury.
If a person has received brain concussion mild, to the development of encephalopathy such injury will not result. As a rule, the development of this syndrome can cause the shaking of 2 degrees of severity, concussion, fractured skull and crushing the brain. Most often such injuries people get in car crashes, during fights, after a fall from a height.
Symptoms of post-traumatic encephalopathy
That after injury a person develops encephalopathy, will specify the following characteristics:
- Severe headache, nausea, constant desire to sleep. Analgesics allows you to ease the pain only for a short time period, but they can be completely eliminated with the change of body position.
- Possible loss of consciousness.
- The person begins to suffer from vertigo, he had frequent falling, gait changes.
- Suffering with memory, attention, reaction speed, lost the ability to analyze and reasoning.
- Patients become depressed, they become apathetic and lethargic.
- Typical seizures.
Treatment of post-traumatic encephalopathy
To identify evolving encephalopathy, the patient should undergo an MRI. Auxiliary diagnostic methods are x-ray, electrocardiogram, blood tests.
Immediately after injury, the patient should be hospitalized. When he will be discharged from the hospital, he needs to come on reception to the neurologist. If encephalopathy is manifested acutely, the patient again hospitalitynet.
For the treatment of injuries administered antioxidants, cardiovascular drugs and nootropics.
Toxic encephalopathyWhen toxic encephalopathy the brain is damaged by toxins, which enter it from the outside or are produced by the body.
Lead to the development of toxic encephalopathy is capable of the following reasons:
- Hemolytic disease, receiving the woman of drugs or alcohol during pregnancy, treatment with anticonvulsants, neuroleptics or antidepressants. All these factors contribute to the development of toxic encephalopathy in a newborn.
Poisoning drugdrugs, alcoholic beverages, inhalation of gasoline vapors or mercury. These factors can trigger the development of encephalopathy in infants and adolescence. At the age of 3 brain cells can get hurt even with the flu, intestinal infection or SARS. This is called neurotoxicity.
- People of Mature age often suffer from encephalopathy on the background of poisoning with carbon monoxide, lead, manganese, mercury, gasoline, pesticides, drugs. If a person frequently abuses alcohol, then it becomes an additional risk factor in the development of toxic encephalopathy. This statement is especially true for low-quality alcohol.
The symptoms of toxic encephalopathy
Neonatal jaundice is commonly observed, approximately 65% of children born. The bilirubin in the blood rises to high elevations in no more than 1-5% of children. It was from these kids developing toxic encephalopathy.
It will specify the following symptoms:
- Lethargy of the newborn;
- Disorders of reflexes;
- Impairment of respiratory function;
- Cardiac activity;
- Spasm of the occipital muscles;
- Loud cry of a baby.
If the baby develops a severe form of the disease, he can fall into a coma. Encephalopathy on the background of poisoning with opioids or drugs a baby develops in a similar clinical picture.
If older child or an adult was subjected to acute poisoning with poisons, then it occurs a state of mild stupefaction and lethargy. Also possible seizures, depression of respiratory functions, disturbances in the circulatory system. If a strong poisoning people are killed.
If the poisoning is chronic, it is expressed by the following symptoms:
Nausea and vomiting.
- Jumps in blood pressure.
- Uncontrolled acts of defecation and urination.
- Violation of the sensitivity.
Delirium, aggression, seizures, fainting – all these symptoms are typical of severe brain damage by toxic substances.
If a person has encephalopathy develops on the background of acute poisoning with alcohol, it is characterized by the following symptoms:
- Hallucinations, both visual and sound.
- The refusal of food.
- Care in your own consciousness, disconnected from the real world.
- Muscle weakness.
- The impossibility of independent movement in space.
If the disease has a rapid course, then after 3-5 days comes a coma, and the person dies.
Encephalopathy on the background of chronic alcohol poisoning is characterized by the following symptoms:
- The intensification of anxiety.
- Depressed mood.
- The sleep disturbance.
- Tremor of eyelids, tongue, hands.
- The weakening of the will.
- Deterioration of mental activities.
- Loss of consciousness.
When alcohol reaches the terminal stage, there is degradation of the personality, dementia.
Treatment of toxic encephalopathy
To find out what substance the poisoning of the body, the patient to take blood and urine for analysis. To determine the extent of brain damage demonstrates a CT or MRI.
Bilirubin encephalopathy requires transfusions of blood plasma to the baby, taking nootropics, and antioxidants.
When poisoning of the body acute or chronic nature of developing encephalopathy, the patient is prescribed cardiovascular drugs and nootropics. The patient should be hospitalized. Alcoholism require the interaction of the patient with the psychiatrist.
What is dangerous encephalopathy?Prognostication of patients with encephalopathy rather problematic task. The human brain is designed so that it is available for extensive compensation.
However, if the syndrome is severe, the following complications may occur:
- In 10-15% of people in old age, developing dementia, or senile dementia.
- In 11-20% of cases develop epilepsy after suffering post-traumatic encephalopathy.
- The baby, suffering from bilirubinemia encephalopathy can have problems with vision, hearing, not excluded mental retardation and paralysis.
If the brain has suffered greatly, it develops edema, coma and death of the patient.