Pathological damage to the brain due to the death of nerve cells is called encephalopathy. It is caused by a lack of oxygen in the brain tissues and impaired blood supply. This pathology is not a separate disease. It includes several types. The article deals with the causes, symptoms, diagnosis of encephalopathy. We will also talk about the treatment of various types of ailments related to this prefabricated concept.
Types of encephalopathy
There are several forms of this pathology:
- hypertensive;
- progressive vascular leukoencephalopathy with and without hypertension;
- same multifocal;
- discirculatory;
- toxic;
- Wernicke.
The last variety occurs with toxic brain damage due to a lack of vitamin B1.
The types of encephalopathy are discussed below in more detail.
Residual view
She is tagged aspersistent neurological deficit, manifested as a result of the action of ailments or various pathological factors. This type of cerebral encephalopathy is characterized by the following symptoms:
- mental disorders;
- fatigue;
- decrease in intelligence;
- cognitive functions;
- fainting;
- vegetovascular dystonia;
- pyramidal reflex insufficiency;
- paresis;
- headaches.
Often, in the diagnosis, it is confused with a mental illness, prescribing symptomatic treatment.
This type of encephalopathy also occurs in children. Her reasons in this case are as follows:
- hereditary mutations;
- congenital brain anomalies;
- vaccination;
- birth traumas and bruises;
- ischemic, neonatal hypoxic, perinatal brain lesions.
The danger of the disease lies in the fact that the initial symptoms may appear early, and the pathology itself will manifest itself in a few years.
Alcoholic encephalopathy
This is a severe form of psychosis, which mainly develops in the third stage of alcoholism. This type of encephalopathy occurs mainly in adults. Under this name, several diseases with similar etiology and clinical pictures are combined. In addition to mental symptoms, there are somatic and neurological symptoms.manifestations. The disease can be acute and chronic. Between them there are transitional types. Usually, people who have this disease have ever used alcohol substitutes.
Discirculatory (vascular) encephalopathy
In this case, there is an organic lesion of a non-inflammatory nature of the brain, which occurs due to circulatory failure in this organ. The main reasons for its occurrence are as follows:
- pathology of cerebral vessels;
- injuries and tumors;
- infection.
According to etiology, the following types of dyscirculatory encephalopathy are distinguished:
- venous - there is a deterioration in brain function due to edema, which develops as a result of obstruction of the outflow of blood;
- hypertensive - may appear at an early age, there is an exacerbation of the disease during hypertensive crises, the pathology can progress, while memory and intelligence are disturbed up to deep dementia;
- atherosclerotic - the most common form with deterioration of brain function as the disease progresses;
- mixed - combines features of the second and third types.
By the nature of the course, this type of cerebral encephalopathy can be galloping (rapidly progressive), remitting, classic (slowly progressive).
Post Traumatic Encephalopathy
It occurs due to moderate or severe brain injury. This type of encephalopathy is accompanied bydisorders such as neuropsychological and behavioral disorders. This is observed:
- loss of control over behavior;
- impaired attention, memory;
- same with thinking.
These symptoms do not appear immediately, but after a certain time interval after the cure. A person begins to notice that he does not have enough wit and strength to solve important problems.
Patients report:
- neurological disorders;
- sexual problems;
- insomnia;
- epileptic seizures;
- excessive aggressiveness.
Toxic encephalopathy
With it, there is diffuse organic brain damage that develops as a result of chronic occupational neurointoxication or acute poisoning with neurotropic poisons, which are severe.
At the initial stage of this type of encephalopathy, the following symptoms are noted:
- sleep disorder;
- general weakness;
- fatigue;
- memory loss;
- dizziness;
- constant headaches.
When asthenia occurs diffuse organic symptoms:
- disappearance or weakening of skin reflexes;
- anisoreflexia;
- high tendon reflexes;
- slight hypomimia;
- language deviation;
- asymmetry of facial innervation;
- reflexes of oral automatism.
At the same time, psycho-emotional disorders are also noted:
- expressed emotionallability;
- depressed mood;
- unmotivated anxiety;
- apathy;
- retardation;
- slowness;
- decrease in mental performance, attention and memory.
Hypertensive encephalopathy
In this disease, there is a slow progression of focal and diffuse damage to the substance of the brain, which occurs due to impaired blood circulation due to prolonged uncontrolled arterial hypertension. Further development of the pathology may be associated with the addition of cerebral atherosclerosis to it, which leads to mixed dyscirculatory encephalopathy. Other concomitant factors also have a damaging effect on blood vessels:
- smoking;
- lipid metabolism disorder;
- diabetes.
There are three stages of this disease. On the first of them there are subjective complaints, and on 2 and 3 neurological syndromes appear:
- violation of emotions, intellect, memory;
- extrapyramidal, manifested by slowness of movement, muscle rigidity, hypomimia, tremor of the fingers and head;
- pseudobulbar, in which there are choking when swallowing, violent crying and laughter, slurred speech;
- vestibulocerebellar, manifested in instability when walking, staggering, dizziness.
Hypoxic ischemic encephalopathy
This condition is destructive and common. It happens due toimpaired oxygen supply to the brain due to respiratory failure or hypotension.
Below we consider what it is - encephalopathy of the brain and the causes in relation to the species in question.
She is called:
- carbon monoxide poisoning, depressant breathing and cardiovascular function;
- pathologies leading to respiratory failure (epilepsy, traumatic and vascular lesions of the brain) or paralysis of the respiratory muscles, which causes heart failure;
- asphyxia observed when a foreign body enters the trachea, it is squeezed with a surgical swab or hemorrhage, aspiration of blood or vomit, strangulation, drowning;
- traumatic and infectious shock;
- cardiac arrest;
- hemorrhage with circulatory collapse and shock, in which the blood supply to the brain is affected first, and then breathing;
- myocardial infarction.
Circulatory encephalopathy
With it, there is a progressive dynamics in the brain tissue and the formation of a pseudo-neurasthenic syndrome. Transient perinatal encephalopathy leads to episodic circulatory disorders in the brain, which can cause complications:
- attacks of cerebrovascular disease;
- hypertensive cerebral crises;
- transient ischemic attacks.
Hypoxic encephalopathy
Under this term they combine a group of pathologies of the central nervous system and the brain associated with oxygenstarvation of the latter. They may occur due to the course of certain diseases or with a lack of this element in the surrounding air.
The following symptoms are noted:
- hyperexcitability;
- dizziness;
- increased intracranial pressure;
- headaches;
- memory and sleep disorders.
This disease can lead to complications:
- mental retardation, including mental retardation;
- neuropathy;
- myelopathy;
- epilepsy;
- CP.
The residual encephalopathy discussed earlier is a variant of this species.
It is mainly caused by the following reasons:
- brain hypoxia and intrauterine infections during childbirth;
- cephalohematomas due to birth trauma.
With a lack of oxygen in the amount of 50% or more, severe consequences can occur for the development of the child.
Types of encephalopathy in children
They may have this disease immediately after birth, in which case it is called perinotal, or at an older age, usually after three years - residual.
The symptoms of cerebral encephalopathy depend on the causes that cause it. Newborns are characterized by the following types of pathology:
- Wernicke's encephalopathy - the death of brain cells occurs due to a lack of nutrition of their B vitamins;
- hypertensive - noted with impaired functions of the adrenal glands and kidneys, frequent increase in blood pressure;
- toxic - may occur when newborns develop jaundice, hemolytic disease and other consequences of exposure to various pollutants;
- small focal leukoencephalopathy - brain cells are affected after suffering encephalitis or meningitis;
- post-traumatic - appears as a result of birth trauma;
- discirculatory - is formed due to a violation of the outflow of blood from the brain.
Illness can be due to several reasons.
Reasons
The main risk factors in newborns are:
- neuroinfections;
- difficult opening of the birth canal;
- umbilical cord entanglement;
- high fetal weight;
- preterm birth;
- complicated pregnancy;
- pathology during pregnancy.
Acquired encephalopathy is caused by:
- vegetovascular dystonia;
- diabetes mellitus;
- ischemia;
- atherosclerosis;
- liver failure;
- tumors;
- traumatic brain injury;
- vascular changes in the brain;
- intoxication of the body;
- infection.
At birth, one child may have a strong body that allows the central nervous system to recover quickly, while the other, due to the presence of various problems, does not allow it to return to normal.
Symptoms
The types of encephalopathy and their distinctive features were discussed above. Each of them has its own characteristics. However, there are also common symptoms. To them in the early stagesinclude the following:
- vegetative disorders;
- discoordination;
- presence of pathological pyramidal and oral reflexes;
- increased tendon reflexes and muscle tone;
- decrease in hearing and visual acuity;
- nystagmus;
- irritability, unstable mood, general weakness;
- tinnitus;
- diffuse headaches;
- general fatigue;
- daytime sluggishness;
- sleep disorder;
- difficulty changing activities;
- decrease in short-term memory, mental performance.
They can progress with the development of the pathology with which encephalopathy accompanies.
In advanced stages, the following neurological syndromes may occur:
- pseudobulbar;
- parkinsonian.
Some patients get mentally upset. With cerebral edema, significant microcirculation disorders, general brain damage, the following symptoms appear:
- staggering;
- dizziness;
- vision disorder;
- nausea and vomiting;
- severe headache, localized mainly in the occipital region;
- general concern.
The latter is replaced by lethargy and, possibly, clouding of consciousness.
In acute renal, pancreatic, hepatic encephalopathy, seizures and disturbances of consciousness can be observed. With exacerbation of chronic pneumonia, infarctiona similar disease, pulmonary embolism, the following clinical picture is observed:
- sometimes convulsions;
- mental disorders;
- paresis;
- nystagmus;
- nausea and vomiting;
- intense headaches.
The most common symptoms of encephalopathies are:
- depression;
- dizziness;
- headaches;
- lack of initiative;
- disorders of consciousness and memory.
Patients often have general weakness, poor sleep, tearfulness, distraction, irritability, fatigue. When examining them, difficulty in pronouncing certain words, daytime sleepiness, narrowing of the circle of interests and criticism, verbosity, viscosity of thought, apathy can be detected.
Diagnosis
The state of memory, coordination of movements are checked, psychological tests are carried out. Before determining how to treat encephalopathy, a correct diagnosis of the pathology must be made.
The following tests may be ordered to make a diagnosis:
- autoantibody test for the underlying pathology of dementia caused by antibodies that destroy neurons;
- encephalogram, EEG with brain dysfunction;
- doppler ultrasound for abscesses and abnormal blood circulation in tissues;
- MRI and CT for infections, anomalies of anatomy and brain tumors;
- determination of creatinine content to detect kidney function;
- drug and toxin levels;
- metabolictests: the amount of liver enzymes, the level of ammonia and oxygen, lactic acid, glucose, electrolytes in the blood;
- determination of blood pressure;
- general blood test (definition of infections).
Treatment
With therapeutic methods, in many cases it is only possible to slightly stabilize the patient's condition. Below is how to treat encephalopathy.
Complex treatment includes the following drugs:
- adaptogens;
- vitamins;
- nootropics;
- drugs that improve cerebral circulation.
In addition, additional healing methods are used.
Treatment of encephalopathy disease is aimed at eliminating the symptoms and the pathology that led to brain damage.
In case of severe acute illness, the following methods are used:
- parenteral nutrition;
- hemodialysis;
- ventilation;
- hemoperfusion.
Also prescribed drugs that prevent the development of seizures, improve cerebral circulation, reduce intracranial pressure.
Also assigned:
- reflexology;
- breathing exercises;
- physiotherapy.
The following shows how to treat types of cerebral encephalopathy in their acute forms. In these cases, life support systems are used:
- long-term parenteral nutrition;
- hemoperfusion;
- artificial lung ventilation;
- hemodialysis;
- reduce seizures;
- reduce intracranialpressure.
In the future, drugs are prescribed that improve brain metabolism:
- biostimulants: vitreous body, aloe extract;
- antiplatelet agents: "Pentoxifylline";
- folic and ascorbic acid;
- angioprotectors (if necessary): Sermion, Cavinton, Parmidin, Xanthinol nicotinate, Cinnarizine;
- tocopherol;
- vitamins A and group B;
- lipotropic compounds: "Lecithin", "Essentiale";
- amino acids: glutamic acid, methionine, alvesin, cerebrolysin;
- nootropic core: Piracetam, Pyriditol.
Drugs are used in combination. One course lasts from one to three months. Surgery may also be required to normalize cerebral blood supply.
The prognosis depends on the possibility of specific therapy, the degree of brain damage, the dynamics of the disease that provoked the appearance of encephalopathy.
In closing
There are different types of encephalopathy. They differ in causes and symptoms. The disease can be congenital or acquired. The first of these is mainly associated with birth trauma. The danger of encephalopathy and its types lies in the fact that they can lead to various neurological and mental problems, the development of epilepsy, lethargy, apathy, and vegetative vascular diseases. Proper diagnosis is necessary to prescribe adequate treatment. In many cases, therapeutic treatment leadsonly to relieve symptoms.
