Encephalopathy, unspecified - a disease of class VI (diseases of the nervous system), which is included in the block G90-G99 (other disorders of the nervous system) and has a disease code G93.4.
Description of disease
Encephalopathy is a non-localized disease of the brain. It is expressed by the death of nerve cells due to circulatory arrest, oxygen starvation and disease.
To diagnose diseases, specialists need to find out the pronounced location of the lesion, the localization of the disease in the gray or white matter of the brain, as well as the degree of impaired blood flow. If the cause of the disease could not be established, then they call encephalopathy unspecified (idiopathic, that is, arising independently). The most common is vascular.
Causes of disease
Unspecified encephalopathy (ICD-10 diagnosis code G93.4) is classified into two types: congenital and acquired. Congenital is divided into prenatal (when damage occurs even in the womb) and perinatal (in the event that the damaging factor acted in the last weeks before the birth of the baby orright after it). This kind of pathology is called:
- defects, consisting in abnormal processes of brain development;
- metabolic disorders in the body caused by genetic factors;
- if a damaging factor acted on the baby during pregnancy;
- traumatic brain injury that occurs in the baby during childbirth.
Mitochondrial encephalopathy
Mitochondrial unspecified encephalopathy in infants is classified as a separate group of congenital diseases. It is formed as a result of violations of the functions and structures of mitochondria.
Acquired encephalopathy
Acquired encephalopathy is classified into several types due to various damaging factors:
- Post-traumatic is the result of craniocerebral injuries of moderate and severe degree (for example, falling from a height, head injuries in athletes, road accidents, etc.). With this type of disease, various lesions of the nervous tissue of the frontal and temporal lobes, atrophic changes (shrinkage and shrinkage of the brain), hydrocephalus are observed.
- Toxic encephalopathy, unspecified in adults, occurs due to poisoning by various toxins: alcohol, high doses of pesticides, heavy metals, gasoline, etc. It is mainly manifested by various kinds of nervous and mental disorders (insomnia, anxiety, irritability, hallucinations, prolonged headaches, etc.).
- Radiation is the result of ionizing radiation of the body duringradiation sickness. With this pathology, various neurological disorders are observed.
- Metabolic occurs due to metabolic disorders against the background of diseases of internal organs: liver, kidneys, pancreas. It manifests itself depending on the properties of the underlying pathology.
- Vascular encephalopathy. The cause of the occurrence may be addiction to bad habits, old injuries, atherosclerosis, diabetes, radiation exposure and other factors that cause cerebral hypertension. Signs of this type of disease are: loss of structure and integrity of consciousness, frequent headaches, depression, partial loss of one's own memory.
- Hypoxic is the result of prolonged oxygen starvation. Leads to serious neuralgic complications.
And this is not all varieties.
In children
There is an unspecified encephalopathy in children. So, due to traumatic effects in the womb, infections or other causes, residual encephalopathy is diagnosed in older children. The venous form is a particular type of the vascular form, which is manifested by the stagnation of venous blood in the brain due to a violation of its outflow.
Metabolic encephalopathy is divided into several more types:
- Bilirubin found only in newborn babies. It develops against the background of incompatibility of the blood of the mother and fetus, as well as due to infectious toxoplasmosis, jaundice, and diabetes in the mother. Appears commonweakness, decreased muscle tone, poor appetite, belching, vomiting.
- Gaye-Wernicke encephalopathy occurs due to vitamin B1 deficiency. Adverse conditions can develop due to alcohol dependence, severe beriberi, HIV, malignant neoplasms. Mainly manifested by hallucinogenic syndrome, anxiety states.
- Leukoencephalopathy is manifested by a violation of the white matter of the brain. The disease is progressive. Appears after an infection due to a decrease in the protective functions of the body.
- Atherosclerotic develops mainly due to a violation of lipid metabolism in the body. Manifested by increased fatigue, weakness, dizziness, headaches, sleep disorders, isolation.
Scientists say that the cause of any type of unspecified encephalopathy is primarily brain hypoxia (lack of oxygen). This happens due to the fact that the organ begins to be washed with blood worse, excessive venous accumulations, edema, and hemorrhages appear. Anoxic encephalopathy can occur due to the low supply of nutrients to neurons and eventually stand out as a separate disease. Metabolic encephalopathy is a special case of toxic, when toxins are not excreted, as a result of which they penetrate into the bloodstream.
There are several stages in the development of this disease. Specialists distinguish the following of them:
- In the case of the initial or first stage, the patient's memory decreases, heirritable, sleeps poorly and sleeps anxiously, and also suffers from headaches.
- When the second nature of the disease is more pronounced, all symptoms are aggravated. In addition to headaches and sleep disturbances, the patient may complain of apathy and lethargy.
- At the third stage, serious changes in the brain are diagnosed, there are paresis, speech is disturbed, vascular parkinsonism develops.
Symptoms
Manifestations of unspecified encephalopathy vary greatly depending on severity, type, age, and treatment used. As a rule, in the first stages of the disease, sleep disturbances, lethargy, daytime sleepiness, absent-mindedness, tearfulness, lack of interest, increased fatigue, memory loss, mental abilities are noted. Pain, noises and ringing in the head, decreased auditory and visual functions, mood swings, impaired coordination, irritability may also begin to appear.
What symptoms occur as the disease progresses?
In advanced cases, symptoms can progress, resulting in parkinsonism (slow movements combined with trembling of the limbs) and pseudobulbar paralysis (manifested by a violation of speech, chewing and swallowing functions). Also, do not forget that mental disorders (depression, suicidal thoughts, phobias) may develop. Consider how encephalopathy, unspecified G 93.4, is diagnosed in infants and adults.
Diagnosis of encephalopathy, unspecified
In order to correctly establish the form of the disease, the doctor mustcarefully analyze the patient's history for traumatic brain injury, intoxication, atherosclerosis, kidney, liver, lung, pancreatic disease, hypertension, radiation exposure, as well as acquired or genetic metabolic disorders.
To make a diagnosis of encephalopathy, unspecified G 93.4, the following procedures are performed:
- Complete blood count.
- Complete urinalysis.
- Various metabolic tests (liver enzymes, glucose, electrolytes, ammonia, lactic acid, blood oxygen).
- Measuring blood pressure.
- CT and MRI (to detect brain tumors, various anatomical anomalies, infections).
- Creatinine.
- Drug and toxin levels (cocaine, alcohol, amphetamines).
- Doppler ultrasound.
- EEG or encephalogram (to detect brain dysfunctions).
- Autoantibody testing.
These are far from all the tests needed to make a diagnosis. Only the attending physician can prescribe certain tests based on the patient's symptoms and medical history.
Treatment of encephalopathy
Treatment of unspecified encephalopathy is aimed at eliminating the underlying causes and symptoms that gave impetus to the development of this disease. Basically, conservative and medical methods are used for treatment.
If the disease is acute, then treatment in the first placeaimed at reducing intracranial pressure and eliminating seizures. For this, artificial lung ventilation, extrarenal blood purification, and nutrients are administered through a dropper.
Medicines
The patient is then prescribed medication to be taken for several months:
- various lipotropic drugs that help normalize the metabolism of cholesterol and fats (dietary supplements with choline, methionine, carnitine, lecithin, "Lipostabil");
- drugs that prevent thrombosis (Ginkgo Biloba, Aspirin, Cardiomagnyl);
- angioprotectors prescribed for various heart diseases to normalize the walls of blood vessels, movement and outflow of venous blood ("Troxerutin", "Detralex", "Indovazin");
- neuroprotectors for nourishing nerve tissues (group B vitamins, Piracetam;
- tranquilizers and sedatives to rarefy the accelerated nerve impulses in the affected neurons ("Sibazon");
- vitamins and amino acids;
- various performance stimulants.
Also, for a speedy recovery, physiotherapy, acupuncture, walking, gymnastics, massage, and a certain rest regimen are prescribed. What is the prognosis for a diagnosis of encephalopathy, unspecified?
Disease prognosis
For any kind of encephalopathy is characterized by vomiting, nausea, dizziness and headaches. If severe brain damage (or edema) occurs, then the disease develops very sharply, appearsdizziness, very severe headache, restlessness, blurred vision and more.
Typical complications of encephalopathy of unspecified origin are:
- coma;
- paralysis;
- convulsions.
If you follow the recommendations of your doctor, you can hope for a favorable prognosis. However, if the disease is started, then they can develop:
- epilepsy;
- paralysis, various kinds of movement disorders;
- loss of brain function, memory, intelligence;
- emotional instability, depression, mood swings;
- disability.
