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Vegeto-sosudistaya dystonia

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Vegeto-sosudistaya dystonia – a complex of functional frustration which cornerstone violation of regulation of a vascular tone the autonomic nervous system is. It is shown by pristupoobrazny or continuous heartbeat, the increased perspiration, a headache, a pricking in heart, reddening or a pobledneniye of the person, a chill, unconscious states. Can lead to development of neurosises, persistent arterial hypertension, it is considerable worsen quality of life.

Vegeto-sosudistaya dystonia

Vegeto-sosudistaya dystonia – a complex of functional frustration which cornerstone violation of regulation of a vascular tone the autonomic nervous system is. It is shown by pristupoobrazny or continuous heartbeat, the increased perspiration, a headache, a pricking in heart, reddening or a pobledneniye of the person, a chill, unconscious states. Can lead to development of neurosises, persistent arterial hypertension, it is considerable worsen quality of life.

In modern medicine vegeto-vascular dystonia is not considered as an independent disease as is set of the symptoms developing against the background of the course of any organic pathology. Vegeto-sosudistaya dystonia is quite often designated as vegetative dysfunction, , psychovegetative neurosis, vasomotorial dystonia, a syndrome of vegetative dystonia, etc.

Vegeto-vascular dystonia is meant the term the violation of vegetative regulation of an internal homeostasis of an organism (AD, ChSS, a thermolysis, width of pupils, bronchial tubes, digestive and secretory functions, synthesis of insulin and adrenaline) which is followed by change of a vascular tone and blood circulation in fabrics and bodies.

Vegeto-sosudistaya dystonia is extremely widespread frustration and is observed at 80% of the population, a third from these cases demands the therapeutic and neurologic help. Emergence of the first displays of vegeto-vascular dystonia belongs, as a rule, to children's or youthful age; the expressed violations have an effect by 20-40 years. Women are subject to development of vegetative dysfunction 3 times bigger, than men.

Morfo-funktsionalnaya characteristic of the autonomic nervous system

The functions which are carried out by the autonomic nervous system (ANS) in an organism are extremely important: it exercises the control and regulation of activity of internals providing maintenance of a homeostasis – constant balance of the internal environment. On the functioning VNS is autonomous, i.e. not submitting to conscious, strong-willed control and other parts of the nervous system. The autonomic nervous system provides regulation of a set of physiological and biochemical processes: maintenance of thermal control, optimum level HELL, processes of metabolism, mocheobrazovaniye and digestion, endocrine, cardiovascular, immune reactions etc.

VNS consists of the sympathetic and parasympathetic departments rendering opposite effects on regulation of various functions. Expansion of a pupil, strengthening of exchange processes, increase HELL, reduction of a tone of smooth muscles, increase in ChSS, breath increase belong to sympathetic effects of influence of VNS. To parasympathetic – narrowing of a pupil, decrease HELL, increase in a tone of smooth muscles, reduction of ChSS, breath delay, strengthening of sekretorny function of digestive glands, etc.

Normal activity of VNS is provided with coherence of functioning of sympathetic and parasympathetic departments and their proper response to changes of internal and external factors. Violation of balance between sympathetic and parasympathetic effects of VNS causes development of vegeto-vascular dystonia.

Reasons and development of vegeto-vascular dystonia

Development of vegetato-vascular dystonia in children of younger age can be caused by pathology of the perinatal period (a pre-natal hypoxia of a fruit), patrimonial injuries, neonatality period diseases. These factors have an adverse effect on formation somatic and the autonomic nervous system, full value of the functions which are carried out by them. Vegetative dysfunction at such children is shown by digestive violations (frequent vomiting, a meteorizm, unstable character of a chair, small appetite), an emotional imbalance (the raised conflictness, a capriciousness), tendency to catarrhal diseases.

During puberty development of internals and growth of an organism in general advances formation of neuroendocrine regulation that leads to aggravation of vegetative dysfunction. At this age vegeto-vascular dystonia is shown by pains in heart, interruptions and heartbeat, lability of arterial pressure, psychoneurological frustration (increased fatigue, decrease in memory and attention, irascibility, high uneasiness, irritability). Vegeto-sosudistaya dystonia occurs at 12-29% of children and teenagers.

At adult patients developing of vegeto-vascular dystonia can be provoked and aggravated in connection with influence of chronic diseases, depressions, stresses, neurosises, craniocereberal injuries and injuries of cervical department of a backbone, endocrine diseases, pathologies of a GIT, hormonal reorganizations (pregnancy, a climax). At any age risk factor of development of vegeto-vascular dystonia is constitutional heredity.

Classification of vegeto-vascular dystonia

Today uniform classification of vegeto-vascular dystonia is not developed. According to various authors, vegetative dysfunction differs by a number of the following criteria:

  • On prevalence of sympathetic or parasympathetic effects: simpatikotonicheskiya, parasimpatikotonicheskiya (vagotonichesky) and mixed (simpato-parasympathetic) type of vegeto-vascular dystonia;
  • On prevalence of vegetative frustration: generalized (with interest at the same time several systems of bodies), system (with interest of one system of bodies) and local (local) forms of vegeto-vascular dystonia;
  • On expressiveness of a current: latent (hidden), paroksizmalny (pristupoobrazny) and permanent (constant) options of a course of vegeto-vascular dystonia;
  • On weight of manifestations: easy, medium-weight and heavy current;
  • On an etiology: primary (konstitutsionalno caused) and secondary (caused by various pathological states) vegeto-vascular dystonia.

On character of the attacks complicating the course of vegeto-vascular dystonia allocate the sipmpatoadrenalovy, vagoinsulyarny and mixed crises. Slight crises are characterized by monosimptomny manifestations, proceed with the expressed vegetative shifts, 10-15 minutes proceed. Crises of average weight have polisimptomny manifestations, the expressed vegetative shifts and duration from 15 to 20 minutes. The heavy course of crises is shown by polysymptomatology, heavy vegetative frustration, giperkineza, spasms, lasting attack more than one hour and a poslekrizovy adynamy within several days.

Symptoms of vegeto-vascular dystonia

Displays of vegeto-vascular dystonia are diverse that is caused by many-sided influence on an organism of VNS regulating the main vegetative functions - breath, blood supply, sweating, an urination, digestion, etc. Symptoms of vegetative dysfunction can be expressed constantly or be shown by attacks, crises (the panic attacks, faints, other pristupoobrazny states).

Allocate several groups of symptoms of vegeto-vascular dystonia on primary violations of activity of various systems of an organism. These violations can be shown separately or be combined with each other. Pains in heart, tachycardia, feeling of interruptions and dying down in work of heart belong to kardialny displays of vegeto-vascular dystonia.

At violations of regulation of respiratory system vegeto-vascular dystonia is shown by respiratory symptoms: the speeded-up breath (), impossibility of implementation of a deep breath and full exhalation, feelings of shortage of air, weight, a congestion in a breast, the sharp pristupoobrazny short wind reminding asthmatic attacks. Vegeto-sosudistaya dystonia can be shown by various disdinamichesky violations: fluctuations of venous and arterial pressure, violation of blood circulation and a lymph in fabrics.

Vegetative violations of thermal control include lability of body temperature (increase to 37-38 °C or decrease to 35 °C), feelings of a chill or feeling of heat, perspiration. Manifestation of thermoregulatory violations can be short-term, long or constant. Disorder of vegetative regulation of digestive function is expressed by dispeptichesky violations: pain and spasms in a stomach, nausea, eructation, vomiting, locks or ponosa.

Vegeto-sosudistaya dystonia can cause different emergence of urinogenital frustration: an anorgazmiya at the kept sexual desire; the painful, speeded-up urination in the absence of organic pathology of urinary tract etc. Psychoneurological displays of vegeto-vascular dystonia include slackness, weakness, fatigue at insignificant loading, the reduced working capacity, the increased irritability and tearfulness. Patients have headaches, meteodependence, frustration of a dream (an insomniya, a superficial and uneasy dream).

Complications of vegeto-vascular dystonia

The course of vegeto-vascular dystonia can be complicated by the vegetative crises which are found more than at a half of patients. Depending on prevalence of violations in this or that department of vegetative system the simpatoadrenalovy, vagoinsulyarny and mixed crises differ.

Development of simpatoadrenalovy crisis or "the panic attack" happens under the influence of sharp emission of the adrenaline in blood occurring at the command of vegetative system. The course of crisis begins with suddenly arising headache, tachycardia, a kardialgiya, a pobledneniye or face reddening. Arterial hypertension is noted, pulse becomes frequent, appears subfebrilitt, an oznobopodobny tremor, a sleep of extremities, feeling of strong alarm and fear. Termination of crisis same sudden, as well as beginning; after the termination – an adynamy, a polyuria with release of urine of low specific weight.

Vagoinsulyarny crisis is shown by symptoms, in many respects opposite to sympathetic effects. Its development is followed by emission in insulin blood, sharp decrease in level of glucose, increase in activity of a gastrointestinal tract. Feelings of sinking heart, dizziness, arrhythmia, difficulty of breath and feeling of shortage of air are characteristic of vagoinsulyarny crisis. The urezheniye of pulse and decrease HELL, perspiration, skin hyperaemia, weakness, darkening in eyes is noted.

During crisis the intestines vermicular movement amplifies, the meteorizm, rumbling, desires on the act of defecation appears, the liquid chair is possible. Upon termination of an attack there comes the condition of the expressed poslekrizovy adynamy. The mixed simpato-parasympathetic crises which are characterized by activation of both departments of the autonomic nervous system meet more often.

Diagnosis of vegeto-vascular dystonia

Diagnosing of vegeto-vascular dystonia is complicated in view of variety of symptoms and lack of accurate objective parameters. In case of vegeto-vascular dystonia it is rather possible to speak about differential diagnostics and an exception of organic pathology of this or that system. For this purpose patients undergo consultation of the neurologist, endocrinologist and survey of the cardiologist.

At clarification of the anamnesis it is necessary to establish a family otyagoshchennost on vegetative dysfunction. At patients cases of incidence of stomach ulcer of a stomach, bronchial asthma, neurodermatitis meet with a vagotoniya in a family more often; with a simpatikotoniya - a hypertension, IBS, gipertireozy, diabetes. At children with vegeto-vascular dystonia the anamnesis is quite often burdened by an adverse current of the perinatal period, recurrent sharp and chronic focal infections.

At diagnosis of vegeto-vascular dystonia evaluating an initial vegetative tone and indicators of vegetative reactivity is necessary. The initial condition of VNS is estimated at rest according to the analysis of complaints, EEG of a brain and the ECG. Vegetative reactions of nervous system decide on the help of various functional tests (orthostatic, pharmacological).

Treatment of vegeto-vascular dystonia

Patients with vegeto-vascular dystonia are treated under observation of the general practitioner, neurologist, endocrinologist or psychiatrist depending on primary manifestations of a syndrome. At vegeto-vascular dystonia the complex, long, individual therapy considering the nature of vegetative dysfunction and its etiology is carried out.

Preference is given in the choice of methods of treatment to a nemedikamentoznym to approach: to normalization of the labor mode and rest, elimination of a hypodynamia, the dosed physical activity, restriction of emotional influences (stresses, computer games, viewing of telecasts), to individual and family psychological correction, balanced and regular diet.

The positive result at treatment of vegeto-vascular dystonia is observed from medical massage, reflexotherapy, water procedures. The applied physiotherapeutic influence depends on type of vegetative dysfunction: at a vagotoniya carrying out an electrophoresis with calcium, mezatony, caffeine is shown; at a simpatikotoniya - with a papaverine, eufilliny, bromine, magnesium).

At insufficiency of the all-strengthening and physiotherapeutic actions individually picked up medicamentous therapy is appointed. For decrease of the activity of vegetative reactions appoint sedative medicines (a valerian, a motherwort, a St. John's Wort, a melissa, etc.), antidepressants, tranquilizers, nootropic means. The favorable medical effect is quite often rendered by glycine, gopantenovy acid, glutamic acid, complex vitamin and mineral medicines.

β-adrenoblokator (propranolol, ), vagotonichesky effects - vegetable psychostimulators are applied to reduction of manifestations of a simpatikotoniya (medicines of a magnolia vine, an eleuterokokk, etc.). At vegeto-vascular dystonia treatment of the chronic centers of the infection accompanying endocrine, somatic or other pathology is carried out.

Development of heavy vegetative crises in some cases can demand parenteral introduction of neuroleptics, tranquilizers, β-adrenoblokator, atropine (depending on a crisis form). For patients with vegeto-vascular dystonia regular dispensary observation (once in 3-6 months), especially during the autumn-spring period when repetition of a complex of medical actions is necessary has to be carried out.

Forecast and prevention of vegeto-vascular dystonia

Timely detection and treatment of vegeto-vascular dystonia and its consecutive prevention in 80-90% of cases lead to disappearance or considerable reduction of many manifestations and restoration of adaptation opportunities of an organism. The Nekorregiruyemy course of vegeto-vascular dystonia promotes formation of various psychosomatic violations, psychological and physical disadaptation of patients, adversely affects quality of their life.

The package of measures of prevention of vegeto-vascular dystonia has to be directed to strengthening of mechanisms of self-control of nervous system and increase in adaptive abilities of an organism. It is reached by means of improvement of a way of life, optimization of the mode of rest, work and physical activity. Prevention of exacerbations of vegeto-vascular dystonia is carried out by means of its rational therapy.

Vegeto-sosudistaya dystonia - treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!

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