Hypothalamic syndrome
Hypothalamic syndrome is a complex endocrine, metabolic, vegetative disorders caused bydiseases of hypothalamus. Is characterized by change (usually increase) of body weight,headaches, instability of mood, hypertension, impaired the menstrual cycle, increasedappetite and thirst, increased or decreased libido. To diagnose the syndrome is advancedgipofizarnogo hypothalamic hormone study, EEG, MRI of the brain, ULTRASOUND of the thyroid gland, if necessary, the adrenal glands. Gipofizarnogo hypothalamic syndrometreatment is in identifying effective stimulating or inhibiting hormone therapy, a symptomatic treatment.
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Hypothalamic syndrome
Causes of gipofizarnogo hypothalamic syndrome
Classification of the gipofizarnogo hypothalamic syndrome
Gipofizarnogo hypothalamic syndrome symptoms
Gipofizarnogo hypothalamic syndrome complications
Gipofizarnogo hypothalamic syndrome diagnosis
Gipofizarnogo hypothalamic syndrome treatment
Forecast for gipofizarnogo hypothalamic syndrome
Gipofizarnogo hypothalamic syndrome prevention
Hypothalamic syndrome-treatment in Moscow
Hypothalamic syndrome is a complex endocrine, metabolic, vegetative disorders caused bydiseases of hypothalamus. Is characterized by change (usually increase) of body weight,headaches, instability of mood, hypertension, impaired the menstrual cycle, increasedappetite and thirst, increased or decreased libido. Prognosis depends on the severity of thelesions of the hypothalamus: from complete recovery to the progression of the disease(obesity, pronounced stable development of hypertension, infertility, etc.).
Pathology of the gipotalamicescoy area is often found in the endocrinological,gynecological, neurological practice, causing difficulty in the diagnosis of various forms ofmanifestation. Hypothalamic syndrome are more likely to develop in adolescence (13-15years) and reproductive (31-40 years), the dominating among females (12.5-17.5% women).
The problem of medical and social importance of the gipofizarnogo hypothalamicsyndrome is defined by the young age of the patients, the rapidly progressive course of disease, acute nejroèndokrinnymi violations, often accompanied by partial reduction or total loss of working capacity. Hypothalamic syndrome causes severe violations of women's reproductive health by causing the development of endocrine infertility, cystic ovaries, obstetric and perinatal complications.
Causes of gipofizarnogo hypothalamic syndrome
Hypothalamic section of the brain responsible for regulating humoral and nervous functions for homeostasis (stability of the internal environment). The hypothalamus performs the role of the Supreme central governing vegetative metabolism, thermoregulation, the blood vessels and internal organs, food, sexual behavior, mental functions. In addition, the hypothalamus controls the physiological reactions, so when the pathology is the frequency of a specific function that expresses the vegetative crisis (paroksizmom).
Cause impairment of the hypothalamus and gipofizarnogo hypothalamic syndrome maydevelop the following reasons:
brain tumor compressing the gipotalamičeskuû area;
cranio-cerebral trauma with direct damage to the hypothalamus;
nejrointoksikacii (substance abuse, drug addiction, alcoholism, industrial hazards,environmental degradation, etc.);
vascular disease, stroke, Osteochondrosis of the cervical spine;
viral and bacterial CNS-infections (influenza, rheumatism, malaria, chronic tonsillitis, etc.);
Psychogenic factors (stress, shock, mental workload situation);
pregnancy and involving the hormonal adjustment;
chronic diseases with vegetative components (bronchial asthma, hypertension, ulcersstomach and duodenal ulcers, obesity);
constitutional failure gipotalamicescoy area.
Classification of the gipofizarnogo hypothalamic syndrome
Clinical Endocrinology consists of a large number of studies on the gipofizarnogo hypothalamic syndrome. The results of these studies formed the basis of modern advancedclassification of syndrome.
The ètiologičeskomu principle of hypothalamic syndrome is divided into primary (due toneuro and trauma), secondary (due to constitutional obesity) and mixed.
The leading clinical manifestations are the following forms gipofizarnogo hypothalamicsyndrome:
vegetative-vascular;
disorders of thermoregulation;
gipotalamičeskuû (dièncefal′nuû) epilepsy;
nejrotrofičeskuû;
neuromuscular;
psevdonevrasteničeskuû and psychopathological;
disorder of motivations and impulses;
nejroèndokrinno-metabolic disorder.
Provide clinical variants gipofizarnogo hypothalamic syndrome with predominance ofconstitutional obesity, gipercortitizma, neurocirculatory violations, germinativnyh disorders.
The severity of gipofizarnogo hypothalamic syndrome may be mild, moderate and severeforms, and character development is progressive, stable, retrogressive and recurrent.
Pubertal hypothalamic syndrome can be delayed or accelerated puberty.
Gipofizarnogo hypothalamic syndrome symptoms
Gipofizarnogo hypothalamic syndrome manifestations depend on the kill zone of the hypothalamus (front or rear divisions) and disorders in neurohumoral-inducedhypothalamic-pituitary region.
In the gipofizarnogo hypothalamic syndrome manifestations most often dominated by, the following violations occurred:
vegetative-vascular-32%,
Endocrine-Metabolic-27%,
neuromuscular-10%,
disorders of thermoregulation, etc. -4%, and so on.
Hypothalamic syndrome is general weakness, increased fatigue, physical and mental exhaustion, poor tolerance of changing meteorological conditions, pokalyvaniâmi in theheart, the propensity to allergic reactions, unstable chair, feeling the lack of air, emotional disorders (anxiety, bouts of panic fear), sleep disturbances, increased sweating. Objectivelyreveals tachycardia, asymmetries of blood pressure with a penchant for his improvement, tremor of the fingers and 21.
Most of the patients, hypothalamic syndrome is paroksizmal′no (pristupoobrazno), often in the form of vagoinsulârnyh and Sympatico adrenal crises.
Vazoinsulârnye gipofizarnom gipotalamicescom syndrome when crises are accompanied bya feeling of warmth, and tide head, dizziness, shortness of breath, unpleasant feelings in epigastria, nausea, a sinking heart, sweating, general weakness. You may experienceincreased intestinal motility with the relaxation of the stool, frequent and excessive urination, repeated the urge to pee. May develop allergic reactions in the form of urticaria andangioedema even. Heart rate urežaetsâ up to 45-50 UD. in minutes, hell is reduced to90/60-80/50 mm Hg. art.
Sympatico-adrenalovye crises in gipofizarnom gipotalamicescom syndrome mayprovocirovat′sâ emotional stress, changing weather conditions, menstruation, pain factors, etc. Frequent gamers usually occur suddenly in the evening or at night, sometimespreceded by signs: headaches, mood changes, tingling feeling in the heart, lethargy. During the attack appears chills, tremor, "goose bumps", rapid heartbeat, cold and numb limbs, lifting the HELL up to 150/100-180/110 mm Hg. Church, tachycardia to 100-140 BPM. inmines. Sometimes the Sympatico-adrenalovye crises are accompanied by increases in temperature up to 38-39° c, excitement, anxiety, fear of death (panic attacks). The duration of a crisis can be from 15 minutes. up to 3 or more hours, and then for a few hours is the weakness and fear a repetition of this attack.
Often when gipofizarnom gipotalamicescom syndrome crises are mixed, combiningsymptoms of vagoinsulârnogo and Sympatico-adrenalovy crises.
Violation of thermoregulation in gipofizarnom gipotalamicescom syndrome accompanied by the development of the gipertermičeskogo crisis, characterized by sudden abrupt body temperature to 39-40° c in the background of a long subfebrilita. For heat-regulatingabuses typical morning temperature rise and its decline towards evening, lack of effect ofjaroponijath drugs. Thermoregulation disorders more commonly seen in childhood and adolescence and are dependent on the physical and emotional stress. Teenagers are oftenassociated with school classes and disappear in the holiday period.
The heat-regulating manifestations of violations when gipofizarnom gipotalamicescomsyndrome can serve as a constant chills may also appear, intolerance to cold drafts andcold. Such patients are constantly wear, not shiver with cold weather, even during the summer do not open the vents and Windows, avoid taking a bath.
Disorder of motivations and drives with gipofizarnom gipotalamicescom syndromecharacterized by emotional personality disorders, various phobias, change in libido,abnormal drowsiness (gipersomniej) or insomnia, frequent changes of mood, irritability, anger, wet, etc.
Nejroèndokrinno-metabolic disorders in gipofizarnom gipotalamicescom syndrome are a violation of protein, carbohydrate, fat, water-sharing, bulimia, anorexia, thirst.Neuroendocrine disorders may be accompanied by syndromes itsenko-kushinga, diabetesinsipidus with polyuria, polidipsiej and low specific gravity of urine, acromegaly, early climaxin young women, the changes in the thyroid gland. Can be observed degeneration of bones and muscles, a breach of trophic skin (dryness, itching, decubitus ulcers), izgyazwleniamucous viscera (esophagus, 12-duodenum, stomach).
For gipofizarnogo hypothalamic syndrome characterized by chronic or prolonged period ofrelapses and exacerbations.
Gipofizarnogo hypothalamic syndrome complications
For gipofizarnogo hypothalamic syndrome most often complicated polikistoznymi changesof ovaries, Gynecomastia, menstrual irregularities from oligo-amenorrhea and uterine bleeding and, myocardial, girsutizmom and insulin resistance. Complication of pregnancy ingipofizarnom gipotalamicescom syndrome can be severe late gestosis.
Gipofizarnogo hypothalamic syndrome diagnosis
Polymorphous gipofizarnogo hypothalamic syndrome clinic represents a lot of difficulties inhis diagnosis. Therefore, the leading diagnostic criteria gipofizarnogo hypothalamicsyndrome are the data of specific tests: the sugar curve, Thermometry in three locations,the EEG of the brain, the three-day trial Zimnickogo.
Blood glucose gipofizarnom gipotalamicescom syndrome research on an empty stomach and with a load of 100 g of sugar, defining the level of glucose every 30 minutes. If the following options appear syndrome gipofizarnom gipotalamicescom sugar curve:
giperglikemičeskij (rise in blood glucose levels above normal);
hypoglycemic (glucose below normal);
dvugorbovyj (to reduce glucose alternates with new lift);
torpidnyj (a small rise of glucose is fixed at one point).
Thermometry with gipofizarnom gipotalamicescom syndrome in three locations: botharmpits and in the rectum. Thermometric violations may be of isothermia (of equaltemperature in the rectum or armpit, the norm in the rectum on -1 0.5° c above); hypo-andhyperthermia (in the armpits temperature is below or above normal); termoinversii (the temperature in the rectum than in the armpits).
Electroencephalography detects changes affecting the deeper brain structures.
In the three-day trial in General in patients with gipotalamičeskim syndrome changes theratio of the allocated day and night, fluid diuresis.
Brain MRI method with gipofizarnom gipotalamicescom syndrome is increased intracranial pressure, the effects of hypoxia and tumor formation.
Mandatory diagnostic criterion for gipofizarnogo hypothalamic syndrome is thedetermination of hormones (prolactin, estradiol, LH, FSH, testosterone, cortisol, TSH, T4(free thyroxine), adrenotropnogo hormone in the blood and 17ketosteroidov in daily urine)and biochemical indices for detecting endocrine-metabolic disorders.
Differentiate hypothalamic syndrome with organic defeat other systems allowsULTRASOUND ULTRASOUND of the thyroid gland, adrenal glands and internal organs. If necessary, additionally a MRI or CT SCAN of the adrenal glands.
Gipofizarnogo hypothalamic syndrome treatment
The treatment of gipofizarnogo hypothalamic Syndrome should be carried out jointly by an endocrinologist, neurologist, gynaecologist (women). Selection of treatment methods forgipofizarnogo hypothalamic syndrome is always individual and depends on the leadingsymptoms. The goal of therapy gipofizarnogo hypothalamic syndrome is the correction ofgipotalamičeskih function and normalization of brain structures.
In the first phase of treatment are removal of the etiological factor: sanitation of infectiousfoci, treatment of injuries and tumours etc. in poisonings by alcohol, drugs, insecticides,pesticides, heavy metals are active dezintoksikatsionnaya therapy: intravenously injectedgemodes, sodium thiosulfate, glucose, saline solution, etc.
For prevention of Sympatico adrenal crises are pirroksan, bellataminal, èglonil, grandaksin,antidepressants (amitriptyline, lerivon, koaksil, etc.).
Neuroendocrine abnormalities are corrected zamestitel′nymi, stimulating or inhibithormonal drugs, diet and the appointment of nejromediatornogo Exchange (bromocriptine,difenin) heading up to half a year.
With the development of post-traumatic gipofizarnogo hypothalamic syndrome holddegidratiruûŝuû therapy, spinal puncture.
In case of Exchange assigned to diet therapy, anoreksanty, vitamins.
When gipofizarnom gipotalamicescom syndrome are appointed by means of improvingcerebral circulation (piracetam, cerebrolysin, cavinton), b vitamins, amino acids (glycine,actovegin), calcium preparations. In treatment gipofizarnogo hypothalamic syndrome include reflexology, physiotherapy, therapeutic exercises.
In the treatment gipofizarnogo hypothalamic syndrome has an important role to the normalization regime of work and rest, diet, body mass normalization, kurortoterapii.
Forecast for gipofizarnogo hypothalamic syndrome
Hypothalamic syndrome can lead to a reduction and loss of efficiency in cases of repetitiveparoxysmal autonomic. Such patients because of their professional activities may be a disability group III. Highly pronounced nejroèndokrinno-Exchange form gipofizarnogo hypothalamic syndrome can also result in the loss of ability to work with a III or II disability group.
Gipofizarnogo hypothalamic syndrome prevention
Since the financial crisis in gipofizarnom gipotalamicescom syndrome usually occur at a certain time and changes of weather conditions, significant emotional and physicaloverstress, prevention is warning taking sedatives, antidepressants, tranquilizers. Also, if possible, there should be no provocative attacks factors, mental and physical exercise, work in night shifts.
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