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 of their species. The article discusses the causes, symptoms, diagnosis of encephalopathy. We will also talk about the treatment of various types of ailments related to this collective concept.
Types of Encephalopathy
There are several forms of this pathology:
- hypertensive;
- progressive vascular leukoencephalopathy with and without hypertension;
- the same multi-focal;
- discirculatory;
- toxic
- Wernicke.
The latter variety occurs with toxic brain damage due to a lack of vitamin B1.
The types of encephalopathy are discussed in more detail below.
Residual view
It is noted as a persistent neurological deficit, manifested as a result of the action of ailments or various pathological factors. This type of brain encephalopathy is characterized by the following symptoms:
- mental disorders;
- fatigue;
- decreased intelligence;
- cognitive functions;
- fainting
- vegetovascular dystonia;
- pyramidal reflex failure;
- paresis;
- headache.
When diagnosed, she is often confused with a mental illness, prescribing symptomatic treatment.
This type of encephalopathy also occurs in children . Its reasons in this case are the following:
- hereditary mutations;
- congenital cerebral abnormalities;
- vaccination;
- transferred birth injuries and bruises;
- ischemic, neonatal hypoxic, perinatal brain lesions.
The danger of the disease is that the initial symptoms may appear early, and the pathology itself will appear in a few years.
Alcoholic encephalopathy
It is a severe form of psychosis, which mainly develops in the third stage of alcoholism. This type of encephalopathy in adults is found mainly. Under this name several diseases with a similar etiology and clinical presentation are combined. In addition to mental symptoms, somatic and neurological manifestations are observed here. The disease can be acute and chronic. Between them distinguish transitional types. Usually people who suffer this disease have ever consumed alcoholic surrogates.
Dyscirculatory (vascular) encephalopathy
In this case, there is an organic lesion of the non-inflammatory nature of the brain, which occurs due to circulatory failure in this organ. The main causes of its occurrence are the following:
- pathology of the cerebral vessels;
- injuries and tumors;
- infections.
According to etiology, the following types of discirculatory encephalopathy are distinguished:
- venous - there is a deterioration in brain function due to edema, which develops as a result of difficulty in the outflow of blood;
- hypertonic - can appear at an early age, an exacerbation of the disease is observed with hypertensive crises, pathology can progress, while memory and intelligence are disturbed up to deep dementia;
- atherosclerotic - the most common form with the deterioration of brain functions with the progression of the disease;
- mixed - combines the characteristics of the second and third types.
By the nature of the course, this type of brain encephalopathy can be galloping (rapidly progressing), remitting, classical (slowly progressing).
Post-traumatic encephalopathy
It occurs due to moderate or severe brain injury. This type of encephalopathy is accompanied by disorders such as neuropsychological and behavioral. In this case, it is observed:
- loss of control over behavior;
- impaired attention, memory;
- the same with respect to thinking.
These symptoms do not appear immediately, but after a certain time interval after cure. A person begins to notice that he does not have enough ingenuity and strength to solve important problems.
Patients noted:
- neurological disorders;
- sexual problems;
- insomnia;
- epileptic seizures;
- excessive aggressiveness.
Toxic encephalopathy
With it, there is a diffuse organic brain lesion that develops as a result of chronic occupational neurointoxications or acute poisoning by neurotropic poisons, wearing a severe form.
At the initial stage of this type of encephalopathy, the following symptoms are noted:
- sleep disturbance;
- general weakness;
- fatigue;
- memory impairment;
- dizziness;
- persistent headaches.
With asthenia, diffuse organic symptoms appear:
- disappearance or weakening of skin reflexes;
- anisoreflexia;
- high tendon reflexes;
- mild hypomimia;
- language deviation;
- asymmetry of the facial innervation;
- reflexes of oral automatism.
At the same time, psychoemotional disorders are also noted:
- pronounced emotional lability;
- depressed mood;
- unmotivated anxiety;
- apathy;
- retardation;
- slowness;
- decreased mental performance, attention and memory.
Hypertensive encephalopathy
With this disease, there is a slow progression of focal and diffuse damage to the brain substance, which occurs due to impaired blood circulation due to prolonged uncontrolled arterial hypertension. Further development of the pathology may be associated with the attachment of cerebral arteriosclerosis to it, which leads to mixed discirculatory encephalopathy. Other related factors also have a damaging effect on the vessels:
- smoking;
- violation of lipid metabolism;
- diabetes.
There are three stages of this disease. The first of them has subjective complaints, and neurological syndromes appear on 2 and 3:
- violation of emotions, intelligence, memory;
- extrapyramidal, manifested by slowness of movements, muscular rigidity, hypomyemia, tremor of the fingers and head;
- pseudobulbar, in which there is choking on swallowing, violent crying and laughter, blurred speech;
- vestibulomozhechkovy, manifested in instability when walking, staggering, dizziness.
Hypoxic Ischemic Encephalopathy
This condition is destructive and common. It occurs due to impaired oxygen supply to the brain due to respiratory failure or hypotension.
Below we consider what it is - brain encephalopathy and causes in relation to the species in question.
It is called:
- carbon monoxide poisoning, depressing respiration and the function of the cardiovascular system;
- 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, is squeezed by a surgical swab or hemorrhage, aspiration of blood or vomit, strangulation, drowning;
- traumatic and infectious shock;
- heart failure;
- hemorrhage with circulatory collapse and shock, in which the blood supply to the brain first suffers, and then breathing;
- myocardial infarction.
Circulatory encephalopathy
With it, progressive dynamics in the brain tissue and the formation of pseudo-neurasthenic syndrome are noted. Transient perinatal encephalopathy leads to episodic circulatory disorders in the brain, which can cause complications:
- cerebrovascular disease attacks;
- hypertensive cerebral crises;
- transient ischemic attacks.
Hypoxic encephalopathy
Under this term, a group of pathologies of the central nervous system and the brain associated with oxygen starvation of the latter is combined. They can occur due to the course of certain diseases or with a lack of this element in the ambient air.
The following symptoms are noted:
- increased irritability;
- dizziness;
- increased intracranial pressure;
- headache;
- impaired memory and sleep.
This disease can lead to complications:
- mental retardation, including oligophrenia;
- neuropathy
- myelopathy
- epilepsy;
- Cerebral palsy.
Residual encephalopathy, discussed earlier, is a variation of this species.
It is mainly caused by the following reasons:
- cerebral hypoxia and intrauterine infections during childbirth;
- cephalohematomas resulting from birth injuries.
With a lack of oxygen in an amount of 50% or more, severe consequences can occur for the development of the child.
Types of Encephalopathy in Children
In them, this disease can appear immediately after birth, in which case it is called perinotal, or at an older age, usually after three years, residual.
The symptoms of brain encephalopathy depend on the causes that cause it. The following types of pathology are characteristic for newborns:
- Wernicke encephalopathy - death of brain cells occurs due to a lack of nutrition of their B vitamins;
- hypertensive - it is noted with impaired adrenal and renal function, frequent increase in blood pressure;
- toxic - can be observed with the appearance of jaundice in newborns, hemolytic disease and other consequences of exposure to various pollutants;
- small focal leukoencephalopathy - brain cells are affected after 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.
The disease can be due to several reasons.
Causes
The main risk factors for newborns are as follows:
- neuroinfection;
- difficulty opening the birth canal;
- cord entwining;
- a large body weight of the fetus;
- premature birth;
- complicated pregnancy;
- pathology during pregnancy.
Acquired encephalopathy is caused by the following causes:
- vegetovascular dystonia;
- diabetes;
- ischemia;
- atherosclerosis;
- liver failure;
- tumors;
- head injuries;
- vascular changes in the brain;
- intoxication of the body;
- infections.
One child at birth may have a strong body that allows the central nervous system to recover quickly, while another, due to various problems, does not allow it to return to normal.
Symptoms
The types of encephalopathy and their distinctive features were examined above . Each of them has its own characteristics. However, there are general symptoms. These include the following in their early stages:
- autonomic disorders;
- impaired coordination;
- the presence of pathological pyramidal and oral reflexes;
- increase in tendon reflexes and muscle tone;
- decreased hearing and visual acuity;
- nystagmus;
- irritability, unstable mood, general weakness;
- noise in ears;
- diffuse headaches;
- general fatigue;
- daytime lethargy;
- sleep disturbance;
- difficulty in changing activities;
- decreased short-term memory, mental performance.
They can progress with the development of the pathology with which encephalopathy is associated.
In the later stages, the following neurological syndromes may occur:
- pseudobulbar;
- parkinsonian.
In some patients, the psyche is upset. With cerebral edema, significant microcirculatory 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, confusion.
In acute renal, pancreatic, hepatic encephalopathy, convulsive seizures and impaired consciousness can be observed. With an exacerbation of chronic pneumonia, a heart attack similar to the disease, pulmonary embolism, the following clinical picture is observed:
- sometimes cramps;
- mental disorders;
- paresis;
- nystagmus;
- nausea and vomiting;
- intense headaches.
The most common symptoms of encephalopathy are as follows:
- Depression
- Dizziness
- headache;
- lack of initiative;
- disorders of consciousness and memory.
Patients often have general weakness, poor sleep, tearfulness, distraction, irritability, and fatigue. When examined, difficulty can be revealed in the pronunciation of certain words, drowsiness in the daytime, narrowing of the circle of interests and criticism, verbosity, the viscosity of thought, apathy.
Diagnostics
The state of memory, coordination of movements are checked, tests for the psychological state are carried out. Before determining how to treat encephalopathy, you need to conduct the correct diagnosis of pathology.
The following studies may be prescribed for diagnosis:
- analysis for autoantibodies in the main pathology in the form of dementia caused by antibodies that destroy neurons;
- Encephalogram, EEG for brain dysfunction;
- Doppler ultrasound for abscesses and abnormal blood circulation in the tissues;
- MRI and CT for infections, anatomies of anatomy and brain tumors;
- determination of creatinine to detect kidney function;
- level of drugs and toxins;
- metabolic tests: 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 (determination of infections).
Treatment
With therapeutic methods, in many cases, it is possible to only slightly stabilize the patient's condition. The following describes how to treat encephalopathy.
The complex treatment includes the following drugs:
- adaptogens;
- vitamins;
- nootropics;
- medications 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 of the lungs;
- hemoperfusion.
Also prescribed drugs that prevent the development of seizures, improve cerebral circulation, reduce intracranial pressure.
In addition, are assigned:
- reflexology;
- breathing exercises;
- physiotherapy.
The following shows how to treat types of brain encephalopathy in their acute forms. In these cases, life support systems are used:
- prolonged parenteral nutrition;
- hemoperfusion;
- mechanical ventilation;
- hemodialysis;
- reduce convulsive syndrome;
- reduce intracranial pressure.
In the future, drugs are prescribed that contribute to improving brain metabolism:
- biostimulants: vitreous, aloe extract;
- antiplatelet agents: Pentoxifylline;
- folic and ascorbic acids;
- angioprotectors (if necessary): “Sermion”, “Cavinton”, “Parmidin”, “Xanthinol nicotinate”, “Cinnarizine”;
- tocopherol;
- vitamins A and group B;
- lipotropic compounds: "Lecithin", "Essential";
- amino acids: glutamic acid, methionine, alvesine, cerebrolysin;
- nootropic nucleus: "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, which provoked the appearance of encephalopathy.
Finally
There are various types of encephalopathy. They differ in causes, symptoms. The disease can be congenital and acquired. The first of them is mainly associated with birth injuries. The danger of encephalopathy and its types is that they can lead to various neurological and mental problems, the development of epilepsy, lethargy, apathy, and vegetovascular diseases. Correct diagnosis is necessary to prescribe adequate treatment. In many cases, therapeutic treatment only alleviates the symptoms.