Unspecified encephalopathy is a class VI disease (diseases of the nervous system), which is part of the G90-G99 block (other disorders of the nervous system) and has a disease code G93.4.
Description of the disease
Encephalopathy is a non-localized brain disease. It is expressed by the death of nerve cells due to circulatory arrest, oxygen starvation and diseases.
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 an unspecified encephalopathy (idiopathic, i.e., arising independently). The most common is vascular.
The causes of the 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 or immediately after it). This type of pathology is caused by:
- malformations of abnormal brain development;
- metabolic disorders in the body caused by genetic factors;
- if during pregnancy a damaging factor acted on the baby;
- traumatic brain injury that occurs in the baby during childbirth.
Mitochondrial Encephalopathy
Mitochondrial unspecified encephalopathy in infants is isolated in a separate group of congenital diseases. It is formed due to impaired 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 traumatic brain injuries of moderate and severe degree (for example, a fall from a height, head injuries in athletes, traffic accidents, etc.). With this type of disease, various lesions of the nervous tissue of the frontal and temporal lobes, atrophic changes (drying out and a decrease in the brain), hydrocephalus are observed.
- Unspecified toxic encephalopathy in adults occurs due to poisoning with various toxins: alcohol, high doses of pesticides, heavy metals, gasoline, etc. It mainly manifests itself with various kinds of nervous and mental disorders (insomnia, anxiety, irritability, hallucinations, prolonged headaches, etc.).
- Radiation is the result of ionizing radiation of the body in radiation sickness. With this pathology, various neurological disorders are observed.
- Metabolic occurs due to metabolic disorders against 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 brain hypertension. Signs of this type of disease are: loss of structure and integrity of consciousness, frequent headaches, depressive states, partial loss of one’s own memory.
- Hypoxic is the result of prolonged oxygen starvation. It leads to serious neuralgic complications.
And these are far from all varieties.
In children
There is 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 kind of vascular, which is manifested by stagnation of venous blood in the brain due to a violation of its outflow.
Metabolic encephalopathy is divided into several types:
- Bilirubin is found only in newborn babies. It develops against the background of incompatibility of the blood of the mother and the fetus, as well as due to infectious toxoplasmosis, jaundice, and diabetes in the mother. It manifests itself as general weakness, decreased muscle tone, poor appetite, belching, and vomiting.
- Gaye - Wernicke encephalopathy occurs due to a deficiency of vitamin B1. Adverse conditions can develop due to alcohol dependence, severe vitamin deficiency, HIV, and malignant neoplasms. It is mainly manifested by hallucinogenic syndrome, anxiety conditions.
- Leukoencephalopathy is manifested by a violation of the white matter of the brain. The disease is progressive. Appears after infection due to a decrease in the protective functions of the body.
- Atherosclerotic develops mainly due to impaired lipid metabolism in the body. It is 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 body begins to be washed worse by blood, excessive venous accumulations, edema, hemorrhages appear. Anoxic encephalopathy can occur due to the small intake of nutrients in neurons and stand out as a result in a separate disease. Metabolic encephalopathy is a special case of toxic, when toxins are not eliminated, as a result of which they penetrate the blood.
There are several stages of the development of this disease. The following are distinguished by specialists:
- In the case of the initial or first stage, the patient's memory decreases, he is irritable, falls asleep badly and sleeps anxiously, and he also suffers from headaches.
- When the second nature of the disease is more pronounced, all symptoms are exacerbated. 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 are very diverse depending on the severity, type, age and treatment used. As a rule, in the first stages of the disease, sleep disturbances, lethargy, daytime drowsiness, distraction, tearfulness, lack of interest, increased fatigue, decreased memory, and mental abilities are noted. Painful sensations, noises and ringing in the head may also begin to appear, decrease in auditory and visual functions, mood swings, impaired coordination, irritability.
What are the symptoms of disease progression?
In advanced cases, symptoms can progress, resulting in parkinsonism (slow motion in combination with trembling limbs) and pseudobulbar paralysis (manifested by a violation of speech, chewing and swallowing functions). Also, do not forget that dysfunctions of the psyche may develop (depression, suicidal thoughts, phobias). Consider how unspecified encephalopathy G 93.4 is diagnosed in infants and adults.
Diagnosis of unspecified encephalopathy
In order to correctly establish the form of the disease, the doctor must carefully analyze the patient's history of traumatic brain injury, intoxication, atherosclerosis, kidney, liver, lung, pancreas, hypertension, radiation exposure, as well as acquired or genetic metabolic disorders.
For the diagnosis of “unspecified encephalopathy G 93.4”, the following procedures are performed:
- General blood analysis.
- General urine analysis.
- Various metabolic tests (for the level of enzymes in the liver, glucose, electrolytes, ammonia, lactic acid, oxygen in the blood).
- Blood pressure measurement.
- CT and MRI (to detect brain tumors, various anatomical abnormalities, infections).
- Creatinine.
- Levels of drugs and toxins (cocaine, alcohol, amphetamines).
- Doppler ultrasound.
- EEG or encephalogram (to detect brain dysfunctions).
- Autoantibody assay.
These are not all the tests needed to make a diagnosis. Only the attending physician can prescribe certain tests, judging by the patient’s symptoms and medical history.
Encephalopathy Treatment
Treatment of unspecified encephalopathy is aimed at eliminating the root causes and symptoms that gave impetus to the development of this disease. Mostly, conservative and medical methods are used for treatment.
If the disease is acute, then treatment is primarily aimed at reducing intracranial pressure and eliminating seizures. For this, artificial lung ventilation, extrarenal cleansing of the blood are used, and nutrients are also injected through a dropper.
Medicines
In a subsequent patient, prescribe medications that he must take for several months:
- various lipotropic drugs that contribute to the normalization of the exchange 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 nerve tissue nutrition (B vitamins, Piracetam;
- tranquilizers and sedatives to dilute the frequent nerve impulses in the affected neurons (Sibazon);
- vitamins and amino acids;
- various health stimulants.
Also, physiotherapy procedures, acupuncture, walking, gymnastics, massage, a certain rest regimen are prescribed for a speedy recovery. What is the prognosis for a diagnosis of unspecified encephalopathy?
Disease prognosis
Any type of encephalopathy is characterized by vomiting, nausea, dizziness, and headaches. If a severe brain damage (or edema) has occurred, then the disease develops very acutely, dizziness, very severe headache, anxiety, impaired vision and much more.
Typical complications of encephalopathy of unspecified origin are:
If you follow the recommendations of your doctor, you can hope for favorable forecasts. However, if the disease is started, then it may develop:
- epilepsy;
- paralysis, various kinds of movement disorders;
- loss of brain functions, memory, intelligence;
- emotional instability, depression, mood swings;
- disability.