Hypothalamic syndrome is a complex symptom complex that develops when the hypothalamus is damaged and is characterized by endocrine, autonomic, metabolic and trophic disorders.
Hypothalamic syndrome affects people aged 31-40 years. The percentage of patients with this syndrome among women significantly exceeds the percentage of men with hypothalamic syndrome.
Hypothalamic syndrome is widespread, but not immediately diagnosed, as its symptoms may be masked as signs of other diseases.
The hypothalamus is located in the brain and is responsible for homeostasis (constancy of the internal environment), metabolic processes, thermoregulation, the state of blood vessels and internal organs, as well as nutritional, sexual and mental behavior. In the pathology of the hypothalamus, the periodicity of any functions is disturbed, which manifests itself in the form of a vegetative crisis or paroxysm.
Depending on the prevalence of certain signs of the disease, the following forms of the hypothalamic syndrome are distinguished:
- disturbances of thermoregulation;
- hypothalamic (diencephalic) epilepsy;
- violation of motivation and inclinations (including disorders of sleep and wakefulness);
- neuroendocrine metabolic disorders;
- psevdoneustenic or psychopathological.
In adolescence, hypothalamic syndrome occurs with a delay or acceleration of sexual development (puberty syndrome).
According to the severity of the disease emit mild, moderate and severe.
According to the course of the disease, there is a progressive course, a stable, regressing, recurrent.
The following factors can lead to dysfunction of the hypothalamus with the development of the hypothalamic syndrome:
- brain tumors that squeeze the hypothalamus;
- head injuries with damage to the hypothalamus;
- chronic brain intoxication (drug addiction, alcoholism, substance abuse, work in hazardous industries, disrupted ecology, and others);
- vascular diseases, cerebral stroke, cervical osteochondrosis ;
- viral and bacterial neuroinfections ( malaria , influenza, meningitis , infectious jaundice, rheumatism, chronic tonsillitis );
- chronic stress, mental stress;
- hormonal changes during pregnancy;
- chronic and endocrine diseases ( bronchial asthma, hypertension, gastric ulcer, obesity );
- constitutional failure of the hypothalamus.
Manifestations of the hypothalamic syndrome depend on which part of the (anterior or posterior) hypothalamus is damaged. Symptoms of the syndrome may occur immediately after damage to the hypothalamus or delayed (after a few days, weeks and even years).
In the development of the vegetative-vascular form of the hypothalamic crisis play a role of impaired function of the autonomic nervous system (the parasympathetic and sympathetic divisions). This form manifests itself in the form of crises.
1. During sympathoadrenal crisis, patients complain of
- heart palpitations
- general weakness and lethargy
- anxiety, manifested by anxiety,
- fear of death.
- numbness and coldness of hands and feet,
- pale skin
- exophthalmos (bulging eyes),
- dry mouth
- thirst and chills,
- common tremor
- the rise in blood pressure to 150/100 – 180/110 mm Hg. Art.,
- temperature rise to 38 degrees.
To provoke a crisis can change the weather, menstruation, emotional stress, pain. The duration of paroxysm is 15 minutes – 3 hours.
2. Vaginismular crisis is characterized
- lack of air,
- hot flashes to face.
Also, patients appear
- general weakness, lethargy, drowsiness,
- excessive sweating
- dizziness, tinnitus,
- blood pressure goes down
- heartbeat decreases ,
- symptoms of intestinal upset (flatulence, diarrhea) and bladder (abundant urination) join.
Allergic reactions in the form of urticaria or Quincke’s edema . The attack continues 1 – 2 hours.
Thermal control disturbance
Hypothalamic syndrome with impaired thermoregulation is characterized by long subfebrile (up to 38 degrees) body temperature with its periodic increase (up to 40 degrees).
This form is more common in children and adolescents.
Along with an increase in temperature, there are signs of sympathoadrenal or mixed crises (vegetative-vascular form).
The temperature rises in the morning and normalizes in the evening. There are no obvious signs of inflammation. Changes in thermoregulation are directly related to emotional and physical stress (for example, in children, thermoregulatory changes appear in school and disappear during the holidays).
Characteristic signs of a violation of thermoregulation are constant chilliness, fear of drafts and cooling.
Violation of motivations and drives
This form of hypothalamic syndrome is characterized by emotional and personality disorders (various phobias – fears, increased or weakened sexual desire, pathological drowsiness or insomnia, frequent and sudden mood swings).
Such disorders are characterized by impaired protein, carbohydrate, fat and water-salt metabolism, voracity ( bulimia ) or anorexia (refusal to eat), thirst.
Often, neuroendocrine disorders are accompanied by Itsenko-Cushing syndromes, diabetes mellitus , early menopause, acromegaly and thyroid pathology.
It is characterized by trophic changes (allergic rash, trophic ulcers , itching and dry skin, bedsores , changes in pigment metabolism), osteomalacia (softening of bones) or hardening of bones, the appearance of ulcerations in the esophagus, stomach, duodenum.
Due to the numerous symptoms of the hypothalamic syndrome, its diagnosis presents certain difficulties.
Apply various tests to statement of diagnosis
- determination of the sugar curve with a load: measurement of blood sugar on an empty stomach and after taking 100 gr. sugar glucose determination every 30 minutes
- three-day urine sample according to Zimnitsky ,
- measurement of body temperature at three points: in both armpits and in the rectum,
- electroencephalography .
- purpose MRI of the brain (identification increased intracranial pressure and tumors)
- the study of hormones ( testosterone, prolactin, cortisol, estradiol, LH FSH, TSH, T4 , adrenocorticotropic hormone and level 17-ketosteroids in the urine ),
- Ultrasound of the adrenal and thyroid glands
- MRI of adrenal glands or computed tomography.
Treatment of the hypothalamic syndrome is long-lasting, in most cases life-long. Therapy depends on the leading signs and causes of the hypothalamic syndrome.
An endocrinologist, a neurologist and a gynecologist (in women) are involved in treating patients with this disease.
The first stage of therapy includes the elimination of the causative factor: the appointment of antibiotic therapy or antiviral treatment, therapy of injuries, brain tumors, and so on.
In case of exposure to a poisonous factor hypothalamic syndrome is treated with detoxification therapy ( hemodez , sodium thiosulfate, glucose, saline intravenously).
Fortifying therapy, vitamins of group B, the means improving brain blood circulation (cavinton, piracetam, cerebrolysin ), amino acids (glycine, actovegin ), calcium preparations are recommended. The treatment complex includes physiotherapy, physiotherapy, reflexology (acupuncture).
In order to prevent sympathoadrenal krizov appointed Bellataminalum, pirroksan, Grandaxinum, antidepressants (amitriptyline).
When neuroendocrine disorders (violation of lipid and carbohydrate metabolism), it is recommended to follow a diet that stimulates or inhibits hormonal drugs ( adrenocorticotropic hormone – ACTH and glucocorticoids: prednisone, dexamethasone ).
The prognosis for this disease is relatively favorable.
However, as a rule, the hypothalamic syndrome leads to a decrease in working ability. Such patients are assigned the 3rd, rarely 2nd group of disability. They are contraindicated for work at night, physical and mental stress.
Hypothalamic pubertal syndrome passes to 20-25 years with correct correction.