Encephalopathy is called dystrophic damage to the brain tissue of a widespread nature as a result of exposure to various factors – infections, intoxication, and metabolic disorders.
The main cause of encephalopathy is chronic hypoxia of the brain as a result of exposure to various pathological factors.
Hypoxia or oxygen deficiency – leads to disruption of the normal metabolism of brain tissue, disruption of its nutrition and the death of nerve cells, disabling the work of certain areas of the brain.
All encephalopathies can be divided into two large groups – congenital and acquired.
Congenital forms can occur as a result of genetic metabolism failure, due to malformations of the brain or exposure to damaging factors during pregnancy (hypoxia, infection) or during childbirth (birth injuries, hematomas, hemorrhages).
Acquired encephalopathy occurs throughout life from infancy to extreme old age, can be caused by different factors, they are divided into several groups.
- traumatic are the consequences of head injuries, open and closed skull fractures
- toxic encephalopathy resulting from brain damage by neurotropic toxins (alcohol, methyl alcohol, chloroform, lead)
- toxic-infectious – brain damage by bacterial toxins ( tetanus , botulism )
- radiation, as a result of damage to the brain tissue by ionizing radiation
- metabolic, with hepatic or renal failure, with sugar diabetes due to glucose fluctuations
- encephalopathy due to impaired water-salt balance (due to swelling or dehydration of the brain), acute blood loss
- vascular, due to chronic circulatory disorders (causes can be atherosclerosis, arterial hypertension , venous congestion)
- medicinal encephalopathy, as a toxic variant, in case of overdose or poisoning with medicines.
Manifestations of encephalopathy can be extremely diverse, depending on the cause of its occurrence. The degree of symptoms scrolled on the depth and extent of brain damage, disease duration and sopustvuyuschih health disorders.
The earliest signs of encephalopathy can be:
- decrease in mental abilities, IQ
- the difficulty in performing intellectual tasks, tasks that the patient had previously easily coped with
- memory loss, both short-term (I forgot where I was going) and long-term (I do not remember the events of previous years)
- There may be significant difficulties in performing multi-stage tasks
- difficulties in changing activities where you need to quickly think and act
- sleep disorders and its depths, insomnia, daytime sleepiness, nightmares, speaking , walking in a dream
- daytime fatigue even with habitual activity
- exhaustion with stress
- general fatigue under any load.
Often with encephalopathy, there are complaints of persistent headaches of a spilled nature, episodes of tinnitus, general malaise, irritability without cause, constantly depressed mood.
Patients often note that they have double vision, hearing and hearing are reduced, especially in the evening or during stress, episodes of increased tone of the muscles of the body and limbs can be detected, and tendon reflexes (especially the knee) are enhanced.
When encephalopathy can be detected violations in the extremities, disorders of the cerebellum in the form of a violation of gait, instability, especially with eyes closed, there may be problems with speech – slurring, a sense of stray language.
Vegetative disorders can be added – heart attacks with shortness of breath and a feeling of lack of air, pressure fluctuations, heavy sweating, pallor, fainting and marbling of the skin, disturbances of thermoregulation.
Manifestations of encephalopathy can be progressive and not progressive, can develop in the later stages parkinsonism or damage to the brain nuclei with a sharp violation of the basic functions of life support (respiratory disorders, paralysis).
In the majority of patients, encephalopathy is accompanied by mental disorders in the form of hallucinations, delusional disorders, depression, etc.
Symptoms of acute encephalopathy
Separately allocated acute encephalopathy – they arise as a result of severe, massive and significant brain damage, circulatory disorders and swelling of the brain.
There is acute encephalopathy with a severe headache in the back of the head and general anxiety, nausea with vomiting, problems of vision, dizziness, numbness of the fingers and toes, face, tongue. As progressing occurs, depression of consciousness occurs, lethargy, there may be seizures, paresis.
The basis of diagnosis for suspected encephalopathy is the initial state of health – evidence that there are chronic diseases, diabetes, toxic lesions, etc.
Supplemented by the data of the examination of the neurologist with the definition of neurological symptoms, disorders in the motor sphere, sensitivity and the work of the higher nervous activity.
If you suspect encephalopathy are necessary:
- examination of the oculist to determine the state of the fundus
- general clinical studies – blood, urine, biochemistry blood according to indications, with the identification of inflammatory, toxic, allergic and other nature of the lesion
- instrumental diagnostics
With electroencephalography, pathological waves, epileptic activity, and rhythm disorganization can be detected. When conducting computed tomography and magnetic resonance scan revealed signs of brain atrophy.
When secondary encephalopathy occurs as a symptom of other diseases, a specific examination of the underlying disease is necessary.
The treatment of encephalopathy is carried out by neurologists together with specialists in the diseases that have caused it (endocrinologists, urologists, gastroenterologists, cardiologists, pediatricians).
First of all, there are two directions in treatment – elimination of the cause of encephalopathy and the fight against manifestations.
In acute encephalopathy, hospitalization in intensive care with hemodialysis, mechanical ventilation and detoxification is necessary. Held to combat swelling of the brain, convulsions and vascular disorders.
As the state improves, medications that improve brain function are prescribed – nootropic ( piracetam , nootropil ), amino acid ( glutamine histota , glycine), Essentiale , lecithin, vitamins and metabolites.
If necessary, prescribed vascular preparations picamilon , Cavinton , cinnarizine .
With a tendency to thrombosis, antiplatelet agents are used ( pentoxifylline , aspirin) and stimulants – aloe extract.
Treatment courses lasting up to three months in a row.
Encephalopathy may be complicated by the development of coma, seizures, stroke and death, and organic lesions with movement disorders, muscle tone and speech may remain.
The prognosis largely depends on the causes of encephalopathy and the degree of brain damage. In most cases, you can only stabilize the state, but not completely eliminate the consequences.