General information. Encephalopathy - what is this disease?

Encephalopathy is a generic term for non-inflammatory type brain diseases. The classification of diseases falling under this designation is quite broad: several types of encephalopathy are distinguished, which differ according to the causes of the diseases. First of all, it is customary to distinguish between encephalopathy acquired and perinatal due to the fact that the causes of damage to the brain in an adult and in the fetus during gestation are completely different. The occurrence of perinatal encephalopathy provokes certain deviations in the last months of fetal development or already in the process of childbirth.

In order to prevent such troubles, pregnant women undergo regular examinations, during which the doctor observes whether the fetus is adequately supplied with oxygen, whether there is cord entanglement, and determines other developmental features. Accordingly, measures are taken to prevent pathology. Perinatal encephalopathy in children does not necessarily occur immediately after birth. It is possible that certain problems with memory or intelligence will be noted later.

Causes of Perinatal Encephalopathy

The causes of perinatal encephalopathy in the fetus are many factors. So, the disease manifests itself in view of the chronic diseases that the pregnant woman suffered. Also, the cause may be transferred to the period of pregnancy acute illness infectious, malnutrition, too young an age of the mother, hereditary diseases, pathological course of pregnancy, problems encountered during childbirth, birth injury. Encephalopathy can also occur in those newborns whose mothers lived in poor environmental conditions. The disease often occurs in premature babies. The most common brain lesions in newborns are hypoxic-ischemic and mixed CNS lesionsarising from a violation of the oxygen supply to the fetal brain due to the above reasons.

Symptoms of perinatal encephalopathy

Perinatal encephalopathy in children can occur with certain syndromes during the first month of a child’s life. However, some experts are convinced that a similar ailment can manifest itself later, during the first year of life. So, a sick baby may manifest hypotension or muscle hypertension, that is, motor disorder syndrome. As a rule, it is difficult to assess the condition of the newborn due to the presence of physiological hypertonicity. The next sign is a syndrome of high neuro-reflex excitability. So, the child can fall asleep hard, behave too actively, awake, the manifestation of trembling limbs and chin is possible. Another sign that can signal the presence of encephalopathy is CN depression syndromeFROM. Accordingly, in this condition the child is too lethargic and inhibited, and due to the different muscle tone, he sometimes has asymmetry of the trunk and facial features. Such a baby has poorly expressed sucking skills.

The most serious sign is considered intracranial hypertension syndromeand. Such a symptom is dangerous due to the possibility of a transition to hydrocephalus, a disease that is treated exclusively by the surgical method. It is important to pay attention to the correspondence of the size of the fontanel to the age of the child, as well as the size of the head. Another sign of encephalopathy - convulsive syndrome - is difficult to recognize in babies in their first year of life. After all, it may not manifest itself in “pure” convulsions, but hiccups, spitting uptoo strong saliva. If you suspect it is important to conduct an additional examination.

Diagnosis of perinatal encephalopathy

Diagnosis of this disease is carried out by studying clinical data, taking into account all the features of the course of pregnancy and childbirth. The use of a number of additional research methods helps to identify how serious brain lesions are, and what kind of these lesions are, and also provide control over the course of the disease and the correct selection of treatment methods for encephalopathy in children.

Thanks to the use of neurosonography, a specialist examines the brain of a child. This study allows us to assess the state of brain tissue, cerebrospinal fluid spaces. At neurosonography it is possible to detect intracranial lesions and determine their nature. Thanks to the method dopplerography an assessment of the amount of blood flow in the vessels of the brain.

EEG carried out to assess the functional activity of the brain. To do this, during the study, the electrical potentials of the brain are recorded. The information obtained allows us to draw conclusions about the degree of delay in brain development, to determine the asymmetry of the hemispheres and the presence of foci of epileptic activity in certain parts of the brain. Using video monitoring, the spontaneous activity of the baby's movements is assessed. For this, a video is being recorded. For the diagnosis of neuromuscular diseases of various kinds is used electroneuromyography. Structural changes in the brain help identify methods computed tomography and magnetic resonance imaging. However, these methods require the use of anesthesia, as a result of which their use is difficult in infancy. At positron emission tomography it is determined how intensively the metabolism in the tissues takes place and the blood flow in the brain is carried out. Of all these methods for diagnosing the disease, the most commonly used are neurosonography and electroencephalography.

If the child has a pathology of the central nervous system, then consultation and examination with an oculist are mandatory. It determines the presence of changes in the fundus, which helps to assess the level intracranial pressure, determine what the state of the optic nerves is.

Encephalopathy Treatment

Treatment of perinatal type encephalopathy in its acute period is carried out by doctors immediately in the maternity hospital. If necessary, the newborn for subsequent treatment is transferred to the appropriate medical institution. During therapy, a number of drugs are used to improve blood circulation to the brain. So, newborns are assigned actovegin, vinpocetine, piracetam. In the recovery period, a pediatric neuropathologist should regularly monitor the patient. Depending on what specific symptoms appear in the child, he is prescribed anticonvulsant, diuretic impacts vitamin complexes and other drugs.

With mild manifestations of increased neuro-reflex excitability and impaired motor activity, the treatment of encephalopathy involves the use of pedagogical correction, physiotherapy exercises, and physiotherapeutic methods. Also, child massage sessions, courses are prescribed for the child herbal medicine. During the treatment process, it is very important to strictly comply with all the instructions of the attending physicians.

Residual encephalopathy

Sometimes a child is diagnosed withresidual encephalopathy", Indicating the presence of brain damage that arose as a result of previous illnesses. Residual encephalopathy is manifested not only due to brain injuries, but also due to exposure to infections, inflammation, poor blood supply to the brain. In this case, the symptoms of encephalopathy can manifest themselves in different ways. So, a child can suffer from constant headaches, and sometimes he has mental problems and even lowered intelligence. Due to such manifestations, sometimes the residual type of this disease is mistaken for certain mental disorders in the patient.

Encephalopathy Complications

With the right approach to treatment, about 20-30% of children fully recover. The consequence of the disease may be hydrocephalic syndrome, minimal cerebral dysfunction, vegetative-vascular dystonia. The most serious complications of encephalopathy can be epilepsy, as well as cerebral palsy.

Acquired Encephalopathy

This form of this ailment manifests itself already at an older age and becomes a consequence of a number of reasons, namely: transferred infectious diseaseb, intoxication, tumors, injuries, changes the structure and brain vessel functionality. A similar form of encephalopathy is usually divided into several types. So, post-traumatic encephalopathy is a disease resulting from a variety of craniocerebral injuries. Encephalopathy of this type primarily affects the frontal and temporal lobes of the brain. As a result, a person may experience memory lapses, a decrease in intellectual abilities, and problems with controlling behavior. Also, this ailment is accompanied by dizzyheadache, trouble sleeping and distracted attention. If the symptoms of encephalopathy appear after a certain time after the injury, the patient may suffer from mental disorders, depression, manifest periodic aggression, and face problems of an intimate nature.

EncephalopathyAlso called vascular, it is a lesion of brain tissue that manifests itself due to circulatory disorders. The cause of this form of the disease is often high intracranial pressure, hypertension, atherosclerosis, osteochondrosis of the cervical spine, vegetative-vascular dystonia.

This term in the international classification of diseases is defined as cerebral ischemia. With this type of disease, destructive processes occur in the human brain that affect only certain foci of the brain. But after a certain period of time, the foci become more extensive, as a result of which the patient has more pronounced symptoms of encephalopathy. This diagnosis is quite common among the population: according to experts, 5-7% of people have a similar form of encephalopathy. In this case, the main cause of such a violation is poor blood supply to the brain. Most often, this disease occurs in people who experience constant stress, abuse alcohol, smoke a lot.

Toxic encephalopathy - This is the result of acute or chronic poisoning of the brain with different poisons. Such toxic substances can form directly in the human body or enter the brain from the external environment. The first option is possible with the development of a number of infectious processes - diphtheria, measles, botulism, tetanus. In such diseases, bacterial toxins are released, subsequently poisoning the brain. Also, similar toxins are released during the systematic use of alcohol, certain medications, as well as a number of chemical compounds. If the intoxication is acute, a person needs emergency medical help, because due to severe poisoning, epileptic seizures and even the patient falling into a coma are possible. When exposed to the patient’s brain, ionizing radiation is determined radiation encephalopathy.

Dystrophic processes in the brain tissue can also develop as a result of a number of endocrine pathologies. it hypothyroidism, diabetes, kidney dysfunction, liver, pancreas. As the first symptoms of such a disease, a noticeable decrease in mental activity, memory impairment, sleep problems, high fatigue, inadequate manifestation of the functions of the organs of hearing and vision are manifested. Often the patient has signs of a mental disorder. In the acute period of the disease, body cramps, very severe headaches, vomiting, nausea, and impaired consciousness can occur.

Treatment for Acquired Encephalopathy

Encephalopathy should only be treated using a professional approach because of the severity of the disease. Based on the results of a comprehensive examination, the specialist prescribes the optimal treatment regimen. As a rule, symptomatic therapy is used, as well as massage, regular exercises from a complex of physiotherapy exercises, following a certain diet. Treatment is prescribed solely taking into account the individual characteristics of each patient.

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List of sources

  • Shtulman, D.R. Neurology: Handbook of a Practitioner / D.R. Shtulman, O.S. Levin. M .: Medpress-inform. - 2007.
  • Nikiforov, A.C. Clinical Neurology /A.C. Nikiforov, A.N. Konovalov, E.I. Gusev. M :: Medicine. - 2002.
  • Mumentaler M., Mattle H. Neurology / Ed. O.S. Levin. - M .: MEDpress - inform, 2007.
  • Parfenov VA. Discirculatory encephalopathy: differential diagnosis and treatment. Clinician. 2008

Watch the video: Hepatic Encephalopathy (January 2020).

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