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Hypothalamic syndrome


The hypothalamic syndrome represents a combination of the vegetative, endocrine, exchange and trophic frustration caused by defeat of a hypothalamus. An indispensable component of a hypothalamic syndrome are neuroendocrinal frustration.

Symptoms of the Hypothalamic syndrome:

Most often defeat of a hypothalamus is shown by vegeto-vascular neuroendocrinal frustration, thermal control disturbances, frustration of a dream and wakefulness. At patients the general weakness, increased fatigue, pains in heart, feeling of shortage of air, an unstable chair are noted. At inspection increase in tendon and periosteal jerks, asymmetry of arterial pressure, its fluctuation with bent to increase, tachycardia, lability of pulse, the increased perspiration, a tremor a century and fingers of outstretched arms, tendency to allergic reactions, the expressed dermographism, emotional disturbances (alarm, fear), frustration of a dream are found.

Against the background of permanent vegetative frustration there are vegeto-vascular paroxysms (crises). Usually they are provoked by emotional pressure, change of weather conditions, periods, painful factors. Attacks arise more often in the second half of day or at night, appear without harbingers. Duration of an attack is from 15 - 20 min. to 2–3 h and more. Crises can be sympathoadrenal, vagoinsulyarny and mixed.

Thermal control disturbances arise at defeat of a front part of a hypothalamus more often. Are characterized by long subfebrile body temperature with its periodic increase till 38-40? With in the form of hyper thermal crises. In blood the changes characteristic of inflammatory processes do not come to light. Use of pyramidon for such patients does not give decrease in temperature. Thermoregulatory disturbances are depending on emotional and physical pressure. So, at children they quite often appear during the occupations at school and disappear during vacation. Patients badly transfer sharp changes of weather, cold, drafts, there are emotional and personal disturbances, generally hypochiondrial type.

Neuroendocrinal frustration develop against the background of vegetative disturbances, there are disturbances fatty, carbohydrate, proteinaceous, a water salt metabolism, bulimia or anorexia, thirst, sexual frustration are noted. Neuroendocrinal exchange syndromes can develop: Itsenko-Cushing, adiposagenital syndrome of Freylikha-Babinsky (obesity, hypogenitalism), Simmonds (cachexia, depression), not diabetes mellitus (polyuria, polydipsia, low relative density of urine). Signs hypo – or a hyperthyroidism, an early climax are noted.

The chronic current with bent to aggravations is characteristic of hypothalamic frustration.

Область гипоталамуса и гипофиза на МР-томограмме

Area of a hypothalamus and hypophysis on the MR-tomogram

Reasons of the Hypothalamic syndrome:

Acute and chronic neuroinfection, craniocereberal injury, acute and chronic intoxication, brain tumors, insufficiency of cerebral circulation, mental injury, endocrine disturbances and chronic diseases of internals can be the reasons of a hypothalamic syndrome.

Treatment of the Hypothalamic syndrome:

Treatment has to include:
the means which are selectively influencing a condition of a sympathetic and parasympathetic tone. – Belloidum (белласпон), adrenolytic drugs (Pyrroxanum), beta adrenoblockers (Obsidanum), cholinolytics (Platyphyllinum, belladonna drugs), ganglioblokator;
psychotropic drugs – antidepressants (amitriptyline, Prozac, леривон), anxiolytics (ксанакс, clonazepam);
fortifying means (vitamins C, groups B, metabolic drugs);
drugs for treatment of a basic disease (resorptional, anti-inflammatory drugs), for performing disintoxication therapy, Haemodesum, glucose, isotonic solution of sodium chloride).

In case of sympathoadrenal crisis the patient is given the comfortable position promoting relaxation of muscles. Appoint calmatives (a valerian, a motherwort, valocordin, tranquilizers), alpha and beta adrenoblockers (сермион, анаприлин). If necessary apply an Euphyllinum, Dibazolum, Diuretinum, Diacarbum.

At parasympathetic crisis use the means increasing the arterial pressure (caffeine, Cordiaminum), cholinolytics of the central and peripheral influence (atropine, Methacinum, amizyl, bellataminal). Upon termination of crisis it is necessary to treat with antidepressants, vegetotropny drugs, psychotherapeutic treatment.

Working capacity. Is defined by the leading symptom complex. It is necessary to limit psychological and physical tension, to exclude work at night. As a rule, permanent disability arises only at the expressed, frequent vegetative paroxysms (crises) and at heavy neuroendocrinal disturbances. By this patient taking into account the main profession the II group of disability can be established to III and even.

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