Bettolepsy

Description:

Bettolepsy (Greek bzttu to cough + lzpsis a hvataniye, an attack) — disorders of consciousness, sometimes in combination with spasms, developing at height of a tussive attack. The disturbances of blood supply of a brain caused by increase in intrathoracic pressure and a hyperventilation are their cornerstone.

Bettolepsy reasons:

Most often the bettolepsy is observed at patients with a pulmonary heart and a venous plethora of vessels. Respiratory and cerebral epileptic seizures at patients with whooping cough, bronchial asthma are described, and also at neuralgia of an upper guttural nerve.

Bettolepsy symptoms:

In a bettolepsy pathogeny the leading role along with acute venous stagnation is played by a pathological impulsation from reflexogenic zones of respiratory tracts, an upper guttural nerve, carotoid-sinus receptors, aortas, jugular veins, venous sine of a brain that breaks vegetative activity, leads to excitement of the center of a vagus nerve and sharp bradycardia, up to development of Morganyi — Adams — Stokes of a syndrome.

Clinical displays of a bettolepsy differ on weight at different patients, and sometimes and at one patient at different times.
Options from short-term twilight consciousness are possible during cough to a deep loss of consciousness in combination with spasms and an incontience of urine and a calla.
Usually the patient during cough suddenly faints and falls, but soon recovers.
Epileptiform spasms which can be limited to some one area of a body are sometimes observed.
Most often the attack quickly comes to an end without the period of mental disturbances inherent to epilepsy.


The bettolepsy is observed preferential at senior citizens with chronic respiratory diseases and lungs (pharyngitis, laryngitis, emphysema of lungs, bronchial asthma, etc.).

At younger age emergence of faints at cough is observed rather seldom, mainly, at persons with hypersensitivity of a carotid sine, or at functional insufficiency of the mechanisms supporting a postural tone. The children having whooping cough at height of a tussive paroxysm have lipotimiya and unconscious states.

Fits of coughing arise at patients in a sitting position or standing, is frequent during food or soon after it. Among provocative factors there can be a cold air, a pungent smell, tobacco smoke, excessive laughter, etc.

With the advent of cough the hyperemia of the person develops, then it becomes cyanochroic, veins on a neck bulk up. Usually there are no harbingers, there can be only slight dizziness.

The loss of consciousness arises within the first minute from the beginning of cough. There is cyanosis, patients quite often fall, often hurt. With a loss of consciousness cough stops, the person becomes pale. Spasms usually are not observed (tonic spasms are sometimes possible). There is no bite of language and an involuntary urination. Duration of a loss of consciousness from several seconds to one minute. Return of consciousness and an exit from an attack bystry.

At vomiting, defecation, sometimes repeated sneezing, at a raising of weight and in general at different tension similar conditions with above described, leading to increase in intrathoracic pressure and faints can be created. Similar mechanisms lead to a loss of consciousness and at laughter (gelolepsiya). Such attacks are more often observed at children. The current and an outcome of a bettolepsy depend, generally on the general somatic condition of the patient. At patients with chronic insufficiency of cerebral circulation because of atherosclerosis, an idiopathic hypertensia the attack of a bettolepsy can lead to structural damages of a brain with resistant effects.

Treatment of a bettolepsy:

Treatment is directed to a basic disease. The attack of a bettolepsy passes usually without therapeutic intervention in several seconds or minutes.

At for the first time the revealed bettolepsy of the patient needs to hospitalize for inspection.
For the purpose of the prevention of a bettolepsy at the patient with a chronic bronchopulmonary disease appoint the antibechic drugs and means improving passability of bronchial tubes.
If during an attack bradycardia is registered, purpose of atropine is shown. Patients with a bettolepsy have to be observed both by the therapist, and the neuropathologist.