In the broad sense of encephalopathy in children is a disease in which the brain is affected. Numerous factors can provoke diseases.

Forecastsdiseases directly depend on the timeliness of diagnosis and therapy. Ignoring symptoms of encephalopathy can cause a cardinal violation of the functioning of certain brain departments, to restore the performance of which will not work.

Encephalopathy brain - what is it?

The term "encephalopathy" in medical practice is united by a group of diseases of non-inflammatory etiology, affecting the nervous system.

The cause of such pathologies is the defeat of a certain group of brain neurons with negative external and internal factors.

Encephalopathy is not an independent disease and develops only against the background of complications of various pathological conditions.

Why develops?

Encephalopathy factors in newborn childrenThey differ from the causes of the ailment in older children.

In the first case, the process of intrauterine development of the fetus plays an important role.

Generic injuries There may also be caused by the development of encephalopathy.

In most cases, older children have a complication of other pathologies or result.

Provoke encephalopathy Children can have the following factors:

• consequences of intrauterine hypoxia;
• complications ;
• abuse of bad habits during pregnancy;
• congenital diseases of the cardiovascular and respiratory system;
• instability;
• complications of infectious and viral diseases;
• violation of blood circulation system;
• consequences of cranial injuries;
• complications ;
• in the body (especially vitamin B);
• toxic effect on the central nervous system.

What happens?

Encephalopathy can be congenital and acquired.

In the first case, pathology develops as a result of the negative impact of factors various etiology On the head of the child during its intrauterine development.

Acquired forms of the disease begin to progress after birth(including due to generic injuries). Additionally, encephalopathy is divided into several types depending on the cause provoked the development of alert.

Encephalopathy classification:

In medical practice there are three degrees of progression of encephalopathy. At the initial stage of development clinical manifestations The illness can be erased. The second degree of the disease is characterized by the exacerbation of symptoms.

The third stage of the progression of the disease is accompanied by the development of irreversible processes, which can cause disabilities and the emergence of persistent neurological disorders.

How to recognize?

The intensity of symptoms of encephalopathy in children depends on numerous factors. An important role is played by the age of the child, state of it nervous system, kind of cause of the development of the disease, as well as the presence or absence of provoking diseases of chronic form.

The development of the pathological state occurs gradually, but in some cases characteristic symptoms appear suddenly and with high degree Intensity.

Symptoms and signs Encephalopathy in children can be the following states:

What is dangerous?

Encephalopathy has an extremely negative impact on brain neurons. Progressionpathology can cause irreversible processes. Relief from some complications will be impossible.

At encephalopathy, the working capacity of the nervous system is disturbed, which can provoke a child's tendency to depressively states, asthenic syndrome and a series of vegetative-vascular dysfunctions.

In the absence of timely therapy, complications increase their scale. Complications of encephalopathythe following pathologies can be:

Establishing diagnosis

In the diagnosis of encephalopathy, several specialists are involved, but diagnosis is engaged in neuropathologist.

An additional inspection in profile doctors is carried out with difficulty to identify the causes of the ailment or determine the degree of defeat. children's body. The main methods of diagnosisencephalopathy are instrumental and laboratory procedures.

Diagnostics use the following methods:

Treatment methods and drugs

Therapeutic course for encephalopathy appointed individually. When choosing the necessary drugs and procedures, the child's age is taken into account, the total clinical picture The state of his health, the causes of the lesion of the brain neurons and the degree of progression of pathology.

Self-medication during encephalopathy should be excluded. Otherwise, it will be impossible to get rid of its complications.

In the treatment of encephalopathy, the following can be appointed preparations and procedures:

What is the outcome?

In most cases, Encephalopathy ends with recovery of the child. However, this forecast is possible only when conducting full and complex therapy.

If the symptoms of pathology have been ignored for a long time, the diagnosis of the disease was carried out untimely, and the treatment was carried out with regime impairment, such factors could provoke Complications and negative consequencesfor a children's body.

Encephalopathy can provoke irreversible processes in the brain, because of which it will not be possible to restore its performance.

Prevention objectives

Prevention of encephalopathy includes elementary rules for care for the child and care about his health.

FROM early age The baby must eat right and get enough vitamins.

Parents must send to doctors in a timely manner, if the child has symptoms of working capacity internal organs and deterioration general status organism. Special attention to your lifestyle women should pay during pregnancy.

Prevention of encephalopathy includes the following recommendations:

1. Prevention of generic injuries in a child.
2. Prevention of hypoxia fetal during intrauterine development.
3. Strengthening immune system Child from an early age.
4. Refusal of bad habits during pregnancy.
5. Prevention of toxic impact on a children's body.
6. Full and timely therapy of diseases of infectious nature.

If the child has elevated intracranial pressure, it is necessary to conduct a comprehensive examination as soon as possible.

Such a symptom in most cases is the first signal of brain neurons. Thanks timely diagnosis You can identify encephalopathy at the initial stage of development. The probability of complete recovery of a small patient will increase largely.

Children's neurologist about encephalopathy in children in this video:

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Organic brain lesion

The diagnosis of organic brain lesion (OPM) in children is a very frequent phenomenon in pediatric practice. A child with severe neurological pathology is easier to put it, than to understand the nature of the disease. However, experience shows that thoroughly used history, data of objective examination methods, as well as the results of the assessment of laboratory and instrumental studies allow you to clarify a very much diagnosis and a pediatrician doctor, and the pathologist (in the event of a patient's death).

The OPM is a wide concept of determining the definition of which does not exist. It is a consequence of pre- and perinatal pathology with the exception of genetic diseases and congenital malformations. Provide to such an OPM manifestation may acquired infectious and not infectious diseases, in particular, the brain injury, neuroinfection (meningoencephalite), hypoxic states whose assessment is not included in the purpose of this article. Practical experience testifies to the abuse of the diagnosis of OPM. On the one hand, this is explained by the insufficient level of methodological opportunities, on the other - the abundance of diseases that lead to OPM, with the third - the reluctance of some clinicians involved in the treatment of intercrivers in such children, to delve into neurological pathology.

Since the OMP is not entered in International Classification Diseases X of revision (MKB X), for its encryption, useless formulations "Encephalopathy uncomfortable" G93.4 or "Defeat of the brain in unspecified" G93.9. The ICD also has asphyxia (in relation to perinatal period), P20-21, birth injury, P10-11, and various intracranial hemorrhages, P52, and to denote the consequences of these states, nosological units are not provided. We list the main most common in the practice of pediatrics of diseases, which can be formulated in terms of ICD X as independent diagnoses:

• congenital brain development vices, Q00-07,
• thesaurisms with the defeat of the central nervous system, E70-83,
• intrauterine infections (toxoplasmosis, cytomegaly, tuberculosis, syphilis and others), A50, P35, P37, P39,
• childish cerebral paralysis (Cerebral palsy), G80,
• hydrocephalius, G91.

The main in the formulation of the diagnosis are: the history of mothers, the course of pregnancy and childbirth, the state of the last, the results of the laboratory research, the dynamics clinical symptoms The child, the top of the brain lesions and, in the event of a child's death, the morphological picture of changes not only to the brain, but also internal organs. This information helps to hold differential diagnosis With other neurological diseases and identify leading and secondary etiological factors of the disease.

Most reasonable reasons OPM in children are as follows:

1. Asphyxia. It requires careful collection of anamnesis in the mother (decompensated heart defects, hypertonic disease, severe anemia, chronic diseases Lungs, diabetes, toxicosis of pregnant women), as well as the flow of labor, objective clinical data.
2. Intracranial generic injury. The main thing that is needed to pay attention is the inconsistency of the fetus and generic sizes, a long anhydrous period, a protracted or rapid course of a generic act.
3. Intracranial hemorrhages intra- and postnatal, primarily cerebral, intraventric and subarachnoidal. Such hemorrhages are usually associated with generic injury or asphyxia in childbirth, but they will be completed directly.
4. Intrauterine infections with the damage to the central nervous system. In this regard, infectious (acute and chronic) diseases of the mother both before and during pregnancy, despite the fact that there is often a direct dependence between the severity of the disease of the pregnant and fetus; Prenatal fetal hypotrophy, presence, chronic placental insufficiency. The spectrum of pathogens is very wide: the simplest, mushrooms, bacteria, mycoplasma, ureaplasma, chlamydia and, finally, numerous viruses (viruses of a simple herpes, respiratory viruses, enteroviruses, rubella virus, human immunodeficiency and others). Some of them can penetrate the CNS antenatal, part of intranatally and postnatally.
5. Hemolytic disease Newborn, accompanied by a nuclear jaundice.
6. Toxic effects on the fetus during pregnancy.
7. Mixed etiology, which is observed most often, since the pathological conditions characteristic of the perinatal period are usually closely interrelated. Breakly we present clinical data that can be detected at the OPM, noting that during the diversity of the clinic to allocate individual syndromes still possible:
1. Syndromes Palsy: spastic diplegegia, double hemiplegia, hyperkinetic shape, an astonic form, hemiplegia.
2. Convulsive syndrome. With asphyxia, the newborns most often tonic tonic-clonic convulsions are noted. With intracranial hemorrhage, they have focal nature. Their duration is usually small. They arise immediately (1-3 minutes) or shortly after delivery. After the acute period of asphyxia, the convulsions may stop and resume aged 1.5 - 2 months of communication with the coming morphological changes in the brain. In the cranial injury, convulsions are often partial in nature: face, limb or hemite; Also more often convulsions appear after a few hours or even 2-3 days due to increasing hemorrhagic syndrome; Next after a light gap from 2 months to several years convulsive syndrome May appear again. With a nuclear jaundice, the convulsions are tonic to the opistonus. With intrauterine infectious lesions of the brain, cramps can wear a different character and arise, as a rule, after a bright interval in a few days after delivery.
3. Oligophrenia various degrees (retardation in psychomotor development), speech disorders and disorders of simple and / or complex sensitivity may arise in connection with all these etiological factors.
4. Secondary microcephaly - a decrease in the size of the skull begins after the birth of a child, the skull can be symmetrical, and may be asymmetrical.
5. Occlusal hydrocephalus.
6. The syndrome of minimal cerebral dysfunction - can begin with breast-age children, and the most vivid manifestations are celebrated from schoolchildren; It is fundamentally characterized by moderately pronounced motor, speech and vegetative disorders.

The pathoanatomy picture (in the event of a child's death) also makes it possible to conduct differential diagnosis in such situations and often clarify the nature of suffering. With severe asphyxia in the perinatal period, it usually arises, as a rule, the so-called hypoxic-ischemic encephalopathy. It has several options.

1. With long, gradually developing hypoxia, generalized and cortical necrosis occurs with the damage to the bark of large hemispheres of the brain and cerebellum. The most vulnerable cells 3, 5 and the 6th layers of the bark and the Purkinier cells are often developing necrosis of the brain stem nuclear. Clinically - mental underdevelopment, cerebral paralysis, epilepsy.
2. Perivnricular lekomolaying - multiple small foci of necrosis in the perivativericular white substance. Clinically - spastic diplegegia.
3. The defeat of the border arterial zone is acemia of the dark-occipital region, hemorrhagic heart attack is often developing. The clinic correlates with the lesion area.
4. The defeat of blood supply zones is manifested by necrosis in the fields of vascularization of the main cerebral arteries. False porcerephalia develops, with multiple necrotic cavities, the term multistallic encephalomying is used.

The consequences of the described processes are false cysts of the respective localizations, as well as the foci of gliosis and glial scars. Moreover, for transferred asphyxia, multiple cysts are characterized. The brain generic injury is manifested primarily in various localization of hemorrhages in the central nervous system. The outcome of hemorrhages in the brain is to dissolve with the formation of a cyst, in the wall of which Siderophages can be detected, gemiderine.

With the consequences of the nuclear jaundice, dystrophy and neurons neurons occur, as well as focal giam in the subtalalamic nuclei, ammonov rhog, a pale bowl, Lower Olive, casket casket. These include:

• secondary microcephaly, distinguished from congenital relatively uniform decrease in the sizes of the skull;
• occlusal hydrocephalus due to the growths of glialileelements, blockage of organized bodies, inflammatory detritus;
• secondary microhyria due to the collapse of the nervous tissue after necrotic changes, it is usually expressed unevenly and asymmetrically.
• histologically foci of the loss of neurons, violation of architectonics of the bark, the bodies of the dead neurons.

In the absence of an infectious factor, these changes other than hydrocephalus after the formation are not progressing. We would once again focus on the fact that the processes described can be combined in different combinations and do not always correspond to the severity of transferred asphyxia or generic injury.

From a practical point of view, OPM combines a large number of diseases and syndromes with its etiology and requiring special therapeutic approaches. The diagnosis of OPM is not nosological and should be set only in cases where it is not possible to determine its nature accessible methods.

Antonov P.V., Cand. honey. science
head of the pathoanatomic department
children's infectious hospital number 5. N.F. Filatova,
St. Petersburg.

The diagnosis of organic brain lesion (OPM) in children is a very frequent phenomenon in pediatric practice. A child with severe neurological pathology is easier to put it, than to understand the nature of the disease. However, experience shows that carefully assembled history, data of objective examination methods, as well as the results of the assessment of laboratory and instrumental studies allow you to clarify a very much diagnosis and a pediatrician doctor, and the pathologist (in the event of the patient's death).

OPM represents a wide concept of determining the definition of which does not exist. It is a consequence of pre- and perinatal pathology with the exception of genetic diseases and congenital malformations. Certain infectious and noncommunicable diseases can lead to such an OPM, in particular, the crank-brain injury, neuroinfection (meningoencephalites), hypoxic states whose assessment is not included in the purpose of this article.

Practical experience testifies to the abuse of the diagnosis of OPM. On the one hand, this is explained by the insufficient level of methodological opportunities, on the other - the abundance of diseases that lead to OPM, with the third - the reluctance of some clinicians involved in the treatment of intercrivers in such children, to delve into neurological pathology.

Since the OMP has not been made to the international classification of diseases x of the revision (MKB X), for its encryption, the faceless formulations "Encephalopathy unspecified" G93.4 or "Defeat of the brain uncomputed" G93.9 are used. The ICD also has asphyxia (in relation to perinatal period), P20-21, generic injury, P10-11, and various intracranial hemorrhages, P52, and nosological units are not provided for the consequences of these states.

We list the main most common in the practice of pediatrics of diseases, which can be formulated in terms of ICD X as independent diagnoses:

• congenital brain development vices, Q00-07,
• thesaurisms with the defeat of the central nervous system, E70-83,
• intrauterine infections (toxoplasmosis, cytomegaly, tuberculosis, and others), A50, P35, P37, P39,
• child cerebral (cerebral palsy), G80,
• hydrocephalius, G91.

The main diagnosis is: history of mothers, the course of pregnancy and childbirth, the condition of the last, the results of the laboratory research, the dynamics of clinical symptoms in the child, the topics of brain lesions and, in the event of a child's death, the morphological picture of changes not only for the brain, but also internal organs. This information helps to carry out a differential diagnosis with other neurological diseases and identify leading and secondary etiological factors of the disease.

The most significant reasons for OPM in children are the following:

1. Asphyxia. To state it, careful collection of history of the mother is needed (decompensated heart defects, severe, chronic light diseases, s pregnant), as well as the flow of labor, objective clinical data.
2. Intracranial generic injury. The main thing that is needed to pay attention is the inconsistency of the fetus and generic sizes, a long anhydrous period, a protracted or rapid course of a generic act.
3. Intracranial hemorrhages intra- and postnatal, primarily cerebral, intraventric and subarachnoidal. Such hemorrhages are usually associated with generic injury or asphyxia in childbirth, but they lead directly to OPM.
4. Intrauterine infections with the damage to the central nervous system. In this regard, infectious (acute and chronic) diseases of the mother both before and during pregnancy, despite the fact that there is often a direct dependence between the severity of the disease of the pregnant and fetus; Prenatal fetus, prematurity, chronic placental. The spectrum of pathogens is very wide: the simplest, mushrooms, bacteria, mycoplasma, ureaplasma, chlamydia and, finally, numerous viruses (simple viruses, respiratory viruses, enteroviruses, rubella virus, human immunodeficiency). Some of them can penetrate the CNS antenatal, part of intranatally and postnatally.
5. Hemolytic disease of newborns, accompanied by a "nuclear jaundice".
6. Toxic effects on the fetus during pregnancy.
7. Mixed etiology, which is observed most often, since the pathological conditions characteristic of the perinatal period are usually closely interrelated.

We briefly present clinical data that can be detected at the OPM, noting that with the diversity of the clinic to allocate separate syndromes, it is still possible:

1. CPP syndromes: spastic diplegegia, double hemiplegia, hyperkinetic form, atony-astatic form, hemiplegia.
2. Convulsive syndrome. With asphyxia, tonic and tonic-clonic convulsions are most often noted in the newborns. With intracranial hemorrhage, they have focal nature. Their duration is usually small. They arise immediately (1-3 minutes) or shortly after delivery. After the acute period of asphyxia, the convulsions may stop and resume aged 1.5 - 2 months due to the coming morphological changes in the brain. In the cranial injury, convulsions are often partial in nature: face, limb or hemite; Also more often convulsions appear after a few hours or even 2-3 days due to the increase in hemorrhagic syndrome; Next, after a light gap from 2 months to several years, convulsive syndrome can appear again. With a nuclear jaundice, the tonic convulsions with the transition to opistotonus. With intrauterine infectious lesions of the brain, cramps can wear a different character and arise, as a rule, after a bright interval in a few days after delivery.
3. Oligophrenia of varying degrees (retardation in psychomotor development), speech disorders and violations of simple and / or complex sensitivity may arise in connection with all these etiological factors.
4. Secondary - a decrease in the dimensions of the skull begins after the birth of a child, the skull can be symmetrical, and maybe asymmetrical.
5. Occlusive.
6. The syndrome of minimal cerebral dysfunction - can begin with breast-age children, and the most vivid manifestations are celebrated from schoolchildren; It is fundamentally characterized by moderately pronounced motor, speech and vegetative disorders.

The pathoanatomy picture (in the event of the death of a child) also gives the opportunity to hold differential diagnosis In such situations and often clarify the nature of suffering. With severe asphyxia in the perinatal period, it usually arises, as a rule, the so-called hypoxic-ischemic. It has several options.

1. With long, gradually developing hypoxia, generalized and cortical necrosis occurs with the damage to the bark of large hemispheres of the brain and cerebellum. The most vulnerable cells 3, 5 and the 6th layers of the bark and the Purkinier cells are often developing necrosis of the brain stem nuclear. Clinically - mental underdevelopment, cerebral,.
2. Perivnricular lekomolaying - multiple small foci of necrosis in the perivativericular white substance. Clinically - spastic diplegegia.
3. The defeat of the border arterial zone - the dark-occipital region, is often developing a hemorrhagic heart attack. The clinic correlates with the lesion area.
4. The defeat of blood supply zones is manifested by necrosis in the fields of vascularization of the main cerebral arteries. False porcerephalia develops, with multiple necrotic cavities, the term multistallic encephalomying is used.

The consequences of the described processes are false cysts of the respective localizations, as well as the foci of gliosis and glial scars. Moreover, multiple cysts are characterized for transferred asphyxia.

The brain-brain generic injury is primarily manifested by various localization of hemorrhages in the central nervous system. The outcome of hemorrhages in the brain - dissipation with the formation of a cyst, in the wall of which Siderophages can be detected,

Encephalopathy unspecified - class VI disease (nervous system disease), which is included in the G90-G99 block (other disorders of the nervous system) and has a disease code G93.4.

Description of the disease

Encephalopathy is called a non-coalized brain disease. It is expressed by the death of nerve cells due to the stopping of blood circulation, oxygen starvation and diseases.

For diagnosis of diseases, specialists need to find out the pronounced place of lesion, localization of the disease in a gray or white brain substance, as well as the degree of impaired blood flow. If the cause of the disease failed to be established, then called the encephalopathy of the unspecified (idiopathic, i.e. arising independently). The most common is vascular.

Causes of the disease

Encephalopathy uncomfortable (according to the ICD-10 diagnosis code G93.4) \u200b\u200bis classified into two types: congenital and acquired. Congenital shared on the prenatal (when damage occurs in the mother's womb) and perinatal (if the damaging factor acted in the last weeks before the birth of the baby or immediately after it). This type of pathology is called:

• vices consisting in the anomalous brain development processes;
• disorders of metabolism in the body caused by genetic factors;
• if during pregnancy, a damaging factor acted on the kid;
• the cranial trauma arising from the kid during childbirth.

Mitochondrial Encephalopathy

Mitochondrial unspecified encephalopathy in infants is allocated in a separate group of congenital diseases. It is formed due to violations of functions and mitochondrial structures.

Acquired encephalopathy

Acquired encephalopathy is classified for several species due to various damaging factors:

• The post-traumatic is the result of the middle and heavy degree of cranial injuries (for example, a drop from a height, head injuries in athletes, an accident, etc.). With this form, there are various lesions of the nervous tissue of the frontal and atrophic changes (drying and decrease in the brain), hydrocephalus.
• Toxic encephalopathy uncomfortable in adults arises due to poisoning with various toxins: alcohol, high doses of pesticides, heavy metals, gasoline, etc. Basically, various kinds of nerve and mental disorders (insomnia, anxiety, irritability, hallucinations, long-lasting headaches, etc.) are manifested.
• Rady is the result of ionizing irradiation of the body at radiation sickness. With this pathology, various neurological disorders are observed.
• Metabolic arises due to metabolic disorders against the background of internal organs: liver, kidneys, pancreas. Manifests itself depending on the properties of the main pathology.
• Vascular encephalopathy. The reason for the occurrence may be addicted to harmful habits, old injuries, atherosclerosis, diabetes, radiation irradiation and other factors causing brain hypertension. The signs of this type of disease are: loss of structurality and integrity of consciousness, frequent headaches, depressive states, partial loss of their own memory.
• Gluinic is the result of long oxygen fasting. Leads to serious neuralgic complications.

And this is not all varieties.

In children

It happens encephalopathy uncomfortable in children. So, due to the injured influences in the womb, infections or other reasons, residual encephalopathy is diagnosed in older children. Venous form is a private variety of vascular, which is manifested by the stress venous blood In the brain due to the violation of her outflow.

Metabolic encephalopathy is divided into several more species:

• Bilirubinic is found only in newborns of babies. Developed against the background of the incompatibility of the blood of mother and fetus, as well as due to infectious toxoplasmosis, jaundice, sugar diabetes at the mother. Manifest total weakness, reduced muscle tone, bad appetite, belching, vomiting.
• Encephalopathy Guya - Vernika arises due to vitamin B1 deficiency. Side conditions may develop due to alcohol dependence, heavy avitaminosis, HIV, malignant neoplasms. Basically manifests itself with hallucinogenic syndrome, disturbing states.
• Leicoentephalopathy is manifested by violation white substance brain. The disease has a progressive nature. It appears after transferring infection due to lowering the protective functions of the body.
• Atherosclerotic develops mainly due to the violation of lipid metabolism in the body. It is manifested by increased fatigue, weakness, dizziness, headaches, sleep disorders, closedness.

Scientists say that the cause of any kind uncomfortable encephalopathy It is primarily the hypoxia of the brain (lack of oxygen). This occurs due to the fact that the body begins to be worse than blood, excessive venous accumulations, edema, hemorrhage appear. Anoxic encephalopathy may occur due to the small flow of nutrients in neurons and stand out for a separate disease. Metabolic encephalopathy is a particular case of toxic when toxins are not output, as a result of which they penetrate the blood.

There are several stages of the development of this disease. The following of them are distinguished by experts:

• In the case of the initial or first stage, the patient decreases the memory, it is irritable, poorly falls asleep and is asleep asleep, as well as headaches are tormented.
• With the second nature of the disease is more pronounced, all the symptoms are exacerbated. In addition to headaches and sleep disorders, the patient may complain about apathy and lethargy.
• In the third stage, serious changes in the brain are diagnosed, there are paresses, it is impaired, vascular Parkinsonism develops.

Symptoms

The manifestations of unspecified encephalopathy are very diverse depending on the degree of severity, the species, age and the treatment applied. As a rule, at the first stages of the disease, sleep disorders are noted, lethargy, daily drowsiness, scattering, plasticity, lack of interest, increased fatigue, reduction in memory, mental abilities. Can also start appearing painful feelings, noises and stons in the head, decline in auditory and visual functions, mood swings, coordination disruption, irritability.

What symptoms arise when progressing the disease?

In the launched cases, the symptoms may progress, as a result of which Parkinsonism appears (slow motion in combination with a tremor of the extremities) and false-roll paralysis (manifests itself with a violation of speech, chewing and swallowing functions). Also, do not forget that violations of the functions of the psyche can develop (depression, suicidal thoughts, phobias). Consider how encephalopathy is diagnosed G 93.4 in infants and adults.

Diagnosis of encephalopathy uncomfortable

In order to correctly establish the form of the disease, the doctor must carefully analyze the history of the patient on the cranial and brain injuries, intoxication, atherosclerosis, kidney disease, liver, light, pancreas, hypertension, exposure to radiation, as well as acquired or genetic metabolic disorders.

To form a diagnosis of "Encephalopathy uncomfortable G 93.4" holds the following procedures:

• General blood analysis.
• General urine analysis.
• Various metabolic tests (on the level of enzymes in the liver, glucose, electrolytes, ammonia, lactic acid, oxygen in the blood).
• Measuring blood pressure level.
• CT and MRI (to identify brain tumors, various anatomical anomalies, infections).
• Creatine.
• The level of drugs and toxins (cocaine, alcohol, amphetamines).
• Ultrasonic Doppler.
• EEG or Encephalogram (on the detection of brain dysfunctions).
• Analysis on autoantibodies.

This is not all the tests necessary for diagnosis. Only the attending physician may assign certain analyzes, judging by the symptoms and history of the patient's disease.

Treatment of encephalopathy

Treatment of unspecified encephalopathy awarded to eliminate root causes and symptoms that gave impetus to the development of this disease. Basically, conservative and drug methods are used for treatment.

If the disease is acute, the treatment is primarily aimed at reducing intracranial pressure and liquidation of seizures. For this apply artificial ventilation Light, out-of-seeking blood purification, and also injected with a dropper nutrients.

Medications

Subsequently, the patient is prescribed drugs that it must take within a few months:

• various lipotropic medicinal productswho contribute to the normalization of cholesterol and fats (dietary supplements with choline, methionine, carnitine, lecithine, "lipostabil");
• preparations that prevent thrombosis ("Ginkgo Biloba", "Aspirin", "Cardiomagnet");
• angioprotectors appointed with various disease hearts to normalize the walls of the vessels, movement and outflow of venous blood ("Troxerutin", "Detralex", "Indusan");
• neuroprotectors for the nutrition of nervous tissues (vitamins of group B, "piracetam";
• tranquilizers and sedatives for the permission of rapid nerve impulses in affected neurons ("Sibazon");
• vitamins and amino acids;
• various performance stimulants.

Physiotherapy procedures, acupuncture, walks, gymnastics, massages, a certain recreation mode are prescribed for speedy recovery. What is the forecast for the diagnosis of "Encephalopathy unclean"?

Forecast Disease

For any variety of encephalopathy is characterized by vomiting, nausea, dizziness and headaches. If there was a heavy brain defeat (or his edema), then the disease develops very sharply, dizziness appears, very strong headache, anxiety, vision and much more.

Typical complications of encephalopathy uncomfortable genesis are:

• coma;
• paralysis;
• cramps.

• epilepsy;
• paralysis, various kinds of traffic disorders;
• loss of brain functions, memory, intelligence;
• emotional instability, depression, mood swings;
• disability.

Any form of encephalopathy requires heavy treatment and the responsible approach of doctors, patients to their own state. Encephalopathy uncomfortable is a special kind of diagnosis, which is set with a lack of information for 100% confirmation of the exact form of pathology.

The ICD-10 defines unspected encephalopathy by the G93 number. Synonym - acquired unspecified encephalopathy.

The diagnosis has specific features:

• is set when it is not possible to clarify additional studies;
• pediatricians often find the symptoms of unspecified encephalopathy in newborn children;
• in 80% of cases, the diagnosed diagnosis in 2-3 years is not confirmed;
• men are sick more often than 21%;
• the accuracy of the diagnosis is higher, if it is placed in 5 or 65 years (the peaks of the identification of the disease).

An uncomfortable form of illness requires additional examinations and is confirmed far from all cases. Most often, real encephalopathy is found in people of middle and elderly.

Classification of shapes

When making diagnoses, signs of illness are taken into account. At the first stage of encephalopathy, uncomfortable is confirmed less often, since there are no pathology during surveys, at the same time cerebral changes are already present.

The second degree of gravity allows you to make a diagnosis faster, since patients show light and moderate signs of illness. In the third stage, severe neuralgic violations are noticeable and the diagnosis is confirmed even without additional examinations.

The specificity of unspecified encephalopathy is that depending on the type of disease (inxication, infectious) changes the type of stages. In the acute course of infectious pathology, the first degree almost immediately goes into the second or third.

Causes of the disease

Any encephalopathy is unspecified or confirmed - it happens both congenital and acquired. Congenital pathology is associated with several factors. The first is prenatal, the fetal injury and other negative factors affecting the embryo are characteristic. The second is perinatal caused by childbirth, as well as adverse effects after birth.

Most often, these forms of encephalopathy develop as a result:

• the skull injuries obtained at the passage of the fetus through the generic paths;
• diseases of metabolism inherited from parents;
• anomalies in the development of the nervous system and brain;
• alcoholism, drug addiction, mother infectious diseases during pregnancy.

There is a more accurate classification of encephalopathy, the types of which can occur in an uncomfortable form. This form, as a metabolic, is divided into several subspecies. They may be associated with other disorders, for example, vascular: cholesterol plaques are narrowing the clearance and cause metabolic disorders.

Medicine researchers believe that the main cause of any encephalopathy is hypoxia brain.

Diagnosis of the disease - multistage, difficult processrequiring long time. It is impossible to rely on the results of one analysis, since other violations can be hidden under any kind of encephalopathy. And never pathology may not arise as an independent disease.

Development mechanism

For a more accurate understanding, what encephalopathy is unspecified, it is necessary to consider the mechanism of development:

• Occurs . It is caused by vessels and other violations in organs, blood circulation systems.
• Violation of metabolism. Cells do not receive sufficient nutrients, atrophy begins and degeneration.
• Arrangement of foci. Deeilinized foci, dying fabrics in the white substance of the brain are formed.
• Arise. First, they become small, single, then grow.
• Ekdeek I. stagnation . The formation of these signs leads to the dying of large sections of the brain.

Gradually, a person loses cognitive functions, the nervous system suffers. Launched encephalopathy is not amenable to treatment, the deceased areas of the brain are not restored.

The brain reacts very quickly to any changes, since this body contains a minimum oxygen stock. As soon as it ceases to be enough, pathological processes immediately develop.

Symptoms of pathology

Encephalopathy proceeds slowly, and to achieve the first symptoms since the beginning of the disease, at least 3-6 months should pass. but acute types are characterized by an accelerated current.. On the early stage Regardless of the type of disease, certain features are found:

• difficulties in the implementation of mental activity, which previously did not cause problems;
• problems with step-by-step activities;
• reduction of memory;
• pronounced sleep disturbances, which lead to daytime sleepiness and night insomnia, nightmares occur in the patient;
• strong fatigue even when performing familiar cases, which used to be pleasure before;
• extraneous noise in ears, dizziness, headaches, disturbing patients constantly;
• after stress, the patient feels an incredible decay of strength and devastation;
• character becomes quick-tempered, the mood is often changing, irritability and fiscaliness appears;
• the patient suffers from violations of vision and hearing.

At the initial stages of the disease, the patient maintains normal well-being, and the changes begin mainly when changing weather conditions. Influences the symptoms of stress, experiences and mental overload.

Dysfunctions of the nervous system are developing slowly, begin with coordination disorders and weak seizures. Constantly worsening mental condition: Apathy develops, the circle of interest is narrowed, memory suffers, speech, attention. Dementia - finals of encephalopathy.

Each type of encephalopathy, which initially could be unspecified, appear their own signs.

Vascular form

Developed in elderly people due to problems with vessels, less often occurs in adults 30-50 years. The vessels of the neck, head, the upper half of the body suffer. In the 2 stages, expressed neurological symptoms are manifested: scroll, instability, tremor, urination disorder, disorientation.

It appears at different ages due to injuries, accompanied by severe nausea and headaches, as well as pronounced fatigue. Medications Only for a while give relief. Possible attacks of falling, cramps, asthenia, as well as problems with mental activity.

Hypertensive form

Appears with a hypertensive crisis or from constant impact high pressure. It is characterized by fuzzy speech, muscle weakness and pronounced slowness when moving. Patients can tremble head, worsen swallowing functions.

Venous form

The symptoms affecting memory and intelligence prevail, as well as mental processes. In the hot season during venous encephalopathy, the appearance of chills. The patient is worried about coughing, heaviness in the head. A face and pallor may appear.

Toxic form

For uncomfortable encephalopathy, toxic type is characterized by convulsions, a feeling of stunning, problems with breathing and blood circulation. Nausea, weakness and pressure drops, combined with difficulty control of urination or defecation, can be chronic.

Heavy poisoning almost in all cases is accompanied by losses of consciousness, hallucinations, nonsense. During the launched form of the disease, death often comes.

Alcoholic form

Included in the group of intoxication encephalopathy, is accompanied by white hot (nonsense and hallucinations). If the disease proceeds in chronic form, then after a few months, tremor, weakness, anxiety, oppressed state and disintegration of personality appears constant alcohol.

Leukoentephalopathy

The form of the disease at which nausea appears, severe pain in the head, a person suffers from hallucinations, phobias and obsessive fears. All the functions of the brain are oppressed.

Proceeds with attacks of confused. A person becomes slow, it is difficult for him to be given such processes as speech and performing everyday affairs. Over time, drowsiness, hallucinations develop, the patient falls into someone.

Acute encephalopathy

Rarely leaks in uncomfortable form. Heavy and extensive brain injuries appear, which means its ambulance after stroke or edema. Symptoms acute form Crosses with other diseases and do not allow an accurate diagnosis without additional research.

The diagnosis of unspecified encephalopathy is most often put to the kids up to 6 months. However, it is possible to confirm it only after analyzes.

In a child, the disease occurs in 3 degrees:

Easy. Clamp appears, excitability and constant anxiety. The dream is worse, the level of stress is growing, the appetite decreases, the attacks of vomiting. Muscle tone varies significantly, sometimes developing strabismus.

Average. The work of the nervous system is worsen: pressure increases, convulsions and hydrocephalus appear. The child's skin becomes marble, eyes become a little closed, as in the "setting sun" syndrome. The child almost always presses his arms and legs to the body. There is a constant crying and insomnia.

Heavy. There is a complete oppression of brain functions, consciousness is disturbed. The baby gets into the state of the coma. In most cases, death comes.

Children's encephalopathy often leads to complications. In adults, they also develop in 80% of cases.

Forecast

If a person survived encephalopathy, and therapy was rendered on time, the risk of complications is minimal. These are the most common consequences of the disease: paralysis and paresis, cramps, squint, metabolic disorders, excess weight, -Eepilence-.

In severe forms, there are almost always developing problems with movements, epilepsy arises, mental deviations. Patient put.

The worst consequences It has a toxic, uncomfortable it is almost never happening. Treatment of the disease is complicated by the fact that the symptoms of all its forms are almost the same, and even modern diagnostic methods do not allow to accurately determine the cause of pathology.

Uncomfortable encephalopathy is not a disease, but a diagnosis preceding a detailed study of the patient for setting more accurate verdict. In order to notice the disease in time and prevent its development, you need to take full medical examination at the very first signs and get an opinion from several doctors.