And whether you know...
December 3, 2011
Encephalopathy is the general designation for diseases of a brain of noninflammatory type. Classification of the diseases falling under this designation, quite wide: distinguish several types of encephalopathy which differ it agrees with origins of diseases. First of all, it is accepted to distinguish the encephalopathy acquired and perinatal in view of the fact that origins of damages to a brain at the adult and at a fruit in the course of incubation absolutely different. Developing of perinatal encephalopathy is provoked by certain deviations last months fetation or already in the course of childbirth.
To warn similar troubles, pregnant women pass regular inspections during which the doctor observes whether the fruit is enough supplied with oxygen, whether there is no encirclement by an umbilical cord, and defines other features of development. Respectively, measures for prevention of pathology are taken. Perinatal encephalopathy at children is not necessarily shown at once after the child's birth. It is quite possible that certain problems with memory or intelligence will be noted later.
Reasons of perinatal encephalopathy
The fruit has origins of perinatal encephalopathy many factors. So, the illness is shown in view of chronic diseases to which the pregnant woman suffered. Also the acute diseases of infectious character, improper feeding, too early age of mother, an illness of hereditary character, the pathological course of pregnancy, the problems which arose at the time of delivery, birth trauma transferred to the period of pregnancy can become the reason. Also encephalopathy can be shown at those newborns whose mothers lived in unsuccessful ecological conditions. The illness often arises at premature children. The most frequent damages of a brain at newborns are hypoxemic - the ischemic and mixed defeats of TsNS arising because of disturbance of intake of oxygen in a fruit brain in view of the above described reasons.
Symptoms of perinatal encephalopathy
Perinatal encephalopathy at children can be shown by certain syndromes during the first month of life of the child. However, the part of specialists is convinced, the similar illness can prove later, for the first year of life. So, at the sick kid hypotonia or a hypertension of muscles, that is a syndrome of motive frustration can be shown. As a rule, it is difficult to estimate the newborn's condition in view of existence of a physiological hyper tone. The following sign — a syndrome of high neuroreflex irritability. So, the child can hard fall asleep, is too active behave, being awake, manifestation of trembling of extremities and a chin is possible. One more sign which can signal about existence of encephalopathy — a syndrome of oppression of TsNS. Respectively, in such state the child too sluggish and slowed down, and in view of a different tone of muscles at it is sometimes observed asymmetry of a trunk and features. At such kid sucking skills are badly expressed.
As the most serious sign it is considered to be a syndrome of intracranial hypertensia. Such symptom is dangerous by a possibility of transition to hydrocephaly, a disease which is treated by exclusively surgical method. It is important to pay attention to compliance of size of a fontanel to age of the child, and also to the head sizes. One more symptom of encephalopathy — – it is rather difficult to distinguish a convulsive syndrome at kids on the first year of life. It can be shown not by "pure" spasms, but a hiccups, vomiting, too strong department of saliva. At suspicion it is important to conduct additional examination.
Diagnosis of perinatal encephalopathy
Diagnosis of this disease is carried out by studying of clinical data taking into account all features of course of pregnancy and childbirth. Use of a number of additional methods of research is helped to be revealed, damages of a brain and what nature of these defeats, and also control over disease and the correct selection of methods of treatment of encephalopathy at children provide are how serious.
Thanks to a neyrosonografiya the specialist performs inspection of a brain of the child. This research allows to make an assessment of a condition of brain fabric, likvorny spaces. At a neyrosonografiya it is possible to find intracranial defeats and to define their character. Thanks to a method of doppler sonography the blood-groove size assessment in brain vessels is made.
The electroencephalogram is carried out for an assessment of functional activity of a brain. For this purpose during research electric potentials of a brain are registered. The acquired information allows to draw conclusions on degree of an arrest of development of a brain, to define asymmetry of hemispheres and existence of the centers of epileptic activity in certain departments of a brain. By means of video monitoring spontaneous activity of movements of the kid is estimated. Video is for this purpose conducted. For diagnosis of any neuromuscular diseases the elektroneyromiografiya is used. Structural changes in a brain help to define methods of a computer tomography and a magnetic and resonant tomography. However these methods demand use of an anesthesia owing to what at infantile age their use is complicated. At positron emission tomography is defined, how intensively there passes the metabolism in fabrics and the blood stream in a brain is carried out. From all listed ways of diagnosis of an illness the neyrosonografiya and an electroencephalography are the most often used.
If at the child pathology of the central nervous system is recorded, then consultations and survey at the doctor-oculist are obligatory. It defines existence of changes on an eyeground that helps to estimate the level of intracranial pressure, to determine what the condition of optic nerves is.
Treatment of encephalopathy
Treatment of encephalopathy of perinatal type in its acute period is carried out by doctors at once in a maternity home. If there is a need, the newborn for the subsequent treatment is transferred to the relevant medical institutions. When carrying out therapy a number of the drugs urged to improve blood supply of a brain is used. So, Actovegin, a Vinpocetine, piracetam are appointed newborn. In the recovery period the children's neuropathologist has to watch the patient regularly. Depending on what symptoms are shown at the child, to him appoint reception of means of anticonvulsant, diuretic influence, vitamin complexes and other drugs.
At easy manifestations of the increased neuroreflex irritability and disturbances of a physical activity treatment of encephalopathy assumes use of pedagogical correction, exercises of physiotherapy exercises, physiotherapeutic methods. Also to the child sessions of a baby massage, phytotherapy courses are appointed. In the course of treatment it is very important to observe all instructions of attending physicians strictly.
Sometimes make to the child the diagnosis "residual encephalopathy "designating existence of injury of a brain which arose owing to the postponed diseases earlier. Residual encephalopathy is shown not only because of brain injuries, but also owing to influence of infections, an inflammation, bad blood supply of a brain. In this case symptoms of encephalopathy can be shown differently. So, the child can have constant headaches, also at him sometimes be observed problems with mentality and even the lowered intelligence. In view of similar manifestations sometimes the residual type of this disease is taken for certain frustration of mentality at the patient.
Complications of encephalopathy
At the correct approach to treatment about 20-30% of children completely recover. The gidrotsefalny syndrome, the minimum brain dysfunction, vegeto-vascular dystonia can be a consequence of a disease. Epilepsy, and also a children's cerebral palsy can become the heaviest complications of encephalopathy.
The acquired encephalopathy
Such form of this illness is shown already at more advanced age and to turn out to be consequence of a variety of reasons, namely: the postponed infectious disease, intoxication, tumors, injuries, changes of structure and functionality of vessels of a brain. The similar form of encephalopathy can be divided into several types. So, posttraumatic encephalopathy is the illness arising owing to various craniocereberal damages. Encephalopathy of this type affects first of all frontal and temporal lobes of a brain. As a result, at the person memory blackouts, decrease in mental abilities, problems with control of behavior can be observed. Also this illness is followed by dizzinesses, a headache, problems with a dream and scattered attention. If symptoms of encephalopathy appear already after certain time after an injury, then the patient can suffer from frustration of mentality, a depression, to show periodic aggression, to face problems of intimate character.
The Distsirkulyatorny encephalopathy called also vascular, it defeats of tissues of brain which is shown because of blood supply disturbances. High intracranial pressure, a hypertension, atherosclerosis, osteochondrosis of cervical department of a backbone, a neurangiosis happens the reason of this form of an illness often.
This term in the international classification of diseases is defined as brain ischemia. At such type of a disease in a brain of the person there take place the destructive processes striking only the certain centers of a brain. But after certain intervals of time the centers become more extensive owing to what at the patient it is more expressed encephalopathy symptoms are shown. This diagnosis is rather distributed among the population: according to specialists, 5-7% of people have the similar form of encephalopathy. At the same time bad blood supply of a brain becomes a basic reason of such disturbance. Most often this illness takes place at people who have constant stresses, abuse alcohol, smoke much.
Toxic encephalopathy is a result of acute or chronic poisoning of a brain with different poisons. Similar toxic agents can directly be formed in a human body or get into his brain from external environment. The first option is possible at development of a number of infectious processes – diphtherias, measles, botulism, tetanus. At such diseases the bacterial toxins poisoning afterwards a brain are emitted. Also similar toxins are emitted at systematic alcohol intake, some medicines, and also a number of chemical compounds. If intoxication acute, is necessary for the person acute management of specialists, owing to severe poisoning epileptic seizures and even the patient's falling into a coma are possible. At impact on a brain of sick ionizing radiation beam encephalopathy is defined.
Dystrophic processes in tissues of a brain can develop also owing to a number of endocrine pathologies. It is a hypothyroidism, a diabetes mellitus, dysfunction of kidneys, a liver, a pancreas. As the first symptoms of a similar disease notable lowering of intellectual activity, disturbance of memory, a problem with a dream, high fatigue, inadequate manifestation of functions of acoustic organs and sight is shown. Often the patient has signs of frustration of mentality. During the acute period of an illness there can be body spasms, very severe headaches, vomiting, nausea, disturbances of consciousness.
Treatment of the acquired encephalopathy
Treatment of encephalopathy should be carried out only with use of professional approach in view of gravity of a disease. On the basis of results of complex inspection the specialist appoints the optimum scheme of treatment. As a rule, symptomatic therapy, and also massage, regular exercises from a complex of physiotherapy exercises, following to a certain diet is used. Treatment is appointed only taking into account specific features of each patient.
Section: Brain diseases