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Neyroobmenno-endokrinny the syndrome is shown owing to impact of disturbances of hypothalamic character. Recently specialists speak about a direct impact on a course of a disease of genetic tendency. Besides, manifestation of resistance to insulin is characteristic of this pathology. As a result, this factor, and also excess weight can become the reason of development of serious complications. It is a hypertension, an insulinonezavisimy diabetes mellitus, atherosclerosis, a stroke, a heart attack. Often weight reduction is premises to considerable improvement, and sometimes – and to recovery.
Therefore existence at the woman of obesity and resistance to insulin often in medicine is defined as a separate metabolic syndrome. This name sometimes is also applied in medicine, but it is necessary to consider that diagnosis and inspection of patients in this case is not limited only to the purpose to reduce body weight. It is important to women for whom the neyroobmenno-endocrine syndrome is diagnosed to recover full reproductive function of an organism, and also to carry out effective therapy of a giperandrogeniya.
Symptoms of a neyroobmenno-endocrine syndrome
At development of this pathology in the person hormonal function of adrenal glands and ovaries is significantly broken. The syndrome arises also owing to certain disturbances of functions of a hypophysis, a hypothalamus, fatty tissue. If this syndrome develops at the nonpregnant woman, then its manifestations very much remind an easy form of an illness Itsenko-Kushinga.
The main symptoms of a neyroobmenno-endocrine syndrome is disturbance of a menstrual cycle, very prompt set of body weight conducting to obesity, thirst, appetite changes, frequent headaches, sleeplessness, regularly arising respiratory and viral infections.
This disease most often develops at the woman after the child's birth. If young mother transferred difficult childbirth, or she has complications in a puerperal period, then the speech can go about a puerperal neuroendocrinal syndrome.
But its manifestations can take place also after injuries, severe stresses, infections which influence a nervous system. Sometimes the neyroobmenno-endocrine syndrome is also shown after the happened abortion or abortion. Doctors-endocrinologists define such diagnosis as a hypothalamic syndrome.
Symptoms of such state are shown also by changes of integuments: on skin there are extensions – strips which remind scars. Initially their color dark and claret, after a striya find a light pink shade.
In places of folds on skin the woman has nevus pigmentosus, a little rough to the touch. Such spots are generally formed in armpits, under a breast, on stomach skin, in a groin. Similar changes – result of an anesthesia to insulin. In view of insufficiency of women's hormones on a breast, a stomach, a back, a chin the woman can have so-called rod hair, the hirsutism is shown. Also in these parts often acne rash develops.
Hypothalamic syndrome of the pubertal period
Defining a hypothalamic syndrome of the pubertal period, specialists apply also other terms to designation of this pathology. The disease is an effect of disturbances of exchange processes, and also hormonal balance in an organism. However accurately expressed origin of this pathology, as a rule, does not manage to be defined. A certain impact on development of this illness is exerted by the injuries got at childbirth, chronic infectious diseases and intoxications. Also abuse of alcohol can affect a course of a disease.
Patients complain of frequent headaches, excess weight, manifestation of thirst and periodic attacks of strong hunger. Also the menstrual cycle is broken, increased fatigue is noted.
This illness generally develops at teenagers in 12-15 years, sometimes the hypothalamic syndrome of the pubertal period is noted also at 17-19 summer. Most often this state develops at girls. One of the main features of this illness – the intensive growth of the teenager in the period of odes 11 till 14 flyings. As a rule, patients are much higher growth, than their peers. Teenagers with a hypothalamic syndrome have obesity. At the same time fat is laid evenly on all body. The person at such teenager, as a rule, roundish, is present at it a pathological flush. At the same time fat is not redistributed as it is characteristic of a disease of Itsenko-Kushinga.
The skin trophicity at this disease is also broken. Skin, as a rule, cold to the touch, has a marble and cyanochroic shade. There are also extensions, most often on a stomach, mammary glands, buttocks and a thorax.
At girls who suffer from a hypothalamic syndrome of the pubertal period secondary signs often form prematurely. Boys have effeminate features, at them face hair, and even after the puberty period vegetation on a face very scanty very late begin to make the way. At the same time on a pubis and armpits hair grow normally.
In this state at teenagers pronounced disturbances of psychological character are noted. Teenagers with a hypothalamic syndrome are constantly irritable, quickly get tired, they periodically show the suppressed mood and even a depression. The sick child can refuse to attend school, preferring constant loneliness.
Establishing the diagnosis in this case, the doctor considers that the clinical picture is rather characteristic. The X-ray of a skull on which symptoms of the developed intracranial hypertensia are noted is surely carried out. Also in the course of diagnosis the increased intraocular pressure is defined.
Diagnosis of a neyroobmenno-endocrine syndrome
To diagnose this state, the doctor, first of all, directs the patient for testing for the content of hormones. Ultrasonic research of bodies of a small pelvis is also without fail conducted. Poll in the course of which it is necessary to define whether disturbance of a menstrual cycle takes place is important, whether really at the patient body weight promptly grows, and also whether there are other complaints. In certain cases reasonablly also carrying out a biopsy for what the part of fabric for further studying is excised.
As a rule, results of analyses testify to the increased insulin level. Data of ultrasonography show the increased follicles of ovaries. For specification of the diagnosis the X-ray analysis of a skull, EEG with functional loads is also carried out.
Neyroobmenno-endokrinny the syndrome should be differentiated with an illness of Kushinga as at this disease the high level of cortisol and prolactin, symptoms of a hyperplasia of bark of adrenal glands are also noted.
Besides, it is important to exclude a stromal thecomatosis at which at the patient obesity and resistance to insulin is also shown. At a pubertal form of a neyroobmenno-endocrine syndrome it is necessary to differentiate with a syndrome of polycystic ovaries.
Treatment of a neyroobmenno-endocrine syndrome
To provide effective treatment of a metabolic syndrome, initially all efforts should be bent on that at the patient body weight was normalized. If the disease at the woman is revealed at an early stage, before development of a polycystosis of ovaries, then by means of the correct scheme of treatment it is possible not only to normalize functioning of TsNS, but also to recover a monthly cycle. And in the future the woman will be able to become pregnant and take out the child.
Therapy of a neyroobmenno-endocrine syndrome is subdivided into several different stages. Initially, at the first stage of the patient has to follow strictly specially developed diet to achieve certain results in the course of normalization of weight. From a food allowance it is necessary to clean completely all farinaceous food, sweet, fried and smoked dishes. The woman has to be mindful of need to follow certain rules of food. At the same time it is impossible to starve at all: best of all during this period to adhere to a diet with the high content of proteins. In view of loss of protein owing to a gluconeogenesis the goloaniye can lead to negative effects.
It is not necessary to play sports selflessly: optimum at this stage every day to carry out a set of exercises of physiotherapy exercises. In especially difficult cases to the patient the psychotherapy is appointed.
The second stage of treatment except physiotherapy exercises and a diet also includes medicamentous drugs which properties is recovery of a neuromediator exchange in the central nervous system. This stage of treatment proceeds about half a year.
Women have to remember that during treatment it is optimum to be protected from approach conception as in the course of a correcting of disturbances of a metabolism rather serious complications can be shown. To patients at whom against a neyroobomenno-endocrine symptom the polycystosis of ovaries already developed the surgery is sometimes appointed. But an operative measure is carried out after the termination of the first two stages of treatment. But in most cases symptoms of a disease disappear after considerable reduction of weight. Difficulties in the course of treatment arise because it is possible to recover menstrual and reproductive function only on condition of reduction to norm of body weight, and also recovery of a metabolism.
Drug treatment of a disease includes reception of regulators of a neuromediator exchange, medicines with adrenergic influence. Also to patients if necessary also other drugs rekoyendutsya. Ksenikal who is inhibitor of gastric and pancreatic lipases is sometimes appointed. Drug prevents splitting and absorption of fats. Treatment by this drug continues about 9 months.
If after treatment and normalization of body weight at the patient resistant anovulation remains, then in this case the speech can go about the created secondary polycystic ovaries. At such diagnosis the ovulation can be stimulated with either a conservative, or surgical method.
Thus, if the neyroobmenno-endocrine syndrome comes to light and treated timely, then the forecast quite favorable. But if adequate treatment is not made, then during the premenopauzalny period at the woman the risk of emergence of cardiovascular diseases, adenocarcinomas of an endometria, a diabetes mellitus sharply increases.
Treatment of a hypothalamic syndrome at teenagers has to be made also timely. Observance of a subcaloric diet is surely recommended to patients. But at the same time at a daily diet there have to be surely products, substances containing everything necessary for the teenager and vitamins. Sometimes the doctor also recommends reception of anorektichesky drugs, and also diuretics. If at the patient arterial hypertension is periodically shown, then reception of anti-hypertensive drugs is reasonable.
At the correct approach to regulation of a diet and a daily food allowance the body weight of the teenager gradually decreases that, in turn, promotes disappearance of other symptoms of an illness.