Vegeto-vascular dystonia is a fairly extensive symptom complex characterized by polymorphism of clinical manifestations caused by disorders in the autonomic nervous system. This polytheological syndrome is also called somatoform autonomic dysfunction.
According to the ICD-10, vegetative-vascular dystonia is classified as a pathological condition combining such diagnoses as cardiogenic neurosis, neurocirculatory asthenia and dystonia, neurosis of vegetative genesis, and psycho-vegetative symptom complex. Disturbances caused by this pathological phenomenon are often combined with somatic injuries.
Vegeto-vascular dystonia causes
The prerequisites for the development and progression of vegetative-vascular dystonia are a large number. The most important value belongs to deviations in the structure and functioning of certain parts of the autonomic nervous system. These deviations are due to the genetic factor and are often traced along the mother's line of the patient. The remaining factors in most cases contribute to the manifestation of the already present latent dysfunction in the ANS.
The development of vegetative-vascular dystonia is caused by damage to the nervous system during the newborn period, as they cause disorders in the functioning of the cerebral vessels and the movement of the cerebrospinal fluid. Damage to the central nervous system in the perinatal period causes a pronounced emotional lability of the child's nervous system, the development of acute psychoses and neuroses, reduces stress resistance. All this contributes to the formation of vegetative-vascular dystonia, and also accelerates its development.
The likelihood of development of vegetative-vascular dystonia in children, often experiencing nervous shocks (quarrels with parents, conflicts with peers in kindergartens and schools, restriction of freedom and increased care, the absence of one of the parents), significantly increases. A major role in the formation of the disease is played by chronic mental overstrain.
To provoke vegeto-vascular dystonia neurological diseases, pathology of the endocrine system, allergies , frequent changes in climatic conditions, unfavorable weather conditions, excessive physical stress on the growing organism or, conversely, decreased motor activity, diet disorders, changes in the body that occur during puberty .
Vegeto-vascular dystonia symptoms
For vegetative-vascular dystonia, a variety of manifestations is inherent. This disease is characterized by the presence of a large number of complaints from various organs and systems, polymorphism of symptoms and symptom complexes that can manifest themselves for no apparent reason and disappear without a trace. Such manifestations can be explained by specific features of the course of vegetative-vascular dystonia associated with the involvement of hypothalamic regions in the process.
Most often, this nosology is manifested by pain in the projection of the heart, intermittent headache, dizziness, heart rhythm disturbance, tremor in the upper limbs, tremor in the body, pastoznost, arthralgia of various intensity, more often large joints, aches and pain in muscles, impaired breathing. For patients with vegetative-vascular dystonia, subfebrile condition , fainting states and orthostatic collapse are characteristic.
Vegeto-vascular dystonia signs
The most persistent and common signs of vegetative-vascular dystonia include cardialgia, autonomic dysfunction, neurotic disorders, vascular dystonia, tachycardia and tachyarrhythmia.
Cardialgia in people suffering from vegetative-vascular dystonia is manifested by suddenly arising pressing painful sensations in the region of the heart. Pain can be of varying intensity and duration. In some cases, it can be piercing, compressive in nature and be sufficiently pronounced. Vegetative dysfunction makes itself felt orthostatic hypotension with a sharp change in body position, fainting, a feeling of heat in the skin of the face and neck. Neurotic disorders are the occurrence of vegetative-vascular paroxysm, cardiopathy and headache. Vascular dystonia is manifested by a feeling of cold in the upper and lower extremities, the pallor of the skin and mucous membranes, a feeling of inner trembling.
With VSD, it is possible to develop and increase the phenomena of dysuria, which promote the development of urolithiasis.
Manifestations of vegetative-vascular dystonia directly depend on what vegetative disorders prevail in a given patient (vagotonia or sympathicotonia).
People with vagotonia complain about decreased performance, a significant memory impairment, fatigue during physical and mental work, constant sleepiness during the day and frequent sleeplessness at night, low mood and general emotional background, depression, prolonged depression , fearfulness and alertness. Such patients are poorly tolerated by the cold and heat, stuffy rooms with a large crowd of people. They eat little because of lack of appetite and frequent nausea, but are consistently added to the body, often complain of a sensation of a coma in the throat, pain in the calf muscles, mainly at night, abrupt pain in the abdomen.
During the examination, you can see that the skin of a person with a vagotonia has a marble pattern, a slight acrocyanosis of both upper and lower extremities is seen, the eyelids are pastose due to a constant fluid retention. Dermographism in vegeto-vascular dystonia with predominance of vagotonia is intensely red. With this pathology is characterized by increased secretion of sweat and sebum, as well as hypersalivation .
As the disease progresses, the size of the heart begins to increase due to a decrease in myocardial contractility, bradyarrhythmia, and cardialgia are often manifested. The electrocardiogram determines the sinus bradycardia , sometimes - the extrasystole, the interval between the teeth P and Q increases significantly, the segment ST is displaced beyond the isoline, and the tooth T increases the amplitude.
Children with sympathicotonia are hot-tempered, very susceptible to pain, are prone to neuroses and sharp changes in mood, inattentive and temperamental. The most common complaints are: a feeling of heat in the body and heart palpitations. Often children with sympathicotonia asthenic type of build, have a deficit of body weight with excellent appetite. Such patients look pale, the skin is dry with palpation, dermographism is pronounced, white. They often complain of numbness of hands and feet in the morning, note in their subfebrile condition in the evening, cold extremities, poor tolerance of high air temperature. There are disorders from the genitourinary system and the gastrointestinal tract: increased urinary excretion and frequent atonic constipation . Disorders of the respiratory system and the vestibular apparatus, as in the case of vagotonia, are absent.
Vegeto-vascular dystonia in adolescents is characterized by cardiovascular disorders, such as increased rhythm and periodic arterial hypertension. On the ECG will be visible sinus tachycardia, shortening the distance between the teeth P and Q, flattening the tooth T, shifting the tooth ST down.
In the event that disorders in the autonomic disorders are prevalent in the cardiovascular system, the term "neurocirculatory dystonia" is applicable.
Vegeto-vascular dystonia types
Varieties of vegetative-vascular dystonia are distinguished by a large number. It is worth paying special attention to the classification of the VSD according to the nature of the reaction of the cardiovascular system of the patient. So, the hypertensive, hypotensive and cardiac type of vegetative-vascular dystonia is distinguished.
For the hypertensive type of vegetative-vascular dystonia, complaints of frequent pressing headaches , rapid fatigue with reasonable physical exertion, memory impairment, and a rapid heart rate are common. Systolic blood pressure (upper limit) can suddenly rise above 140 mm Hg. Art. The increase happens unexpectedly, it is short-term and practically does not affect the person's health.
For the cardiac type of vegetative-vascular dystonia, the most characteristic are complaints about the feeling of "fading" of the heart, interruptions in his work, tachycardia, a sense of lack of air. On the ECG will be seen multiple ventricular extrasystoles, as well as sinus tachycardia.
A hypotensive variety of vegetative-vascular dystonia is characterized by a decrease in the upper arterial pressure index to 80-100 mm Hg. Art. Such a person feels constant fatigue and weakness, a decline in vitality. Characterized by desiccation, fainting in the morning hours or in stuffy rooms, cold and numbness in the palms and feet, headaches, low mood and general emotional background, the skin is cool and pale.
In pure form, the types are very rare, mixed vegetative-vascular dystonia (cardiac-hypotensive or cardiac-hypertensive) is more often diagnosed.
In vegetative-vascular dystonia, three degrees of severity of the course are distinguished: mild, moderate and severe.
The mild degree is characterized by a wave-like course with exacerbation times and a long period of remission (absence of all manifestations of the disease). Attacks of vegetative-vascular dystonia occur after emotional shock, stressful situation or prolonged mental or physical stress. They happen rarely (not more than twice a year), characterized by painful sensations in the heart of weak intensity, mild neurasthenic manifestations. The patient is fully functional.
For moderate severity, polymorphism of symptoms and symptom complexes is characteristic, they are more pronounced. The course is also wavy, but the periods of exacerbation are protracted (up to several months), and remission is short-lived. During the crisis, the physical and mental performance of the patient can be significantly reduced or completely lost.
Severe degree of vegetative-vascular dystonia is characterized by an almost constant pain symptom in the region of the heart, stable violations in the heart rhythm. People with an antihypertensive type have persistent arterial hypotension , crises are frequent enough, and they are difficult. During the attack, the patient experiences fear of death due to severe disruptions in the work of the heart. Crises occur often enough and are accompanied by a violation of the act of breathing. During periods of exacerbation, physical performance is almost lost. In special cases, the patient needs a ward.
Vegeto-vascular dystonia in children
In most cases, vegetative-vascular dystonia first time manifests in the younger and middle classes (6-13 years). The child complains of constant weakness, shortness of breath during physical exertion (especially in physical education classes or during play in the yard), coldness of hands and feet, intense sweating and sensation of fever, aching pain in the heart and in the hypochondrium.
A characteristic symptom is a darkening in the eyes, an unconscious condition. The sick child's appetite decreases until he categorically refuses to eat, he sleeps restlessly, falls asleep and gets up in the morning.
Vegeto-vascular dystonia is affected by children who were diagnosed with fetal hypoxia or trauma (especially craniocerebral trauma), who often had colds, as well as children with chronic respiratory and cardiovascular diseases. In addition to all of the above, the development of vegetative-vascular dystonia is facilitated by frequent stresses and emotional overstrain, restless conditions in the family and the team, aggressive environmental conditions, frequent changes in climatic conditions and bad habits.
Disease in children proceeds undulating, the attacks of vegetative-vascular dystonia have a clear correlation with a decrease in the resistance of the growing organism (during acute respiratory disease, influenza, seasonal hypovitaminosis), a sharp increase in loads (school tests, training before the competition), stressful situations (bad mark, quarrel with friends), with hormonal changes (pubertal age, hormonal failure).
Vegeto-vascular dystonia in childhood and adolescence can be transitory in nature, and can turn into a chronic, prolonged course. In order not to allow serious consequences, it is necessary to provide the child with a quiet environment in the family and the team, to control his workloads and to undergo preventive examinations with the district pediatrician on time.
Vegeto-vascular dystonia treatment
To assign the correct treatment of vegetative-vascular dystonia, which will give the desired result, it is necessary to conduct a thorough diagnosis in order to exclude the pathology of internal organs. Start the examination from the organ to which the patient complains. It is best to start the examination with general clinical analysis, and after their detailed interpretation, samples are assigned to detect dysfunction of the autonomic nervous system, echocardiogram and ECG, various respiratory tests.
If complaints are present on the organs of the gastrointestinal tract, ultrasound must be done without fail. Echoencephalography and electroencephalography also will not become superfluous, since these methods will allow to fully appreciate the work of the central nervous system. A very important item is the collection of an anamnesis of life. It is necessary to find out information about what hurted close relatives, whether they suffered from dystonia. The parents of the vagotonics often encounter neurodermatitis, peptic ulcer , asthma , and in sympathetics - diabetes mellitus , hypertension. With vegeto-vascular dystonia, it is highly recommended to get advice from an otolaryngologist, neurologist, endocrinologist, oculist and psychotherapist.
If as a result of a full medical examination organic pathology was not found, and tests for autonomic nervous system dysfunction gave a positive result, they put the final diagnosis of "vegetative-vascular dystonia" indicating the type and severity of the course.
Treatment of vegetative-vascular dystonia is long-term, complex, purely individual. When giving advice and prescribing drugs, one must take into account the etiology of the disease and the nature of the abnormalities of the ANS. The main methods are non-medicinal. These include the normalization of sleep and wakefulness, the reduction of physical and mental loads, the elimination of all psychotraumatic factors, the provision of regular, high-grade and healthy nutrition. It is necessary to limit the impact of telecasts and computer games on the emotional sphere. In order to obtain the optimal effect of treatment, you must abandon the existing bad habits (smoking and alcohol).
Widespread use now received such methods of therapy of vegetative-vascular dystonia, as water procedures (circular and contrast shower, pearl bath with essential oils, pool), relaxing massage. Of the physiotherapy, the best results were shown by magneto- and laser puncture, electrostimulation and vacuum therapy. The effectiveness of laser therapy is due to a calming and vasodilating effect, as well as analgesic and spasmolytic. Magnetopuncture well eliminates chronic pain symptoms accompanying vegetative-vascular dystonia of moderate and severe severity, helps restore the body after long-term exposure to psychoemotional factors.
Vacuum therapy is prescribed for the thoracic region. It provides analgesic and sedative action, helps to restore impaired blood circulation. It is especially effective in vegetative-vascular dystonia for hypotensive and hypotensive-cardiac types of moderate and severe severity.
The method of electrostimulation is indicated for violations of the circulation of the upper and lower extremities, accompanied by cold and numbness of hands and feet. This method has its own contraindications. Electrostimulation is contraindicated in people with high blood pressure, as it can lead to hypertensive crisis, with a low number of platelets in the blood (the risk of rupture of small vessels, the formation of extensive bruising), with large ulcers or wounds on the body, with exacerbation of chronic diseases and high body temperature . Contraindication is the active phase of rheumatoid arthritis.
In the therapy of vegetative-vascular dystonia well-established and acupuncture. It helps to cope with headaches and activates the broken hemodynamics. In addition, it reduces the craving for cigarettes and spirits, and the rejection of these harmful substances is essential for the successful treatment of the disease.
For the benefit of the patient vegetative-vascular dystonia will go respiratory gymnastics. It is very simple and useful: it is necessary to take a deep and slow inhalation (the breath lasts about 6-7 seconds), and on the exhalation that lasts the same, to pronounce the sounds: and, e, o, y, ah, w. Exercise should be done at least 5 minutes, at least 10 times a day, and it is better to bring to 20.
If the methods of physiotherapy and image correction have not produced the desired result, treatment with medications is prescribed. With the purpose of therapy of vegetative-vascular dystonia prescribe sedatives, neuroleptics, drugs that improve the flow of blood into the brain, complexes of vitamins and minerals. In some cases, it may be necessary to prescribe antidepressants and tranquilizers. Treatment begins with minimal doses and slowly increases to therapeutic.
Among the sedatives the most safe and effective for the treatment of vegetative-vascular dystonia are herbal remedies. Tincture of valerian is prescribed for 20-25 drops every 6-12 hours for adults and 1 drop for 1 year of life for children. Multiplicity of admission in children is the same. Tincture of motherwort used for 30-40 drops per half a cup of water every 8 hours. Children are dosed in exactly the same way as valerian (1 drop - 1 year). In the right dosages, these drugs will not give undesirable effects.
Highly effective drug is Novo-Passit. Used to treat vegeto-vascular dystonia as an anxiolytic and sedative. Dosage: 5-10 mg every 8 hours. Soothing preparations №2-3 are consumed by first preparing an infusion of 10 grams of herbs for a glass of hot water. Drink the fourth part of the glass after eating 1 or 2 times a day.
In the treatment plan, doctors include nootropics. Among them, the most popular agents for the treatment of vegetative-vascular dystonia are Aminalon, Pikamilon, Nootropil (Pyracetam), Glycid (Glycine).
Admission Aminalon adults start with 0.5 g every 12 hours. By the end of the first week of treatment, the dose should be doubled, and the frequency of reception should be kept the same. Children under three take 0.5 g twice a day, the dose does not increase. Children from 4 to 6 years should take one and a half grams a day. The dose of the medicine is divided into two doses. Patients older than seven years drink two grams of Aminalon per day (1 g in the morning and in the evening). The course of treatment is appointed individually.
Pikamilon is prescribed in a daily dose of 40-80 mg. Divide by 2-3 reception. The dosage of the drug depends on the severity of the symptoms of vegetative-vascular dystonia and the severity of its course. The duration of the course is on average 4-8 weeks.
Nootropil is prescribed at the rate of 30 to 160 mg per kg of body weight of the patient. The received daily dose is divided into several receptions, more often by four. The drug is taken with food, washed down with water. Special care should be taken when prescribing this remedy to people suffering from kidney disease. In this case the therapy is carried out under the constant strict control of creatinine. If the clearance is less than 20 ml in 60 seconds, Nootropil is categorically contraindicated.
Glycides take under the tongue. Dosage and treatment directly depends on the individual characteristics of the course of vegetative-vascular dystonia. So, with mild symptoms (nervousness, memory impairment), patients drink 1 tablet every 8 hours. If the asthenic syndrome is expressed, the dose is doubled. The duration of treatment in these cases will be 4-6 weeks. If the leading symptom is disamenia, you should drink one tablet 15-20 minutes before bedtime. Repeated courses of treatment with Glycisedom are carried out in the presence of indications 2-4 times a year. Almost always this remedy is well tolerated, in exceptional cases there may be mild nausea, unpleasant sensations in the abdomen, hives .
In severe vegetative-vascular dystonia, antidepressants may be needed. Bethol and Pirazidol proved to be very successful. Befol appoint 100-300 mg per day, dividing the dose into 2-3 doses. Pyrazidol is given for 100 mg every 8-12 hours. It is important to know that only a therapist can prescribe antidepressants, self-medication with these drugs is unacceptable.
In severe psychoemotional disorders tranquilizers are prescribed. The drug of choice is Atarax. He is a strong vegeto-corrector, does not cause addiction and is well tolerated. It is used in the treatment of asthenia, phobic disorders, increased sweating and feelings of heat, shortness of breath and nausea of neurogenic genesis. Dosage is individual: from 25 to 100 mg per day. With a severe degree of vegetative-vascular dystonia, the hypertensive type is Oxylidine. It reduces pressure, acts as an anxiolytic and sedative, eliminates difficulties in falling asleep, improves hemodynamics of the brain. The drug is ingested by 0.02 mg every 8 hours. Treatment with this drug is carried out under the strict supervision of the treating doctor. Duration of treatment usually does not exceed 3-8 weeks.
Vegeto-vascular dystonia consequences
Despite the mass of unpleasant manifestations and symptoms of this disease, the prognosis of vegetative-vascular dystonia is positive, and the consequences with the observance of the correct regime of the day, the alternation of wakefulness and rest, the abandonment of pernicious habits, the correct intake of medications prescribed by the attending physician are minimal.
In the case of a non-serious attitude to vegetative-vascular dystonia and ignoring adequate treatment, you can face a lot of problems. In the first place are violations of the cardiovascular system: an increase in the boundaries of the heart, tachyarrhythmia, a persistent increase in blood pressure, which is almost not stopped by medication. People with this disease should closely monitor their emotions and control them intensively, as they are more likely than others to have the risk of developing strokes and heart attacks, and at a young age. That is why avoiding conflicts and stressful situations is the main method of preventing the development of these diseases.
People with vegeto-vascular dystonia are more likely to experience reduced immunity and resistance to infectious diseases. And, as we have already found out, bouts of vegetative-vascular dystonia often happen just during catarrhal diseases, when the body is most exhausted and weak. In this case, there is a vicious circle. Therefore, such people need to protect themselves: limit contact with sick people, dress in the weather to avoid hypothermia and overheating, take vitamins, microelements and immunostimulants in the fall and spring.
Prevention of acute respiratory diseases will help prevent the progression of vegetative-vascular dystonia, to minimize its negative manifestations. In addition to all of the above, the consequences for patients who do not want to give up drinking and smoking cigarettes will be much more serious and numerous: the symptoms will become much brighter, crises will happen many times more often, and drug therapy and physiotherapy will not bring the desired effect. In addition, against the background of bad habits, chronic diseases of the respiratory and cardiovascular system, which will complicate the course of vegetative-vascular dystonia, catalyze its development.