Encephalopathy - This is a complex of symptoms that result from the death of brain cells due to prolonged bleeding, poisoning or oxygen starvation due to a pathological condition or any disease.
Depending on the period of occurrence of encephalopathy, there are:
- Acquired, resulting from diseases and various pathological conditions after birth.
- Congenital, due to the death of nerve cells during fetal development.
Congenital encephalopathy is associated with malformations of the central nervous system and genetic malfunctions of metabolic processes. It can be the result of exposure to the fetus of various damaging factors (birth trauma of the brain and fetal hypoxia).
Acquired encephalopathy is the result of exposure to the brain of damaging factors after birth.
In most cases, the disease progresses slowly. But it can develop suddenly and acutely, for example, with a malignant development of hypertension due to nephropathy of pregnant women or severe kidney damage.
Encephalopathy - Causes
The development of encephalopathy is primarily associated with brain hypoxia (oxygen deprivation of brain tissue). Hypoxia occurs with cerebrovascular accidents, cerebral hemorrhages, with a decrease in arterial blood flow to the brain and difficulty in the outflow of venous blood, as well as exposure to toxic substances that affect metabolic processes in the nervous tissue.
With encephalopathy, brain damage is manifested by a decrease in the number of nerve cells and their destruction, the occurrence of small areas of decay of the brain tissue, small hemorrhages, signs of blood stasis, and swelling of the meninges. Various localization and severity of the foci of lesion, a predominant violation of gray or white matter and disturbances in cerebral circulation are noted.
Encephalopathy - Symptoms
Encephalopathy can have various clinical manifestations. The earliest symptoms are: decreased mental performance and weak memory. The patient experiences difficulty in changing the type of activity and when switching attention. Irritability, mood changes, insomnia, fatigue and lethargy appear. Complaints about tinnitus, headaches, impaired vision and hearing are frequent.
An examination reveals an increase in muscle tone and tendon reflexes, the appearance of pathological reflexes, a violation in the functioning of the autonomic nervous system, and impaired coordination of movements. In the last stages, neurological symptoms - paralysis, parkinsonism and paresis - join. Some patients develop dementia and the psyche is disturbed.
The acute development of encephalopathy implies a fairly rapid course of the overall clinical picture of the disease. Suddenly, the patient becomes restless, there is a severe headache, nausea, dizziness, visual impairment. Numbness of the tongue, nose, lips, fingers develops. Speech disorder and coordination of movements are noted. Later, anxiety is replaced by lethargy, lethargy and confusion.
Encephalopathy - Diagnosis
Diagnosis of the disease is based on the analysis of the data obtained by questioning the patient. With congenital encephalopathy, an important role is played by the facts of intrauterine growth disorders, severe pregnancy, and birth trauma. In adult patients, cases of traumatic brain injury, alcohol abuse, the presence of acquired or hereditary metabolic diseases and vascular diseases are specified.
EEG (electroencephalography), CT (computed tomography), MRI (magnetic resonance imaging), NMR (nuclear magnetic resonance imaging) are optionally performed. A biochemical and general analysis of blood and urine is additionally prescribed. If necessary, a spinal puncture is performed and cerebrospinal fluid is examined.
Encephalopathy - treatment and prevention
The treatment of encephalopathy is complex, aimed at combating both the main disease that caused encephalopathy and the weakening of the manifestations of emerging disorders.
- In acute encephalopathies, artificial lung ventilation, hemodialysis, and parenteral nutrition are used.
- To reduce intracranial pressure and eliminate the convulsive syndrome, anticonvulsants and diuretics are prescribed.
- To improve blood circulation in the brain, angioprotectors (nicotinic acid, cinarizine and cavinton) are indicated.
- As an adjunct, acupuncture, physiotherapy, respiratory and therapeutic exercises are used.
Prevention of congenital encephalopathy is the prevention and treatment of pregnancy complications (fetal hypoxia, Rhesus conflict, gestosis), proper management of childbirth, and prevention of birth injury.
In the prevention of acquired encephalopathy, the timely treatment of diseases that cause brain damage, the correct use of drugs, the rejection of alcohol, and the prevention of head injuries are of great importance.
