Somatoform disorder of the autonomic nervous system. Autonomic dysfunction syndrome. Mixed disorder of the autonomic nervous system Autonomic dysfunction

The autonomic nervous system (ANS) controls the work of all internal organs. She sends them nerve impulses that ensure the smooth functioning of the whole organism. VNS provides information transfer from the central nervous system to the innervated organs, but at the same time it practically does not obey the consciousness and will of a person.

Dysfunction of the autonomic nervous system- a condition in which impulses sent by the ANS disrupt the work of internal organs, causing pain and other symptoms. However, the examination does not reveal any diseases or serious organic disorders that could cause such sensations.

The manifestations of ANS dysfunction are very diverse and depend on the organ in which autonomic regulation is impaired. If the ANS is disrupted, a picture of ischemic heart disease, osteochondrosis, intestinal diseases and Bladder, there are rises in temperature and jumps in blood pressure, etc.

According to statistics, impaired functioning of the ANS is found in 20% of children and 65% of adults. In women, such disorders occur 3 times more often than in men, which is associated with the inherent female body hormonal fluctuations.

VNS structure

The autonomic nervous system is an autonomous part of the nervous system that regulates the work of the body: internal organs, external glands and internal secretion, blood and lymphatic vessels.

According to the topographic principle, the ANS is divided into two sections - central and peripheral.

Central department VNS comprises:

Segmental (higher) centers, located in the cortex, subcortical region, cerebellum and brain stem. They analyze information and manage the work of other departments of the ANS.
Vegetative nuclei- clusters nerve cells located in the brain and spinal cord, which regulate the work of individual functions and organs.

Peripheral VNS department make up:

Vegetative nodes(ganglia) - clusters of nerve cells enclosed in a capsule, lying outside the head and spinal cord... They contribute to the transmission of impulse between the organ and the vegetative nuclei.
Nerve fibers, nerves and branches that extend from the nuclei and nerve plexuses passing in the walls of internal organs. They transmit information about the state of organs to the vegetative nuclei, and commands from the nuclei to the organs.
Vegetative receptors, located in the walls of internal organs, which track changes occurring in them. Thanks to receptors, a person develops sensations of thirst, hunger, pain, etc.

ANS is anatomically divided into two sections:

Sympathetic nervous system. The nuclei are located in the chest and lumbar spinal cord. It innervates all internal organs, without exception, their smooth muscles. It is activated in stressful situations: it accelerates the heartbeat, quickens breathing, increases blood pressure, dilates the vessels of the heart, while contracting the vessels in the skin and organs abdominal cavity, enhances the production of hormones, activates sweat glands, increases metabolism and blood circulation in skeletal muscles, increasing their strength, activates immune responses and brain activity. In doing so, it prevents the act of urination and bowel movement. Thus, the sympathetic division of the ANS prepares the body for active action- defense or attack.
Parasympathetic nervous system. Its nuclei are found in the brain (middle and oblong), as well as in the sacral spinal cord. This section slows down the heartbeat, lowers pressure, narrows the lumen of the bronchi, and reduces blood circulation in the heart and skeletal muscles. It enhances the formation of urine in the kidneys and increases the frequency of urination. It provides the restoration of immunity, replenishment energy reserves(the formation of glycogen in the liver), enhances the work of the digestive glands and accelerates intestinal motility, ensuring its emptying. Mediators parasympathetic department have an anti-stress effect. The work of the parasympathetic department is primarily aimed at maintaining homeostasis (stability of the internal environment) and restoring body functions in calm conditions.

Sympathetic department is responsible for an active response to external stimuli (struggle, action), and parasympathetic for the restoration of strength, functions and energy reserves. Normally, these two sections work in a balanced way: when external stimuli stimulate one section, the other comes to a relaxed state. However, unfavorable factors (which are considered to be the causes of VNS dysfunction) disturb the vegetative balance. As a result, the ANS sends incorrect signals and one or more organs malfunction.

Causes of dysfunction of the autonomic nervous system

Personality traits human – high level anxiety, low stress resistance, a tendency to hypochondria, a demonstrative or anxious-suspicious type of character.
Stress... Prolonged stressful situations or chronic stress unnecessarily stimulate the work of the sympathetic division and inhibit the parasympathetic.
Mental and physical stress ... Overwork is often the cause of the disorder in children. school age and in adults.
Hormonal Disorders - diseases of the endocrine organs, age-related or periodic fluctuations in the level of hormones. Adolescence, pregnancy, the postpartum period, menopause are periods when the load on the ANS increases, and therefore the risk of developing dysfunction increases.
Immaturity of the ANS. In infants and young children, one section may dominate the other.
Unfavorable course of pregnancy and childbirth often cause autonomic disorders in children.
Allergic reactions. Allergy is a complex of immune reactions that can affect the state of all organs and systems.
Consequences of serious diseases. Infections inflammatory processes, severe injuries and surgical interventions accompanied by stress and intoxication, which disrupts the functioning of the ANS.
Long-term use of potent drugs. VNS dysfunction can be side effect some medicines especially with long-term use or self-medication.
Brain and spinal cord injuries, which led to damage to the centers and nuclei of the ANS.
Sedentary image life... Sedentary work, physical inactivity, prolonged sitting at the computer and the lack of regular physical activity disrupt the well-coordinated work of the NS.
Deficiency of vitamins and nutrients necessary for the normal functioning of the nervous system.
Exposure to alcohol and nicotine. These substances have a toxic effect on the NS and cause the death of nerve cells.

Types of ANS dysfunction

Somatoform autonomic dysfunction... Disorder of the ANS, as a result of which symptoms of the disease and signs of organ dysfunction develop, while there are no changes that could cause this condition. For example, people with a healthy heart may suffer from pain in the region of the heart, rapid heartbeat, and irregular heartbeats. For the same reason, a cough may develop, itchy skin, pain in the stomach and intestines, urinary disorders, diarrhea and constipation, etc.
Syndrome of defeat of the subcortical parts of the brain. It develops after brain injuries and with damage to the cortical and subcortical centers of the autonomic nervous system. It is manifested by numerous disorders in the work of organs, metabolic disorders, disruption of the gonads and reproductive organs, unreasonable rises in temperature. This is accompanied by deviations from the central nervous system - disorientation, mood swings, various mental disorders.
VNS dysfunction due to constant irritation of autonomic receptors. This happens when the receptors in the internal organs detect a violation of their work. For example, kidney stones, an allergic reaction in the bronchi, helminths in the intestines. Constant irritation leads to a disruption in the work of the ANS. To eliminate dysfunction, it is necessary to treat the disease that caused it.

This article will focus on somatoform autonomic dysfunction as the most common type of disorder. This disease is common in people of all ages. So, doctors find it in 75% of children who come with non-infectious diseases. The disorder may present with one or more symptoms, which will be described below.

Pain in the region of the heart

Psychogenic cardialgia - pain in the region of the heart with dysfunction of the ANS, which can occur at any age. In this case, the electrocardiogram, the results of ultrasound of the heart and other studies are normal.

At psychogenic cardialgia, stitching pain, radiates to the scapula, left arm, right half of the chest. It is caused by excitement, overwork, and may be associated with a change in the weather. The pain is not related to exercise. When palpating, painful sensations in the area are revealed pectoral muscle, between the ribs, on the left shoulder and forearm along the nerve.

Painful sensations may be accompanied by:

Heart palpitations;
Blood pressure surges;
Shortness of breath without exertion;
Sweating attacks;
Panic attacks appearing at night.

Psychogenic cardialgia disappears after taking sedatives. But if the ANS dysfunction is not treated, then chest pain reappears with emotional stress.

Psychogenic cough

Psychogenic cough dry and hoarse, sometimes loud and barking. It occurs in the form of seizures or coughing that appears at regular intervals. In children, a sign of a psychogenic cough may be a prolonged cough (persistent or intermittent) that does not respond to treatment, in the absence of changes in respiratory organs... Over time, the cough can become "habitual" when the cough continues all day, regardless of the situation, and only disappears during sleep.

A psychogenic cough develops in unexpected or unpleasant situations. During or after stress, the person experiences dry, tickling or tickling in the throat and a feeling of irritation in the airways (feeling of cats stuck, squeezing in the throat). This sensation is often accompanied by palpitations and soreness in the region of the heart, sometimes with fear of death.

A psychogenic cough can be caused by:

Emotional stress, and not only in stressful situations, but also with fears about an insignificant reason;
Pungent odors;
Change of weather;
By conversation;
Exercise.

Typically, these disorders cause a person to breathe deeper, which causes hyperventilation, when more air is drawn into the lungs than is required for normal functioning. The overflow of the airways causes a spasm of the smooth muscles of the bronchi and a coughing fit.

Psychogenic cough can be accompanied by other breathing problems:

Shortness of breath, feeling short of breath;
Laryngospasm, manifested by a sharp hoarseness of the voice that suddenly develops and stops;
Inability to take a full breath, a feeling of congestion in the chest;
Frequent shallow breathing, alternating with deep sighs or short breath holdings;
Wavelike increase in the frequency and depth of respiratory movements with pauses between waves.

First aid for psychogenic cough are distracting activities. You can offer the patient to drink fluids, wash your hands up to the elbow with cold water, breathe in a paper bag.

Angioneurosis

Angioneurosis - a disease caused by spasm small arteries and stretching of veins in the skin. The disease develops in people over 30 years of age. One of the reasons is considered to be autonomic disturbances in the regulation of the tone of blood and lymphatic vessels, which arose due to the excitation of the sympathetic division of the ANS.

In most cases, the skin of the face is affected. In this regard, changes develop in the skin:

on initial stage- areas of redness, spider veins;
papules and pustules - dense nodules and vesicles with purulent contents are formed;
nodes and growths - against the background of skin edema, large brownish-red elements are formed, sometimes with liquid contents.

The condition of the skin improves somewhat with the observance of the rules of hygiene and stimulation of blood circulation ( cold and hot shower, physical exercises). It is possible to avoid new rashes after the normalization of the functions of the ANS.

Itching

Itching is one of skin manifestations work disruptions vegetative system... The onset of itching is associated with irritation of peripheral receptors in the skin, due to autonomic dysfunction. Itching can occur in certain areas corresponding to the areas of innervation of certain nerves (for example, intercostal) or not have a specific localization.

Itching disrupts the emotional state of a person, impairs sleep and reduces performance. Except for the itch skin symptoms vegetative disorders can be:

Feeling of tingling, burning, "creeping creeps";
Chilliness or heat sensation on the skin;
Excessive dryness or moisture of the skin;
Marbling or cyanosis of the skin;
Temporary skin pigmentation disorders - darker or lighter spots;
Rash, red rash like urticaria;
Deterioration of the condition of the nails;
Breakage and hair loss;
Formation of ulcers and erosion.

Vegetative itching occurs in suspicious and anxious people who are sensitive to stress. It does not depend on allergic reactions and does not go away even after eliminating contact with allergens. Also skin changes not related to skin diseases other nature (fungal, infectious, trophic). To alleviate the condition, patients are prescribed antihistamines and sedatives.

Hiccups

Hiccups - a sharp rhythmic contraction of the muscles of the diaphragm with a frequency of 5-50 times per minute. Neurogenic hiccups develop when irritated vagus nerve and is not associated with eating, swallowing air while laughing or eating.

If the autonomic regulation of the diaphragm is disturbed, hiccups develop several times a day or a week. The hiccups last more than 10 minutes. They can end on their own or after additional stimulation of the vagus nerve. To stop an attack of neurogenic hiccups, it is recommended:

Drink a glass of water quickly;
Eat something dry;
Take a deep breath and hold your breath;
Bring your knees to your chest.

Aerophagia

Aerophagia is the swallowing of excess air with its subsequent regurgitation. Usually, air can be swallowed while eating, talking, or swallowing saliva. With a vegetative disorder, it can appear in a stressful situation with a violation of swallowing, when trying to get rid of the "lump in the throat." Over time, air is swallowed out of habit and a person all the time, except for a night's sleep, swallows and regurgitates air.

Aerophagia symptoms:

Frequent loud belching of air without the smell of food;
Feeling of fullness and heaviness in the epigastric region;
Nausea;
Difficulty breathing
Difficulty swallowing
Chest pain, extraordinary contractions of the heart.

Pylorospasm

Pylorospasm is a spasm of the muscles of the lower stomach at the place of its transition to the duodenum. Muscle spasm makes it difficult to empty the stomach and move food into the intestines. When probing the abdomen, a seal can be found in this area. The main cause of pylorospasm is considered to be a violation of the autonomic system.

Pylorospasm is most common in newborns, but can develop at any age. In children, pylorospasm is manifested by frequent regurgitation or vomiting with sharp jerks, which occurs some time after feeding. Complaints in adults are more varied:

Belching;
Cramping pains in the stomach;
Vomiting of acidic stomach contents;
Feeling of hyperextension of the stomach and vomiting "fountain", as a sign of the atonic form of pylorospasm.

To alleviate the condition with pylorospasm, frequent meals in small portions are recommended. Food should be semi-liquid and not spicy. Good effect provide regular exercise and massage. To completely eliminate the symptoms, it is necessary to undergo a course of treatment of the autonomic system.

Flatulence

Psychogenic flatulence - increased formation and accumulation of gas in the intestines, not associated with indigestion or the consumption of certain foods. The cause of its appearance is considered to be a spasm of the smooth muscles of the intestine and a violation of its peristalsis. As a result, the reabsorption of gases through the intestinal wall and their natural elimination is slowed down.

Psychogenic flatulence develops during or after psycho-emotional stress. Its manifestations:

Rumbling and “transfusion” in the abdomen;
Violent discharge of gases;
Cramping pain in different sites abdomen;
Nausea;
Belching;
Decreased appetite
Constipation or diarrhea.

To eliminate symptoms, you can take adsorbents ( Activated carbon, enterosgel), but to eliminate the cause, it is necessary to treat the dysfunction of the autonomic nervous system.

Diarrhea

Psychogenic diarrhea (diarrhea) or "bear disease" - disorder of the stool during psycho-emotional stress. Stool disorder for the first time nervous soil happens in response to a stressful situation. Then the urge to defecate occurs in the same type of situations or with a similar emotional state, which makes life much more difficult for a person. Over time, this way of expressing emotions can be fixed as a pathological reflex, and arise in response not only to negative, but also to positive emotions.

The cause of the development of psychogenic diarrhea is:

Experienced fright;
Sadness;
Rejection life situation;
Fear of future events;
Anxious expectations;
Depressive reaction.

The development of diarrhea is based on accelerated intestinal peristalsis, which occurs as a result of increased stimulation of its walls by the nerve endings of the ANS.

In addition to diarrhea, dysfunction of the ANS can lead to the development of other functional disorders digestive system:

Loss of appetite;
Nausea;
Vomit;
Biliary dyskinesia;
Painful sensations in various parts of the digestive system.

Psychogenic digestive disorders do not depend on the quantity and quality of food, and therefore cannot be treated with diet therapy. To eliminate their symptoms, adsorbents and sedatives are used.

Frequent urination

Psychogenic urinary frequency or irritable bladder syndrome - frequent urge to urinate during or after psychological stress... Violation nervous regulation leads to the fact that the pressure inside the bladder increases in response to the smallest stimuli.

The disorder manifests itself by frequent (up to 15 times per hour) urge to urinate in the presence of a small amount of urine in the bladder. The daily amount of urine does not increase and rarely exceeds 1.5-2 liters. Mostly during a night's sleep, the patient's bladder is not disturbed.

Other symptoms of an irritated bladder include:

Emptying the bladder in small portions, sometimes a few drops;
Feeling empty of the bladder after urinating;
Involuntary flow of urine - usually against the background of a strong emotional experience;
An increase in the number of nocturnal urination if a person suffers from insomnia or if anxiety does not leave even in sleep.

As a rule, such changes are reversible. Sibutin, no-shpu, and sedatives are used to temporarily relieve symptoms. However, to normalize the nervous regulation of the bladder, a full course of treatment is required.

Sexual dysfunction

Reproductive system partly under the influence of vegetative NS. In men, under her control are the processes of erection and ejaculation, in women - the contraction of the uterus. Autonomic disorders of sexual function are associated with a weakening of the parasympathetic department due to constant sympathetic tension. This condition is caused by overwork, chronic stress and negative emotions.

The consequences of vegetative disorders can be:

Weakening of an erection;
Ejaculation disorder;
Anorgasmia is the inability to reach orgasm.

Diagnostics

The diagnosis and treatment of dysfunction of the autonomic nervous system is carried out by a neurologist. As a rule, patients get to see him after examination by other specialists who have established that the organs are healthy or that changes in them cannot cause these symptoms.

At the appointment, the doctor assesses the nature of the patient's complaints, determines the reactivity and tone of the ANS, as well as which department is leading and which one needs additional stimulation.

For diagnostics are used:

M. Wayne's tables, which describe all the symptoms and indicators that allow you to determine the strengthening of which part of the ANS causes the disorder. In the table, each symptom is rated on a 5-point scale, and the results are determined by the sum of the points.
Pharmacological, physical and physiological tests:

Variation heart rate monitoring using stress index of regulatory systems;
Stress tests;
Load test;
Respiratory test;
Atropine test;
Determination of skin sensitivity to pain and heat irritation;

Measurement of blood pressure and ECG, RЄG before and after mental and physical exertion.

It is also possible to determine the leading department of the ANS by the appearance of a person. For example, the sympathotonic person often has a slender, toned physique, while the vagotonic person is prone to fullness and uneven distribution of adipose tissue. For the same purpose, a study of dermographism is carried out - if it is carried out on the skin, then the left trace in the sympathotonic person turns red, and in the vagotonics it turns pale.

Based on the results of the examination, treatment will be prescribed.

Treatment of VNS dysfunction

Treatment of dysfunction of the autonomic nervous system is a complex and lengthy process. Treatment is carried out taking into account the symptoms, cause, severity of the disease, the dominant part of the ANS and other factors.

Treatment necessarily includes:

Normalization of the daily routine;
Dosing of mental and physical activity;
Prevention of hypodynamia - daily gymnastics, walks for 2-3 hours and playing sports;
Limiting the time spent near the TV and computer;
Sedative teas and preparations - mint, lemon balm, motherwort, hawthorn, valerian, chamomile. Herbs alternate every 3-4 weeks for 10-12 months;
Good nutrition with a sufficient amount of minerals and vitamins (especially B and C);
Compilation of the menu taking into account the prevailing department of the ANS. People with increased activity of the sympathetic department need to limit tea, coffee, chocolate, spicy foods and smoked meats. At enhanced function parasympathetic department recommended pickled foods, tea, chocolate, buckwheat porridge.

Drug treatment

Sedatives for plant based – Nobrassit, Fito-Novossed, Nervoflux.
Tranquilizers a course for 1 month is prescribed if herbal sedatives are not effective:

WITH sedative effect to reduce excitability and anxiety with the predominance of the sympathetic nervous system, diazepam 3 mg 2 r / day;
Daytime tranquilizers are prescribed to relieve emotional tension, apathy, decreased activity of medazepam, 5 mg 2 r / day.

Antipsychotics prescribed for increased anxiety and severe emotional and motor restlessness for 3-4 weeks. Alimenazine 5 mg 3 r / day, thioridazine 10 mg 3 r / day.
Nootropic drugs with a decrease in attention, memory and intelligence. Duration of admission is 2-3 months. Treatment is carried out in courses 2-3 times a year. In order to improve blood circulation and nutrition of the nervous system, the functioning of nerve cells and relieve excessive excitement, one of the drugs is prescribed:

Gamma aminobutyric acid, aminalon 3 r / day;
Glycised 1-2 tab. 2-3 r / day;
Piracetam 1-2 tab. 2-3 r / day;
Pyritinol 1 tab 2 r / day.

Psychostimulants to increase the activity of the ANS, it is prescribed to people with a predominance of the parasympathetic department. The drugs are prescribed in courses of 3-4 weeks, then take a break for 2-3 weeks.

Eleutherococcus extract;
Tincture of ginseng root;
Radiola tincture pink.

Vitamins and minerals improve the state of the ANS, make it less sensitive to external influences, contribute to the balanced work of all departments.

Multivitamin complexes;
Coenzyme Q10;
Elcar L-carnitine;
Betacarotene.

Physiotherapy

Procedures aimed at improving the work of the ANS and restoring the balance of its departments.

Electrotherapy- treatment with an electric field and low currents:

Galvanization, galvanic collar according to Shcherbak;
Ultrasound therapy;
Sinusoidal modulated currents;
Inductothermy;
Electric sleep.

Paraffin and ozokerite on the cervico-occipital region. Thermal treatments increase the activity of the parasympathetic division of the ANS.
Massage- general, neck-collar and lumbar zone, arms and calf muscles. Massage improves blood circulation, relieves spasm of blood vessels in the skin, relieves emotional stress and improves the innervation of organs.
Acupuncture... Acupuncture is a harmless method that complements the rest well therapeutic measures... It shows the best results in the treatment of respiratory and cutaneous autonomic disorders, as well as urinary disorders.
Balneotherapy. The revitalizing effect on the nervous system has mineral water and water procedures - circular shower, contrast shower, radon, pearl, sulfide, coniferous medicinal baths, sauna.
Hardening procedures- rubbing, dousing with cold water are indicated with the predominance of the parasympathetic department.
Spa treatment - air baths and sea baths are prescribed for all patients with vegetative disorders.

Psychotherapy with dysfunction of the ANS

Psychotherapy can significantly shorten the duration of treatment and reduce the number of prescribed drugs. With dysfunction of the ANS in children, it helps to improve the general condition and maintain mental health in the future. In adults, psychotherapy can eliminate the causes of the disorder and reduce the dependence of the ANS on stress.

Family psychotherapy... This type of psychotherapy is necessarily used in the treatment of children and adolescents, since similar problems are found in one of the parents (more often in the mother) and are transmitted to the child. The psychotherapist talks about the essence of the disease, advises how to change the situation in the family in order to eliminate the traumatic factor.
Hypnotherapy... Exposure in a state of hypnotic sleep allows you to eliminate deep psychological and emotional problems that disturb the balance of the ANS.
BFB therapy. This technique increases the control of consciousness over the functions of organs and normalizes them. neurohumoral regulation... The acquisition of skills for self-regulation and conscious relaxation helps to improve self-control in stressful situations and to avoid the onset of symptoms of autonomic nervous system dysfunction.
Self-training and relaxation. This method is given great importance in adolescents and adults. Relaxation and self-hypnosis techniques should be applied daily for the entire period of treatment. The mastery of relaxation methods takes place in individual or group sessions with a psychotherapist.

Prevention

Prevention of ANS dysfunction includes:

Adequate sleep;
Rational alternation of work and rest;
Increased stress resistance;
Regular sports activities and outdoor walks;
Rational nutrition, including enough protein, fruit, complex carbohydrates... Honey and mineral waters are also recommended.

Preventive measures allow you to avoid the development of autonomic dysfunction and its reappearance after treatment.

Vegetative dysfunction is a complex of functional disorders caused by dysregulation of vascular tone and leading to the development of neuroses and a deterioration in the quality of life. This condition is characterized by the loss of the normal reaction of the vessels to various stimuli: they either strongly narrow or expand. Such processes disrupt the general well-being of a person.

Autonomic dysfunction is quite common, affecting 15% of children, 80% of adults, and 100% of adolescents. The first manifestations of dystonia are noted in children and adolescence, the peak incidence occurs in the age range of 20-40 years. Women suffer from vegetative dystonia several times more often than men.

The autonomic nervous system regulates the functions of organs and systems in accordance with exogenous and endogenous irritating factors. It functions unconsciously, helps maintain homeostasis and adapts the body to changing environmental conditions. The autonomic nervous system is divided into two subsystems - sympathetic and parasympathetic, which work in the opposite direction.

Sympathetic nervous system weakens intestinal motility, increases sweating, increases heart rate and enhances heart function, dilates pupils, narrows blood vessels, increases blood pressure.

Parasympathetic division reduces muscles and enhances gastrointestinal motility, stimulates the body's glands, dilates blood vessels, slows down the heart, lowers blood pressure, narrows the pupil.

Both of these departments are in a state of equilibrium and are activated only as needed. If one of the systems begins to dominate, the work of the internal organs and the body as a whole is disrupted. This is manifested by the corresponding clinical signs, as well as the development, psychovegetative syndrome, vegetopathy.

Somatoform dysfunction of the autonomic nervous system is a psychogenic condition accompanied by symptoms of somatic diseases in the absence of organic lesions. Symptoms in these patients are very varied and variable. They visit different doctors and present vague complaints that are not confirmed by examination. Many experts believe that these symptoms are invented, but in fact they cause a lot of suffering and are exclusively psychogenic in nature.

Etiology

Violation of nervous regulation is the basic cause of vegetative dystonia and leads to disorders in the activity of various organs and systems.

Factors contributing to the development of autonomic disorders:

Endocrine diseases - obesity, hypothyroidism, adrenal dysfunction,

Hormonal changes - menopause, pregnancy, puberty,

Heredity,

Increased suspiciousness and anxiety of the patient,

Bad habits,

Improper nutrition

The foci in the body chronic infection- caries, sinusitis, rhinitis, tonsillitis,

Allergy,

Traumatic brain injury

Intoxication,

Occupational hazards - radiation, vibration.

The causes of pathology in children are during pregnancy, birth trauma, diseases during the neonatal period, an unfavorable climate in the family, overwork at school, stressful situations.

Symptoms

Autonomic dysfunction manifests itself in a wide variety of symptoms and signs: asthenization of the body, insomnia, anxiety, shortness of breath, obsessive phobias, a sharp change in fever and chills, numbness of the extremities, tremor of the hands, myalgia and arthralgia, heart pain, low-grade fever, dysuria, biliary dyskinesia, fainting, hyperhidrosis and hypersalivation, dyspepsia , pressure fluctuations.

The initial stage of pathology is characterized by autonomic neurosis. This conditional term is synonymous with autonomic dysfunction, but at the same time it spreads beyond it and provokes further development disease. Vegetative neurosis is characterized by vasomotor changes, impaired skin sensitivity and muscle trophism, visceral disorders and allergic manifestations. At the beginning of the disease, signs of neurasthenia come to the fore, and then the rest of the symptoms join.

The main syndromes of autonomic dysfunction:

Syndrome mental disorders manifests itself depressed mood, impressionability, sentimentality, tearfulness, lethargy, melancholy, a tendency to self-blame, indecision, hypochondria, decreased motor activity. Patients develop uncontrollable anxiety regardless of a specific life event.

Cardiac syndrome manifests itself of a different nature: aching, paroxysmal, burning, short-term, constant. It occurs during or after physical exertion, stress, emotional distress.

Astheno-vegetative syndrome characterized by increased fatigue, decreased performance, exhaustion of the body, intolerance to loud sounds, meteosensitivity. Adaptation disorder is manifested by an excessive painful reaction to any event.

Respiratory Syndrome occurs with somatoform autonomic dysfunction of the respiratory system. It is based on the following clinical signs: shortness of breath at the time of stress, subjective feeling of lack of air, chest compression, difficulty breathing, choking. The acute course of this syndrome is accompanied by severe shortness of breath and may result in suffocation.

Neurogastric syndrome manifested by aerophagia, esophageal spasm, duodenostasis, heartburn, frequent belching, the appearance of hiccups in in public places, flatulence, constipation. Immediately after stress, the swallowing process is disturbed in patients, pain in the chest arises. Solid food becomes much easier to swallow than liquid food. Stomach pain is usually not associated with food intake.

Symptoms of the cardiovascular syndrome are heart pains that occur after stress and are not stopped by the intake of coronalytics. The pulse becomes labile, fluctuates, the heart rate increases.

Cerebrovascular syndrome manifests itself as impaired intelligence, increased irritability, in severe cases- and development.

Syndrome of peripheral vascular disorders characterized by the appearance of edema and hyperemia of the extremities, myalgia,. These signs are due to impaired vascular tone and vascular wall permeability.

Vegetative dysfunction begins to manifest itself in childhood. Children with such problems often get sick, complain of headaches and general malaise with a sharp change in weather. As they get older, autonomic dysfunctions often go away on their own. But this is not always the case. Some children become emotionally labile at puberty, often cry, retire or, on the contrary, become irritable and hot-tempered. If autonomic disorders are disrupting a child's life, you need to see a doctor.

Allocate 3 clinical forms pathology:

Excessive activity of the sympathetic nervous system leads to the development of autonomic dysfunction ... It is manifested by an increased heart rate, attacks of fear, anxiety and fear of death. In patients, blood pressure rises, intestinal motility is weakened, the face becomes pale, pink dermographism appears, a tendency to increase body temperature, agitation and motor restlessness.

Vegetative dysfunction may occur type with excessive activity of the parasympathetic division of the nervous system. In patients, pressure drops sharply, the skin turns red, cyanosis of the extremities appears, greasiness of the skin and acne. usually accompanied by severe weakness, bradycardia, difficulty breathing, shortness of breath, dyspepsia, fainting, and in severe cases - involuntary urination and defecation, abdominal discomfort. There is a tendency to allergies.

Mixed form autonomic dysfunction is manifested by a combination or alternation of symptoms of the first two forms: the activation of the parasympathetic nervous system often ends. Patients develop red dermographism, hyperemia of the chest and head, hyperhidrosis and acrocyanosis, tremor of the hands, subfebrile condition.

Diagnostic measures for autonomic dysfunction include the study of the patient's complaints, his comprehensive examination and conducting a number of diagnostic tests: electroencephalography, electrocardiography, magnetic resonance imaging, ultrasound, FGDS, blood and urine tests.

Treatment

Non-drug treatment

It is necessary to eliminate sources of stress: to normalize family and household relations, to prevent conflicts at work, in children's and educational groups. Patients should not be nervous, they should avoid stressful situations. Positive emotions are simply necessary for patients with autonomic dystonia. It is useful to listen to pleasant music, watch only good films, and receive positive information.

Nutrition should be balanced, fractional and frequent. Patients are advised to limit the use of salty and spicy foods, and in case of sympathicotonia, to completely exclude strong tea and coffee.

Inadequate and inadequate sleep disrupts the nervous system. Sleep at least 8 hours a day in a warm, well-ventilated area on a comfortable bed. The nervous system has been loosened over the years. To restore it requires persistent and long-term treatment.

Medicines

TO individually handpicked drug therapy they pass only in case of insufficiency of general strengthening and physiotherapeutic measures:

Physiotherapy and balneotherapy give good therapeutic effect... Patients are recommended to undergo a course of general and acupressure, acupuncture, visit the pool, exercise exercise therapy and breathing exercises.

Among physiotherapeutic procedures, the most effective in the fight against autonomic dysfunction are electrosleep, galvanization, electrophoresis with antidepressants and tranquilizers, water procedures - medicinal baths, Charcot douches.

Phytotherapy

Besides the main drugs herbal medicines are used to treat autonomic dysfunction:

Prevention

To avoid the development of autonomic dysfunction in children and adults, it is necessary to carry out the following activities:

Video: vegetative-vascular dystonia - Dr. Komarovsky

V neurological practice some of the most common syndromes of damage to the autonomic nervous system are peripheral autonomic failure, Raynaud's phenomenon, nocturnal enuresis, and reflex sympathetic dystrophy syndrome. This material is devoted to the symptoms and treatment of these disorders of the autonomic nervous system, as well as the causes of the disorders.

Segmental and suprasegmental diseases of the autonomic nervous system

Based clinical manifestations according to the level of damage to the autonomic nervous system, segmental, suprasegmental and mixed syndromes are distinguished. This division is conditional, since, given the integrative principle of the activity of the autonomic nervous system, we can only talk about the predominant localization

Segmental diseases of the autonomic nervous system result from damage gray matter spinal cord: motor, sensory, associative cells, as well as cells of the proprioceptors of the cerebellum, cells of the sympathetic and parasympathetic spinal centers (segmental apparatus).

Symptoms of suprasegmental disorders of the autonomic nervous system most often develop as a result of psychogenia and are much less likely to be organic in nature (consequences of closed craniocerebral trauma, diencephalitis, constitutional insufficiency of limbic-reticular structures).

Disease of the autonomic nervous system, peripheral insufficiency

Peripheral autonomic failure (PVF) is a complex of autonomic disorders of the autonomic nervous system, in which a violation of the innervation of internal organs, blood vessels, exo- and endocrine glands leads to a variety of disorders of the internal organs and autonomic disorders in the limbs. Allocate primary and secondary PVN.

Cause primary forms PVN remains unknown. Secondary PVI develops against the background of neurological, somatic,.

Symptoms When moving from a horizontal position to a vertical one, with prolonged standing, dizziness occurs, a veil in front of the eyes, headache, heaviness in the cervico-occipital region, sweating decreases or is absent, heat intolerance appears.

Also, the symptoms of this lesion of the autonomic nervous system are: a feeling of fullness in the stomach after eating, constipation and diarrhea (especially at night) are accompanied by a feeling of fullness in the stomach, nausea, anorexia. Impotence is observed. Violations of urination are expressed in frequent urination, the need for straining when urinating. Vision decreases at dusk. Breathing is impaired.

Treatment of this disease of the autonomic nervous system is insufficiently developed and is aimed mainly at combating orthostatic hypotension (the inability of blood vessels to maintain blood pressure). From non-drug methods a high position of the head during sleep is recommended, a change in posture during prolonged standing, an increase in the consumption of table salt (3-4 g / day) and liquid in the morning and afternoon (2.5-3 l / day), wearing elastic stockings.

At drug treatment prescribe drugs to increase the volume of circulating blood. In addition, drugs are used to improve metabolism and nerve impulse conduction.

With secondary PVI, treatment of the underlying disease is necessary.

Reflex sympathetic dystrophy syndrome: symptoms and treatment

The syndrome of reflex sympathetic dystrophy can develop after microtrauma of the limb, its prolonged immobilization and be accompanied by the involvement of peripheral nerves.

Symptoms Combination of pain syndrome, vegetative and trophic disorders. Women get sick 3 times more often than men. The pain is usually burning, unpleasant in nature with the perception of non-painful irritations as painful. Also, the symptoms of this disease of the autonomic nervous system are local vegetative-trophic disorders, edema. As the progression progresses, Dupuytren's contracture appears on the hands, trophic disorders (pigmentation, dry skin). The limb often freezes in a flexor position (the limb is bent at all joints and brought to the body).

Treatment. The principles are the same as for the treatment of any pain syndrome. Early mobilization with a gradual increase in the motor activity of the affected limb, sympathetic blockade of regional sympathetic nodes, and short (7-10 days) courses of hormonal drugs are of decisive importance in the treatment of this disorder of the autonomic nervous system.

Raynaud's Phenomenon: Symptoms and Treatment of Autonomic Nervous System Disorders

Raynaud's phenomenon- this is very common (in 20% of women and 16% of men) a pathology occurring mainly in regions with a cold and humid climate. Hereditary predisposition was revealed only in 4-6% of patients.

Symptoms Attacks are triggered by cold, emotions and are three-phase in nature. Symptoms of this disorder of the autonomic nervous system in the first phase of an attack are blanching and coldness of the distal extremities, tip of the nose, ears, and the appearance of pain. Then cyanosis develops, pain intensifies. The attack ends with redness of the skin and a gradual abatement of pain. Paroxysm is triggered by cold and emotion.

Raynaud's disease goes through two stages of development:

1. At the first stage, the attack is accompanied only by vascular reactions, trophic disorders join the second. Vascular and trophic disorders are strictly symmetrical.

2. Secondary Raynaud's phenomenon develops against the background systemic diseases connective tissue, with arteritis (aortic disease), vascular compression, vibration sickness, with prolonged use of ergot preparations, spinal pathology, tunnel syndromes, syringomyelia,.

The clinical feature of these disorders is the asymmetry of the lesion, the dependence of the severity of manifestations on the course of the underlying disease and the possibility of the development of the third, gangrenous stage.

Treatment. Avoid local hypothermia, the use of vasospastic drugs. Non-drug therapy includes physical therapy. It is also possible to treat this disease of the autonomic nervous system with a pressure chamber, acupuncture, psychotherapeutic consultations

Autonomic Nervous System Disorder Nocturnal Enuresis: Causes, Symptoms and Treatment

Sleep incontinence can be primary or secondary. Primary nocturnal enuresis occurs from birth. The causes of this disorder of the autonomic nervous system is the delayed maturation of the urinary regulation system.

Secondary enuresis occurs after a more or less long, not less than a year, period of having the skill of neatness. In this case, a family history is often noted. If both parents suffered from enuresis, the probability of its development in a child reaches 80%, if only one parent suffered, then 45%.

Secondary enuresis is caused by psychological, urological pathology, an anomaly in the development of the spinal cord, sometimes the disease is associated with food allergy... Children with low birth weight, delayed psychomotor development, mental retardation... Usually, the disease is diagnosed at the age of 5 years, by the age of 10, enuresis persists in only half of the children, by the age of 15, only 1.5-2% continue to suffer from this disease.

Nocturnal can occur for the first time in 3% of women and 1% of men over the age of 65, more often in patients with heart failure or regularly taking sleeping pills.

A symptom of this disorder of the autonomic nervous system is involuntary urination during sleep.

Treatment. Universal treatment no. Keeping a diary in which the child notes "dry nights", limiting the intake of fluids, fruits and vegetables containing a large number of fluids, obligatory urination before bedtime, favorable home furnishings, exclusion of traumatic situations. With sharply enlarged tonsils or adenoids, their removal can lead to a cure for enuresis.

If a child has signs of this disease, it is necessary to consult a doctor who will find out the cause of the disease and prescribe adequate treatment.

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The vegetative or autonomic nervous system is a part of the system that is responsible for the work of all body functions uncontrolled by consciousness. Such as the movement of blood through the vessels, the beating of the heart muscle, respiration, thermometry and so on. This system subdivided into two main divisions: sympathetic and parasympathetic. The sympathetic division of the nervous system is responsible for immediate reaction the body to external stimuli, parasympathetic - for normal work all body functions in a physiologically normal, everyday state. Consequently, the disruption of the work of this system leads to the development of such a pathology as autonomic dysfunction.
Vegetative dysfunction is not a separate nosological unit, it is a complex of manifestations of disorders on the part of the nervous system.

According to statistics, 70% of the population suffer from disorders of the autonomic system, 20% are children under 18 years of age.

Causes
The causes of autonomic dysfunction can be very different, but the most common ones are distinguished, they include:

hereditary predisposition;

the impact of stressful situations;

endocrine pathology (, violation of the production of adrenal hormones, obesity);

damage to brain structures, due to craniocerebral trauma, germination of tumor formations,;

hormonal disruption (pregnancy, the onset of menstruation, taking hormonal drugs);

bad habits (smoking, drinking alcoholic beverages, narcotic drugs);

the influence of the environment;

intoxication;

improper nutrition;

allergic effects;

chronic pathologies of infectious genesis.

The reason for the development of autonomic dysfunction in children can be fetal hypoxia during pregnancy, birth trauma, the development of diseases during the neonatal period, overwork at school, stressful situations, excessive intellectual activity.

Symptoms of autonomic dysfunction in adults and children can manifest themselves as a violation of one or more systems at the same time. Due to the possible effect on any of the functions, autonomic dysfunction symptoms are similar to other diseases, such as migraines, strokes, etc.

There are several main autonomic dysfunction syndromes:

Psychoneurotic the syndrome is accompanied by emotional instability, the development of depression, insomnia, anxiety. The patient becomes adynamic, irritable, often even absent-minded.

Astheno-vegetative the syndrome is characterized by a decrease in working capacity, a chronic state of fatigue and drowsiness, marked sweating, darkening, loss of consciousness, recurrent headaches, and impaired adaptation.

Syndrome of peripheral vascular disorders manifests itself in the form of the appearance of puffiness, redness of the hands and feet, periodic cramps, or pain on palpation of large joints,

Cerebrovascular the syndrome is characterized by the development of migraine attacks, symptoms, as well as increased fatigue and irritability.

Respiratory accompanied by the appearance of shortness of breath, dry cough, sore throat, or sensation foreign body breathing.

Neurogastric syndrome- This is a complex of symptoms characterizing disorders of the gastrointestinal cycle. They manifest themselves in the form of pain unrelated to food intake, nausea, periodic vomiting, flatulence. One of the distinguishing symptoms is the fear of swallowing food in liquid form, such a change in the patient's behavior clearly indicates a nervous breakdown.

Cardiovascular the syndrome is accompanied by the appearance of pain in the region of the heart, which is not stopped by nitroglycerin and disappears over time on its own, there is also an increase in blood pressure and.

Treatment
Treatment of autonomic dysfunction, like many other diseases of the nervous system, is based on a complex effect.

Non-drug therapy

First of all, patients suffering from autonomic dysfunction are advised to normalize sleep and wakefulness, balance daily, refuse bad habits, more time is spent outdoors.

In cases where restorative procedures and lifestyle changes are not enough to eliminate all symptoms of autonomic dysfunction, they switch to drug therapy. All drugs used for the treatment of pathology should be prescribed by a neuropathologist.

The most commonly used medications for autonomic dysfunction are:

tranquilizers;

sedatives;

antidepressants;

heart medications;

vegetative stabilizers;

antipsychotics.

Physiotherapy

With autonomic dysfunction, procedures such as ultraviolet irradiation of the collar area, electrophoresis, acupressure, acupuncture, magnetotherapy, and a visit to the pool.

Prevention
Prevention of autonomic dysfunction is based on compliance with all the recommendations given by the doctor:

dispensary observation at least once every six months;

decrease in emotional stress;

treatment of concomitant diseases;

undergoing a course of physiotherapy during periods of exacerbation;

maintaining an active lifestyle, normalizing working conditions;

getting rid of bad habits;

seasonal use vitamin complexes(autumn - spring).

The prognosis for the treatment of autonomic dysfunction is most often positive, however, without treatment and adherence to preventive measures, a persistent violation can lead to the development of comorbidities.

Violations and their causes in alphabetical order:

vegetative disorder -

Vegetative disorders, autonomic dysfunction is a collective concept that combines a violation of the functioning of internal organs and systems caused by a disorder of their nervous regulation in diseases of the central or peripheral nervous system, mental and endocrine disorders.
Autonomic disorders can be widespread (i.e., occur in several organ systems at the same time, for example, irregular heartbeat combined with shortness of breath and sweating), systemic (i.e. affect any one organ system, such as the gastrointestinal tract), or the same local (for example, redness of certain areas of the skin). Often, vegetative manifestations capture any one system, more often the cardiovascular system, since it is the most psychologically significant for a person, and the "mobility" of responding to any harmfulness is also different.
Autonomic disorders are usually divided into sympathetic and parasympathetic syndromes, depending on the prevailing disorders in one or another part of the autonomic system of the body.
Sympathetic ones include, for example, sympathoadrenal crises. They are characterized unpleasant feeling in the chest and head, palpitations, rise in blood pressure, dilated pupils of the eyes. There is often a feeling of fear and incomprehensible anxiety. The attack ends with abundant urination with light urine.
Parasympathetic crises are manifested by symptoms, in many respects the opposite of sympathetic manifestations. since sympathetic and parasympathetic system are responsible for different manifestations of the same organ function - for example, the expansion and contraction of blood vessels, an increase or decrease in sweating, an increase or decrease in gastric motility. Parasympathetic crises are characterized by dizziness, nausea, a decrease in blood pressure, sometimes the appearance of a heart rhythm disturbance in the form of extrasystoles and slowing of contractions; a feeling of shortness of breath, a feeling of lack of air is characteristic; possible appearance gastrointestinal disorders in the form of swelling, urge to defecate.
More often, vegetative crises are of a mixed sympathetic-parasympathetic nature, when signs of activation of both parts of the autonomic system occur simultaneously or follow one after the other.
Vegetative disorders can occur as with various diseases, and in the form of an independent syndrome. So, the syndrome of autonomic dystonia can howl primary, constitutionally determined. The most common conditions in which VSD occurs as a symptom are endocrine diseases ( thyroid gland... adrenal glands), as well as endocrine changes in the body are normal (adolescence, pregnancy, menopause). The second most common VSD are neuroses. In addition, autonomic disorders are common with allergies and chronic diseases internal organs (gastritis, hepatitis, pancreatitis, heart disease).

For what diseases there is a vegetative disorder:

Sympathoadrenal crises
Parasympathetic crises
Autonomic dystonia syndrome
Endocrine diseases
Neurosis
Gastritis
Hepatitis
Pancreatitis
Heart diseases

Which doctor should i contact if a vegetative disorder occurs:

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