Muscular dystonia syndrome. Muscular dystonia syndrome in infants Mixed type of VSD

This person has worked himself up so much that he is experiencing real pain. This is something incomprehensible, but it is more related to the psyche, although the nervous system is also affected. It’s not clear what’s wrong with him, but his illness has nothing to do with organ pathology, although we used to think otherwise. If this “otherwise” is expressed in the fact that the patient complains about the heart more often than about the stomach or headaches, then the type of this “something” is hypertensive or cardiac, but there are other types that affect all systems that are controlled by the autonomic nervous .

The diagnosis of VSD is made mainly by specialists in the post-Soviet information space. In the West they now only talk about somaform dysfunctions, which, among others, also have their own mental syndrome. The psyche is capable of working miracles. Sometimes they have a positive expression, but sometimes they have a negative expression. Then a phenomenon arises called "psychosomatic disorders".

The fact is that in the International Classification of Diseases there is no such disease as VSD

Already in the very definition there is a catch. It combines Greek words psyche And soma- “soul” and “body”. The first immediately puzzles scientists. Behind it lies something so strange, which reeks of bioenergetics, not recognized by science, which is why scientists are talking about the nervous system. However, there is no VSD in ICD 10. There is no need to think that it is “cautiously” classified as a block of other disorders. It simply doesn't exist. Not only her, but also the so-called "neurocirculatory dystonia". There is no VSD code according to ICD 10. There are only somatoform autonomic dysfunctions- namely, bodily ones. Yes, and they are identified by exclusion. If doctors do not detect coronary heart disease, hypertension and the like, that is, diseases that can cause secondary hypertension, or mental disorders of a certain type, then this is classified as SVD. And you definitely shouldn’t look for VSD in the ICD. Does not have VSD code according to ICD 10 in children and adults.

The main feature of VSD, or what is called that, is that patients can list their symptoms for a very long time and point to almost any part of the body. However, some localizations still stand out. Most often these are the areas of the heart, stomach and head, and genitourinary system. Thus, types of VSD were formed. This does not mean at all that this will result in an ICD 10 VSD code for the hypertensive type. It’s just that the patient complains more often about blood pressure than about anything else. The complaints themselves remain just that, and studies do not show the presence of somatic diseases or show no more than in relatively healthy people.

VSD, or what is called that, has its own pathogenesis. In this case, we are dealing with a special condition that can create the illusion that many hypothalamic structures are involved in the course of the disease. At the same time, the line between illusions and reality is erased by the symptoms themselves. We assume that this is not a conscious simulation and not hypochondria. This assumption is confirmed primarily by the fact that patients are willing to pay a lot of money - just to make them feel better.

Classic VSD combines many symptoms, but the ICD 10 VSD code for mixed type does not arise from this either. SVD has block code F45. This is a disease or condition when patients repeatedly present somatic symptoms and persistently demand to find the cause of their ailment.

Better call it mixed crisis syndrome. It is expressed by the simultaneous or sequential manifestation of syndromes of various types. At the bodily level, this can manifest itself in the form of red dermographism, spots in the upper half of the chest, eversion and tremors of the hands, sudden changes in body temperature and any temperature asymmetry.

VSD is often determined as part of another disease, the symptoms of which, for example, are headache, dizziness, etc.

It is interesting that almost all syndromes associated with VSD are observed in parallel with at least some syndrome of mental disorders. They often remain in the shadows and do not receive the attention they deserve. These may include behavioral, cognitive and motivational disorders. The emotional sphere is unstable, although there are no obvious signs of bipolar affective disorder. Rather, we can talk about emotional instability. Patients can be literally whiny. They are not only prone to pessimism, but often cannot hold back their tears, although they do not experience severe torment. Almost everyone has a sleep disorder. Usually they have difficulty falling asleep at night, but may fall asleep during the day. There are also certain signs of an anxiety disorder. Often people have difficulty making decisions, and they can easily refuse the ones they make or do the opposite, contrary to their initial aspirations. Diagnosis is complicated by the presence of many neurosis-like conditions.

So, there are clear signs of the division of everything that was once classified as VSD into SVD - somatoform autonomic dysfunction, which also has its own syndrome of mental disorders, and a variety of other disorders, which can also have some kind of physical, bodily, i.e. somatic form. VSD does not have an ICD code and is not directly mentioned in it in any way, and SVD is assigned classes F45.

This is not just a matter of terms. Vegetative-vascular dystonia did not receive an ICD code, since it meant both psychosomatic and diseases provoked by a disorder of the nervous system, which are similar, but have more physical forms.

ICD 10 codes for “VSD diseases”

Domestic specialists know very well that the complexes of symptoms in this disease are sympathetic, parasympathetic and mixed. What we often call VSD of mixed type implies the presence of patient complaints about the cardiovascular, gastrointestinal, respiratory or genitourinary systems. All of them are innervated and controlled by the autonomic nervous system, but in ICD 10 VSD of the mixed type is F45.3, block "Somatoform dysfunction of the autonomic nervous system". It takes into account all the named types of symptoms, but excludes psychological factors that affect the physical condition. At the same time, F45.3 does not separately highlight the hypertensive or cardiac type of dysfunction.

But even if the symptoms coincide, the ICD excludes psychological factors that influence the person’s condition

What are the main syndromes of VDS?

• Syndrome of adaptation disorders. These are disturbances in the body’s ability to respond correctly to adverse conditions. Often associated with a state of anxiety. When adaptation syndrome occurs, patients lose a lot of weight and various signs of metabolic disorders are noticed.
• Asthenic syndrome. Nervous weakness, fatigue, inability to do heavy work or be under mental stress. For example, a patient may start screaming over trifles.
• Hyperventilation syndrome. Patients feel that they do not have enough air, that they are suffocating. At the moment of crisis, people try to take frequent shallow breaths. They complain that their chest feels as if they are being squeezed by some heavy object. There is also a sensation of a spasmodic lump in the throat.
• Neurogastric syndrome. Any disorders that are in one way or another associated with the motor-evacuation and secretory functions of the gastrointestinal system. These are constipation, flatulence, heartburn, nausea.

• Cardiovascular syndrome. Pain in the left side of the chest, which is always associated with some kind of negative experiences, but never occurs due to physical activity. Coronalytics do not help in this case, and ECG and other methods of studying heart disease do not reveal. Of course, this is what is called hypotonic VSD and which in ICD 10 refers to the area of ​​SVD.
• Cerebrovascular syndrome. These are pains in the head that are protracted and sometimes localized in certain places. Tinnitus, dizziness and a condition where the patient complains that he almost fainted can also be observed.
• Syndrome of peripheral vascular disorders. These are swelling of tissues, changes in their color, angiotrophoneurosis and the like.

As we can see, despite the fact that ICD 10 does not have VSD disease codes and classifies them all as somatoform disorders of the nervous system, there are many syndromes. All of them are somehow connected with the psyche. For example, pain in the heart area gives rise to a hypochondriacal reaction, and a general depressed state is to some extent associated with depression.

Nausea and digestive problems are related to neurogastric syndrome

Diagnosis and treatment of this disease is a difficult and long process. However, everything that is traditionally referred to as VSD is most often secondary and occurs as a consequence or against the background of exclusively mental disorders. It is characteristic that drug treatment is usually associated with a regimen, the core of which consists of drugs familiar primarily to psychiatrists and psychotherapists. First of all, these are antidepressants, which reduce anxiety and restore patients’ performance and activity. Sometimes tranquilizers are used. They are mainly prescribed to patients who complain of sleep disorders and tachycardia. True, taking sedatives is associated with the risk of addiction. Nootropics are prescribed as auxiliary medications. They are mainly needed by patients with cerebrovascular syndrome.

Treatment with psychotherapy methods

The main difficulty of psychotherapy is that it is very difficult for patients to change their attitude towards the disease. For example, one of the types of crises that were and are classified as VSD are panic attacks. Many symptoms are very similar: tachycardia, a slight decrease in blood pressure, tremors in the hands, a feeling of shortness of breath and a number of others. This led to the mistaken belief that the reason lay in a disorder of the autonomic nervous system. As a result, patients were treated primarily using neurological methods. It is difficult to say definitively whether such treatment helped them. It is possible that it helped someone. However, the problem remained mysterious and there was no clear picture that would reveal the etiology and pathogenesis completely. The situation changed only when panic attacks began to be considered a mental disorder.

Let us imagine the reaction of a person whose heart was beating with enormous frequency and his head was spinning. Or rather, he was losing orientation in space. His legs gave way and he barely had time to hobble to the bench, and there he was out of breath. He will easily believe in the term “vegetative-vascular dystonia”, because it evokes an association with something bodily, and his problems had a very clear physical expression. People consider mental disorders as hallucinations - visual or auditory, obsessive thoughts, and a tendency to make extra-rational judgments. If a person just sits and looks sad, you can also believe that the problem is mental. But a heart that beats with such frequency and suddenly some kind of psyche? People think that cardiologists were simply too lazy to find the disease and treat it, so they sent me to a psychotherapist. The result is a big vicious circle.

The topic of treating a disease with such a varied set of symptoms using psychotherapy methods is surprisingly not mastered by specialists. Although the diagnosis is one of the most common. Practice shows that the therapeutic approach can be effective.

First of all, you need to pay attention to the technique of body-oriented psychotherapy. In its modern form, these are breathing practices and exercises that are somewhat reminiscent of yoga. For all of the listed syndromes, mastering relaxation methods and auto-training will provide good help. The cognitive approach will make it possible to normalize your life, change your routine and give up bad habits. Unfortunately, many patients consider this to be of secondary or almost unimportant importance. Stories that changes in lifestyle and thinking will help cope with such serious problems are perceived with great skepticism. However, this is far from the case...

Various breathing exercises and yoga are used to treat the disease.

For example, quitting smoking and using breathing exercises helps approximately 80% of patients forget about heart and respiratory syndromes forever. The problem is that giving it up is not so easy. Only a psychologist or narcologist can provide medical assistance in this matter.

Content

Among the serious abnormalities in a newborn baby, muscle dystonia stands out. Because of this pathology, they are either too tense or, conversely, underdeveloped. Parents' fears are associated with ignorance of the causes, diagnosis and treatment of such a disease. If you are concerned about this issue, then study the information below.

What is dystonia

Muscular dystonia in infants is defined as a disorder of motor activity and its abnormal development. While in the amniotic fluid of the mother's womb, the baby begins to make various movements. After birth, it becomes more difficult for him to do this. For this reason, motor activity outside the womb is impetuous, lacking smoothness and coordination, but a certain tone should still be present. Its deviations from the norm are called muscular dystonia.

Muscular dystonia has a separate ICD-10 code. It looks like this - G 24. Next comes a classification highlighting different types of this pathology. Their ICD-10 code is G 24.8. This group includes hypertonicity and hypotonia or muscle hypotonicity. In the first case, they are too tense, and in the second, on the contrary, they are underdeveloped. Another common name for such deviations is dystonic muscle tone, muscle dystonia syndrome or dysfunction.

Why does hypertonicity and hypotonicity occur in infants?

Among the causes of the development of muscular dystonia in infants are intrauterine and those that affect the child during childbirth. The first group includes the following factors:

• previous infections during pregnancy during the 2nd and 3rd trimester;
• gestational diabetes mellitus;
• genetic abnormalities in fetal development that are detected during an ultrasound procedure;
• gestosis;
• pregnancy with more than one fetus;
• extending the gestation period by 10-14 days.

The second group of reasons for the development of dystonic syndrome includes those that affect the child directly during childbirth:

• incorrect position of the fetus - transverse or pelvic;
• low or polyhydramnios;
• general anesthesia during childbirth;
• C-section;
• placental abruption;
• rapid or rapid labor.

How does muscular dystonia syndrome manifest in infants?

The symptoms of the disease depend on its type. Muscle hypotonia has an ICD-10 code of G 24.8.1*, and hypertonicity has a code of G 24.8.0*. It is much easier to determine the latter in a baby. Such newborns begin to hold their heads early and do it very well. Their legs are bent and spread apart, and some resistance arises during extension. In another way, dystonic syndrome in an infant with increased contractions is manifested by the following symptoms:

• frequent regurgitation and restlessness;
• sleep disturbance;
• moodiness;
• chin trembling;
• crying in bright light;
• high excitability.

Muscular hypotonia in infants often goes unnoticed. In such a situation, children are considered simply a gift of fate, although in fact the fact that they hardly cry and only sleep indicates decreased tone in newborns. The baby does not show resistance even when feeding, bathing or dressing. Muscle hypotension syndrome accompanies more serious diseases, such as:

• spinal amyotrophy;
• perinatal encephalopathy;
• Down syndrome;
• rickets;
• diabetes mellitus;
• polio.

Diagnosis in newborns

Neuropathologists diagnose dystonic syndrome. During regular examinations, they are able to notice signs characteristic of the disease. The doctor examines the following nuances:

• muscle tone;
• condition of the fontanelle;
• child's reflexes;
• skull bones;
• position and movement of the limbs.

Diagnosis of the disease is sometimes difficult due to less pronounced signs, so additional tests may be prescribed for a small patient:

• neurosonography;
• electroencephalogram;
• computed tomography;
• video monitoring;
• electroneuromyography.

How is muscular dystonia treated in a child?

Doctors strongly recommend that parents do not self-medicate and even if there is one symptom, seek help, otherwise the child may experience more serious health problems in the future. In general, treatment of dystonic syndrome is carried out using the following methods:

1. Medication. Among the drugs used are: Cerebrolysin, Semax, Mydocalm. Baclofen, Pantocalcin or Solcoseryl and B vitamins are often prescribed.
2. Physiotherapy using laser, ultrasound or magnet, mud baths, electrophoresis and alternating cold with heat.
3. Kinesitherapy. This treatment method consists of active and passive movement procedures. This includes massage, swimming, therapeutic exercises and special exercises.

Why is muscle dystonia dangerous in infants?

Torsion muscular dystonia in infants is considered the most dangerous disease. It develops mainly in childhood and, if left untreated, can even lead to disability. The mental side remains in a normal state, and only the muscles suffer. The consequences of the disease can be as follows:

• clubfoot or irregular gait;
• torticollis;
• problems with the spine, often curvature.

Video

Vegetative-vascular dystonia (VSD) is a common disease that causes disorders of the autonomic nervous system. As a result, internal organs do not work properly, which leads to unpleasant symptoms. The signs of the disease are so varied that ICD 10 was not included as such. It is regarded as part of a whole complex of pathologies of the nervous system, corresponding to codes G90-G99 according to the international classifier.

Modern medicine does not consider vegetative dystonia syndrome to be an independent disease. This is a certain set of symptoms that are part of various somatic and mental pathologies. The basis of VSD is considered to be an imbalance between the parasympathetic and sympathetic autonomic nervous systems. They are responsible for the proper functioning of internal organs.

The sympathetic nervous system supports the body during various stressful situations. It promotes the release of such important hormones for the body as dopamine, adrenaline, norepinephrine. Due to this, the dilation of blood vessels in the brain occurs simultaneously with their narrowing in other organs, the heartbeat and ventilation of the lungs increase, blood pressure increases, and the pupils dilate. As a result, the body is able to endure various stressful and even life-threatening situations.

The parasympathetic system promotes the production of acetylcholine and has completely opposite effects. It is responsible for the dilation of blood vessels in the periphery, reduces the heart rate and their strength, helps reduce ventilation of the lungs, and constricts the pupils.

Normally, these two systems work harmoniously, however, if their actions are not coordinated, various unpleasant symptoms may appear. When the effects of the sympathetic system predominate, arrhythmias develop, the pulse increases, and the person is tormented by feelings of anxiety and fear. Increased action of the parasympathetic system leads to a drop in blood pressure, difficulty breathing, and a decrease in heart rate to 40-50 beats per minute.

Many patients do not take the signs of vegetative-vascular dystonia seriously, however, the symptoms of this pathology can cause serious disorders that affect several organs at once.

Reasons for the development of VSD

Both adults and children are susceptible to the disease. To date, many reasons have been identified that can provoke the development of vegetative-vascular dystonia. The most common of them are worth considering in more detail.

1. The cause of the development of pathology may be a person’s genetic disposition. The risk of developing symptoms of the disease in this case becomes twice as high. The development of VSD can be suspected at an early age. It is expressed by instability of the emotional and mental state, rapid exhaustion of the nervous system.
2. Prolonged stress, depressive states, severe emotional shock, psychological trauma - all this can negatively affect a person’s condition and cause unpredictable harm to the body. Usually the body copes with short-term mental overloads on its own and quickly enough. But if stressful situations are prolonged, then this is a clear prerequisite for the development of pathology.
3. One of the causes of VSD can be excessive physical activity and an overly active lifestyle. Quite often the disease is diagnosed in people involved in sports at a professional level. The daily work of the body for wear and tear, the desire to achieve maximum results in the shortest possible time will eventually lead to the development of pathology.
4. A sedentary lifestyle or too little physical activity can also cause the development of dystonia. With such a slow pace of life, the nervous system also malfunctions, which ultimately leads to pathology.
5. Vegetative-vascular dystonia, which develops against the background of other chronic diseases, is also common. The root cause can be: diabetes mellitus, osteochondrosis, asthma, problems with the endocrine system.
6. VSD can develop with frequent changes in time zones and climate. Every body reacts differently to such drastic changes and not everyone tolerates them well.
7. Focal infections and hormonal changes occurring in the body can also contribute to the development of autonomic disorder.

VSD in childhood

The disease in children develops to a greater extent due to excessive emotional stress. Stressful situations, a feeling of constant anxiety, mental stress at school - all this contributes to the appearance of the first symptoms. Also, the cause of VSD can be age-related hormonal changes in the body.

You can determine whether a child is sick by sudden changes in mood, sleep disturbances, decreased activity, and also by rapid fatigue. Also, vegetative-vascular dysfunction may be accompanied by shortness of breath, vomiting, hearing and vision impairment.

Children who lead an inactive lifestyle and are constantly at the computer are more at risk of developing the disease. To avoid the occurrence of vegetative-vascular dystonia, you need to move a lot, play sports, eat right, and also follow a sleep and rest schedule.

Important: A child in a family must live in love and harmony; psychological trauma in childhood can lead to serious complications in the future.

Types of vegetative-vascular dystonia

Since the disease is accompanied by many different and even opposing symptoms, several types of pathology are distinguished. As already mentioned, vegetative-vascular dystonia does not have a code according to ICD 10, but based on the identified disorders, other diagnoses can be made.

Hypertensive type

VSD of the hypertensive type is accompanied by surges in blood pressure, increased fatigue, and general weakness. Severe headaches and frequent mood swings occur. This type of VSD according to ICD 10 corresponds to codes I10, I15 - the first or second stage of arterial hypertension.

Hypotonic type

This type of dystonia, on the contrary, is characterized by a decrease in pressure, therefore, according to the classification, it belongs to psychosomatic pathologies. Manifested by the following symptoms:

• pale skin;
• dizziness;
• decreased blood pressure;
• tachycardia or bradycardia.

According to the international classification, the totality of such signs establishes the diagnosis of somatophoric dysfunction (F45.3).

Mixed type

The development of pathology is characterized by changes in vascular tone. Blood pressure readings may deviate sharply up or down. Weakness, apathy, headaches and heart pain develop. Each case must be examined individually by doctors to identify the real cause of the pathology.

Cardiac type

With VSD of this type, pain in the heart develops due to a sharp narrowing of the lumen of blood vessels. External signs of pathology: pale skin, less developed chest. When exposed to unfavorable factors (stressful situations), a person’s condition is aggravated by a feeling of constant fatigue and apathy.

Vagotonic type

Autonomic dysfunction of this type is always accompanied by various disturbances in the functioning of the respiratory system. It is difficult for patients to take a full breath, which causes signs of oxygen starvation to develop and a decrease in blood pressure.

Diagnosis of vegetative-vascular dystonia

When a patient seeks medical help with complaints about the symptoms listed above, the doctor’s main task is to exclude somatic diseases that could provoke the unpleasant condition. For this purpose, a full examination is prescribed, including:

• visual and neurological examination;
• urine and blood tests;
• electrocardiogram;
• blood pressure monitoring;
• Ultrasound of blood vessels and heart;
• electroencephalography;
• computed tomography or MRI.

In addition, you will definitely need to consult a neuropsychiatrist to exclude the development of mental disorders. Only after a complete examination will the doctor be able to establish an accurate diagnosis and prescribe appropriate treatment.

Important: In case of vegetative-vascular dysfunction, it is necessary to regularly monitor blood pressure to avoid more serious complications, for example.

VSD therapy

There is no specific drug course of treatment for vegetative-vascular syndrome. Medicines are selected individually in accordance with the developed symptoms. Doctors will help identify internal problems that provoke an inadequate response of the body to external stimuli.

In addition, the patient will be asked to master any relaxation techniques: yoga, breathing exercises.

It is also necessary to follow other medical recommendations, you will need:

1. Properly distribute the time spent on work and rest, and avoid daily mental overload.
2. Avoid drinking alcohol completely, as it can give an imaginary feeling of relief, but in reality only contributes to worsening the problem.
3. Stop smoking tobacco.
4. Carry out hardening procedures every day or at least take a contrast shower.
5. Eliminate fatty, fried and canned foods from your diet, as they contribute to the deterioration of blood vessels.
6. Include physical therapy into your daily schedule.

By following these simple rules, getting rid of the symptoms of vegetative-vascular dystonia will not be difficult. In severe cases, the doctor may prescribe medications to help stabilize the condition. These include antidepressants and sedatives.

Still have questions? Ask them in the comments! A cardiologist will answer them.

Sometimes changes in psychosomatics are positive, but it also happens that they take on a negative meaning. Then a phenomenon is formed, designated by modern experts as “psychosomatic disorders.”

Absence in ICD

This disease itself is unusual. It includes the Greek words psyche and soma - "soul" and "body". The first term is strange, it emits bioenergetic features that are not related to science, accordingly, scientists want to talk exclusively about the nervous system. But VSD is not available in ICD 10. You should not assume that it is “secretly” classified as a category of other ailments. It simply does not exist in modern terminology. As well as its synonym - “neurocirculatory dystonia”. The VSD code according to ICD 10 has absolutely no meaning. Only autonomic dysfunctions - those occurring within the body - are considered. They are found by chance, by exclusion. If neuropathologists do not find:

• coronary heart disease;
• hypertension;
• similar ailments, i.e. pathologies that can provoke secondary hypertension;
• mental defects.

This is considered to be VSD. And trying to find VSD in the ICD will definitely not work.

The key feature of VSD seems to be that people can talk for an extremely long time about their symptoms and point to almost all parts of the body. However, some clear places also stand out.

Most often this is the area of ​​the chest, abdomen and head, bladder dysfunction.

Due to this, it was possible to identify types of VSD. This is not a sign that you can set the ICD 10 VSD code for the hypertensive type. It’s just that the patient complains more often about hypertension than about other manifestations. On their own, complaints remain nothing more than complaints, and tests do not provide confirmation of somatic defects or demonstrate no more than in more or less healthy individuals.

VSD has a characteristic pathogenesis. In this case, it is necessary to argue about specific conditions that give the illusion of the introduction of certain hypothalamic areas into the disease process. However, the line between the apparent and the real is directly removed by symptoms. Hence the conclusion is that this is an unconscious simulation and in no way hypochondria. This assumption is confirmed by a person’s willingness to shell out astronomical sums just to feel better.

The classic form of VSD includes many manifestations, but the ICD 10 VSD code for the mixed type is still not designated. This is a condition as if patients discovered a somatic pathology and demanded to find the cause of their ailment.

It is more correct to designate dystonia as mixed crisis syndrome. It manifests itself as a one-time or stage-by-stage identification of syndromes of certain types.

At the body level, symptoms include the expression of red dermographism, spots in the area of ​​the upper third of the chest, and trembling of the hands.

It is interesting that virtually any syndromes associated with VSD are noticed synchronously with many types of mental pathologies. Occasionally they do not declare themselves in any way. These include behavioral pathologies. The expansive area is unstable, although there are no obvious indicators of bipolar affective disorder. Mainly, the symptoms of emotional variability predominate.

Patients literally become tearful. They transform into pessimists, but are often unable to suppress tears, although there are no prerequisites for this. Virtually every patient has a problem falling asleep. Traditionally, it is difficult for them to fall asleep, but they have every chance of falling asleep during daylight hours.

There are also some symptoms of restless behavior. Patients experience obstacles when it comes to making a decision and drawing the right conclusion, and they can simply abandon those already made or do everything in the reverse order, contrary to their initial aspirations. The test is complicated by the presence of a large number of neurosis-like phenomena.

Finally, obvious features of the division of symptoms once classified as VSD are revealed. In this situation, they talk about somatoform autonomic dysfunction. She has a set of disorders that manifest themselves through a physical, in other words, somatic form.

Vegetative-vascular dystonia did not acquire an ICD code, because it combined psychosomatic and CNS disorder-associated ailments, which are similar, but assume predominant physical forms.

Russian specialists know very well that the set of symptoms for this disease is sympathetic and parasympathetic in nature. There are other mixed options. VSD of a mixed type involves the presence of patient complaints about the heart and blood vessels, gastrointestinal tract, breathing, or, alternatively, the urinary system. In general, they are controlled by the autonomic nervous system and are penetrated by its branches. In terms of ICD 10, VSD of mixed type is F45.3, in this case you need to look at the section “Somatoform dysfunction of the autonomic nervous system”. It assumes all the specified sets of symptoms, but does not assume psychological aspects that affect physical condition. F45.3 does not act specifically on hypertensive or cardiac types of dystonia.

Set of symptoms

The nature of adaptation disorders is noted. These are problems in particular with regard to the body's potential to respond correctly to conditions of discomfort. Often associated with the presence of anxiety. When adaptation syndrome develops, a person loses weight and metabolic disorders are noted. These are the syndromes:

• Asthenic. Nervousness and weakness, fatigue after short work, inability to carry out intensive work or be under psychological stress. In particular, screams and breakdowns over trifles are likely.
• Hyperventilation. People feel like they don't have enough air and feel short of breath. During a crisis, people try to take frequent and quick breaths. They complain that the sternum seems to be crushed by a foreign object. A feeling of a compressed lump in the depths of the throat also forms.
• Neurogastric. Any disorders associated with the motor and secretory function of the gastrointestinal tract. These are problems with the intestines such as constipation, bloating, and possibly heartburn.
• Cardiovascular. Pain in the area of ​​the left sternum, associated with negative emotions, but never noted due to physical activity. Coronalytics do not give anything, and ECG and other tests do not detect cardiac diseases. Without a doubt, this is what is meant by the term VSD of the hypotonic type. In ICD 10, such symptoms belong to SVD. VSD of the cardiac type resembles mild angina in nature.
• Cerebrovascular. Headache that lasts a long time and is sometimes concentrated in fixed areas. In some cases, this is tinnitus, dizziness and a feeling of general discomfort.
• Peripheral vascular disorder syndrome. These are swelling, changes in tissue color, angioneurosis with impaired trophism.

Accordingly, ICD 10 does not provide VSD codes and correlates all this with somatoform pathologies of the central nervous system; there are many syndromes. All of them are associated with the psyche. For example, pain in the heart area provokes hypochondria, and the general state of depression is somehow associated with apathy.

Diagnosis and treatment are lengthy and accompanied by a number of difficulties. However, everything that is classically classified as VSD seems secondary. This happens as a result or against the background of only psychological problems.

Treatment with drugs is often associated with a regimen based on drugs from the field of psychiatry and psychotherapy.

The first choice is antidepressants, which relieve anxiety, normalize work ability and support activity. Sometimes tranquilizers are used.

In fact, these are mental disorders that occur in the form of physical disorders. Their main characteristic is the presence of bodily symptoms that affect general health. Their origin cannot be fully explained. The formation of VSD is caused by exposure to a substance or another mental disorder (for example, panic attacks).

This is a disease that every doctor should know well, since people with these disorders go from doctor to doctor seeking help for diseases for which no “organic” origin can be found. Such patients are regularly told that “they have nothing,” but remain convinced that their physical symptoms and pain are real.

But the patients are right, in a sense. There are specific “organic” diseases. So there's no reason to call them hypochondriacs or even imaginers - that's a degrading term. Sometimes it is difficult for such people to control the characteristic manifestations of VSD.

Symptoms presented by these people:

• pain that has different localizations (for example, in the head, abdomen, spine, joints, limbs, chest, rectum, occurring during menstruation or during urination);
• gastrointestinal dysfunction;
• erectile dysfunction, irregular menstruation.
• difficulty swallowing or lump in the throat, aphonia, urinary retention, hallucinations, loss of touch or pain, double vision, amnesia.

This disorder is characterized by multiple body symptoms that recur and persist for many years. Because of these physical symptoms, patients repeatedly seek medical attention without finding an “organic” cause. Symptoms are often general and unclear. Any of the systems can be affected, but the most common are complaints from the central nervous system, gastrointestinal tract, gynecological or cardiopulmonary. Sometimes symptoms of chronic pain appear (for example, pain in the spine or joints), possibly abdominal pain or sexual dysfunction.

Various disorders

This class is intended for cases where patients have one or more physical complaints that are not explained by a general medical examination or the effect of the substance. They differ in duration of at least six months.

The key element here is that symptoms are not subject to voluntary control, i.e. are not produced intentionally or allegedly at the will of the person (as in the case of malingering), and also that psychological factors are considered as related symptoms. Periods of exacerbation follow certain conflict or other stressful events.

Psychodynamic, biological, cultural and behavioral mechanisms are used to interpret symptoms. Regarding psychodynamic mechanisms, historically and traditionally, the term VSD comes from the psychoanalytic hypothesis that a physical symptom represents a symbolic solution to an unconscious psychological conflict (relating to sexuality, aggression or addiction). Additionally, a person may also have a “secondary effect” of VSD, where their physical symptoms allow them to avoid commitments and receive support and care from those around them.

It must be recognized that psychological factors in the form of confrontations or stress are associated with the onset or exacerbation of symptoms. It is known that symptoms of VSD often occur in people with brain injury. The disease is more common in developing than in developed countries. Often found in rural residents lower on the socioeconomic ladder. The same can be said for people with less knowledge of medical and psychological problems.

Behavioral symptoms are explained as an exaggeration of events or deficits of attention that a person “experiences” after an event or a certain psychological state. This is sometimes reinforced by certain events or situations.

The main feature of this disorder is pain in one or more anatomical areas, for which psychological factors play an important role. There are two types of disorders:

• pain associated with psychological factors;
• pain associated with psychological factors and certain health problems.

However, the disorder is distinguished between acute and chronic and lasts for at least 6 months.

Hypochondriacal syndrome

This disorder is characterized by the fact that a person is afraid of developing a serious illness. Thus, the hypochondriac patient closely monitors the functions of organs and systems and listens to any unfavorable signal. Due to a biased attitude, he may misinterpret physical symptoms, mistaking them for pathological ones (for example, the slightest cough is interpreted as obstructive bronchitis). This is due to the fear of illness, which persists despite the fact that medical examinations (usually several) give the opposite result.

A hypochondriac actively complains about certain body functions (for example, heart rate, sweating, or bowel movements), and talks about minor disturbances (for example, a small wound or an occasional cough) as symptoms of physical illness.

Common phenomena are:

• A disorder with nonpsychotic hypochondriacal symptoms lasting less than 6 months.
• A disorder with unexplained physical symptoms (such as fatigue or weakness) lasting less than 6 months and not due to any other mental disorder.

The treatment is quite complicated. Patients usually deny the possibility that their problems are psychological, and if they do accept this position, they often return to their doubts in the future and resume visiting different doctors. A key element in the therapeutic treatment of these disorders is the creation of a good and stable relationship with the patient, who is asked not to see other doctors, but to see a psychiatrist first. This, combined with maintaining contact with other doctors, will help the patient finally come to terms with the fact that his or her problems do not have an “organic” basis. If the vicious cycle of searching for “organic” causes and the fear that accompanies it cannot be stopped, the therapist can try other options.

VSD can sometimes respond to selective serotonin reuptake inhibitors, such as fluoxetine.

Typically, antidepressants will be given to treat coexisting depression. There is some evidence that they may also help with pain.

However, the main problem is to convince the patient of the psychological nature of his problems, stop visiting doctors, ask him to endure the symptoms, and refuse the secondary benefit of attention from others. It loses its meaning because a person pays for it with anxiety and fear.

Signs of vegetative-vascular dystonia force a person to undergo medical examinations and conduct repeated clinical tests, which leads to a decrease in the quality of life and a significant change in his performance and social functioning.

The most common symptoms are: gastrointestinal dysfunction, difficulty swallowing, joint pain, shortness of breath, etc.

This disorder often occurs before age 30 and lasts for several years.

To diagnose somatization disorder, the following symptoms are present at some point in the disorder:

• Four painful symptoms: pain associated with at least four locations or functions: joints, head, abdomen, back.
• Gastrointestinal symptoms: flatulence, discomfort.
• Sexual symptom: erectile dysfunction, ejaculatory dysfunction, sexual indifference, irregular and/or excessive menstrual cycles.
• Pseudo-neurological symptom: loss of coordination, numbness of extremities, urinary retention, lump in throat, difficulty swallowing, trembling, dissociative symptoms.

Independent somatoform disorders

Undifferentiated somatoform disorder is characterized by one or more physical complaints, such as gastrointestinal problems, fatigue, and difficulty urinating.

These symptoms are not associated with organic diseases. The identified symptoms cause clinically significant discomfort by reducing the subject's performance and social functioning.

To be able to make a diagnosis of disordered somatoform disorder, the disorder must have been present for at least six months.

Sometimes sensory and motor dysfunctions are recorded, which indicates the presence of organic pathology.

The presence of such symptoms precedes the appearance of psychological conflicts or stressful situations, while there are no objective reasons or organic diseases that can explain the presence of these symptoms.

Symptoms cause clinically significant discomfort and deterioration in the person’s general condition.

There are 4 subtypes:

• with motor deficits: changes in coordination and balance, localized hyposthenia or paresis, difficulty swallowing or lump in the throat, aphonia, urinary retention;
• with the appearance of trembling;
• with sensory symptoms: loss of tactile sensitivity, painful sensations, diplopia, partial blindness, deafness, hallucinations;
• with mixed symptoms: symptoms of several categories are present.

A pain syndrome is characterized by the presence of pain in one or more anatomical regions that is of such severity that it requires clinical attention.

The pain causes serious discomfort and impairment of ability to work and participate in social life. It is important to exclude so-called phantom pain.

Psychological factors determine the onset, severity, and maintenance of pain.

It is an acute disorder if the duration of the illness is less than six months, and chronic if the duration of the illness exceeds six months.

Hypochondria is common. A person with this condition lives in constant fear or belief that he has a serious illness, and this belief is based on an incorrect interpretation of physical symptoms. Concerns remain despite ongoing testing and continued medical monitoring.

To be diagnosed with hypochondria, the fear must have been present for at least six months.

Hypochondria causes discomfort and deterioration in social, professional and other important areas of a person's life.

Prevalence

Dysfunction is expressed as a feeling of excessive concern about the presence of a physical defect that does not actually exist, or is slightly present but is still perceived in a distorted and exaggerated way.

Facts

FDD (also called functional disorder) is when a person continues to see a doctor for physical complaints even if the doctor has previously found that he does not have a physical illness.

A doctor makes a diagnosis by taking a medical history and, among other things, determining whether there is a physical or mental illness.

Often treatment consists of teaching a person to deal with thoughts and their conditions correctly.

However, psychotherapy and medication may also be an option.

Physical abnormalities may be detected, but they do not explain the person's problems.

Somatoform disorder may simulate symptoms of damage to several organs, or symptoms of a defect in one or two of them:

• Heart and lungs: palpitations or fast heart rate, chest pressure, shortness of breath without exertion, hyperventilation.
• Stomach and intestines: pain in the abdomen, problems with stool, flatulence, tension or feeling of a lump in the abdomen, belching, constipation, burning in the abdomen up the middle, just below the ribs.
• Muscles and skeleton: pain in the arms or legs, muscle pain, joint pain, numbness or decreased strength, back pain, pain that moves from place to place.
• Common symptoms: problems with concentration and memory, severe fatigue, headache, dizziness, dry mouth, redness of the skin.

The patient should try not to focus on the physical symptoms and learn to cope better with them.

To make a correct diagnosis, it is also important that the doctor compares events in a person’s life before and after the onset of the disease.

If, despite a thorough examination, the doctor is unsure of the diagnosis, further investigation may be required.

Patient sensitivity and anxiety about the disease lead to repeated medical visits. Usually this is completely optional. Therefore, the doctor often does not approve of such a wish. Communication between doctor and patient can be problematic.

May require evaluation and treatment by psychiatrists or possibly. in specialized clinics.

The patient must learn to control himself better. Many people improve their physical activity and increase their social circle.

Typically, drug treatment has limited effect, but antidepressants may be beneficial. This medicine should be taken regularly. Cognitive behavioral therapy is the most relevant.

Relaxation exercises have helped many people because tension is often the main cause of discomfort. Physical exercises aimed at studying body signals.

Try to live with your illness and master your symptoms on a day-to-day basis rather than focusing on getting better quickly.

It is important to be physically, mentally and socially active. However, be sure to set realistic goals and avoid overexerting yourself.

These conditions can last for years, but often in varying degrees of intensity, so you won't necessarily suffer from them on a permanent basis. If symptoms persist for a long time, the prospect of a complete cure is unlikely, but symptoms may be alleviated.

Depressive disorders requiring treatment may arise during treatment. The negative consequences of futile medical and surgical treatment can be significant. Pain medications and sedatives may be used.

How frequent are the manifestations of the disease?

10-30% of people have nonspecific symptoms such as pain, fatigue, weakness and fear of illness.

A large number of patients have functional ailments. The disorder is most often observed in women. Symptoms vary depending on cultural and social factors.

Since the disease causes severe psychological and social burden for the individual patient, while at the same time incurring significant financial costs, new forms of treatment are needed. Even the less pronounced effect on an individual patient is of interest because the disease affects many people today.

Herbal recipes against VSD

Cardioneurosis can be affected by various types of herbs; these methods have been known for a long time and have been successfully practiced.

Sleepless nights, tears for no reason and irritation that accompany VSD will go away if you use herbal treatment.

• A mixture of different herbs is very useful for VSD. It includes about 10 parts of thyme, 1 part of St. John's wort, 3 parts of lilac buds, 2 parts of lovage root, 2 parts of hop cones, 1 part of plantain. Everything is finely chopped and mixed. In the evening, mix 3 tablespoons of the mixture and half a liter of boiling water. Leave for half an hour and strain. In the morning, warm it up slightly and drink 1 cup of coffee half an hour before meals three times a day. Treatment lasts 60 days and then stops. It can be repeated after two months.
• Melissa-based tea is also very useful for neurosis. You can make tea from 1 tablespoon of plant leaves and 1 liter of boiling water. Tea is drunk cold, with the addition of honey. You can drink the entire volume of the finished drink throughout the day.
• Black radish juice is very useful for VSD. A medium radish is peeled, the core is cut out and filled with honey. Leave it overnight and drink the juice in the morning.
• Dill juice significantly helps with neurosis. Drink half a cup of tea three times a day after meals.
• It is very useful to drink a glass of water in which you boiled potatoes three times a week. It should be drunk cold, to make it more palatable, the composition is sweetened with honey.
• Valerian root is very useful for neurosis. Valerian root is cut into small pieces, placed in a bottle so as to fill one fifth of its volume and filled to the brim with vodka or alcohol. Leave in a cool and dark place for nine days.
• The cuff also helps a lot with VSD. A cup of boiling water is poured over half a tablespoon of mint leaves. Cover with a lid and heat in a water bath for 15 minutes while stirring. Cool for 1 hour, strain, boil until a volume of 200 ml is obtained. Drink half a glass three times a day 15 minutes before meals. Store in a cool place and take within two days.
• Kava (Polynesian pepper) is a medicinal herb known to boost metabolism and help burn fat. But even a little carelessness regarding the amount of kava can cause serious health problems.
• Ginseng and its versatile benefits make it applicable to almost all disease conditions. It is extremely useful for overexertion and stops the aging process in the body. Significantly improves overall condition, reducing depression, stress, stimulating the heart and brain, eliminating headaches, improving cellular respiration and blood composition, and stabilizing heart rate and eliminating heartburn.
• Valerian is one of the most famous herbs for neurosis. It is used for neuroses, painful menstruation, and the harmful effects of the age factor. It copes very well with suppressing the excitability of the central nervous system, enhancing the effect of hypnotic drugs. Valerian is very useful for maintaining neuron function. You don’t have to drink it, just inhale a couple of liquid valerian for half a minute, which you can buy at the pharmacy. Another positive feature is that valerian reduces chest pain in VSD patients. The herb reduces smooth muscle spasms and regulates heart activity.
• Chamomile calms the nervous system. This helps overcome anxiety and insomnia.

The exact form of cognitive changes may vary, but most disorders appear to the patient to be:

• a source of excessive health hazard;
• a person's tendency to misinterpret any symptoms.

Negative thoughts lead to anxiety, and changes in cortisol levels increase physical symptoms as well as the discomfort experienced by the person due to them. These changes may mean that:

• the individual assumes the sick role, which may worsen symptoms by limiting physical activity and other health-promoting behaviors;
• a person is looking for help and confirmation that he is sick.

How about psychotherapy?

The main goal of treatment is to recognize and accept the psychological nature of the problem. In this way, the therapist can help the patient actively participate in treatment. He must emphasize that the very existence of the symptoms is not disputed, however, there may be an alternative explanation for them. The main therapeutic strategy is based on finding alternative ways to interpret symptoms.

The therapist asks the patient to test the feasibility of an alternative interpretation of his physical symptoms for 4 months and then decide whether he wants to return to his original opinion regarding the diagnosis. The ultimate goal is to change or replace dysfunctional thoughts with more realistic assessments of symptoms. Supportive pre-intervention is very important. It involves demonstrating with specific examples the various factors that cause health concern. For example, the doctor explains the appearance of such symptoms as the result of a search for self-confidence and control over the physical condition. This is where bias comes from in the way we process information and in making connections between thoughts and emotions.

The person is explained that stress and anxiety often do not come from the symptoms themselves, but from the thoughts (negative) that accompany it.

Regarding treatments for pain and anxiety, diagnostics provide precise information about certain physiological functions (such as muscle tension) that are under the control of the nervous system. Having this information, a person learns to control and regulate these functions at will. The mechanisms can be handled by the person themselves and help control anxiety and pain, as well as muscle relaxation. T The relaxation method also helps in problems where the symptoms that the patient is afraid of are the result of muscle tension or excitation of the autonomic nervous system.

The main sign of insufficient relaxation is a vicious circle: anxiety, stress, pain, which is interrupted by the use of antispasmodics. It has been proven that when neuromuscular tone is low, a person cannot feel stress. When a person relaxes, the sensation of pain decreases.

Other pain management techniques that can be used simultaneously with relaxation are guided mental imagery, in which a person imagines a pleasant scene (that has taken place in his life) in as much detail as possible. A person can turn to their imagination whenever they feel anxious and can also distract themselves from pain. Distraction can be:

• passive (for example, watching a good movie);
• or active (for example, singing).

Behavior change programs in which behavior is determined by the presence or absence of support are quite effective in treating symptoms of pain. The implementation of these programs is a later stage of treatment and involves agreement between therapist and patient. The term reinforcer includes any stimulus that increases the likelihood of a response occurring. Positive reinforcement is used, for example, it is said that whenever an individual exhibits a desired behavior (such as physical activity), he will be rewarded by the environment in various ways (such as praise, attention, smiling, etc.).

Accordingly, cushioning is used to ensure that there is no reinforcement when an undesirable behavior occurs, so that the behavior will not be repeated in the future.

It is reported that when the patient feels pain, they will stop helping. As a bonus, he will receive indifference on the part of his loved ones, as well as avoidance of contact with the patient while the unwanted behavior persists.

As soon as the course of treatment ends and the person shows interest in physical activity, he should be positively motivated (by smiling, showing interest). The therapist teaches people from the patient's social environment to record wrong behaviors, try not to indulge them, and systematically reward the patient's physical activity.

Is psychotherapy effective?

Using cognitive-behavioral techniques, people with VSD are able to effectively manipulate symptoms and realize that they have control over their physical condition. This approach increases their self-confidence and reduces anxiety. Although the treatment of VSD is quite difficult due to multifactorial problems and the refusal of patients to seek psychological help, however, for many people a noticeable change or even complete relief of well-being is possible.

Video “VSD causes, treatment”

In this video, neurologist A. Borisov talks about the causes of vegotovascular distance, and also touches on methods of its treatment.

And a little about secrets...

Have you ever tried to get rid of varicose veins on your own? Judging by the fact that you are reading this article, victory was not on your side. And of course you know firsthand what it is:

• again and again to observe the next portion of spider veins on the legs
• wake up in the morning wondering what to wear to cover the swollen veins
• suffer every evening from heaviness, schedule, swelling or buzzing in the legs
• a constantly seething cocktail of hope for success, agonizing anticipation and disappointment from a new unsuccessful treatment

Education: Federal State Budgetary Institution Clinical Hospital, Moscow. Field of activity: general surgery…

Many people do not know what the ICD 10 NDC code means: F45.3. In fact, in the ICD - International Classification of Diseases, 10th revision - neurocirculatory dystonia is called somatoform dysfunction of the autonomic nervous system and is recognized as a symptom complex that is caused by an imbalance in the interaction of the sympathetic, parasympathetic and metasympathetic parts of the autonomic nervous system. The same phenomenon is called vegetative-vascular dystonia, autonomic dysfunction.

The percentage of susceptibility to this disease is high - up to 70%. It is observed in both adults and children. Over time, symptoms become less severe.

Causes of neurocirculatory dystonia:

1. Diseases of the nervous system.

They can be genetically determined: violations of the structure and functions of the ANS are inherited. They arise as a result of a disease of the nervous system that develops during life.

NCD can occur as a consequence of impaired intrauterine development of the fetus and abnormal course of labor.

1. Chronic diseases of internal organs.

1. Frequent stress, physical and mental fatigue, emotional turmoil.

If a person is unable to overcome a traumatic situation, it is repressed, neuroses are formed, the targets of which are individual organs or entire systems.

Mechanism of neurocirculatory dystonia

The autonomic nervous system regulates the functioning of internal organs, ensures the constancy of the internal environment of the body (homeostasis), and helps adapt to external changes. Its departments exert the opposite effect:

Normally, the ANS departments work in a balanced manner. But if disharmony occurs, conditions develop in individual organs and in the body as a whole, which a person perceives as diseases.

The ANS also influences mental activity, as it participates in the regulation of many behavioral acts under the control of the central nervous system.

Manifestations of pathology

Cardiovascular (cardiovascular) syndrome:

• heart rhythm disturbances (increase, decrease);
• changes in blood pressure levels;
• capillary spasms (pallor, redness of the skin, marbled pattern, cold feet and hands);
• pain in the heart.

Hyperventilation (respiratory) syndrome:

• increased breathing;
• feeling of lack of air;
• dizziness;
• numbness of the mouth, hands, feet.

Irritable bowel syndrome:

• pain and bloating;
• increased frequency of bowel movements;
• constipation or diarrhea;
• nausea;
• vomit;
• loss of appetite;
• difficulty swallowing.

Besides:

1. 1. Hyperhidrosis - sweating, especially of the hands and feet.

1. 1. Violation of thermoregulation:

• increased or decreased temperature;
• difference in indicators in the left and right armpits.

1. 1. Cystalgia:

• frequent urination;
• painful sensations.

1. 1. Rapidly passing pain throughout the body.

1. 1. Sexual disorders:

• anorgasmia;
• vaginismus;
• erectile dysfunction;
• lack of ejaculation.

1. 1. Changes in psycho-emotional state:

• anxiety, fear, worry;
• depressed mood;
• tearfulness;
• insomnia or drowsiness.

1. 1. Vegetative crises.

Classification according to Savitsky

So:

1. 1. NCD according to cardiac type:

• heart pain;
• heart rhythm disturbance.

1. 1. NCD of the hypertensive type (sympathicotonia - the tone of the sympathetic section of the ANS predominates):

• high blood pressure;
• interruptions and increased heart rate;
• increased headache with physical activity;
• dizziness;
• elevated temperature;
• weakness of intestinal motility, constipation;
• weather dependence;
• hypofunction of the lacrimal glands.

1. 1. NCD of the hypotonic type (vagotonia - the parasympathetic division of the ANS predominates):

• low blood pressure;
• heart pain;
• the pulse is rare, quickly turning into a rapid one;
• dizziness;
• headaches as a reaction to mental and physical stress;
• weather dependence;
• low temperature;
• disruption of the gallbladder;
• flatulence, diarrhea;
• dyspnea;
• pallor/marbled pattern on the skin, cyanosis of the extremities;
• increased sweating;
• allergic reactions;
• low performance, causeless fatigue.

1. 1. NDC of a mixed type (the predominance of the ANS departments alternates):

• low blood pressure is sharply replaced by high blood pressure, and vice versa;
• heart pain;
• heart rhythm disturbance;
• the skin turns pale and red;
• high temperature quickly gives way to low temperature;
• headaches, dizziness, fainting;
• stool instability (diarrhea, constipation).

Crises with neurocirculatory dystonia:

1. 1. Vagoinsular (activity of the parasympathetic division of the ANS):

• slow heart rate;
• weakness;
• darkening of the eyes;
• temperature drop;
• sweating;
• nausea;
• pressure drop.

1. 1. Sympathoadrenal (activity of the sympathetic division of the ANS):

• heart pain;
• causeless fear;
• severe headache;
• increase in temperature and pressure;
• sudden paleness or redness of the skin.

Another definition is “panic attack.” More often it appears at night or in the afternoon due to physical fatigue, emotional stress, premenstrual syndrome. Suddenly there is severe pain in the heart, rapid heartbeat, suffocation, headache, trembling, cold extremities. A person develops a panicky fear of death. The duration of the crisis is up to two hours. Upon completion, a large volume of light-colored urine is released.

Diagnosis of the disease

1. 1. Blood and urine analysis. With NCD, the indicators do not change.
2. 2. Blood pressure chart for 14 days. Allows you to confirm or reject hypertension.
3. 3. Heart examination: ECG - electrocardiography, FCG - phonocardiography, EchoCG - echocardiography. Necessary to exclude organic or functional heart diseases.
4. 4. Rheoencephalography - study of cerebral vessels.
5. 5. Consultations with a neurologist, endocrinologist, ophthalmologist and otolaryngologist.

Differences between cardialgia in NCD and other diseases:

NDC	Angina pectoris	Osteochondrosis
Nature of pain: aching, stabbing	The pain is burning, pressing	From weak to intense, of different character
In the area of ​​the heart	Behind the sternum	On the left side of the chest
Does not radiate to other parts of the body	Feels on the left side of the body	Radiates to other areas
Does not depend on body position	Responsive to changes in posture
Does not occur during physical activity	Caused by physical or mental stress	Aggravated by static or dynamic load on the cervical and thoracic spine
Duration: from several hours to a day	Short-term, up to 10 minutes	Long-term, up to several months
Disappears when taking sedatives	Stops after taking nitroglycerin	Taking analgesics helps

Features of changes in blood pressure during NCD.

Hypertension - increase to 160/100 mmHg. Art. may be asymptomatic, sometimes accompanied by headache. During a breath-hold test, the pressure increases by 20-25 units.

Hypotension is a decrease in blood pressure below normal.

Dizziness, weakness, and drowsiness occur.

Treatment of the disease:

1. 1. Medication.

It is prescribed only by a doctor, taking into account the type of neurocirculatory dystonia and the characteristics of the patient.

Sedatives: bromine and magnesium salts (Magnerot, Cardiomagnyl, Magnesium Citrate, Magne-B6), Glycised (Glycine).

Tranquilizers: Tenoten, Afobazol, Adaptol, Grandaxin (Tofisopam), Medazepam (Mezapam, Rudotel), Oxazepam (Nozepam, Tazepam), Phenazepam, Diazepam (Seduxen, Relanium), Elenium.

Antidepressants: Agomelatine (Melitor), Gelarium, Remeron, Venlafaxine, Cymbalta, Milnacipran, Prozac, Citalopram, Cipralex, Paroxetine, Fevarin, Zoloft. Prescribed with caution in case of acute symptoms due to numerous side effects.

Antispasmodics with a sedative component are used: Bellataminal (Bellaspon), Belloid.

To improve cerebral circulation: Cavinton (Vinpocetine), Piracetam (Nootropil), Phenotropil, Pantocalcin, Picamilon, Stugeron (Cinnarizine), Instenon.

1. 1. General health activities and physiotherapy:

• therapeutic massage;
• electrosleep;
• circular and contrast shower;
• electrophoresis with sedatives;
• acupuncture;
• vitamin therapy;
• breathing exercises;
• baths (oxygen, pine, nitrogen, pearl, valerian, carbon dioxide, radon);
• aeroionotherapy.

1. 1. Traditional medicine.

Plants that have a calming (sedative) effect: valerian, oregano, motherwort, St. John's wort, hawthorn, strawberry, blackberry, calendula, thyme, hops, chamomile, licorice, wormwood, yarrow, mint, linden, lemon balm, fireweed.

Prevention:

• lead an active lifestyle;
• engage in physical therapy;
• observe work and rest schedules;
• avoid stressful situations;
• conduct auto-training and relaxation;
• do not drink alcohol, tobacco;
• Avoid spices and spicy foods.

Neurocirculatory dystonia does not pose a real threat to life, but it negatively affects the quality of life, so diagnosing, treating and taking measures to prevent this condition is vital.