Hypothalamic syndrome: pubertal, neuroendocrine, with impaired thermoregulation

The hypothalamus is an important part of the brain that regulates a wide range of vital functions of the body. It is the vegetative center that innervates literally all internal organs of the human body. The human body in the process of life constantly has to adapt to the effects of the external environment: various temperature and climate conditions, maintain metabolism, eat, reproduce and become a person. All of the above processes are also controlled by the hypothalamus. Disturbances that occur in the work of the hypothalamus lead to hormonal and metabolic disorders.

Hypothalamic syndrome, also known as diencephalic syndrome, is a combination of a number of functional disorders, represented by the following disorders:

• vegetative;
• endocrine;
• exchange;
• trophic.

These pathologies are manifested by an increase in body weight (up to obesity), changes in blood pressure up to the development of hypertension, vegetative vascular dystonia, infertility and other complications.

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Causes hypothalamic syndrome

The most common causes of the syndrome, both in adults and children, may be:

• malignant and benign neoplasms in the brain that put pressure on the hypothalamus;
• TBI (traumatic brain injury of varying severity);
• intoxication of the body (poor ecology, exposure to hazardous production, neurointoxication with alcohol and other toxic substances);
• neuroinfections of both viral and bacterial origin (influenza, chronic tonsillitis, rheumatism, etc.);
• psycho-emotional factors (stress and shock conditions);
• changes in hormonal levels in pregnant women;
• congenital defects of the hypothalamus;
• hypoxia of the brain (consequences of strangulation, drowning).

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Pathogenesis

Since the hypothalamus regulates most of the body's important functions, including maintaining the constancy of its internal homeostasis, any pathological conditions in the hypothalamus can lead to disruptions in the functioning of virtually any organs or systems and manifest as autonomic disorders.

The development of pathology is caused by increased permeability of the brain vessels in the hypothalamic region.

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Symptoms hypothalamic syndrome

The first signs of this pathology may be severe fatigue and weakness. Then you can indicate the following most common symptoms of this disease are considered to be sleep and wakefulness disorders, body thermoregulation, body weight, palpitations, increased sweating, changes in arterial (blood) pressure, mood.

Hypothalamic syndrome in adults is most often observed in women aged 31-40 years.

Attacks of hypothalamic syndrome as one of the manifestations of the disease.

With this pathology, the course of the disease can be constantly accompanied by clinical manifestations, or it can occur in attacks in the form of crises.

A provocative factor may be a change in weather conditions, the onset of the menstrual cycle, strong emotional or painful impact. In the medical classification, there are two types of hypothalamic crisis: vasoinsular and sympathicoadrenal. During vasoinsular crises, the following symptoms appear: a feeling of heat in the body and hot flushes to the face and head, a feeling of dizziness, a feeling of suffocation, a feeling of heaviness in the epigastric region, a decrease in blood pressure, bradycardia (slowing of the heartbeat) and a feeling of cardiac arrest, increased intestinal peristalsis, frequent urge to urinate are possible. During sympathetic-adrenal crises, the following symptoms can be noted: pale skin due to narrowing of blood vessels, high blood pressure, tachycardia (increased heart rate and pulse rate), chill-like tremors (body tremors), decreased body temperature (hypothermia), obsessive feeling of fear.

Hypothalamic syndrome in puberty in children

During puberty, boys and girls may develop signs of hypothalamic syndrome due to hormonal changes in the body. Its development may be the same as in adults, due to a number of reasons. In adolescents, the following etiological factors can be distinguished: fetal (newborn) hypoxia, the presence of chronic foci of infection (such as caries, tonsillitis), complications of normal pregnancy, hypotrophy. The impetus for the development of the disease can be: teenage pregnancy, psychological trauma, viruses and infections affecting the hypothalamic region, craniocerebral trauma, radiation and toxic effects on the child's body during puberty. Symptoms include such signs as obesity, stretch marks on the skin, increased appetite (bulimia), frequent headaches, decreased performance, mood swings and frequent depression, menstrual irregularities in girls.

To clarify the diagnosis, it is necessary to conduct a number of additional studies and consultations with various medical specialists. In terms of symptoms, the hypothalamic syndrome of the pubertal period is similar to Itsenko-Cushing syndrome, so this diagnosis should be excluded.

Treatment of the syndrome in children consists primarily of following a diet, which includes fractional five-time meals and reducing the caloric content of food. And also drug treatment, which depends on the etiology of the disease and may include drugs that improve blood circulation in the vessels of the brain, diuretics, vitamins, hormone therapy, anticonvulsants. With timely correct treatment, the prognosis of the disease is good and in most cases a complete recovery is observed, with the exception of very rare and severe forms of the disease. In such cases, treatment lasts for years and contributes to a significant relief of the physical condition and adaptation.

The risk group includes teenagers who began to have early sexual activity (early pregnancy and abortions), children with increased body weight, as well as those involved in heavy sports, using anabolic steroids, drugs and doping.

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Neuroendocrine form of hypothalamic syndrome

This type of disease is characterized by disturbances in protein, fat, carbohydrate, and water-salt metabolism and is manifested either by bulimia (gluttony) or dramatic weight loss (anorexia). In women, menstrual cycle disorders are possible, and in men, decreased potency. In the case of a pathological condition of the thyroid-stimulating lobe of the pituitary gland, symptoms of hypothyroidism (insufficiency of thyroid hormones) and toxic diffuse goiter (increased production of thyroid hormones) may occur. The causes of this phenomenon may be craniocerebral trauma, intoxication of the body and neurointoxication. Therefore, treatment of this form of the disease consists of eliminating and curing the underlying cause of the pathology (if the disease is secondary), detoxification of the body, vitamin therapy, urinary and absorbable drugs, anti-inflammatory drugs, the use of central adrenolytics (reserpine, raunatin, aminazine), cholinomimetic drugs (anticholinesterase substances).

Hypothalamic hypersexuality syndrome

Some patients suffering from hypothalamic syndrome may have pathologically increased sexual desire or hypothalamic hypersexuality syndrome. The course of the disease manifests itself in crises. At times, a woman experiences a very strong libido, which causes specific sensations in the genitals and their increased sensitivity. And strong sexual arousal can build up to orgasm. During sexual intercourse, such women experience several orgasms (multi-orgasms). To the above symptoms, one can add a feeling of heat, false urges to urinate and a feeling of a full bladder, as well as painful sensations in the lower abdomen and back. Women with this pathology achieve orgasm much faster and easier than healthy women (even during erotic dreams), the feeling of satisfaction either does not occur or occurs for a short period of time. Then they again experience strong sexual arousal. Sexual arousal occurs in fits and starts, in the form of crises. There are also other symptoms of hypothalamic syndrome: hyperemia or paleness of the skin, headaches and dizziness, general weakness. This syndrome can lead to various neuropsychiatric disorders, such as: sleep disorders (drowsiness or insomnia), asthenia, anxiety and fear. The disease can lead a woman to antisocial behavior and promiscuous sex life.

The diagnosis takes into account objective data and anamnesis. In addition to pathological hypersexuality, there are other symptoms of hypothalamic crisis.

Treatment is aimed at combating the cause of the disease, for example, prescribing antibiotics for infectious lesions of the brain and hypothalamus. Calcium preparations are used to reduce the tone of the sympathetic nervous system and increase the tone of the parasympathetic system. If crises are accompanied by epilepsy, anticonvulsants and tranquilizers are prescribed, such as elenium and seduxen. In case of mental disorders, psychotropic drugs are used. In case of cyclic attacks of hypersexuality, synthetic progestins are used: bisecurin and infecundin.

Hypothalamic syndrome with impaired thermoregulation

The hypothalamus plays an important role in body temperature regulation. Patients have skin temperature disturbances, elevated body temperature from subfebrile to febrile, temperature fluctuations increase during crises. In the period between attacks, body temperature can be both normal and low. It is necessary to pay attention to patients with a prolonged period of subfebrile temperature and no obvious signs of diseases and pathologies of organs. Such patients can also have a number of other symptoms characteristic of the hypothalamic syndrome: bulimia, obesity and thirst. This is an important factor in the differential diagnosis of this disease. An important symptom of thermoregulation disturbances is chills. There may also be trembling like chills, which can usually occur during a crisis. Chills may be accompanied by polyuria and profuse sweating. Patients with this disease often freeze, shiver, wrap themselves in warm things, tightly close the windows even in the warm season.

Forms

According to etiology, this syndrome is divided into both primary (brain diseases with damage to the hypothalamic region) and secondary (is a consequence of diseases and pathological processes of internal organs and systems). According to the main clinical signs, the syndrome in medicine is divided into the following forms:

• neuromuscular;
• vegetative-vascular;
• neurotrophic;
• disturbance of the sleep and wakefulness process;
• disturbances in the thermoregulation process;
• hypothalamic or diencephalic epilepsy;
• pseudo-neurasthenic and psychopathological.

Based on clinical signs, it is also possible to distinguish variants of syndromes with dominant constitutional obesity (in the form of impaired fat and carbohydrate metabolism), hypercorticism, neurocirculatory disorders, and germinal disorders.

According to the severity in medical practice, the syndrome can be in a mild, moderate and severe form of this disease. The characteristic development can be progressive, as well as stable, regressive and recurrent. In the puberty period (the period of sexual maturation), this pathology can accelerate sexual development, and slow it down.

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Diagnostics hypothalamic syndrome

Due to the wide variety of clinical manifestations of the syndrome, its diagnosis is complicated. The main criteria in the diagnosis of hypothalamic syndrome are data from special medical tests and various methods of instrumental diagnostics: examination of sugar levels in the body (laboratory tests of urine and blood), measurement of body temperature (skin, rectal and oral methods of measuring temperature).

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Differential diagnosis

For differential diagnostics, MRI data, encephalogram and tomogram of the brain, Zimnitsky test, ultrasound of the endocrine organs are taken into account. A very important factor for diagnosing hypothalamic syndrome is the study of hormone levels in the body (luteinizing hormone, prolactin, follicle-stimulating hormone, estradiol, testosterone, cortisol, free thyroxine, adrenotropic hormone).

Treatment hypothalamic syndrome

To prescribe the correct treatment, it is extremely important to establish the causes of this disease. Then, doctors, in a hospital setting, prescribe conservative treatment. Surgical treatment can be used if the cause of the syndrome is a neoplasm. Etiological treatment of hypothalamic syndrome should be aimed at combating the tumor, infections and viruses, injuries and diseases of the brain). To prevent sympathicoadrenal crises, the following drugs are prescribed: pyrroxan, eglonil, bellataminal, grandaxin. Antidepressants are prescribed. For neuroendocrine disorders, hormonal drugs are prescribed. For metabolic disorders, diet therapy and appetite suppressants are prescribed.

• Pyrroxan - pyrroxan hydrochloride is the main active ingredient in a dosage of 0.015 g. In the preparation. It is produced in tablets of 15 - 39 mg and in ampoules of 1 ml.

It is used for panic and depressive syndromes, allergic reactions and dermatoses, seasickness, hypertensive crises of the sympathoadrenal type, and dysfunctions of the autonomic nervous system.

Precautions: Use with caution in elderly people; monitor blood glucose levels after treatment.

Side effects: decreased blood pressure, bradycardia, increased pain in the heart area.

• Eglonil - tablets of 50 and 200 mg, ampoules of 2 ml 2% solution.

It is used for depressive disorders, schizophrenia, migraines, encephalopathy, dizziness.

Precautions for use: during use of the drug, do not drink alcohol, take Levodol or antihypertensive drugs.

Side effects: drowsiness, dizziness, menstrual irregularities, tachycardia, increased or decreased blood pressure, skin rash.

• Bellataminal - prescribed orally 1 tablet 2-3 times a day after meals for insomnia, increased irritability, for the treatment of vegetative vascular dystonia.

Precautionary measures include: do not prescribe to pregnant women, during lactation, or to persons whose work requires rapid reaction.

Side effects: Rare. Dry mouth, blurred vision, drowsiness are possible.

• Grandaxin – 50 mg tablets for the treatment of neuroses and stress.

Precautions: Use with caution in patients with mental retardation, the elderly, and people with lactose intolerance.

Side effects: headache, insomnia, psychomotor agitation, loss of appetite, nausea, flatulence, muscle pain.

The use of traditional medicine in the treatment of hypothalamic syndrome.

Traditional medicine recommends using decoctions and infusions of medicinal herbs. To reduce the feeling of hunger, you can use a decoction of burdock roots. Prepare it as follows: boil 10 grams of burdock root in 300 ml of water for 15 minutes. Let it cool, strain and take 1 tablespoon 5-7 times a day.

To reduce blood sugar levels, a decoction of blueberry leaves is recommended: pour 1 tablespoon of crushed blueberry leaves with two glasses of boiling water and cook for 4 minutes. Cool, strain and drink 2 times a day fifteen minutes before meals.

To reduce blood pressure: take 4 parts of rose hips and hawthorn, three parts of chokeberry and two parts of dill seeds, mix, pour 1 liter of boiling water and boil for 3 minutes. Take 1 glass of the strained broth 3 times a day.

When using traditional medicine methods, one must not forget that it is necessary to continue drug treatment, since herbal decoctions cannot fully replace drugs. Traditional medicine can only be an addition to the main treatment.

Homeopathic Treatment for Hypothalamic Syndrome

Homeopathic medicines will be prescribed in parallel with the main treatment. These medicines help the body fight the consequences and complications of hypothalamic syndrome. So, with constitutional obesity, homeopathic medicines can be prescribed that help fight increased appetite Ignatia, Nux Vomica, Anacardium, Acidum phosphoricum. With disorders of fat metabolism Pulsatilla, Thuja, Graffitis, Fucus. Drainage medicines - Carduus marianus, Lycopodium.

• Ignatia is a homeopathic medicine. It is available in the form of drops (30 ml bottle) or homeopathic granules (10 g package).

It has a sedative (calming), antispasmodic, antidepressant effect on the body. Directions: Adults: 10 drops under the tongue or orally, after dissolving in 1 teaspoon of water, 3 times a day half an hour before meals or an hour after meals.

No side effects have been identified with the use of Ignatia.

Precautions: If there is no therapeutic effect, consult a doctor and stop using the drug.

• Pulsatilla - homeopathic granules.

The basis of this drug is the herb pasqueflower (sleep-herb). It is used to treat headaches, neurasthenia, neuralgia, vegetative-vascular dystonia.

The drug is diluted from 3 to 30 parts. The dosage is determined by the doctor.

Side effects: in case of individual intolerance to the components of the drug, an allergic reaction may develop.

Precautions: if the temperature rises, replace with another homeopathic medicine, do not take antibiotics and anti-inflammatory drugs.

• Fucus - homeopathic granules of 5, 10, 15, 20 and 40 g.

The drug is taken at least one hour before meals or one hour after meals under the tongue, 8 granules 5 times a day.

Side effects: digestive disorders, allergies may occur, should not be used with mint preparations, avoid drinking alcohol and coffee.

Precautions: individual intolerance, pregnancy and lactation.

• Lycopodium is a homeopathic granule in 10 g jars and tincture in 15 ml glass bottles. Granules are used sublingually, the tincture is dissolved in a small amount of water and placed under the tongue for half a minute.

Side effects: slight exacerbation of the disease is possible.

Precautions: Avoid brushing your teeth with menthol toothpastes.

Physiotherapy for hypothalamic syndrome

Excellent physiotherapeutic methods of treating the syndrome include medicinal electrophoresis with sedatives, hydromassage baths, pine baths, as a sedative method of physiotherapy. The tonic method includes medicinal electrophoresis with tonics, showers, massages, thalassotherapy (treatment with the sea, sea water, seaweed). Transcerebral UHF, ultraviolet irradiation in small doses, heliotherapy, sodium chloride, radon baths have a positive effect on the body.

Consequences and complications, prevention and prognosis for hypothalamic syndrome.

Since hypothalamic syndrome is a complex disease, complications affect many organs and systems of the body. For example, if the body's metabolism is disturbed, obesity, diabetes mellitus, and stretch marks may develop on the skin.

In vegetative vascular forms of the syndrome, blood pressure may fluctuate, and an increase in blood pressure may be complicated by a hypertensive crisis.

The central nervous system can react with mood swings, depression, and sleep and wakefulness disturbances.

In women, hypothalamic syndrome is fraught with the development of polycystic ovary disease, infertility, mastopathy, and menstrual irregularities.

Patients diagnosed with the syndrome require constant medical supervision. In the absence of proper supervision and treatment correction, the prognosis can be extremely difficult: from loss of ability to work to a comatose state, as well as death.

Preventive measures for the syndrome include maintaining a healthy active lifestyle, fighting bad habits, proper healthy nutrition, moderate physical and mental exercise, and timely treatment of diseases.

Frequently asked questions on the topic of hypothalamic syndrome:

How to lose weight with hypothalamic syndrome?

It is possible to lose weight with this pathology if you approach this problem comprehensively. First of all, a low-calorie diet is necessary, fractional nutrition, which implies five meals a day in small portions. To combat excess weight, it is necessary to do physical exercise and sports. The intensity of physical activity should be monitored by a doctor. Walks in the fresh air, healthy sleep. To reduce appetite, you can resort to medications, as well as traditional medicine methods.

Forecast

The prognosis for this pathology will depend on the severity of all disorders in the hypothalamus and can vary from full recovery to the transition of disorders into chronic forms of the disease in question.

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Conscription and hypothalamic syndrome

When diagnosing this disease in young men of draft age, one may ask the question: are they taken into the army with a diagnosis of hypothalamic syndrome?

This diagnosis itself cannot be the basis for unfitness for military service. However, severe forms of the disease and their complications can serve as grounds for exemption from military service. For example, with severe endocrine forms of hypothalamic syndrome, which led to 3rd degree obesity, or, conversely, to severe trophic exhaustion. With severe vegetative-vascular form of the syndrome, which is complicated by intracranial hypertension, chronic hypertension of stages 2, 3, and 4. And also, the main diseases of the body that led to the development of the syndrome, for example: neoplasms in the brain, can become the basis for exemption from military service.

In such cases, conscripts are sent for examination by a military medical commission, which, in a hospital setting, conducts thorough examinations and determines their suitability for military service.

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