Hypothalamic syndrome: pubertal period, neuroendocrine, with a violation of thermoregulation

Hypothalamus is an important part of the brain, which regulates a wide range of vital functions of the body. It is a vegetative center that innervates all the internal organs of a person. The human organism in the process of vital activity constantly has to adapt to the influences of the external environment: different temperature and climatic regimes, maintain metabolism, feed, multiply and become a person. All of the above processes are also controlled by the hypothalamus. The disorders that occur in the work of the hypothalamus lead to hormonal and metabolic disorders.

Hypothalamic syndrome, the same diencephalic syndrome is a combination of a number of functional disorders, represented by such 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.

[1], [2], [3], [4], [5]

Causes of the hypothalamic syndrome

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

• Malignant and benign neoplasms in the brain, exerting pressure on the hypothalamus;
• TBI (craniocerebral injuries of varying severity);
• intoxication of the body (bad ecology, exposure to harmful production, neurointoxication with alcohol and other toxic substances);
• Neuroinfection of both viral and bacterial origin (with influenza, chronic tonsillitis, rheumatism, etc.);
• psychoemotional factors (stress and shock states);
• a change in the hormonal background in pregnant women;
• congenital defects of the hypothalamus;
• hypoxia of the brain (consequences of asphyxiation, drowning).

[6], [7], [8], [9], [10], [11], [12]

Pathogenesis

In view of the fact that the hypothalamus regulates most of the important functions of the body, including maintaining the constancy of its internal homeostasis, any pathological conditions in the hypothalamus can lead to malfunctions in the functioning of virtually any organs or systems and manifests itself as vegetative disorders.

The development of pathology leads to increased permeability of the cerebral vessels in the hypothalamic region.

[13], [14], [15], [16], [17]

Symptoms of the hypothalamic syndrome

The first signs of this pathology can be severe fatigue and weakness. Next, you can indicate the following most common symptoms of this disease is considered to be sleep and wakefulness disorders, body thermoregulation, body weight, palpitation, increased sweating, changes in blood pressure, mood.

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

Attacks of the 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, and can proceed paroxysmally in the form of crises.

A provocative factor may be a change in weather conditions, the onset of the menstrual cycle, a strong emotional or painful effect. In the medical classification, there are two types of hypothalamic crisis: vasoinsular, as well as sympathetic adrenal. During vasoinsular crises, the following symptoms are manifested: 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, a bradycardia (a palpitation) and a feeling of cardiac arrest, intestines, frequent urge to urinate. During sympathetic-adrenal crises, the following symptoms can be noted: the pallor of the skin, due to the narrowing of the blood vessels, increased pressure, tachycardia (accelerated heartbeat and increased heart rate), shivering (tremor of the body), lowering of body temperature (hypothermia), obsessive sense of fear.

Hypothalamic syndrome in pubertal period in children

During puberty in young men and girls, due to hormonal changes in the body, there may be signs of a hypothalamic syndrome. The development of it can be the same as in adults, as a result of a number of reasons. Adolescents can identify the following etiological factors: fetal hypoxia (newborn), the presence of chronic foci of infection (such as caries, tonsillitis), complications of a normally occurring 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 signs such as obesity, the appearance of stretch marks on the skin, increased appetite (bulimia), frequent headaches, decreased performance, mood swings and frequent depressions, in girls with menstrual irregularities.

To clarify the diagnosis, it is necessary to conduct a number of additional studies and consultations of various medical specialists. According to the symptoms, the hypothalamic syndrome of the pubertal period is similar to the Itenko-Cushing syndrome, therefore, this diagnosis should be deleted.

Treatment of the syndrome in children is, first of all, in the observance of a diet, which includes a fractional five meals a day and a decrease in the calorie content of food. And also drug treatment, which depends on the etiology of the disease, and can include medicines that help improve blood circulation in the vessels of the brain, diuretics, vitamins, hormone therapy, anticonvulsants. With timely correct treatment, the prognosis is good and in most cases there is complete recovery, with the exception of very rare and severe forms of the disease. In such cases, the treatment lasts for years and contributes to significant relief of physical condition and adaptation.

The risk group includes adolescents who started early sexual activity (early pregnancy and abortions), children with increased body weight, as well as those involved in heavy sports that consume anabolic, narcotic drugs and dope.

[18], [19], [20], [21]

Neuroendocrine form of hypothalamic syndrome

This type of disease is characterized by disorders in protein, fatty, carbohydrate, and also water-salt metabolism and is manifested either by bulimia (voracity) or cardinal weight reduction (anorexia). In women, menstrual cycle disorders are possible, in men, a decrease in potency. In the pathological state of the thyrotropic portion 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 can be craniocerebral trauma, intoxication of the body and neurointoxication. Therefore, the treatment of this form of the disease consists in eliminating and curing the main cause of the pathology (if the disease is secondary), detoxifying the body, vitamin therapy, urinary and resorptive drugs, anti-inflammatory drugs, the use of central adrenolytics (reserpine, raunatin, aminazine), cholinomimetic drugs (anticholinesterase substances) .

Syndrome of hypothalamic hypersexuality

Some patients suffering from a hypothalamic syndrome may have a pathologically elevated sexual attraction or hypothalamic hypersexuality syndrome. The course of the disease manifests itself in the form of crises. At times, a woman experiences the strongest libido, in which specific sensations in the sexual organs and their increased sensitivity arise. A strong sexual arousal can grow right up to orgasm. At sexual contacts such women receive several orgasms (multiorasm). To the above symptoms, you can add a feeling of heat, false urge to urinate and a feeling of full bladder, as well as painful sensations in the lower abdomen and back. Women with this pathology reach orgasm much quicker and easier for healthy women (even during erotic dreams), a sense of satisfaction either does not come, or sets in for a short time. Then they again have a strong sexual arousal. Sexual arousal occurs paroxysmally, in the form of crises. There are other symptoms of hypothalamic syndrome: hyperemia or pallor of the skin, headaches and dizziness, general weakness. This syndrome can lead to various neuropsychiatric disorders, such as: sleep disorders (drowsiness or insomnia), asthenia, feelings of anxiety and fear. Disease can lead a woman to antisocial behavior and promiscuity.

Diagnosis takes into account objective data and history. In addition to pathological hypersexuality, there are other symptoms of the hypothalamic crisis.

Treatment is aimed at combating the cause of the disease, for example, prescribing antibiotics for infectious brain and hypothalamic lesions. 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 - prescribe anticonvulsant and tranquilizers, such as elenium and seduxen. For psychiatric disorders use of psychotropic drugs. In the case of cyclical attacks of hypersexuality, the use of synthetic progestins: bisekurin and infecondin.

Hypothalamic syndrome with a violation of thermoregulation

The hypothalamus plays an important role in the temperature regulation of the body. In patients, there is a violation of skin temperature, elevated body temperature from subfebrile to febrile, temperature fluctuations intensify during crises. In the period between bouts, body temperature can be either normal or low. It is necessary to pay attention to patients with a long period of low-grade fever and without obvious signs of diseases and pathologies of organs. In such patients, you can find 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 in the violation of thermoregulation is chills. There may also be a shivering of the type of chill that can occur, as a rule, during a crisis. Chills can be accompanied by polyuria and profuse sweating. Patients with this disease often freeze, chilly, wrapped in a warm, tightly closed windows, even in the warm season.

Forms

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

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

On clinical grounds, it is also possible to identify variants of syndromes with dominant constitutional obesity (in the form of a violation of fat and carbohydrate metabolism), hypercorticism, neurocirculatory disorders, germinative disorders.

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

[22], [23], [24], [25]

Diagnostics of the hypothalamic syndrome

Because of the wide variety of clinical manifestations of the syndrome, its diagnosis becomes more complicated. The main criteria for diagnosing the hypothalamic syndrome are the data of special medical tests and various methods of instrumental diagnostics: the study of sugar levels in the body (laboratory tests of urine and blood), measurement of body temperature (cutaneous, rectal and oral methods of measuring temperature).

[26], [27], [28], [29], [30], [31]

Differential diagnosis

For differential diagnosis, MRI, brain encephalograms and tomograms, sampling of Zimnitskiy, ultrasound of internal secretion organs are taken into account. A very important factor for diagnosing the hypothalamic syndrome is the study of the hormones in the body (luteinizing hormone, prolactin, follicle stimulating hormone, estradiol, testosterone, cortisol, free thyroxine, adrenotropic hormone).

Treatment of the hypothalamic syndrome

For the purpose of proper treatment it is extremely important to establish the causes that caused the disease. Then doctors, in a hospital, are assigned conservative treatment. Operative treatment can be used if the cause of the syndrome is a neoplasm. Etiological treatment of the hypothalamic syndrome should be aimed at combating the tumor, infections and viruses, injuries and brain diseases). To prevent sympatho adrenal crises, the following drugs are prescribed: pyrroxane, eglonyl, bellataminal, grandaxin. Antidepressants are prescribed. When neuroendocrine disorders are prescribed hormonal drugs. When metabolic disorders are prescribed diet therapy, drugs that reduce appetite.

• Piroxane - pyrroxane hydrochloride is the main active substance in a dosage of 0,015 g. In the preparation. 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, for hypertensive crises of the sympathoadrenal type, for disturbances in the functions of the vegetative system.

Precautions: use caution to the elderly; after the course of treatment, to monitor the glucose level in the blood.

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

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

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

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

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

• Bellataminal - prescribe inside 1 tablet 2 3 times a day after meals with insomnia, increased irritability, for treatment of vegetative vascular dystonia.

Precautions are: not to appoint pregnant women, during lactation, to persons whose work is related to the speed of reaction.

Side effects: rarely occur. Possible dry mouth, visual impairment, drowsiness.

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

Precautions: with caution to patients with mental retardation, elderly, persons with lactose intolerance.

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

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

Alternative medicine advises to use the broths and tinctures of medicinal herbs. To reduce the feeling of hunger, you can use the decoction of burdock roots. Prepare it as follows: 10 grams of burdock root boil in 300 ml of water for 15 minutes. Let cool, drain and take 1 tablespoon 5 - 7 times a day.

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

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

Using the methods of alternative medicine, we must not forget that it is necessary to continue drug treatment, since herbal decoctions can not completely replace medicines. Alternative medicine can only complement the basic treatment.

Homeopathic treatment for hypothalamic syndrome

Homeopathic preparations will be prescribed in parallel with the main treatment. These drugs help the body fight the consequences and complications of the hypothalamic syndrome. So in the case of constitutional obesity, homeopathic remedies can be prescribed that help fight the increased appetite of Ignacy, Nuks Vomica, Anacardium, Acidum phosphoricum. For violations of fat metabolism Pulsatilla, Thuya, Graffitis, Fucus. Drainage preparations - Cardus Marianus, Lycopodium.

• Ignacy is a homeopathic drug. Produced in the form of drops (a bottle of 30 ml), or homeopathic granules (packaged 10 gr.)

Has a sedative (calming), antispasmodic, antidepressant effect on the body. How to use: adults 10 drops under the tongue or inside, previously dissolved in 1 teaspoon of water, 3 times a day for half an hour before meals or an hour after eating.

Side effects with application of Ignacia are not revealed.

Precautions: In the absence of a therapeutic effect, consult a doctor and cancel the drug.

• Pulsatilla - homeopathic granules.

At the heart of this drug is a herb chamber (sleep - grass). Applied for the treatment of headaches, neurasthenia, neuralgia, vegetative vascular dystonia.

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

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

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

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

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

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

Precautions: individual intolerance, pregnancy and lactation.

• Likopodium - homeopathic grist in jars of 10 gr. And tincture in glass bottles of 15 ml. The granules are applied sublingually, the tincture dissolves in a small amount of water and is placed under the tongue for half a minute.

Side effects: perhaps a slight exacerbation of the disease.

Precautions: to refrain from cleaning teeth with menthol pastes.

Physiotherapy with hypothalamic syndrome

Excellent physiotherapeutic methods of treatment of the syndrome can be called medicinal electrophoresis with sedatives, a whirlpool bath, coniferous baths, as a sedative method of physiotherapy. To the toning method are medicinal electrophoresis with tonic preparations, showers, massages, thalassotherapy (treatment with sea, sea water, seaweed). Positive effects on the body are provided by transcerebral UHF, ultraviolet irradiation in small doses, heliotherapy, sodium chloride, radon baths.

Consequences and complications, prophylaxis and prognosis in the hypothalamic syndrome.

Since the hypothalamic syndrome is a complex disease, complications affect many organs and systems of the body. For example, if there is a metabolic disorder in the body, obesity can develop, diabetes mellitus, stretch marks appear on the skin.

With vegetative vascular forms of the syndrome, blood pressure may fluctuate, blood pressure may be complicated by hypertensive crisis.

The central nervous system can respond with mood swings, depression, disturbed sleep and wakefulness.

In women, the hypothalamic syndrome is fraught with the development of polycystic ovaries, infertility, mastopathy, menstrual cycle disorders.

Patients who have been diagnosed with the syndrome need constant medical supervision. In the absence of proper observation and treatment correction, the prognosis can be extremely difficult: from loss of ability to work to a coma, as well as a lethal outcome.

To preventive measures in the syndrome include the conduct of a healthy active lifestyle, fighting bad habits, proper healthy eating, moderate physical and mental stress, timely treatment of diseases.

The most frequently asked questions on the topic of hypothalamic syndrome:

How to lose weight with a hypothalamic syndrome?

Lose weight in this pathology is possible if you approach this problem in a comprehensive manner. First of all, you need a low-calorie diet, a fractional diet, which means five meals a day during small meals. To combat excess weight it is necessary to engage in physical culture and sports. The intensity of exercise should be monitored by a physician. Walking in the open air, a healthy sleep. To reduce appetite, you can resort to medical drugs, as well as to alternative medicine methods.

Forecast

The prognosis of this pathology will depend on the severity of all disorders in the hypothalamus region and can range from a full recovery to the transition of disorders to the chronic forms of the disease under consideration.

[32], [33], [34], [35]

Appeal to the army and hypothalamic syndrome

When diagnosing the young men of conscript age of the disease, one may ask: are they taken to the army with a diagnosis of hypothalamic syndrome?

By itself, this diagnosis can not be the reason for the unsuitability of service in the army. However, severe forms of the disease and their complications can serve as a basis for exemption from military service. For example, with severe endocrine forms of the hypothalamic syndrome, which led to the 3rd degree of obesity, or, conversely, to severe trophic depletion. In severe vegetative - vascular form of the syndrome, which was complicated by intracranial hypertension, chronic hypertensive disease 2, 3, and 4 stages. And also, to release from service in the army, can become the main diseases of the body, which entailed the development of the syndrome, for example: neoplasms in the brain.

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

[36], [37]