Neuroendocrine syndromes: causes, symptoms, diagnosis, treatment

Symptoms of neuroendocrine-metabolic syndromes are determined by the degree and nature of dysfunction of the hypothalamic-pituitary system. The peculiarity of neuroendocrine syndromes is their clinical polymorphism and close connection with vegetative, emotional and motivational disorders. The multiplicity of hypothalamic functions, their dependence on neurotransmitter control, close two-way connection with other structures of the limbic-reticular complex, its inclusion in the cerebral systems of neuroendocrine, psychovegetative regulation largely determine the clinical polymorphism of neuroendocrine-metabolic syndromes.

Difficulties in diagnostics of neuroendocrine pathology are largely associated with the need to differentiate them from primary endocrine and somatic pathology. A complex and sometimes insoluble task is to clarify the nosological essence of neuroendocrine-metabolic syndromes. Numerous etiological factors that can lead to organic pathology of the hypothalamic region (neoplastic and granulomatous processes, developmental defects, vascular pathology, meningitis, encephalitis, etc.) require clinical analysis of the corresponding nosological units and paraclinical methods of their diagnosis.

It should be emphasized that neuroendocrine syndromes as a result of the listed ongoing organic processes in the central nervous system are quite rare. In the vast majority of patients with neuroendocrine syndromes, which the doctor most often encounters in everyday practice, it is not possible to identify organic brain damage. In these cases, apparently, there is a constitutionally conditioned biochemical defect of hypothalamic regulation, which is decompensated under the influence of various external-environmental influences (hormonal changes, various types of stress, infections, somatic diseases, injuries). Usually it is possible to identify one or another neuroendocrine pathology in the closest relatives of these patients, complications during the prenatal and natal periods. In addition, neuroendocrine syndromes can occur after emotional stress, against the background of psychopathological disorders, under the influence of pharmacological drugs affecting the neurochemistry of the brain.

In a number of cases, constitutional predisposition to neuroendocrine manifestations cannot be detected. Such syndromes are extremely dynamic and usually disappear after the cessation of the action of the unfavorable factors that caused them. The identified leading role of brain neurotransmitters in controlling the production of releasing and inhibiting factors of the hypothalamus allows us to understand the neurodynamic nature of these neuroendocrine syndromes, which in a number of cases may not be associated with a stable congenital biochemical defect.

It should be emphasized that not only local changes in the hypothalamic-pituitary region, but also disturbances in hypothalamic connections with other structures of the LRC play a role in the formation of clinical manifestations of neuroendocrine syndromes.

Currently, the study of neurochemical regulation of cerebral systems responsible for neurometabolic-endocrine functions and the formation of biological motivations is actively continuing. The role of biochemical processes in the genesis of most neurometabolic-endocrine syndromes makes us look more optimistically at the possibilities of their therapy. The leading role in treatment is beginning to be played by drugs that affect the neurochemistry of the brain. Continuing studies of the synthesis of drugs that affect the releasing factors of the hypothalamus allow us to hope for significant prospects for therapeutic possibilities in the near future.

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