Vegeto-vascular dystonia

Vegeto-vascular dystonia includes the manifestation of all forms of disturbance of vegetative regulation.

In recent years, preference has been given to the term "vegetative dystonia syndrome" before "vegeto-vascular dystonia syndrome", as this makes it possible to talk about the syndrome of vegetative-visceral dystonia, and the latter can be divided into a variety of systemic dystonia (vegetative-cardial, vegetative- gastric, etc.). Therefore, some authors use the term "vegetative dystonia syndrome" more often. Certain discussions were caused by the second part of the definition of the syndrome. NK Bogolepov suggested that "dystonia" be replaced by "dysfunction." This is a logical and attractive position, however, for the pathology and physiology of the autonomic nervous system, such terms as vagotonia, sympathicotonia, amphotonia are traditional.

Vegeto-vascular dystonia is a complex presented in the form of subjective complaints from patients, violations of the functioning of the vegetative part of the nervous system. VSD is by right considered one of the most difficult in terms of diagnosing syndromes. Clinical manifestations that demonstrate vegetative-vascular dystonia are diverse, there are more than 150 of them. All psycho-vegetative symptoms are associated with a violation of the function of the limbic-reticular structure, which controls the work of the autonomic nervous system. Vegeto-vascular dystonia is not an independent nosological unit; rather, it develops as a secondary syndrome reaction in response to persistent, chronic diseases or to long-term stressful situations from the outside. VSD is a three-dimensional concept, more complex than the analogous one - "neurocirculatory disorders", accordingly, diagnostic measures should be deployed in the same way as treatment. Three decades ago vegetative-vascular dystonia was diagnosed relatively rarely, today according to statistics more than 75% of the inhabitants of our planet suffer to some extent this disease. Most of them do not seek medical help, since the symptoms of the syndrome are smoothened, but about a third of patients need complex therapy, and about 10% in hospitalization.

Vegeto-vascular dystonia is called a syndrome because, as a rule, vegetative disorders are secondary manifestations of the most diverse forms of pathology. And although primary and secondary vegetative disorders are distinguished in the classification, the syndrome of vegetative dystonia is common to them. Analyzing the syndrome of vegetative dystonia, a number of factors are taken into account:

1. nature of vegetative disorders;
2. permanence and paroxysmalism of them;
3. the poly- and mono-systemic nature of the disorder;
4. generalized systemic and local disturbances;
5. finally, and this seems particularly important, they distinguish within the syndrome of vegetative dystonia three leading vegetative syndromes:
   • psycho-vegetative syndrome,
   • syndrome of progressive autonomic failure,
   • vegetative-vascular-trophic syndrome.

How does the autonomic nervous system work?

VSD is a dissonance of the work of two subsystems, sympathetic and parasympathetic. The unity of the work of these "allies" should provide homeostasis (internal balance and constancy of the work of organs, systems) and an adaptive mechanism that helps adequately respond to all external factors. The vegetative system is responsible for the unconscious (autonomous) regulation of many important processes, among which are: 

• Normalization of blood pressure, tone of the vascular system; 
• The rhythm of heartbeat, the frequency of its contractions; 
• Secretory activity of glands (internal and external) - salivation, sweat, adrenaline, gastric juice, tear; 
• Normalization of motor functions of the small and large intestine, gall bladder, all the work of smooth muscles.

Under the influence of negative factors, both external and internal, the subsystems cease to work in a coordinated manner and begin to function autonomously from each other. This is how the polymorphic syndrome develops, which is called vegetative-vascular dystonia.

How do violations of subsystems appear? 

• The functions of the sympathetic subsystem are regulated by another system, the sympathoadrenal system, which exercises control of sympathy through the production of adrenaline and norepinephrine. The increase in the number of catecholamine hormones, their concentration provokes crises, seizures, which are very hard to bear by patients. There is a tachycardia that does not have a true cardiac cause, blood pressure rises sharply, dyspnoea and dizziness may begin. All these signs develop rapidly and cause an inexplicable fear in a person. Seizures can be repeated periodically for many years, depleting the nervous system of the patient. Trigger trigger mechanism may be a stressful situation, but often sympathoadrenal crises occur without apparent objective reasons. 
• Vegeto-vascular dystonia can develop in another direction. The parasympathetic subsystem functions due to the activity of special nerve fibers, among which the vagus nerves are the leading ones. Nervus vagus secretes specific neurotransmitters responsible for lowering blood pressure - acetylcholine. Not only does the pressure decrease, but the heart rate decreases, the pulse slows down. As a result, all the excreting glands begin to work in an intensive mode: salivation, sweating increase. Complex of these symptoms often ends with vagoinsular crisis - loss of consciousness, incontinence of urine and feces, severe pain in the epigastric region. Often observed hypoglycemia due to increased concentration of insulin.

Vegeto-vascular dystonia is divided by symptoms into types, which in turn directly depend on which subsystem of vegetation is "out of order". 

• The failure of the parasympathetic subsystem leads to an HPA according to the hypotonic type. 
• The failure of the sympathetic subsystem leads to an AVR according to the hypertonic type.
• The dysfunction of the two subsystems simultaneously leads to an IRR in the normotonic type.

Symptoms are very diverse, but among them the most common are: 

Cardiological symptomatology. 

• Tachycardia and arrhythmia (an increase in the frequency of heart contractions and activation of heartbeats) - tachyarrhythmia; 
• Bradycardia and arrhythmia with a decrease in heart rate - bradyarrhythmia; 
• Painful sensations in the heart, feeling of heaviness, pressure; 
• Activation of the vascular tone - hypertension; 
• Decreased vascular tone - hypotension; 
• Blood pressure jumps, fainting; 
• Hyperemia of the skin or vice versa - cyanosis (pallor, cyanosis). 

Respiratory symptoms. 

• Dyspnea; 
• Feeling of a lump in the throat, difficulty in swallowing food, liquids; 
• Sensations of a respiratory spasm. 

Gastrointestinal symptoms. 

• Violation of the digestive process, constipation or diarrhea; 
• Spasms in the epigastric region; 
• Flatulence. 

Neurological symptoms. 

• Fatigue, apathy; 
• Hypochondriacal symptoms, complaints of a minor ailment; 
• Depressive states; 
• Irritability, sometimes aggressiveness; 
• Increased meteosensitivity; 
• Subfebrile body temperature; 
• Periodic headaches of unclear etiology; 
• Sleep disturbance.

Symptoms of vegetative-vascular dystonia

The clinical doctrine of the pathology of the autonomic nervous system is associated with the names of N. Eppinger, L. Hess (1910), who created an idea of such a syndrome as vegetative-vascular dystonia. Taking into account the division of the syndrome of vegetative dystonia into the sympathetic and parasympathetic departments, a second generalized vegetative syndrome, sympathicotonia, soon appeared. In the classical exposition, they looked like this.

Vegeto-vascular dystonia, the symptoms of which are pallor and dryness of the skin, cold extremities, eye shine and mild exophthalmos, unstable temperature, a tendency to tachycardia, tachypnea, a tendency to increase blood pressure, constipation, is characterized by sympathicotonic tension. Characterized by a large work capacity, initiative, physical endurance and good activity by the evening with reduced abilities for memorization and concentration, anxiety. Reduced the tolerance of the sun, heat, noise, bright light, coffee. Sleep restless. Muscle trembling, paresthesia, chilliness, unpleasant sensations in the region of the heart are observed.

Vegeto-vascular dystonia, the symptoms of which are manifested by cold, damp, pale skin, hyperhidrosis and hypersalivation, bright red dermographism, bradycardia, tendency to arterial hypotension, respiratory arrhythmia, tendency to fainting and weight gain is characterized by vagotonia. There are apathy, asthenia, low endurance, low initiative, indecisiveness, timidity, sensitivity, a tendency to depression, the best production activity in the morning hours.

The generalization of individual vegetative disorders in these syndromes contributed to the development of clinical vegetology. There are several circumstances to note. The stated symptoms of vegetative-vascular dystonia, firstly, are not yet formed pathological syndromes and rather reflect certain, often constitutional, features of the organization and response of the autonomic nervous system; secondly, they fully fully reflected the manifestations, which are, with their greater severity, a generalized syndrome of vegetative dystonia; thirdly, it is extremely important that already in these descriptions, vegetative-vascular dystonia, symptoms are given in combination with personality characteristics and emotional response.

The doctrine of sympathicotonia and vagotonia was often criticized, based on the idea of a rarity in the real practice of such pure syndromes. Based on this, A. Guillaume identifies the intermediate symptoms of vegetative-vascular dystonia - neurotonia, and A. Danielopolu designates it as "hyperphotonia" or "hypoamphotonia". Indeed, it is more often necessary to deal with mixed sympathetic or parasympathetic manifestations, but often it is possible to distinguish the predominant direction of the disorders or a different orientation in individual functional systems (for example, sympathetic activity in cardiovascular and parasympathetic in the gastrointestinal system). With all reservations and additions, it should be recognized that the principle of isolating vegetative disorders from sympathetic-tonic and vagotonic manifestations has remained fruitful today.

Vegeto-vascular dystonia symptoms are permanent (permanent) and characterized by paroxysmal vegetative disorders (that is, periods of sharp exacerbation of symptoms). If the latter represent the outlined in time and intensive vegetative storms, the designation of the remaining violations as "permanent" is to a certain extent conditional. All symptoms of vegetative-vascular dystonia are mobile. This applies to hyperhidrosis, and to heart rate, and to arterial pressure. Thus, permanent disturbances are not absolutely stable indicators, but their frequent fluctuations, not observed clinically and not reaching the level of vegetative crises (VC). The latter have been described in the literature for a long time and are referred to as "Hover's wagon-vasal crises", "Barre sympathetic crises" and "mixed sympathetic-vagal seizures of Polzerer", and in modern English literature they are referred to as "panic attacks".

Local symptoms

Like any attempt to classify, the isolation of generalized, systemic and local disorders is to some extent conditional. It would seem that the question of local syndromes is most clear. It is known that unilateral vegetative disorders can occur in vertebrogenic pathology, tunnel syndromes, mononeuropathies of various genesis. Undoubtedly, these are local symptoms of vegetative-vascular dystonia. However, as they develop and deepen, they begin to develop generalized psycho-vegetative disorders that arise as a reaction to chronic pain (if there is one) or to maladaptation caused by local disorders. And yet this situation seems to be sufficiently delineated from the standpoint of the dominance of local forms of the syndrome of vegetative dystonia.

Generalized Symptoms

The division of generalized and system forms is more complicated. If with local syndromes speech is usually about the defeat of the peripheral segmental vegetative system, generalized and systemic disorders can be the result of a disruption in the functioning of the supra-segmental vegetative formations (psycho-vegetative syndrome), and lesions of peripheral vegetative apparatus (syndrome of progressive autonomic failure). We consider it necessary to emphasize that in principle these violations are polysystemic. The reasons for this polysystemic nature are different.

These circumstances led to a rather active discussion, which is now being conducted around the terms "vegetative dystonia syndrome" and "neurocirculatory dystonia" (vegetative-vascular dystonia). 60 years ago in the foreign literature the term "neurocirculatory asthenia" was proposed. After several decades, it was transferred to the soil of Soviet medicine, with a slightly different and its designation: "asthenia" was replaced by "dystonia." It should be recognized that the concept of "neurocirculatory dystonia" proved to be tenacious and widely used in practice (this undoubtedly indicates its pragmatic potential).

Syndromes of vegetative-vascular dystonia

What makes us for many years to lead with varying success the fight against the concept of "neurocirculatory dystonia"? First of all, the fact that therapists, cardiologists want to see in the vegetative-vascular dystonia not a syndrome, but an independent disease. An alarm is clear about these ideas. The doctor, diagnosing vegetative-vascular dystonia, begins to treat this "illness", completing the necessary in this situation search for the causes that caused this syndrome. This is the practical danger of using the term "neurocirculatory dystonia". The second series of objections consists of the erroneousness of the notion that in vegeto-vascular dystonia we have functional disorders exclusively in the cardiovascular system. To explain these views is possible first of all by the fact that the diagnosis of "vegetative-vascular dystonia" is born mainly in cardiological institutions, with violations in the respiratory sphere (practically obligate), gastrointestinal tract, thermoregulatory sphere not given any importance. The third objection concerns the fact that, having entered the path of vegetative-vascular dystonia, we must give way to such syndromes as hyperventilation, neurohastral dystonia, neurogenic thermoregulation, etc. All of them are absolute clinical reality, and a number of them (especially hyperventilation disorders) is the subject of our serious analysis.

Vegeto-vascular dystonia: symptoms of autonomic dystonia

Of course, the syndrome of vegetative dystonia is a very broad and diverse clinical concept, combining, on the one hand, bright vegetative crises, prolonged subfebrile conditions, neurogenic faints and, on the other hand, vascular-trophic local syndromes, orthostatic hypotension, anhidrosis, neurogenic bladder. This led to the fact that we identified three generalized syndromes in the syndrome of autonomic dysfunction. Psycho-vegetative syndrome is manifested by permanent-paroxysmal impairments, caused by dysfunction of nonspecific brain systems. All of them are included in the I section of the classification of autonomic disorders.

Vegeto-vascular dystonia: symptoms of progressive autonomic failure

The second syndrome is progressive vegetative failure. Its main manifestations are located in decreasing frequency: syncope in orthostatic hypotension, impotence, weakness, anhidrosis, arterial hypertension in horizontal position, symptom of "fixed pulse", weight loss, urinary incontinence, constipation, dysarthria, nasal congestion, angina pectoris. It occurs much less often, is studied by neurologists and occurs with peripheral (segmental), as well as combined cerebral and peripheral vegetative disorders (see classification of vegetative disorders). The basis of this syndrome is visceral vegetative polyneuropathy - pathology of the peripheral vegetative system, mainly innervating the visceral system. At the same time, there are certain neurological symptoms, indicating a parallel interest of a number of cerebral systems, and diffuse vegetative disorders (anhidrosis).

Vegeto-vascular dystonia: symptoms vegetative-vascular-trophic

The third syndrome is the vegetative-vascular-trophic syndrome , which in the past was sometimes referred to as "angiotrophoneurotic" or, more precisely, "angiotropho- pathetic". Primarily manifested in the hands and feet, within this framework (for example, tunnel syndromes or autonomic disorders in neural amyotrophies). It is included in the second part of the classification (peripheral vegetative disorders), and it is based on the defeat of mixed nerves, plexuses and rootlets innervating the arms and legs. Naturally, this syndrome is also the prerogative of neurology; it can be part of the psycho-vegetative syndrome (Raynaud's disease).

Vegeto-vascular dystonia: symptoms of autonomic dysfunction

The syndrome of autonomic dysfunction, as a rule, is not a nosological unit. In the classification, primary and secondary cerebral (supra-segmental), peripheral (segmental) and combined vegeto-vascular dystonia are allocated. It is obvious that the overwhelming proportion of vegetative disorders is secondary, and in these situations the analysis of the nosological nature of the pathology leading to the syndrome of autonomic dysfunction is essential for proper diagnosis and, especially, the use of nosological methods of treatment.

1. Vegeto-vascular dystonia, the symptoms of which are usually manifested in early childhood and characterized by instability of vegetative parameters: rapid skin color change, sweating, fluctuations in heart rate and arterial pressure, pain and dyskinesia in the gastrointestinal tract, a tendency to subfebrile, nausea, poor physical tolerance and mental tension, meteotropism, is called constitutional. N. Eppinger, and then A. Guillaume defined them figuratively as "invalids of the vegetative system", not yet sick, but prone to intensifying all of these manifestations under unfavorable environmental influences. Often, these disorders are of a family-hereditary nature. With age, these patients, with proper hardening upbringing, achieve certain compensation, although they remain vegetative-stigmatized all their lives. The role of genetic factors in the formation of migraine is undoubted. However, there are sometimes very severe vegetative-vascular dystonia. It is about family disautonomy, Riley's syndrome - Deia, in which there are gross violations in the internal environment of the body, incompatible with life. It usually appears in early childhood. The syndrome of progressive vegetative insufficiency can be combined with parkinsonism, multiple systemic atrophy and idiopathic orthostatic hypotension (Bradbury syndrome), degenerative diseases manifested at a late age. The primary lesions include hereditary neuropathies (sensory, neural amyotrophy Sharko - Marie - Tooth, etc.).

Thus, constitutional, degenerative, hereditary diseases can manifest themselves both psycho-vegetative, and the syndrome of progressive vegetative insufficiency, and vegetative-vascular-trophic syndrome.

2. Vegeto-vascular dystonia, the symptoms of which appear in healthy people against acute or chronic stress, is called autonomic dysfunction of psychophysiological nature. Emotional-vegetative-endocrine reactions to acute stress are normal physiological response of the body and can not be considered pathological. However, excessive inadequate expression of reactions, duration and frequency of them against a background of chronic stress, a violation of human adaptive capacity are already pathological, the basis of clinical manifestations of which is psycho-vegetative syndrome. Mass manifestation of the syndrome of autonomic dysfunction of psychophysiological nature is observed in catastrophes, earthquakes and other stressful extreme situations.
3. Vegeto-vascular dystonia, the symptoms of which are manifested during hormonal changes. These include the periods of puberty and menopause. At pubertal age, there are two prerequisites for the emergence of autonomic syndromes: the emergence of new endocrine-vegetative relationships that require the formation of other integrative patterns, and a rapid, often accelerated growth increase, which creates a gap between the new physical parameters and the possibilities of vascular supply. Typical manifestations of this are vegeto-vascular dystonia against the background of mild or severe endocrine disorders, fluctuations in blood pressure, orthostatic syndromes with pre-fainting and syncope, emotional instability, thermoregulatory disorders.

Vegetative processes are exacerbated during the menopause, which is associated with the physiological endocrine and emotional support of this condition. Vegeto-vascular dystonia is both permanent and paroxysmal, and among the latter, in addition to the characteristic tides, feelings of heat and excessive sweating, vegetative crises may occur. All the described manifestations occur in physiologically occurring pubertal and menopause, but they are especially pronounced in the pathological course of these conditions. In these situations, we are talking about a psycho-vegetative syndrome, usually decreasing with the passage of these periods, but in some cases, psycho-vegetative-endocrine disorders are quite persistent.

4. Vegeto-vascular dystonia, the symptoms of which are manifested in organic somatic diseases. With many psychosomatic diseases (hypertonic, ischemic, peptic ulcer, bronchial asthma), as well as visceral diseases with pronounced algic component (cholelithiasis, urolithiasis, chronic pancreatitis) psycho-vegetative syndromes are often formed. In psychosomatic diseases, these disorders are an important factor in pathogenesis, occur before the final formation of the described diseases and are of an early psychophysiological nature. Chronic pain syndromes, which are essentially chronic painful stress, are also overgrown with psycho-vegetative disorders. The latter are clearly represented in allergic disorders.

A large group of somatic suffering, including endocrine (diabetes mellitus, hypothyroidism, etc.), systemic and autoimmune (amyloidosis, scleroderma, etc.), metabolic (porphyria, cryoglobulinemia, etc.) disease, is accompanied by a syndrome of progressive autonomic failure. Vascular diseases may manifest as a syndrome of vegetative-vascular-trophic disorders. Particular importance should be given to diabetes mellitus (in view of its high prevalence), in which peripheral vegetative disorders occur in 50-60%, and amyloidosis (up to 80%).

5. Vegeto-vascular dystonia, the symptoms of which are manifested in organic diseases of the nervous system. There are no divisions of the brain that would not take part in vegetative and psychic regulation. This position does not in any way resurrect the ideas of equipotentialism, since the available vegetative-endocrine disorders are often subclinical, can be identified in special studies and, as a rule, is blocked by sensorimotor, speech and mental disorders. Clinical practice allowed to highlight the importance of the structures of the limbic-reticular complex, integrative brain systems, providing holistic behavior and adequate adaptation. The nodal structure is the hypothalamic region, which primarily provides neuroendocrinal, motivational and thermoregulatory manifestations. Stem structures integrate functional states of the brain in the wakefulness cycle - sleep, regulation of cardiovascular and respiratory functions, supraspinal control of muscle tone. The role and vestibulo-vegetative interaction is indisputable. The possibilities of the involvement of the rhinencephalic structures in the realization of psycho-vegetative-endocrine symptom-complexes are shown; a temporal epilepsy can serve as a clinical model. In the experiment, starting with LA Orbeli, the role of the cerebellum in vegetative regulation is demonstrated. So far, there are practically no adequate clinical observations.

In addition to the role of the limbic-reticular complex, the role of interhemispheric asymmetry is also revealed. A closer connection is shown between the right hemisphere of the brain and psycho-vegetative regulation. The above considerations are based on the topical principle, which is entirely justified, since the nature of the disease is of less importance. In this case, we should not forget the type of violations (destruction and irritation, vastness and depth of brain destruction).

The clinical manifestation of the cerebral disorders described above will be the psycho-vegetative syndrome in patients.

Vegeto-vascular dystonia, the symptoms of which occur in peripheral syndromes (radiculopathy, plexopathy, neuropathy) is called vegetative-vascular-trophic. Let us emphasize the role of tunnel (trap) symptom complexes. The main clinical manifestations are found on the hands and feet, often they are one-sided. In recent years, the theory of myofascial syndromes (vertebrogenic reflex disorders) is developing rapidly, manifested by muscular, sharply painful seals accompanied by both segmental vegetative disorders and psycho-vegetative reactions to pain. One should remember the irritation of the vegetative plexuses of vertebral arteries (Frank's nerve), often manifested with a posterior sympathetic syndrome (cervical migraine, Barre syndrome). Also described are facial sympathologies as a result of injury (involvement) of the pterygoid node (Slader's syndrome) and nosoresnichnogo (Charlene syndrome). They are extremely rare, and in such cases, it is necessary to exclude primarily a bundle headache.

Vegeto-vascular dystonia, the symptoms of which occur with myasthenia gravis, Guillain-Barre syndrome, multiple sclerosis, is called progressive vegetative failure.

Peripheral (segmental) vegetative syndromes that manifest in vegeto-vascular dystonia have only recently been reduced to the diagnosis of ganglionitis (trumpets) of the sympathetic chain and damage to the solar plexus (solarar). It should be emphasized with certainty that such a diagnosis is not justified, has no analogues in the world of neurology and has arisen in the "pre-osteochondrosis era" of neurology and before the description and detailed study of the syndrome of progressive autonomic failure.

6. Vegeto-vascular dystonia, the symptoms of which arise in occupational diseases. The leading manifestations are psycho-vegetative (mainly asteno-vegetative) and a syndrome of vegetative-vascular-trophic disorders in the hands and - cutting - legs.
7. Vegeto-vascular dystonia, the symptoms of which occur with neuroses - one of the most common forms that cause vegetative disorders. The latter are considered as an obligate manifestation of neuroses, and disorders of the neurotic circle are widespread. The syndrome of vegetative dysfunction in this situation is a classic manifestation of psycho-vegetative syndrome.
8. Vegeto-vascular dystonia, the symptoms of which arise in mental disorders. This is primarily about affective-emotional-personal disorders. Intellectual-mnestic syndromes are less connected with vegetative manifestations. The role of various forms of endogenous depression should be emphasized, both in the form of a distinct syndrome and in the form of masked (larvated) forms. As with organic cerebral disorders, when vegetative-vascular dystonia is blocked by sensorimotor, psychopathological syndromes clearly dominate the picture of mental illnesses. In this case, psychiatrists often ignore the concomitant vegetative dysfunction. The substantiation of this rather pragmatic position is the disappearance of vegetative disorders in the successful treatment of psychopathological disorders. It is a form of psycho-vegetative syndrome.

How is vegetative-vascular dystonia treated?

Vegeto-vascular dystonia is treated depending on the type of the syndrome, and the therapeutic strategy must take into account other available somatic diseases. The complex of treatment includes medication methods for the supervision of VSD and non-drug methods, which can sometimes be very effective and even replace basic medical therapy

Non-pharmacological methods and methods include such recommendations: 

Making a rational regime of the day. A healthy lifestyle is not a familiar concept that has already become a household name, it is really an effective way to neutralize the symptoms. Elementary rule - the awakening no later than 7:00 am and falling asleep not later than 22:00 pm, can remove a few symptoms of the VSD in just one month. This regimen resumes the normal production of "daytime" and "nightly" hormones. Moreover, observing the conditions of normal sleep, it is possible to improve not only well-being, but also appearance, since a special hormone that controls the slowing down of aging processes is allocated from 24.00 to 3:00 am during deep sleep. This miracle regulator is called intermedin, it stops developing from those who work at night, or simply does not sleep because of watching a movie or participating in an online game. 

Observance of the air mode in the room. Elementary airing should become a habit. In addition, it is necessary to exclude voluminous feather beds or inconvenient mattresses, pillows. Bedding should be optimally comfortable and ergonomic. Even if a person thinks that he is sleeping, but waking up, he feels broken, you can consider the dream to be unsuccessful. Often the reason for this are excessively soft beds, uncomfortable pillows, and overall external discomfort. 

It is necessary to make a variety in everyday life. Switching activities every 1.5-2 hours makes the brain activate its unused functions. In addition, the change in the type of occupation makes you involuntarily change your posture, activate stagnation in muscles and tissues. Such regular workouts should become a habit, they must be at least five a day. 

A positive result is the study of methods of autogenic training. You can study them on your own, the good of today is a lot of such literature. The method is absolutely safe and does not harm the subconscious, unlike other esoteric "delights". 

Ideally, if alcohol and nicotine are excluded from life forever. If this radical cancellation is difficult, it is necessary to minimize their use. Nicotine contributes to the development of chronic oxygen starvation of the brain, the harm of alcohol and can not speak. These habits are not useful, because they drain the already exhausted nervous system and body resources. 

The physical exercise can also help reduce the severity of symptoms of VSD. Vegeto-vascular dystonia often disappears after three to four months of training under the guidance of a professional fitness trainer. 

It is necessary to revise the diet and include a sufficient number of foods containing vitamins and trace elements. Everything that contains magnesium, calcium, potassium and B vitamins should become a daily "participant" of the menu. 

Physiotherapeutic procedures can help reduce the frequency of manifestations of VSD. Well-proven courses of electrophoresis on the collar area of the spine, mud baths, SPA procedures, acupuncture.

Vegeto-vascular dystonia is medicated with the help of medications, especially for those who need seizures, crises. 

Adrenoblockers are prescribed to patients with VSD with sympathoadrenal crises. The choice of medicines is performed by the doctor, as a rule, atenolol and its derivatives, metoprolol and nadolol are prescribed. 

Tranquilizers are prescribed for anxiety conditions for relief of symptoms of crisis. The entire group of benzodiazepines (phenazepam, oxazepam, diazepam) have well proven themselves as anti-anxiety agents. In particularly severe conditions, anxiolytics can also be prescribed. 

Vagoinsular crises are stopped with the help of preparations of the atropine group. As a holinoblocker, atropine neutralizes the main symptom of the crisis, as a rule, the drug is injected, subcutaneously. It is also effective to introduce pacemakers to activate the heart (cordyamine intramuscularly). The use of caffeine-containing drugs recently is not practiced due to various side effects. 

Bronchospasm of vegetative etiology is supervised by means of preparations of bronchodilator action. Also effective are salbutamol, ferodual in the form of inhalations. In cases of severe exacerbation and choking, ephedrine is administered intramuscularly. 

Hypoglycemia is controlled by intra-administration of glucose. 

Vegeto-vascular dystonia, which has vestibular symptoms, is treated with nootropic drugs - fesam, cinnarizine, pyrocetam.

Vegeto-vascular dystonia can be treated, the duration of which depends on the severity of the syndrome and the patient's desire to get rid of painful symptoms. The main principles of therapy, used in the treatment of VSD, are as follows: 

• Timely appeal to a neurologist, neurologist. 
• A comprehensive thorough examination, which is carried out either on an outpatient basis or in a hospital. The most effective is in-patient examinations under the supervision of the attending physician, since this method allows us to see the symptomatic dynamics more objectively. 
• Elimination of concomitant somatic diseases, which are often primary and trigger for the manifestation of the VSD. 
• An obligatory condition is observance and fulfillment of all the recommendations of the doctor, no matter how extensive they may be. Vegeto-vascular dystonia is treated for a long time, at least one year, so the patient needs to gain strength, patience and confidence in the successful outcome of therapeutic actions. 
• An obligatory condition is a psycho-emotional correction of the personality traits of the patient. Long courses of psychotherapeutic sessions are effective.

Vegeto-vascular dystonia is not a fatal disease, as a rule, this syndrome is successfully supervised in case of accurate diagnosis and correctly selected treatment.