Vestibulo-atactic syndrome

Vestibulo-atactic syndrome is not a separate disease. This diagnosis is made by doctors when the patient has a certain set of certain symptoms. Separately, these symptoms can indicate a variety of diseases, and in combination they allow us to diagnose pathology, which is caused by various disorders in the vascular system of the body.

Causes of the vestibulo-atactic syndrome

What can cause vestibulo-atactic syndrome? It is impossible to answer this question unambiguously, since various events and diseases can precede the appearance of this pathology:

• Dysfunction of the cerebellum.
• Chronic circulatory failure.
• Various pathologies of the brain.

And:

• Children's cerebral palsy (cerebral palsy).
• Dropsy of the brain (hydrocephalus).
• Dying (atrophy) of cells of the brain.
• Hypertensive disorders.
• Atherosclerosis.
• Malignant or benign brain tumors.

Symptoms of ataxia often accompany multiple sclerosis - a disease that almost does not respond to therapy, affecting the brain and spinal cord.

In 25% of cases, vestibulo-atactic syndrome is observed in patients after removal of an extracerebral tumor.

Risk factors

Risk factors include:

• Birth trauma in newborns.
• Various injuries of the skull.
• Complicated infectious diseases.
• Acute or chronic drug intoxication.
• Elevated background radiation.
• Lack of vitamins and trace elements in the body.
• Bad habits.
• Heredity.

As you can see, the vestibulo-atactic syndrome accompanies many diseases, so do not underestimate it. Symptoms of this pathology are only the consequence of more serious diseases associated with brain dysfunction, which in neglected forms can lead to disability and even to death.

In some cases, the appearance of signs of ataxia, in other words, a violation of the motor functions of the body, may indicate age-related disorders in the work of the musculoskeletal and vestibular apparatus.

[1], [2]

Pathogenesis

In the practice of a neuropathologist, the vestibulo-atactic syndrome is most often observed in patients with cerebral ischemia, when the brain receives insufficient oxygen because of a violation of blood flow.

The pathogenesis of this pathology includes the lack of blood flow in the vertebro-basilar system, which unites the vertebral and central (base) arteries of the brain, the violation of blood circulation in the brain stem structures, as a result of which their energy supply and connections with other parts of the central nervous system (CNS) are disrupted.

Stem brain formations are sensitive to hypoxia (oxygen starvation of systems and organs), which causes a large prevalence of vestibular-ataxic syndrome and also the variety of forms and manifestations of this pathology in cerebral ischemia.

The clinical picture can vary depending on the cause of the disease, age and condition of the patient. For example, in elderly patients, the disruption of the central part of the vestibular analyzer is often combined with the lesion of its peripheral part, which forms a peculiar picture of the pathological disorder.

[3], [4], [5]

Symptoms of the vestibulo-atactic syndrome

This pathology - a combination of motor and vestibular disorders due to violations of the general and cerebral circulation. It is quite common, many of its symptoms have been noticed in itself, without giving them much importance. If, when walking, a person begins to feel dizzy, he throws from side to side, coordination of movements is disturbed - this is an occasion to immediately consult a doctor.

What constitutes a vestibulo-atactic syndrome and what are its causes we have figured out. What are the signs and complaints of patients that enable the neurologist to diagnose ataxia?

Ischemic disorders in the work of the brain are dangerous because in the early stages they can simply not be noticed, since the first symptoms that appear can correspond to various disorders of the patient's health and condition. A person can simply not pay attention to individual cases of malaise. This makes it difficult to timely diagnose and treat diseases that are the companions of the vestibulo-atactic syndrome.

The first signs of the initial stage of the disease are:

• Frequent dizziness, especially when walking.
• Flicker and "flies" before the eyes.
• Nausea and vomiting.
• Headache.

In later stages, motor disorders appear:

• Loss of balance.
• Throwing from side to side.
• Falls.
• Involuntary twitching of the eyelid

In addition, many patients complain about:

• Deterioration in the quantity and quality of sleep.
• Chronic fatigue, loss of strength.
• Noise or ringing in the ears.
• Unpleasant sensations with prolonged preservation of the same position of the body.

Cephalgic syndrome

The cephalgic vestibulo-atactic syndrome, in other words the headache, is a disorder of a person's health, which not only brings discomfort to our life, but can also be a warning signal about more serious disorders of the functioning of the body, such as brain and CNS diseases. Especially vigilant among doctors is the growing prevalence of this condition, both among the adult population and among children and adolescents.

Cefalgia is perhaps the most common symptom and sign of many pathological states of the brain. Its occurrence is associated with oncological, inflammatory, infectious diseases, metabolic disorders, vascular, neuralgic diseases. Even the presence of bad habits and disruption of the daily routine can cause acute cephalgic syndrome.

The variety of causes that cause this disorder makes it very difficult to diagnose cephalgia as a symptom of a particular disease. After all, eliminating the headache should be one of the stages of treatment of the disease that caused it, and not a separate process.

The cephalgic syndrome can be caused both by usual nervous overstrain, fatigue, and to be one of the basic symptoms of a vestibulo-atactic syndrome connected with serious diseases of a brain. Therefore, it is necessary to take responsibly any of its manifestations in order to protect oneself from the development of severe forms of the disease with irreversible neuro-psychic processes.

[6], [7], [8]

Dyscirculatory encephalopathy with vestibulo-atactic syndrome

Vestibulo-atactic syndrome may be a harbinger of such a serious disease as discirculatory encephalopathy.

The brain is the main organ of the central nervous system, which is responsible for the vital activity of the organism and controls its functioning. It consists of nerve cells that perform different functions and are responsible for certain actions, such as speech, thinking, movement, memory, etc.

For the normal functioning of the brain, oxygen is needed, which helps to break down glucose and produce the energy necessary for work. With insufficient intake of oxygen supplied by the blood stream, and toxic effects on the brain cells of certain substances, nerve cells begin to die, causing certain disruptions in the work of the brain depending on which part of the brain is affected.

Such disorders in the work of the brain are called brain encephalopathy. The most common form of it is discirculatory encephalopathy with a vestibulo-atactic syndrome, which in the last 3 stages of the disease can lead to gross violations of memory, intelligence and thinking in general (dementia).

Forms

Depending on the stage of the disease and the degree of its progression, 3 types of atactic pathology are distinguished: mild, moderate and severe ataxia. Each of the stages is characterized by a specific set of symptoms indicating how serious the situation is. Knowledge of this information helps to diagnose vestibular-atactic disorder at any stage of it and on time to initiate further diagnosis and treatment of associated pathological conditions.

Light vestibulo-atactic syndrome does not have pronounced specific symptoms. Patients notice slight changes in gait and coordination of movements.

With a moderate degree of severity of the vestibulo-atactic syndrome, disruptions in motor functions and coordination of movements are already more noticeable. Staggering gait, throwing from side to side, expressed problems with coordination are all symptoms of moderate ataxia. They are added problems with the vestibular apparatus: headache, dizziness, nausea, nervous reactions of the eye and its environment.

The marked vestibulo-atactic syndrome is the most severe stage of the disease. At this stage, it is difficult for a person to move or hold a certain position, the gait is completely reminiscent of a person's movement in a state of strong intoxication, which necessitates constantly carrying a certificate confirming the diagnosis, if detained by police officers who take such patients for drunk or drug addicts.

As a rule, at this stage of the disease, patients are disable. But the possibility of establishing disability depends not so much on the presence of a particular stage of the disease, but on the persistence and severity of its symptoms.

As we see, the more advanced the disease, the more serious the symptoms are inherent in it. Vestibulo-atactic syndrome with insufficient attention can have various complications and unpleasant (sometimes tragic) consequences. These are trauma at falling, spasms of cerebral vessels, development of cephalgic syndrome with a constant headache, paralysis, stroke, etc.

[9], [10], [11]

Diagnostics of the vestibulo-atactic syndrome

Diagnosis of the vestibulo-atactic syndrome involves multiple examinations of the body, aimed not only at diagnosing this vestibular disorder, but also in identifying the possible cause of the syndrome itself, the concomitant diseases.

For accurate and correct diagnosis is used differential diagnosis, which, in addition to collecting anamnesis, neurologic examination of the patient, taking into account his complaints and testing, includes methods of laboratory and instrumental diagnostics.

Laboratory tests for suspected vestibular ataxia include the following tests:

• Blood test for biochemistry
• General urine analysis
• Biopsy of cerebrospinal fluid

A clearer picture of the disease is provided by instrumental diagnostics, consisting of:

• Magnetic resonance and computed tomography, which can detect neoplasms in the brain
• Electroencephalography for determining the bioelectrical activity of the brain
• Echoencephalography, which allows to determine the state of the cerebrospinal fluid system responsible for the well-being of a person, and also to detect such entities as hematoma, tumor or brain abscess.
• Rheoencephalography, which helps assess the condition of blood vessels and blood circulation in them.
• Rhengenography of the skull and spine.

Additional information on the severity of the disease can be obtained by using for rapid diagnostic tests:

• A Romberg sample for evaluation of cerebellar function and static ataxia.

The patient becomes in the right position: legs together, arms forward, fingers arranged. He is asked to close his eyes. If a person begins to stagger, loses balance, this indicates certain irregularities in the functioning of the functions of the cerebellum. Deviation of the fingers on the hands indicates how much the hemisphere of the brain is affected.

• Palcose test

The patient is asked to close his eyes and alternately reach the tip of the nose with the index fingers of both hands. The presence of vestibulo-atactic syndrome is determined by tremors in the hands, inaccurate hits.

• Knee-joint test

From the "lying on the back" position, people are asked to lift one leg and touch it to the knee of the other leg, then lower the leg, passing the heel along the shin of the second leg. The defeat of the cerebellum, which is responsible for coordination and balance, causes certain difficulties in the performance of this task.

The diagnosis is made by a specialist doctor or a board of doctors on the basis of the prescribed studies.

[12], [13]

Treatment of the vestibulo-atactic syndrome

Treatment of vestibulo-atactic syndrome is carried out on the basis of diagnostic examination. It's not just medicines and physiotherapy. To obtain good results in the treatment of this disorder, patients are recommended to reconsider their attitude to the issue of health by conducting a healthy lifestyle with the abandonment of bad habits and a full-fledged diet.

Since one of the main causes of vestibular disorders is high blood pressure, the first stage of therapy is to lower the cholesterol in the blood (statins - Atoris, Rosuvastatin) and blood pressure (antihypertensive drugs - Captopril, Enalapril, etc.).

Priority in the treatment of vestibulo-atactic syndrome is given to such drugs:

Actovegin

Produced in the following forms:

• Solution for injection - ampoules of 2 ml, 5 ml and 10 ml.
• Solution for infusions - a bottle of 250 mg.
• Tablets - 200 mg.

Actovegin is recommended to be used orally for 1-2 tablets. Three times a day before eating, without chewing the tablet, squeezed a little water.

The initial recommended dosage for injections is 10-20 ml and depends on the severity of the disease, then the dosage should be reduced to 5 ml once a day or several times a week.

For the dropper use 250 ml of solution for infusion at a rate of 2-3 ml per minute once a day (10-20 droppers per course).

Precautions : It is undesirable to use the drug during the period of bearing and breastfeeding.

When injected, there is a risk of angioedema angioedema.

Adverse reactions : Urticaria in the form of itching and redness of the skin, hyperhidrosis (excessive sweating), slight chills or fever.

Mildronate

Produced in the following forms:

• Solution for injection - ampoules 5 ml.
• Capsules (tablets) - 250 mg, 500 mg.

In the chronic course of the disease, 0.5-1 g (1-2 tablets of 500 mg or 2-4 tablets of 250 mg) per day for 4-6 weeks.

In the acute phase - intravenously 0.5 g once a day for 10 days.

It is not recommended to use during pregnancy and lactating mothers. It is used with caution in the pathological conditions of the liver and kidneys. Contraindicated in children under 18 years of age, patients with increased intracranial hypertension, intracranial neoplasms and venous outflow.

It should be taken with caution in conjunction with other medications, as it tends to enhance the effect of many of them.

Side effects : Often does not cause life-threatening adverse reactions.

Sometimes there are allergic reactions, changes in blood pressure, excitation, increased heart rate, dyspepsia: heartburn, belching, diarrhea, etc.

Mexidol

Produced in the following forms:

• Solution for injection - 2 ml, 5 ml
• Tablets 125 mg

Mexidol is taken orally on one or two tablets three times a day for 2-6 weeks.

Injection drug begins to enter from a dose of 0.1 g 1-3 times a day, gradually increasing the dosage. The maximum is 0.8 g.

Precautions : The drug is contraindicated in the presence of allergies to vitamin B6, childhood, during childbearing, breastfeeding, as well as severe violations of the functional state, organic lesions of the liver and kidneys.

When an overdose causes drowsiness, affects the response rate of the reaction.

Side effects : Allergic reactions of varying intensity are possible, skin reactions in the form of hives, itching, skin flushing, nausea, sometimes vomiting, a feeling of dryness in the oral cavity.

In general, the drug is well tolerated by most patients.

Additionally, the following can be assigned:

Cavinton

• Tablets - 5 mg, 10 mg.

Cavinton for this pathology is taken orally at 5 mg (1 tablet 5 mg or ½ tablets 10 mg) 2-3 times a day for 1-8 weeks.

Contraindicated in pregnancy and breastfeeding. It is not prescribed for hypersensitivity to the components, acute phase of cerebral hemorrhage, severe severity of IHD (unstable angina) and conduction disorders of the heart rhythm (arrhythmias).

Cavinton can influence the speed of the response.

Adverse reactions : Tachycardia, irregularities in the functioning of the heart, insignificant skin pallor, signs of allergy (itching, redness of the skin), sleep quality disorder (insomnia, night terrors), vertigo (dizziness), low intensity headache, migraine attacks, hyperhidrosis, fatigue and weakness, nausea, sometimes vomiting, heartburn, a feeling of dryness in the mouth.

[14]

Trental

Forms of issue:

• Solution for injection - ampoule 5 ml.
• Tablets - 100 mg.

Method of application :

• Droppers - 100-600 mg once or twice a day.
• Intravenous injection of 100 mg once or twice a day. The patient should be in a horizontal position.
• Inside take two or four tablets 2-3 times a day after meals, without chewing, washing with water.

Precautions : It is contraindicated to use trental in pregnancy and breast-feeding, peptic ulcer of stomach and duodenum, propensity to gastrointestinal hemorrhages, strokes of different genesis, hemorrhages in the retina of the eye.

It is used with caution in severe forms of cardiovascular pathological conditions, propensity to abrupt changes in blood pressure, gastric ulcer, in the postoperative period.

Side effects : Usually well tolerated by patients, but occasionally there are such disorders: nausea, sometimes the urge to vomit, stool (constipation or diarrhea), lowering blood pressure, palpitations, headache, migraine attacks, vertigo, irritability, emotional instability, sleep quality disorder (insomnia, nightmares), skin allergic reactions in the form of hyperemia and skin itching, angioedema Quincke.

The complex therapy shows the use of drugs from the group: vitamins and trace elements, for example from the Vitrum series.

Physiotherapy treatment usually complements the medication and includes therapeutic baths, massage and therapeutic gymnastics, oxygen therapy and other physiotherapy procedures as indicated by the doctor. Sometimes it is used acupuncture and hypnosis.

Alternative treatment of vestibulo-atactic syndrome is carried out in conjunction with medication. Consider several recipes that will help to remove the main symptoms of the disease:

• To dilute blood and increase blood flow in the vessels of the brain, we use garlic.

Large heads of garlic, peel, grind into a meat grinder and put for 3 days in a dark cool place. Strain and mix 1: 1: 1 with honey and lemon juice. Take 1 tbsp. Before bedtime.

• At increased pressure.

Corn stigmas (40 g) and melissa (20 g) are mixed with lemon juice and pour 1 liter of boiling water. Insist 1 hour.

Strain and take half a cup 3 times a day half an hour after a meal.

• To improve cerebral circulation.

½ kg of cranberries, 150 g finely grated horseradish and 350 grams of honey mixed thoroughly. Take every day for 2 tsp. After eating, washing down with tea or water.

• To clean the vessels.

1 tbsp. L. Berries juniper pour 200 grams of boiled water at room temperature. Infuse 8-10 hours. Take 1 tbsp. L. 3-4 times a day. The course is 1,5-2 months.

Good results in the treatment of vestibulo-atactic syndrome are treated with herbs. Doctors of alternative medicine offer several recipes:

• With dizziness and noise in the ears.

Mix equal parts of herb thyme, motherwort, mint and cucumber grass flowers. Art. No. L. Mix 450 g of boiling water and insist for 2 hours. Thoroughly strain and take ½ cup 2 times a day after meals.

• With dizziness and headaches.

1 tbsp. L. Dry flowers of spring primrose to pour 1 tbsp. Boiling water and infuse for 30 minutes. Drink warm instead of tea.

• With headaches.

2-3 tsp. Mint grass pour a glass of boiling water. Insist half an hour. Take equal parts during the day, before straining.

With intolerance of synthetic drugs and various contraindications, homeopathy comes to the rescue. From homeopathic medicines showed good efficacy:

Gold iodine

Dosage: 5 granules twice a day under the tongue 20 minutes before meals or one hour after a meal for 2 months.

Precautions : Gold iodine is contraindicated with individual hypersensitivity to the components of the drug, bearing and breastfeeding. It is undesirable to use in childhood.

Side effects : Occasionally there are allergic reactions: skin rash, itching sensation.

Hypertensin

Take the drug for five granules in the morning and evening for half an hour before meals.

In acute conditions, three to five pellets every 10-15 minutes.

Precautions : Contraindicated in case of hypersensitivity to the drug.

There were no side effects.

Venartin

The usual dosage is 7 granules 2-3 times a day under the tongue half an hour before meals

The course of treatment is 1 month with repetition in 1-2 weeks.

Precautions : Do not combine with food intake, various teas, including herbal, nicotine, alcohol, camphor-menthol preparations and essential oil-based inhalations.

There were no side effects.

Tanakan is a preparation based on the ginkgo biloba plant.

Dosage:

• Tablets take one piece three times a day with food, washed down with water.
• A solution of one dose three times a day during meals, previously dissolved in 0.5 tbsp. Water.

Duration of the course is 1-3 months.

Precautions : Contraindicated in children under 18 years of age, used only for individual indications.

It is not applied during the period of gestation and breastfeeding, with peptic ulcer disease, erosive gastritis, lactose intolerance, acute myocardial infarction, unstable angina and with reduced blood coagulation.

Do not apply simultaneously with Warfarin and Aspirin.

Side effects : Allergic reactions are possible, reduced blood clotting, gastrointestinal bleeding, eczema, digestive disorders (dyspepsia), diarrhea, constipation, nausea, sometimes vomiting, headaches and migraine attacks, tinnitus, vertigo.

If the proposed methods do not bring the desired results, surgical treatment is prescribed. The operation on the vertebral artery is carried out by doctors of the highest category, since it refers to complex surgical interventions. Nevertheless, it is low-traumatic and yields good results.

Prevention

The first principle of prevention of vestibulo-atactic syndrome is the prevention of the development and progression of cerebral ischemia - the main cause of this syndrome. When signs of motor and vestibular disorders appear, you should immediately consult a doctor. Do not ignore the recurring headaches that can be the cause of serious illnesses.

But the most important thing is a healthy, active way of life, rejection of bad habits, fight against obesity. It is also necessary to limit stay in the sun, avoid stressful situations (especially for patients at risk), comply with prescriptions of doctors in the presence of certain diseases.

[15], [16]

Forecast

With timely access to a doctor and appropriate treatment, the prognosis of the vestibular-atactic syndrome is generally favorable. Difficulties in treatment can arise only in elderly patients due to irreversible changes in the body and in patients with neoplasms in the brain that require surgical intervention.

[17], [18]