Hypothalamic syndrome: treatment in Russia, Saratov, how to treat pubertal hypothalamic syndrome. Hypothalamic syndrome of puberty: what it is, symptoms and treatment in boys and girls

Hypothalamic syndrome of puberty is a different combination of symptoms that develops in adolescence, when hormonal changes occur throughout the body. It develops as a result of a complex of reasons leading to disruption of the normal relationship between the “guiding” endocrine glands - the hypothalamus, pituitary gland - and the structures connecting them (limbic-reticular complex). It is characterized by a different set of autonomic, endocrine and metabolic disorders. The disease is not always completely cured, but with the help of complex therapy it is possible to achieve significant improvement quality of life.

Causes of the disease

The disease develops between 10 and 20 years of age, more often in boys.

The exact cause of the disease is unknown. It is believed that hypothalamic syndrome develops due to the influence of the following factors on the child’s body:

hypoxia of the fetus and/or newborn;
malnutrition;
preeclampsia;
chronic foci of infection in the child’s body: tonsillitis, caries, bronchitis.

Predispose to development hypothalamic syndrome such states:

early puberty;
obesity;
job change thyroid gland.

The mechanisms that lead to the development of pubertal hypothalamic syndrome are “turned on” under the influence of:

teenage pregnancy;
traumatic brain injury;
mental trauma;
exposure to the hypothalamic region of viruses (especially influenza virus), bacteria (streptococcus), malarial plasmodium;
radiation or other unfavorable environmental factors that affected the child’s body during puberty.

As a result of the influence of all these factors, the interaction between the hypothalamus, the limbic-reticular system (several brain structures) and the pituitary gland is disrupted. The work of the hypothalamus itself changes, which is not only the main endocrine gland, but also:

responsible for thermoregulation;
regulates the functioning of blood vessels;
coordinates vegetative functions;
ensures the constancy of the internal environment of the body;
responsible for the feeling of hunger and satiety;
dictates sexual behavior.

Forms of the disease

Hypothalamic syndrome may consist of a combination various symptoms, which can be combined into groups. Depending on this, they distinguish following forms syndrome:

neuromuscular;
thermoregulation disorders;
vegetative-vascular;
neurotrophic;
hypothalamic epilepsy;
endocrine-neuro-metabolic disorders;
form with a motivation disorder.

Symptoms

The main symptom of the disease is obesity: fat is deposited not only on the abdomen, but also on the lower and upper extremities. Boys develop a wide pelvis, a plump white-skinned face, an increase in mammary glands due to the deposition of fat in them. The size of the genital organs is not reduced. They have a desire to start sexual relations early.

Girls have excess male pattern hair, their nipples are more colored dark color, and appear on the face juvenile acne. The menstrual cycle is disrupted.

Other signs are also observed:

headache;
even though teenagers look like more adults and healthy people, they get tired very quickly;
pink stretch marks on the skin of the shoulders, abdomen, buttocks and thighs;
lipomas, warts, vitiligo, skin warts;
brittle and thin nails;
sweaty hands, they are very cold and cyanotic;
gluttony of a teenager, especially at night;
mental disorders: depression, rudeness, panic attacks, isolation of a teenager;
thirst;
excretion of a large volume of urine;
there may be lethargy, drowsiness;
where there is no abundance sweat glands, skin is rough, dry. The driest skin is observed in the elbows, neck, and in areas of friction with clothing;
an unreasonable morning increase in temperature with its decrease to normal in the evening;
tendency to allergies.

The syndrome can occur paroxysmally, in the form of one of the types of crises:

Vagoinsular: feeling of hot flashes, nausea, decreased heart rate, nausea, sweating, feeling of lack of air, weakness, diarrhea, excessive urination;
Sympathoadrenal, which often develop after “precursors” - headache, lethargy, tingling in the heart. Then the crisis itself develops: rapid heartbeat, fear of death, fever and blood pressure.

Juvenile basophilism is one of the forms of hypothalamic pubertal syndrome, in which increased production in the pituitary gland of the hormone ACTH. With this disease, obesity will also be observed: “lower” obesity in girls, female pelvis and enlarged mammary glands in boys. At the same time, girls will have well-developed secondary sexual characteristics, while boys will be taller than their peers.

How is the disease diagnosed?

In order to make a diagnosis, you need:

examination by a pediatric endocrinologist;
determination of the level of ACTH and cortisol in plasma depending on the time of day;
study of glucose tolerance;
determination of the content of prolactin, luteinizing and follicle-stimulating hormones, TSH;
MRI of the brain;
Dopplerography of brachiocephalic vessels;
Ultrasound of the pelvic organs;
Ultrasound of the thyroid gland.

Treatment

Hypothalamic syndrome of puberty can be treated over a long period of time with diet and drug therapy.

Diet principles:

calories should be slightly less than needed for a given basic metabolism;
limit carbohydrate intake and almost eliminate animal fats;
5 meals a day;
you can’t go hungry;
if there is impaired glucose tolerance, use fructose, xylitol or sorbitol.

Drug therapy:

Taking fat-soluble vitamins is mandatory.
To reduce testosterone levels, a drug with a diuretic effect, Veroshpiron, is prescribed.
Drug correction of thyroid function is carried out.
If glucose tolerance is impaired, tableted glucose-lowering drugs are used.
In case of violation menstrual cycle girls receive treatment with sex hormones depending on the initial level of progesterone and estriol.
If prolactin levels are elevated, bromocriptine is used.
For obesity stages III and IV, anorectics are used.
If blood pressure is elevated even when following a salt-free diet, diuretics are prescribed, drugs such as Enalapril, Captopril or Phenigidine, Nifedipine.
If necessary, anticonvulsant therapy and crisis prevention are carried out.

To achieve the effect, it is also necessary to change the lifestyle and sanitize foci of chronic infection. You need to undergo a course of acupuncture and sanatorium-resort treatment.

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

ICD-10 code

E23.3 Hypothalamic dysfunction, not elsewhere classified

Causes of 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 states of shock);
change hormonal levels in pregnant women;
birth defects development of the hypothalamus;
brain hypoxia (consequences of suffocation, drowning).

Pathogenesis

Due to the fact that the hypothalamus regulates most important functions body, including maintaining the constancy of its internal homeostasis, then any pathological conditions in the hypothalamus can lead to malfunctions in the functioning of almost any organs or systems and manifest themselves as autonomic disorders.

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

Symptoms of hypothalamic syndrome

The first signs of this pathology may be severe fatigue and weakness. Further, we can indicate the following, the most common symptoms of this disease are considered to be disturbances in sleep and wakefulness, thermoregulation of the body, body weight, palpitations, excessive 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, and can occur paroxysmally in the form of crises.

A provocative factor may be a change in weather conditions, the beginning of the menstrual cycle, strong emotional or painful effects. In the medical classification, there are two types of hypothalamic crisis: vasoinsular and sympathetic adrenal. 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 (decreased heartbeat) and a feeling of cardiac arrest, increased peristalsis is possible intestines, frequent urge to urinate. During sympathetic-adrenal crises, the following symptoms can be noted: pallor skin, due to narrowing blood vessels, high blood pressure, tachycardia (accelerated heartbeat and increased pulse), chill-like tremors (body tremors), decreased body temperature (hypothermia), obsessive feeling of fear.

Hypothalamic syndrome during puberty in children

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

To clarify the diagnosis, it is necessary to carry out a series of additional research and consultations with various medical specialists. The symptoms of hypothalamic syndrome of the puberty period are 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 split five meals a day and reducing the caloric content of food. And drug treatment, which depends on the etiology of the disease, and may include medicines, which help improve blood circulation in the vessels of the brain, diuretics, vitamins, hormone therapy, anticonvulsants. With timely, proper treatment, the prognosis of the disease is good and in most cases complete recovery is observed, with the exception of very rare and severe forms of the disease. In such cases, treatment lasts for years and provides significant relief. physical condition and adaptation.

The risk group includes adolescents 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, narcotic drugs and doping.

Neuroendocrine form of hypothalamic syndrome

This type of disease is characterized by disturbances in protein, fat, carbohydrate, as well as water salt metabolism and is manifested by either bulimia (gluttony) or dramatic weight loss (anorexia). Women may experience menstrual irregularities, and men may experience decreased potency. In the pathological condition of the thyroid-stimulating lobe of the pituitary gland, symptoms of hypothyroidism (thyroid hormone deficiency) and toxic diffuse goiter(increased production of thyroid hormones). The causes of this phenomenon may be traumatic brain injury, intoxication of the body and neurointoxication. Therefore, treatment of this form of the disease consists of eliminating and curing the main cause of the pathology (if the disease is secondary), detoxification of the body, vitamin therapy, urinary and absorbent medications, anti-inflammatory drugs, the use of central adrenergic agents (reserpine, raunatin, aminazine), cholinomimetic drugs (anticholinesterase substances) .

Hypothalamic hypersexuality syndrome

Some patients suffering from hypothalamic syndrome may experience pathologically increased sexual attraction or hypothalamic hypersexuality syndrome. The course of the disease manifests itself in the form of crises. At times, a woman experiences a strong libido, during which specific sensations arise in the genitals and their increased sensitivity. And strong sexual arousal can increase until orgasm. During sexual intercourse, such women experience several orgasms (multiorgasms). To the above symptoms you can add a feeling of heat, false urges to urination and feeling full Bladder, as well as painful sensations in the lower abdomen and back. Women with this pathology achieve orgasm much faster and easier healthy women(even during erotic dreams), the feeling of satisfaction either does not occur or occurs only short period time. Then they again experience strong sexual arousal. Sexual arousal occurs in fits and starts, in the form of crises. In this case, other symptoms of hypothalamic syndrome are present: 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, anxiety and fear. The disease can lead a woman to antisocial behavior and promiscuous sex life.

When diagnosing, objective data and anamnesis are taken into account. 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 tone parasympathetic system. If crises are accompanied by epilepsy, anticonvulsants and tranquilizers, such as Elenium and Seduxen, are prescribed. For mental disorders, the use of psychotropic drugs. During cyclical attacks of hypersexuality, the use of synthetic progestins is used: bisecurin and infekundin.

Hypothalamic syndrome with impaired thermoregulation

The hypothalamus plays an important role in temperature regulation of the body. Patients have a violation of skin temperature, increased body temperature from subfebrile to febrile, temperature fluctuations intensify during crises. During the period between attacks, body temperature can be either normal or low. It is necessary to pay attention to patients with a prolonged period of low-grade fever and without obvious signs diseases and pathologies of organs. In such patients, a number of other symptoms characteristic of hypothalamic syndrome can be found: bulimia, obesity and thirst. This is important factor for differential diagnosis of this disease. An important symptom of impaired thermoregulation 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 feel cold, chilly, wrap themselves in warm clothes, and close the windows tightly even in the warm season.

Forms

By etiology this syndrome divided into both primary (brain diseases with damage to the hypothalamic region) and secondary (resulting from diseases and pathological processes internal organs and systems). By main clinical signs The syndrome in medicine is divided into the following forms:

neuromuscular;
vegetative – vascular;
neurotrophic;
disruption of the process of sleep and wakefulness;
violations of the thermoregulation process;
hypothalamic or diencephalic epilepsy;
pseudoneurasthenic and psychopathological.

Based on clinical signs, one can also distinguish variants of syndromes with dominant constitutional obesity (in the form of impaired fat and carbohydrate metabolism), hypercortisolism, neurocirculatory disorders, and germinal disorders.

According to severity in medical practice The syndrome occurs in mild, moderate and severe forms of the disease. Characteristic development It can be progressive, as well as stable, regressive and recurrent. During puberty (puberty), this pathology can accelerate sexual development and slow it down.

Diagnosis of hypothalamic syndrome

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

Differential diagnosis

For differential diagnosis, MRI data, encephalogram and tomogram of the brain, Zimnitsky test, and ultrasound examination of the internal secretion 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 of hypothalamic syndrome

For appointment proper treatment It is imperative to establish the causes of this disease. Next, 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 tumors, infections and viruses, injuries and diseases of the brain). To prevent sympathetic adrenal crises, the following drugs are prescribed: pyrroxan, eglonil, bellataminal, grandaxin. Antidepressants are prescribed. For neuroendocrine disorders, hormonal drugs are prescribed. In case of metabolic disorders, diet therapy and appetite suppressants are prescribed.

Pyrroxane – pyrroxane hydrochloride main active substance in a dosage of 0.015 g. In the preparation. Available in tablets of 15–39 mg and in ampoules of 1 ml.

It is used for panic and depressive syndromes, allergic reactions and dermatoses, motion sickness, hypertensive crises of the sympathoadrenal type, and dysfunction of the autonomic system.

Precautionary measures: use with caution in elderly people; After the course of treatment, monitor blood glucose levels.

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

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

Used when depressive disorders, schizophrenia, migraines, encephalopathy, dizziness.

Precautions for use: while using the drug, do not drink alcohol, take Levodol and 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 are: do not prescribe to pregnant women, during lactation, to persons whose work is related to the speed of reaction.

Side effects: rare. Possible dry mouth, blurred vision, drowsiness.

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

Precautions: use caution in patients with mental retardation, the elderly, and those 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 advises using decoctions and tinctures medicinal herbs. To reduce the feeling of hunger, you can use a decoction of burdock roots. They're preparing it in the following way: Boil 10 grams of burdock root in 300 ml of water for 15 minutes. Let cool, strain and take 1 tablespoon 5 – 7 times a day.

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

Using traditional medicine methods, we must not forget that it is necessary to continue drug treatment, since herbal decoctions cannot fully replace medications. 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 drugs help the body fight the consequences and complications of hypothalamic syndrome. So, for constitutional obesity, you can prescribe homeopathic remedies that help fight increased appetite: Ignacy, Nux Vomica, Anacardium, Acidum phosphoricum. For lipid metabolism disorders Pulsatilla, Thuja, Graffitis, Fucus. Drainage preparations – Carduus marianus, Lycopodium.

Ignacy is a homeopathic medicine. Available in the form of drops (30 ml bottle), or homeopathic granules (10 g in a package)

It has a sedative (calming), antispasmodic, antidepressant effect on the body. Directions for use: adults, 10 drops under the tongue or orally, pre-dissolved 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 Ignacy.

Precautionary measures: if there is no therapeutic effect, consult a doctor and stop using the drug.

Pulsatilla - homeopathic granules.

This drug is based on the herb lumbago (sleep - grass). 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: if you are hypersensitive 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 an hour before meals or an hour after meals, 8 granules under the tongue 5 times a day.

Side effects: digestive disorders and allergies may occur; do not use with mint preparations; avoid drinking alcohol and coffee.

Precautions: individual intolerance, pregnancy and lactation.

Lycopodium is a homeopathic cereal in 10 g jars. and tincture in glass bottles of 15 ml. The granules are applied sublingually, the tincture is dissolved in a small amount of water and placed under the tongue for half a minute.

Side effects: a slight exacerbation of the disease is possible.

Precautionary measures: refrain from brushing your teeth with menthol toothpastes.

Physiotherapy for hypothalamic syndrome

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

Consequences and complications, prevention and prognosis for hypothalamic syndrome.

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

When vegetative vascular forms syndrome, blood pressure may fluctuate, and increased blood pressure may be complicated by a hypertensive crisis.

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

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

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

TO preventive measures syndrome may include maintaining a healthy active image life, struggle with bad habits, correct 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 hypothalamic syndrome?

It is possible to lose weight with this pathology if you approach this problem comprehensively. First of all it is necessary low calorie diet, fractional meals, which involve eating five times a day in small portions. To combat overweight it is necessary to engage in physical education and sports. Intensity physical activity must be supervised by a doctor. Walks in the fresh air, healthy sleep. To reduce appetite, you can resort to medications, as well as traditional medicine methods.

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

IN Lately The prevalence of hypothalamic pubertal syndrome (HPS) has doubled. The problem of the medical and social significance of hypothalamic syndrome (HS) is determined by the young age of the patients, the rapidly progressing course of the disease, and severe neuroendocrine disorders, which are often accompanied by reduced or complete loss of performance. HS calls serious violations reproductive health girls, causes the development of endocrine infertility, polycystic ovary syndrome, obstetric and perinatal complications in the future.

The hypothalamic-pituitary neurosecretory complex (HPGNSC) is the highest regulator of the body, which coordinates the endocrine regulation of metabolism with the work of the autonomic nervous system and emotional and behavioral reactions. Disruption of the interaction of individual parts of the HNSCC leads to the development of hypothalamic syndrome in children and adolescents, and disruption of the regulatory function of the HNSCC leads to activation of the glucocorticoid function of the adrenal cortex and is accompanied by disorders of fat and carbohydrate metabolism.

The hypothalamic-pituitary complex includes:

hypothalamus - a section of the diencephalon and the central circuit of the limbic system;
neurohypophysis - consists of two parts; the anterior part is the median eminence and the posterior part is the actual posterior lobe of the pituitary gland
adenohypophysis - anterior lobe of the pituitary gland.

With pathology of the hypothalamic region, a symptom complex arises, which is characterized by vegetative, endocrine, metabolic and trophic disorders and which depends on the location of the lesion of the hypothalamus (in the posterior or anterior section).

The hypothalamus is the part of the brain where the integration of nervous and humoral functions occurs, which ensures the immutability and stability of the internal environment - homeostasis. The hypothalamus plays the role of a higher vegetative center, regulates metabolism, thermoregulation, the activity of blood vessels and internal organs, eating and sexual behavior, and psychological functions. In addition, the hypothalamus controls physiological reactions, so its pathology can disrupt a certain function and manifest itself as a crisis of a vegetative nature.

Hypothalamic syndrome of puberty is a neuroendocrine syndrome of age-related changes in the body with dysfunction of the hypothalamus, pituitary gland and other endocrine glands. Synonyms: obesity with pink stretch marks; Simpson-Page syndrome; pubertal basophilism; basophilism of puberty; juvenile hypercortisolism; pubertal hypercortisolism; Juvenile Cushingoid; functional cushingoid; pubertal-adolescent dispituitarism; transient juvenile diencephalic syndrome, juvenile hypothalamic syndrome of puberty; hypothalamic syndrome of puberty; diencephalic hyperandrogenism (ICD-10 code - E.33.0).

This is the most common endocrine metabolic pathology in adolescents, the frequency of which has increased significantly in recent years. HSPP often begins during puberty at the age of 10-18 years ( average age- 16-17 years old). It is generally accepted that boys get sick more often than girls.

Hypothalamic syndrome of puberty is a neuroendocrine syndrome that occurs during puberty or postpuberty as a result of functional endocrine disorders. Mostly it's hard to figure it out main reason, since clinical manifestations in manifest form often occur years after exposure to the causative factor.

GSPP is a disease in which, as a rule, secondary obesity is formed, that is, not associated with leptin deficiency. However, GSPP can develop primarily (in adolescents with normal body weight) and secondary (in adolescents with primary leptin-dependent obesity). Risk factors for the development of primary HSPP:

pathological course of pregnancy in the patient’s mother (fetoplacental insufficiency, toxicosis or gestosis in the first and second half of pregnancy)
complicated pregnancy ( acute diseases and exacerbation of chronic diseases of the mother during pregnancy, poisoning, intoxication, etc.);
pathological or complicated childbirth ( premature birth, weakness labor activity, umbilical cord entanglement, etc.);
birth injuries (asphyxia, traumatic brain injury)
perinatal encephalopathy
brain tumors that compress the hypothalamic region;
neurotoxicosis in young children;
traumatic brain injuries in childhood (direct lesions of the hypothalamus)
neuroinfections (meningoencephalitis, arachnoiditis and vasculitis) in children
neurointoxication (drug addiction, alcoholism, industrial hazards, environmental problems)
non-endocrine autoimmune diseases;
recurrent bronchitis, acute respiratory viral infections, chronic foci of nasopharyngeal infection and paranasal sinuses nose, frequent sore throats;
acute viral diseases (measles, mumps, influenza, hepatitis)
chronic diseases with a vegetative component ( bronchial asthma, hypertension, gastric and duodenal ulcers, obesity);
chronic stress, endogenous depression, mental overload;
autoallergic diseases of the central nervous system;
abuse of anabolic steroids;
use hormonal contraceptives teenage girls; pregnancy and abortion in adolescence.

Secondary GSPP develops against the background of leptin (nutritional-constitutional, hypodynamic obesity). The disease is characterized by dysfunction of the hypothalamus with impaired production of adenohypophysotropic hormones (corticoliberin, somatotropic hormones) and, as a consequence, dysfunction of the adenohypophysis - dyspituitarism with impaired secretion of tropic hormones: adrenocorticotropic, somatotropic, luteinizing.

Characteristic are: somatotropic hyperfunction of the adenohypophysis with increased production of somatoliberin and, as a consequence, increased growth; disruption of the production of gonadoliberin and gonadotropins, which leads to early or, conversely, late puberty; hyperfunction of basophilic cells of the adenohypophysis without their hyperplasia and functional hypercortisolism. The synthesis of dopamine, serotonin, and endorphins is disrupted, hyperprolactinemia develops, which is manifested by the development of gynecomastia (usually false, due to gynoid obesity).

There is hyperfunction of the hypothalamic-pituitary-thyroid-adrenal system with hyperproduction of corticotropin-releasing hormone, corticotropin, glucocorticoids and adrenal androgens, impaired production of thyrotropin-releasing hormone, thyroid-stimulating hormone and thyroid hormones. A sign of HSPP in adolescents is predominantly hyperproduction of cortisol and dehydroepiandrosterone.

The mechanism of obesity in hypothalamic syndrome puberty is associated with the actual lipogenetic effect of adrenocorticotropic hormone and glucocorticoids (conversion of carbohydrates into fatty acids) and the effect of corticotropin on the beta cells of the islets of Langerhans with the release of insulin

You can also highlight hereditary risk factors HS, especially those that have an autosomal dominant type of inheritance: hypertension, obesity, type 2 diabetes mellitus, autoimmune endocrine syndromes and diseases. The risk of developing HS increases significantly if there are three or more risk factors at the same time.

Hypothalamic syndrome is a combination of autonomic, endocrine, metabolic and trophic disorders caused by damage to the hypothalamus. An indispensable component of HS are neuroendocrine disorders.

The period of manifestation of GSPP in early puberty is due to the activation of the tropic functions of the pituitary gland, primarily adrenocorticotropic, gonadotropic, somatotropic, thyrotropic, which causes a pubertal “surge” of growth and is manifested by changes in the functioning of the adrenal glands, gonads, and thyroid gland. Mostly with GSPP, physiological feedback and the secretion of hormones, especially from the adrenal glands, are disrupted.

During this period, the load on the hypothalamic-pituitary system increases significantly, which leads to its dysfunction under the influence of pathogenic factors. The main link in the pathogenesis is a violation of the synthesis and metabolism of monoamines (especially neuropeptides, serotonin, norepinephrine), which leads to hyperactivation of the tropic functions of the pituitary gland, primarily corticotropic and gonadotropic, and to a lesser extent somatotropic and thyroidotropic functions. Dysfunctional feedback is formed between the central and peripheral endocrine glands, and hormonal metabolic disorders develop.

Increased secretion of gonadotropins leads to stimulation of the gonads and an increase in the level of total and free testosterone (hypertestosteronemia) in boys 10-14 years of age and progesterone (hyperprogesteronemia) in girls of the same age.

With GSPP, activation of the pituitary-thyroid system is observed, which is accompanied by a moderate increase in the level of thyroid-stimulating hormone. This subsequently leads to stimulation of the thyroid gland, which increases in volume with a simultaneous increase in the secretion of thyroid hormones, mainly triiodothyronine. Prolactin secretion remains normal throughout the disease.

The manifestation of HS is noted against the background of activation of the sympathoadrenal system (SAS), increased secretion serotonin and level reduction melatonin.

As the pathology progresses, SAS reserves decrease, but serotonin secretion remains elevated. Melatonin level indicators are more closely related to the clinical manifestations of HS and remain low in the case of recurrent unfavorable course of pathology.

GSPP plays a significant role in the pathogenesis adipose tissue hormone leptin, responsible for increasing the feeling of satiety. The concentration of leptin in the blood of patients with HS is many times higher than physiological indicators, especially in abdominal obesity. Against this background, it is formed leptin resistance.

Against the background of the above hormonal disorders arises insulin resistance(IR), which leads to increased secretion of immunoreactive insulin and C-peptide. The level of hyperinsulinemia and IR directly depends on the degree of obesity and increases significantly with its abdominal type.

The leading pathogenetic significance is dysregulation of fat (an increase in leptin content in the blood is accompanied by an increase in appetite, which indicates a disorder feedback regulation eating behavior) and carbohydrate metabolism (hyperinsulinemia leads to a rapid increase in body fat and protein mass and the development of arterial hypertension).

It is believed that hyperinsulinemia causes sodium and water retention and affects the distal parts of the nephron, stimulates the sympathetic nervous system in a dose-dependent manner, and increases the content of catecholamines in the blood. The development of GSPP is accompanied by an increase in the activity of proteolytic enzymes - collagenase and elastase, and a disturbance in the metabolism of connective tissue proteins.

The main metabolic disorders in HSPP include lipid metabolism disorders. The most typical type of dyslipoproteinemia for patients with HSPP is:

increased triglyceride (TG) concentrations;
increased levels of very low-density lipoprotein cholesterol (VLDL)
normal level of total cholesterol (TC)
increased levels of very low-density lipoproteins and low-density lipoproteins (LDL).

Dyslipoproteinemia type II-A occurs less frequently when the LDL levels with a moderate increase in total cholesterol while maintaining normal TG levels.

Against the background of IR and hyperinsulinemia, HS occurs carbohydrate metabolism disorder. Patients with HSPP experience characteristic metabolic disorders of connective tissue proteins. Almost a third of patients have a “flat” (hyperinsulinemic) glycemic curve. Impaired carbohydrate tolerance is often diagnosed, especially with typical clinical version HS, and it is in these patients that the indicators of the insulin resistance index HOMA-IR (homeostasis model assessment) reach maximum values, although in other variants of the disease they significantly exceed the normative values.

The acute stage of the disease is characterized by an increase in functional activity central departments SAS and is accompanied by an increase in the secretion of catecholamines and serotonin, which excites the hypothalamic nuclei responsible for reproductive function. Excessive activation of the hypothalamic-pituitary-adrenal system occurs due to an increase in the level of pituitary tropic hormones.

Hormonal imbalance leads to endocrine metabolic disorders: fat, carbohydrate and water-electrolyte metabolism, which is accompanied by secondary dysfunction of the endocrine glands. After two to three years, depletion of catecholamine- and serotonin-producing structures is observed. The activity of the hypothalamus, pituitary gland and endocrine glands dependent on them decreases, which leads to a decrease in the level of secretion of the corresponding hormones. At the same time, hyperinsulinism persists. The disease progresses to chronic stage, which lasts for at least four years - neurovegetative symptoms come to the fore.

The main pathogenetic and clinical aspect GSPP is arterial hypertension(AG). The mechanisms that determine the relationship between hypertension and obesity are complex and multifactorial. Thus, obesity in HSPP is associated with endothelial dysfunction, dyslipidemia, excessive formation of C-reactive protein, increased blood viscosity, impaired glucose tolerance, microalbuminuria, increased levels of inflammatory markers, vascular remodeling, left ventricular myocardial hypertrophy and premature atherosclerosis - almost all factors risk of development cardiovascular diseases and target organ damage in hypertension. All these factors play an important role in increasing blood pressure (BP) and the development of hypertension in children and adolescents with HSPP.

At the same time, one of the leading places in the pathogenesis of HSPP belongs to hyperinsulinemia and IR, promoting the activation of oxidative stress, tissue hypoxia, hyperproduction of insulin-like growth factor against the background of disturbances in carbohydrate, lipid, protein metabolism, hemodynamic and other properties of the blood. Hyperinsulinemia activates AT-I and AT-II receptors, promotes the development of hypertension and atherosclerosis, activates SAS, and increases the level of endothelin-1. Hypertension is closely associated with high levels of plasma renin, plasminogen, and insulin-like growth factor, which play an important role in the development of GSPP.

The development of hypertension in GSPP is largely associated with an increase in the body's need for oxygen, which occurs when overweight bodies. Obesity is accompanied by a compensatory increase cardiac output due to an increase in stroke volume and circulating blood volume. In this case, the total peripheral vascular resistance decreases slightly and inadequately, resulting in an increase in blood pressure. In turn, hypervolemic and hyperkinetic types of blood circulation lead to increased load on the heart, which creates a vicious circle.

Hyperactivity of the SAS is critical in the development of concomitant metabolic disorders such as insulin resistance (IR) and hyperlipidemia. Activation of the sympathetic nervous system (SNS) in HSPP is one of the pathogenetic mechanisms chains of overeating: hyperinsulinemia - IR - increased metabolic products of fatty acids. The SNS contributes to the development of peripheral IR, while hyperinsulinemia has a restimulating effect on the SNS, thus closing the “pathological circle.”

Hypothalamic syndrome is a symptom complex characterized by a rapidly progressive course and a combination of autonomic, endocrine, trophic and metabolic disorders. This condition is caused by pathology of the hypothalamus.

Most of the patients diagnosed with this pathology are people of reproductive age from 30 to 40 years. Women get sick much more often than men. Hypothalamic syndrome is often detected in adolescents during puberty (12-15 years). Diagnosis can be difficult because symptoms can “masquerade” as other disorders.

Classification

Within the framework of modern endocrinology, an expanded classification of the symptom complex has been developed.

According to its origin, hypothalamic syndrome is divided into primary, secondary and mixed. The primary form develops against the background and exposure to infectious agents, and the secondary most often becomes a consequence.

In accordance with the predominance of certain symptoms, the following types of syndrome are distinguished:

neuromuscular;
thermoregulation disorders;
hypothalamic epilepsy;
neurotrophic;
vegetative-vascular;
metabolic and neuroendocrine disorders;
pseudoneurasthenic (psychopathological);
disturbance of drives and motivations.

IN clinical practice Variants of the syndrome with a predominance of neurocirculatory pathology, hypercortisolism (excess of adrenal hormones) or constitutional obesity are considered separately.

Based on severity, mild, moderate and severe forms of pathology are distinguished.

Classification of hypothalamic syndrome by type of development includes 4 forms:

Stable.
Progressive.
Regressive.
Recurrent.

Causes

Note:The hypothalamus is a small area in diencephalon, responsible for homeostasis, thermoregulation, metabolism, eating and sexual behavior, as well as the condition of blood vessels. When hypothalamic structures are damaged, the regulation of the body's physiological reactions is disrupted, and an autonomic crisis develops.

Possible causes of hypothalamic syndrome include:

Neurointoxication may result from occupational hazards (working with toxic compounds) or bad habits(or chronic).

The presence of a vegetative component is typical for such chronic pathologies, as well as constitutional.

Infectious diseases that can negatively affect the activity of the hypothalamus include, as well as common ones with the development of complications.

Symptoms of hypothalamic syndrome

Manifestations of pathology include:

Important:in adolescents during puberty, the symptom complex can accelerate or slow down sexual development.

The symptom complex is often complicated by dystrophic changes in the heart muscle, and. Insulin resistance may develop.

In most cases, paroxysmal manifestations of the syndrome are observed.

Patients experience vasoinsular crises, characterized by a feeling of heat, a rush of blood to the face, suffocation, sweating, dizziness and general weakness. Many patients complain about discomfort V epigastric region. Urination is normal, and the volume of urine output increases. Hypersensitivity reactions in the form of skin rashes And angioedema. Bradycardia is objectively detected (heart rate drops to 45-50 beats per minute). Blood pressure drops to 80/50 mm. rt. Art.

Sympathetic-adrenal crises develop against the background of psycho-emotional stress, changes in weather, pain or menstruation. Paroxysms make themselves felt more often at night. The patient experiences trembling, numbness and coldness of the extremities and a feeling of chills. The pulse rate increases to 100-130 beats/min, and blood pressure numbers increase to 180/110. Hyperthermia is often observed (body temperature reaches 39°C). The patient experiences a feeling of anxiety and fear of death.

Note:before the onset of sympathetic-adrenal crises, the so-called “harbingers” - general lethargy, cephalgia, unmotivated mood swings and stabbing pain.

The duration of a paroxysmal attack is from 15 minutes. up to 3-4 hours. After its completion, the patient experiences weakness and fear of a new crisis for a long time.

Paroxysms can be mixed, i.e. the patient exhibits signs of both sympathetic-adrenal and vasoinsular crisis.

If thermoregulation suffers against the background of hypothalamic syndrome, patients maintain a low-grade fever for a long time, and periodically it rises to values of 39-40 ° C. This phenomenon is called hyperthermic crisis; it is quite often diagnosed in children and adolescents against the background of psycho-emotional stress. Failures in the thermoregulation system are characterized by a rise in temperature in the morning and a decrease in the evening. Experts associate this symptom with physical and mental stress; it often develops during active periods at school and goes away during rest.

Note:One of the signs of impaired thermoregulation against the background of hypothalamic syndrome is intolerance to insufficiently comfortable (low) temperatures and chilliness.

Manifestations of drive and motivation disorders:

change in sexual desire;
the emergence of a wide variety of phobias;
hypersomnia (constant drowsiness);
behavioral disorders;
lability of emotions;
increased irritability;
anger and aggression;
tearfulness;

With neuroendocrine and metabolic disorders, almost any metabolic processes can suffer.

Their possible manifestations include:

(refusal to eat);
(wolf hunger);
strong thirst;
polyuria with decreased urine density;
dyspeptic disorders;
pathological changes in the thyroid gland;
hypercortisolism syndrome;
early attack.

Complications of neuroendocrine-metabolic manifestations of hypothalamic syndrome can include ulcers of the gastrointestinal tract, dystrophic changes skin, muscle and bone tissue.

Diagnostics

Identification and treatment of hypothalamic syndrome is the task of endocrinologists, neurologists and gynecologists. Diagnosis is complicated by the polymorphism of pathological manifestations.

The main criteria to verify the diagnosis include:

thermometry (axillary on both sides and rectal);
(the test is carried out on an empty stomach and with a load, and the indicators are measured every half hour);
on the ratio of the volume of fluid drunk and diuresis.

Important:To make a diagnosis, electroencephalography of the brain and an extensive laboratory study of the patient’s hormonal background are performed. EEG allows you to detect pathological changes in the deep structures of the brain. Using MRI, it is possible to evaluate and identify neoplasms and the consequences of TBI and oxygen starvation of tissues.

According to indications, doctors resort to organ endocrine system– adrenal glands and thyroid gland.

When diagnosing hypothalamic syndrome, the levels of the following hormones are necessarily measured:

The content of 17-ketosteroids is also assessed in daily urine.

Treatment of hypothalamic syndrome and prognosis

As a rule, symptomatic therapy is carried out and inhibitory or, on the contrary, stimulating hormone therapy is prescribed. Its main goal is the correction of disorders of the hypothalamic structures.

First of all, it is eliminated possible reason violations that have arisen. Injuries and tumors are subject to appropriate treatment, and chronic foci of infection are subject to sanitation. When identifying toxic lesions active detoxification therapy is carried out, involving the intravenous administration of specific antidotes, saline solutions and glucose.

To prevent sympathetic-adrenal paroxysms, belladonna alkaloids, Phenobarbital, Pyrroxan, Tofisopam, Sulpiride and drugs from the group (in particular, Amitriptyline) are indicated.

The fight against neuroendocrine disorders involves prescribing therapeutic diet and drugs that regulate the metabolism of neurotransmitters (requires long-term course treatment Phenytoin or Bromocriptine). In parallel, replacement, stimulating or inhibitory hormone therapy is carried out.

Post-traumatic syndrome requires cerebrospinal puncture and measures to dehydrate the body.

Metabolic disorders are an indication for diet and vitamin therapy, as well as the prescription of anorexiant drugs.

Effective means for stimulating cerebral blood flow:

Non-drug methods include physiotherapy, a variety of physiotherapy and reflexology.

Weight normalization and spa therapy are of great importance. Patients are strongly advised to strictly adhere to the optimal work and rest regime.

Important:prevention of crises comes down to minimizing psychotraumatic factors and preventive treatment

Hypothalamic syndrome is a symptom complex of damage to the hypothalamic region, characterized by autonomic, endocrine, metabolic and trophic disorders.

Various factors play a significant role in the occurrence of hypothalamic syndrome. stressful situations, psychotraumatic effects, intoxication, traumatic brain injuries, vascular diseases, tumors, acute infections(flu, ARVI (ARI), pneumonia, viral neuroinfections), chronic infections (cholecystitis, sinusitis, tonsillitis, rheumatism, tuberculosis). Increased vascular permeability of the hypothalamus can facilitate the penetration of toxins and viruses from the blood into the brain, and displacement of cerebrospinal fluid during traumatic brain injury can cause hypothalamic dysfunction. The occurrence of hypothalamic syndrome is also facilitated by hereditary and acquired constitutional defects of the hypothalamus and closely related structures of the limbic-reticular complex (limbic system and reticular formation) and the pituitary gland. Often, the pathological course of pregnancy and childbirth can be one of the factors of improper formation and maturation of the hypothalamus at various stages of fetal ontogenesis.

Hypothalamic syndrome, forms

Neurologists and neuropathologists distinguish the following clinical forms hypothalamic syndrome :

1) vegetative-vascular (vegetative-vascular) form;

2) neuroendocrine-metabolic form;

3) violation of thermoregulation;

4) hypothalamic (diencephalic) epilepsy;

5) neurotrophic form;

6) neuromuscular form;

7) disturbance of sleep and wakefulness.

Hypothalamic syndrome, symptoms

The symptoms and clinical picture of hypothalamic disorders are very multifaceted and polymorphic; they can manifest as transient (often paroxysmal) or permanent neurological disorders.

Vegetative-vascular form

Vegetative-vascular form (vegetative-vascular) form hypothalamic syndrome characterized by the presence of sympathoadrenal, vagoinsular and mixed crises. Sympathoadrenal, vagoinsular, mixed crises usually begin acutely, often in inadequate conditions, and are quite long - from 5 minutes to several hours. After a crisis, post-crisis asthenia remains for a long time.

Sympathoadrenal crisis

Sympathoadrenal crisis with hypothalamic syndrome it manifests itself as severe headache, pain in the heart area, palpitations, a feeling of fear, palpitations, a feeling of fear, difficulty breathing, numbness of the extremities. During a crisis, the skin is pale, dry, blood pressure (BP) is elevated, there may be slight hyperthermia (37.0; 37.1; 37.2; 37.3; 37.4; 37.5; 37.6; 37.8 ; 37.9 degrees Celsius), pupil dilation, increased speed(reaction) erythrocyte sedimentation (ESR, ROE), hyperglycemia (increased blood glucose levels). The attack often ends with chills, frequent urination (pollakiuria) or a single copious discharge of urine (polyuria).

Vagoinsular crisis

Vagoinsular crisis(with hypothalamic syndrome) is accompanied by lethargy, general weakness, dizziness, freezing in the heart area, a feeling of lack of air, and increased peristalsis. There is hyperemia (redness) of the skin (skin), increased sweating, bradycardia (slow pulse), decreased blood pressure (BP) and decreased body temperature. The attack often ends with diarrhea ( loose stool, diarrhea).

Mixed crisis

Mixed crises(with hypothalamic syndrome) include a variety of disorders characteristic of sympathoadrenal crisis and vagoinsular crisis.

Neuroendocrine-metabolic form | Hypothalamic syndrome

Neuroendocrine-metabolic form hypothalamic syndrome is characterized mainly by endocrine disorders due to loss or increased secretion of hormones of the anterior pituitary gland.

The following diseases may occur.

Diabetes insipidus

1) diabetes insipidus(polyuria, polydipsia, dry mouth, general weakness);

Adiposogenital dystrophy

2) adiposogenital dystrophy- Pechkrantz-Babinsky-Fröhlich syndrome (nutritional obesity, increased appetite, hypogenitalism, general weakness, various endocrine disorders);

Frontal hyperostosis

3) frontal hyperostosis- Morgagni-Stewart-Morel syndrome (hyperostosis of the internal plate frontal bone, amenorrhea, obesity, virilism);

Juvenile basophilism

4) juvenile basophilism- prepubertal basophilism (obesity, increased blood pressure / arterial hypertension /, stretch marks / stretch marks / on the skin;

Pituitary cachexia

5) pituitary cachexia- hypothalamic-pituitary cachexia, panhypopituitarism, Simmonds syndrome (rapid decrease in body weight by 1.5 - 2 times with the development of cachexia / exhaustion /;

Malignant exophthalmos

6) malignant exophthalmos- exophthalmic ophthalmoplegia (slowly progressive exophthalmos without thyrotoxicosis, at first it can be one-sided, oculomotor disturbances, more often external ophthalmoplegia, diplopia, possible keratitis, atrophy of the optic discs);

Precocious puberty

7) premature puberty(pubertas praecox) - more often manifested in girls by the early development of secondary sexual characteristics, often combined with the following symptoms: high growth, bulimia, polydipsia, polyuria, sleep disturbance (), changes in the emotional-volitional sphere / children become rude, cruel, angry, have a tendency towards vagrancy, theft, antisocial violations/;

Delayed puberty

8) delayed puberty- occurs predominantly in boys during adolescence and manifests itself in female type, hypogenitalism, lethargy, decreased initiative;

Gigantism

9) gigantism- this is a disease that is characterized by the presence in adolescents and children of open epiphyseal growth zones with excessive secretion of self-tropic hormone (STH), height in boys and young men reaches more than 200 cm, and in girls and women more than 190 cm;

Acromegaly

10) acromegaly- Marie syndrome, or Marie-Lehry syndrome, is a neuroendocrine syndrome caused by a significant increase in the secretion of somatotropic hormone of the anterior pituitary gland; the syndrome was first described in 1886 by P. Marie; and in most cases it is associated with an eosinophilic pituitary adenoma, sometimes acromegaly can develop after traumatic brain injury, intoxication, infection, stress conditions; there is an increase in the size of the hands, feet, facial skeleton, nose, tongue, ears, internal organs;

Dwarfism, dwarfism

11) dwarfism/dwarfism/ - (nanos - dwarf) is a clinical syndrome manifested by extremely short stature (compared to sexual and age norm), occurs relatively often, causing mental distress in both the child and his parents, especially against the background of acceleration in other children, often manifests itself in combination with other developmental defects (hydrocephalus, microcephaly, mental retardation, eye changes), in patients with chromosomal syndromes (Down disease, where, along with dwarfism, there are multiple developmental anomalies);

Itsenko-Cushing's disease

12) Itsenko-Cushing's disease(pituitary basophilism, Cushing's disease) develops due to excessive release of adrenocorticotropic hormone (ACTH) by the pituitary gland; first described by N. M. Itsenko and H. W. Cushing; occurs more often with basophilic pituitary adenoma, traumatic brain injury, inflammatory diseases of the brain, long-term use large doses of corticosteroids or ACTH, manifests itself with symptoms of hypercortisolism (uneven obesity, moon face, body fat in the neck, upper half of the body, skin trophic disorders, osteoporosis, increased blood pressure, amyotrophy in the proximal limbs, intracranial hypertension, pyramidal and brainstem symptoms);

Lawrence-Moon-Bardet-Biedl syndrome

13) Lawrence-Moon-Bardet-Biedl syndrome- hereditary diencephalic-retinal pathology, which includes Lawrence-Moon syndrome (first described in 1866 by J. Z. Laurence and R. Ch. Moon) and Bardet-Biedl syndrome (first described by G. Bardet in 1920 and A. Biedl in 1922 year), the type of inheritance is autosomal recessive and polygenic determination, the main symptoms of Lawrence-Moon syndrome - mental retardation, pigmentary retinopathy, hypogenitalism, spastic paraplegia, Bardet-Biedl syndrome - mental retardation, pigmentary retinopathy, hypogenitalism, obesity, polydactyly.

Impaired thermoregulation, hypothalamic syndrome with impaired thermoregulation

Violation of thermoregulation hypothalamic origin most often manifests itself in the form prolonged low-grade fever, against the background of which hyperthermic crises sometimes occur with an increase in body temperature to 38.0 - 38.5 - 39.0 degrees Celsius. In contrast to the increase in temperature at infectious diseases(diseases), this hyperthermia has a number of features and differences: an increase in temperature in the morning and a decrease in the evening, its relatively good tolerability, no changes in the blood and urine, a negative amidopyrine test, a perverted thermoregulatory Shcherbak reflex (with normal thermoregulation rectal temperature increases by 0.5 degrees Celsius after immersing hands in water at a temperature of 32 degrees and gradually increasing it to 42 degrees). Violation of thermoregulation can also manifest itself as hypothermia and poor tolerance to drafts, weather changes, and low temperatures.

Hypothalamic (diencephalic) epilepsy

Hypothalamic (diencephalic) epilepsy characterized by the presence of vegetative-vascular (vegetative-vascular) crises, against the background of which a disturbance of consciousness occurs and tonic convulsions develop. An electroencephalogram (EEG) may reveal epileptic activity (epiactivity) of the temporal localization. These paroxysms are, fortunately, very rare.

Neurotrophic form

Neurotrophic form includes various trophic disorders due to damage to the hypothalamus: trophic ulcers, focal or diffuse edema of different parts of the body (especially in combination with vegetative-vascular crises), brittle nails, osteoporosis, osteodystrophy, some types of alopecia /hair loss/. IN pure form the neurotrophic form is rare, and trophic disorders are included in the structure of other forms of hypothalamic syndrome, more often in the neuroendocrine-metabolic form.

Neuromuscular form, catalepsy, narcolepsy | Hypothalamic syndrome

Neuromuscular form manifested by general weakness, adynamia, and passing atypical attacks of catalepsy. Catalepsy (affective adynamia, emotional asthenia, affective loss muscle tone, Levenfeld-Enneberg syndrome) is a short-term, paroxysmal loss of muscle tone, which occurs more often with strong emotional influences and leads to the patient falling without loss of consciousness. Catalepsy is a symptom of narcolepsy. Narcolepsy (Gelino's disease) is a disease from the group of hypersomnias, characterized by attacks of irresistible drowsiness and falling asleep during the daytime. Neurologists and neuropathologists distinguish essential narcolepsy, which occurs without visible external influences, and symptomatic narcolepsy, which occurs after infections, epidemic encephalitis, traumatic brain injuries, tumors of the 3rd ventricle, pituitary gland, internal hydrocephalus. Attacks of drowsiness occur suddenly, often in inappropriate conditions: while eating, walking, talking, urinating. The attacks usually last for several minutes. Depending on the external manifestations Neurologists distinguish between 2 forms of narcolepsy: monosymptomatic, which manifests itself only in attacks of falling asleep, and polysymptomatic, which manifests itself in attacks of falling asleep, catalepsy, night sleep disturbances, and hypnogogic hallucinations.

Hallucinations, Pickwis' syndrome, Kleine-Lewin syndrome

Hallucinations- this is a false perception without a really existing object. Neuropathologists, psychoneurologists And psychiatrists distinguish between visual, auditory, olfactory, gustatory, tactile, and general senses. Hallucinations that occur while falling asleep are called hypnagogic. Hallucinations that occur upon awakening are called hypnopompic hallucinations. Movement disorders in the neuromuscular form of hypothalamic origin, they do not have a clear clinical picture and delineation, they are very variable, unstable, fragmentary, and prone to paroxysmal flow. Some forms of phenocopies also belong to this form. neuromuscular diseases. Disturbances in sleep and wakefulness can be manifested by changes in the sleep formula (drowsiness during the day and insomnia at night), hypersomnia, narcolepsy, periodic hibernation syndrome, which is characterized by sleep attacks lasting from several hours to several weeks. At this time, muscle hypotonia, areflexia, arterial hypotension, lack of control over the activity of the pelvic organs. More complex syndromes of sleep and wakefulness disorders may also occur: Pickwickian syndrome, Kleine-Lewin syndrome. Pickwickian syndrome - This pathological condition in people of small stature, manifested by shallow breathing, arterial hypertension (increased blood pressure /BP), shortness of breath, drowsiness and general weakness. Kleine-Lewin syndrome characterized by attacks of drowsiness with bulimia.

Clinical forms of hypothalamic syndrome rarely occur in isolated form. Thus, vegetative-vascular (vegetative-vascular) crises can be observed in diseases of internal organs (vegetative-vascular dystonia). Neuroendocrine metabolic disorders occur in other pathological processes of non-hypothalamic localization, as well as in primary endocrine diseases.

Hypothalamic syndrome, treatment in Saratov, Russia

Treatment of hypothalamic syndrome includes the use of etiological, pathogenetic and symptomatic influences. Sarklinik (Saratov) provides treatment for all forms of hypothalamic syndrome. Treatment includes a variety of reflexology methods, linear segmental reflex massage techniques, acupuncture techniques, laser reflexotherapy, tsubotherapy, etc.

How to treat hypothalamic syndrome, how to get rid of hypothalamic syndrome!

Comprehensive differentiated treatment of patients with hypothalamic syndrome with widespread use effective techniques allows you to achieve good results even with severe symptoms.

At the first consultation, the doctor will tell you about the main factors and symptoms of the disease: what is hypothalamic syndrome in newborns, children, adolescents, adults (men and women), what is mild, moderate, severe hypothalamic pubertal juvenile neuroendocrine syndrome (neuroendocrine form) , how the army, Wikipedia and hypothalamic syndrome are connected.

There are contraindications. Specialist consultation is required.
Photo: Dgm007 | Dreamstime.com\Dreamstock.ru. The people depicted in the photo are models, do not suffer from the diseases described and/or all similarities are excluded.