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

Hypothalamic syndrome of puberty is a different combination of symptoms that develops in adolescence, when hormonal changes in the whole organism occur. It develops as a result of a complex of causes leading to a disruption in the normal relationship between the "guiding" endocrine glands - the hypothalamus, the pituitary gland - and the structures that connect 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, a significant improvement in the quality of life can be achieved.

Causes of the disease

The disease develops at the age of 10-20, more often in boys.

The exact cause of the disease is unknown. It is believed that the hypothalamic syndrome develops due to the impact on the child's body of such factors:

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

The following conditions predispose to the development of hypothalamic syndrome:

• early puberty;
• obesity;
• changes in the functioning of the thyroid gland.

The mechanisms leading to the development of pubertal hypothalamic syndrome are “turned on” under the action of:

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

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

1. responsible for thermoregulation;
2. regulates the work of blood vessels;
3. coordinates vegetative functions;
4. ensures the constancy of the internal environment of the body;
5. responsible for the feeling of hunger and satiety;
6. dictates sexual behavior.

Forms of the disease

Hypothalamic syndrome may consist of a combination of various symptoms that can be combined into groups. Depending on this, the following forms of the syndrome are distinguished:

1. neuromuscular;
2. violations of thermoregulation;
3. vegetative-vascular;
4. neurotrophic;
5. hypothalamic epilepsy;
6. endocrine-neuro-metabolic disorders;
7. form with a disorder of motivations.

Symptoms

The main symptom of the disease is obesity: fat is deposited not only on the abdomen, but also on the lower and upper limbs. In boys, a wide pelvis is formed, a plump white-skinned face, an increase in the 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 excessive male-pattern hair, their nipples become darker in color, and juvenile acne appears on their faces. The menstrual cycle is disturbed.

Other signs are also observed:

• headache;
• although teenagers look like older and healthier people, they get tired very quickly;
• pink stretch marks on the skin of the shoulders, abdomen, buttocks and thighs;
• lipomas, warts, vitiligo, warts on the skin;
• brittle and thin nails;
• sweating of the hands, they are very cold and bluish;
• voracity 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 of sweat glands, the skin is rough, dry. The most dry skin is noted in the elbows, neck, in places of friction with clothing;
• causeless morning rise in temperature with its decrease to normal in the evening;
• prone to allergies.

The syndrome can proceed paroxysmal, in the form of one of the types of crises:

1. Vagoinsular: feeling of "hot flashes" of heat, nausea, slowing of the heartbeat, nausea, sweating, feeling of lack of air, weakness, diarrhea, profuse urination;
2. Sympathoadrenal, which often develop after "harbingers" - headache, lethargy, tingling in the heart. Then the crisis itself develops: rapid heartbeat, fear of death, fever and blood pressure.

Juvenile basophilism is a form of hypothalamic pubertal syndrome, in which there is an increased production of the hormone ACTH in the pituitary gland. With this disease, obesity will also be noted: "lower" obesity in girls, the female pelvis and breast enlargement in guys. At the same time, girls will have well-developed secondary sexual characteristics, while boys have a higher height than their peers.

How the disease is 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 is treated for a long time with the help of diet and drug therapy.

Diet principles:

1. calories should be slightly less than necessary for this basic metabolism;
2. limit the intake of carbohydrates and almost exclude animal fats;
3. 5 meals a day;
4. you can't starve;
5. if there is a violation of glucose tolerance, use fructose, xylitol or sorbitol.

Medical therapy:

1. Fat-soluble vitamins are essential.
2. To reduce the level of testosterone, a drug with a diuretic effect "Veroshpiron" is prescribed.
3. Medical correction of thyroid function is carried out.
4. In case of violation of glucose tolerance, tableted hypoglycemic drugs are used.
5. In case of violation of the menstrual cycle, girls receive a course of treatment with sex hormones, depending on the initial level of progesterone and estriol.
6. If the level of prolactin is elevated, bromocriptine preparations are used.
7. In stage III and IV obesity, anorectics are used.
8. If blood pressure is elevated even if a salt-free diet is observed, diuretics, drugs such as Enalapril, Captopril or Fenigidin, Nifedipine are prescribed.
9. If necessary, anticonvulsant therapy is carried out, prevention of crises.

To achieve the effect, it is also necessary to change the lifestyle, sanitation of foci of chronic infection. You need to take a course of acupuncture, spa treatment.

The hypothalamus is an important part of the brain that regulates a wide range of vital body functions. This is a vegetative center that innervates literally all the internal organs of a person. The human body in the process of life constantly has to adapt to the influences of the external environment: various temperature and climatic regimes, maintain metabolism, eat, multiply and become a person. All of the above processes are also controlled by the hypothalamus. Violations that occur in the work 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 such disorders:

• vegetative;
• endocrine;
• exchange;
• trophic.

These pathologies are manifested by an increase in body weight (up to obesity), changes in blood pressure up to the development of hypertension, vegetative vascular dystonia, infertility and other complications.

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);
• body intoxication (bad ecology, exposure to harmful production, neurointoxication with alcohol and other toxic substances);
• neuroinfections of both viral and bacterial origin (with influenza, chronic tonsillitis, rheumatism, etc.);
• psycho-emotional factors (stress and shock conditions);
• hormonal changes in pregnant women;
• congenital defects in the development of the hypothalamus;
• brain hypoxia (consequences of suffocation, drowning).

Pathogenesis

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

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

Symptoms of hypothalamic syndrome

The first signs of this pathology may be severe fatigue and weakness. Further, the following most common symptoms of this disease are considered to be violations of 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 the hypothalamic syndrome as one of the manifestations of the disease.

With this pathology, the course of the disease can be constantly accompanied by clinical manifestations, and it can proceed paroxysmal in the form of crises.

A provocative factor may be a change in weather conditions, the beginning of the menstrual cycle, a strong emotional or painful impact. In the medical classification, there are two types of hypothalamic crisis: vaso-insular, as well as sympathetic-adrenal. During vaso-insular 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 (slow heartbeat) and a feeling of cardiac arrest, increased work of peristalsis is possible bowels, frequent urge to urinate. During sympathetic-adrenal crises, the following symptoms can be noted: pallor of the skin, due to narrowing of blood vessels, high blood pressure, tachycardia (accelerated heartbeat and increased heart rate), chill-like trembling (body tremor), decrease in body temperature (hypothermia), an obsessive feeling of fear.

Hypothalamic syndrome in puberty in children

During puberty in boys and girls, due to hormonal changes in the 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 distinguished: fetal (newborn) hypoxia, 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 signs such as obesity, stretch marks on the skin, increased appetite (bulimia), frequent headaches, decreased performance, mood swings and frequent depression, in girls, menstrual irregularities.

To clarify the diagnosis, it is necessary to conduct a number of additional studies and consultations of various medical specialists. In terms of symptoms, the hypothalamic syndrome of puberty is similar to Itsenko-Cushing's syndrome, so this diagnosis should be excluded.

The treatment of the syndrome in children consists primarily in following a diet that includes fractional five meals a day and a decrease in the calorie content of food. As well as drug treatment, which depends on the etiology of the disease, and may include drugs that 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 there is a complete recovery, with the exception of very rare and severe forms of the disease. In such cases, treatment lasts for years and contributes to a significant improvement in physical condition and adaptation.

The risk group includes adolescents who have begun to have an early sexual life (early pregnancy and abortion), children with increased body weight, as well as those involved in heavy sports, using anabolics, 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 either by bulimia (gluttony) or by cardinal weight loss (anorexia). In women, manifestations of menstrual irregularities are possible, in men, a decrease in potency. In the pathological condition of the thyroid-stimulating lobe of the pituitary gland, symptoms of hypothyroidism (deficiency of thyroid hormones) and toxic diffuse goiter (increased production of thyroid hormones) may occur. The causes of this phenomenon can be craniocerebral trauma, intoxication of the body and neurointoxication. Therefore, the treatment of this form of the disease consists in eliminating and curing the main cause of the pathology (if the disease is secondary), detoxification of the body, vitamin therapy, urinary and absorbable drugs, anti-inflammatory drugs, the use of central adrenolytics (reserpine, raunatin, chlorpromazine), cholinomimetic drugs (anticholinesterase substances) .

Hypothalamic hypersexuality syndrome

Some patients suffering from hypothalamic syndrome may experience a pathologically increased sexual desire or hypothalamic hypersexuality syndrome. The course of the disease manifests itself in the form of crises. At times, a woman experiences a strong libido, in which there are specific sensations in the genitals and their increased sensitivity. A strong sexual arousal can grow up to orgasm. During sexual intercourse, such women get several orgasms (multiorgasms). To the above symptoms, you can add a feeling of heat, false urge to urinate and a feeling of a full bladder, as well as pain in the lower abdomen and back. Women with this pathology achieve orgasm much faster and easier than healthy women (even during erotic dreams), the feeling of satisfaction either does not occur or occurs for a short period of time. Then they again have a strong sexual arousal. Sexual arousal occurs paroxysmal, in the form of crises. At the same time, there are other symptoms of the hypothalamic syndrome: hyperemia or pallor of the skin, headaches and dizziness, general weakness. This syndrome can lead to various neuropsychiatric disorders, such as: sleep disturbances (drowsiness or insomnia), asthenia, anxiety and fear. The disease can lead a woman to antisocial behavior and promiscuity.

When diagnosing, objective data and anamnesis are taken into account. In addition to pathological hypersexuality, there are other symptoms of a 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 the tone of the parasympathetic system. If crises are accompanied by epilepsy, anticonvulsants and tranquilizers, such as Elenium and Seduxen, are prescribed. In mental disorders, the use of psychotropic drugs. With cyclic attacks of hypersexuality, synthetic progestins are used: bisekurina and infekundin.

Hypothalamic syndrome with impaired thermoregulation

The hypothalamus plays an important role in temperature regulation of the body. In patients, there is a violation of skin temperature, elevated body temperature from subfebrile to febrile, temperature fluctuations increase during crises. In 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 subfebrile temperature and who do not have obvious signs of diseases and pathologies of organs. In such patients, a number of other symptoms characteristic of the hypothalamic syndrome can be detected: bulimia, obesity and thirst. This is an important factor in the differential diagnosis of this disease. An important symptom in violation of thermoregulation is chills. There may also be a chill-like trembling, which can occur, as a rule, during a crisis. Chills may be accompanied by polyuria and profuse sweating. Patients with this disease often freeze, shiver, wrap themselves in warm clothes, tightly close windows even in the warm season.

Forms

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

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

According to clinical signs, it is also possible to distinguish variants of syndromes with dominant constitutional obesity (in the form of a violation of fat and carbohydrate metabolism), hypercortisolism, neurocirculatory disorders, and germinal disorders.

According to the severity in medical practice, the syndrome is in mild form, moderate form and severe form of this disease. Characteristic development can be progressive, as well as stable, regressive and recurrent. In 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 is complicated. The main criteria in the diagnosis of hypothalamic syndrome are the data of special medical tests and various methods of instrumental diagnostics: the study of indicators of sugar content in the body (laboratory tests of urine and blood), measurement of body temperature (skin, rectal and oral methods of measuring temperature).

Differential Diagnosis

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

Treatment of hypothalamic syndrome

To prescribe the correct treatment, it is essential to establish the causes that caused this disease. Further, doctors, in a hospital setting, prescribe conservative treatment. Surgical treatment can be used if the cause of the syndrome is a neoplasm. The etiological treatment of hypothalamic syndrome should be aimed at combating the tumor, infections and viruses, trauma and diseases of the brain). To prevent sympathetic adrenal crises, the following drugs are prescribed: pyrroxan, eglonil, bellataminal, grandaxin. Antidepressants are prescribed. With neuroendocrine disorders, hormonal drugs are prescribed. With metabolic disorders, diet therapy, drugs that reduce appetite are prescribed.

• Pyrroxan - pyrroxan hydrochloride, the main active ingredient 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 dermatosis, seasickness, for hypertensive crises of the sympathoadrenal type, dysfunctions of the autonomic system.

Precautions: use with caution in the elderly; after the course of treatment, control the blood glucose content.

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

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

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

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

Side effects: drowsiness, dizziness, menstrual irregularities, tachycardia, increase or decrease in blood pressure, skin rash.

• Bellataminal - is prescribed orally 1 tablet 2 3 times a day after meals for insomnia, increased irritability, for the treatment of vegetative vascular dystonia.

Precautions are: do not prescribe to pregnant women, during lactation, to persons whose work is associated with the speed of reaction.

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

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

Precautions: with caution in patients with mental retardation, the elderly, persons 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 to use decoctions and tinctures of medicinal herbs. To reduce the feeling of hunger, you can use a decoction of burdock roots. Prepare it as follows: boil 10 grams of burdock root in 300 ml of water for 15 minutes. Allow to cool, strain and take 1 tablespoon 5 to 7 times a day.

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

Using the methods of traditional medicine, we must not forget that it is necessary to continue drug treatment, since herbal decoctions cannot fully replace drugs. 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 deal with the consequences and complications of hypothalamic syndrome. So with constitutional obesity, you can prescribe homeopathic remedies that help fight increased appetite Ignacy, Nux Vomica, Anacardium, Phosphoricum Acidum. With violations of fat metabolism Pulsatilla, Thuja, Graffitis, Fucus. Drainage preparations - Carduus marianus, Lycopodium.

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

It has a sedative (calming), antispasmodic, antidepressant effect on the body. Method of application: for adults, 10 drops under the tongue or inside, previously dissolved in 1 teaspoon of water, 3 times a day half an hour before meals or one hour after meals.

Side effects with the use of Ignatia have not been identified.

Precautions: in the absence of a therapeutic effect, consult a doctor and stop using the drug.

• Pulsatilla - homeopathic granules.

At the heart of this drug is grass backache (sleep - grass). Used to treat headaches, neurasthenia, neuralgia, vegetative vascular dystonia.

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

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

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

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

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

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

Precautions: individual intolerance, pregnancy and lactation.

• Lycopodium - homeopathic grains in jars of 10 gr. 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.

Precautions: refrain from brushing your teeth with menthol pastes.

Physiotherapy for hypothalamic syndrome

Excellent physiotherapy methods for treating the syndrome include drug electrophoresis with sedatives, a hot tub, pine baths, as a sedative method of physiotherapy. The tonic method includes - medicinal electrophoresis with tonic preparations, showers, massages, thalassotherapy (treatment by the sea, sea water, seaweed). Transcerebral UHF, ultraviolet irradiation in small doses, heliotherapy, sodium chloride, radon baths have a positive effect on the body.

Consequences and complications, prevention and prognosis in hypothalamic syndrome.

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

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

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

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

Patients who have been diagnosed with the syndrome need constant medical supervision. In the absence of proper monitoring and correction of treatment, the prognosis can be extremely difficult: from disability to coma, as well as death.

Preventive measures for the syndrome include maintaining a healthy active lifestyle, fighting bad habits, proper healthy nutrition, moderate physical and mental stress, and timely treatment of diseases.

The most frequently asked questions about hypothalamic syndrome:

How to lose weight with hypothalamic syndrome?

It is possible to lose weight with this pathology if you approach this problem in a complex way. First of all, you need a low-calorie diet, fractional nutrition, which involves eating five meals a day in small portions. To combat excess weight, you need to engage in physical education and sports. The intensity of physical activity should be controlled by a doctor. Walks in the fresh air, healthy sleep. To reduce appetite, you can resort to medications, as well as to the methods of traditional medicine.

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

Recently, the prevalence of hypothalamic puberty syndrome (HPSPS) has doubled. The problem of medical and social significance of hypothalamic syndrome (HS) is determined by the young age of patients, the rapidly progressive course of the disease, severe neuroendocrine disorders, which are often accompanied by reduced or complete loss of working capacity. HS causes serious disorders in the reproductive health of girls, causes the development of endocrine infertility, polycystic ovaries, obstetric and perinatal complications in the future.

The hypothalamic-pituitary neurosecretory complex (HGNSC) 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. Violation of the interaction of individual departments of HGNSC leads to the development of hypothalamic syndrome in children and adolescents, and a violation of the regulatory function of HGNSC 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 - the division of the diencephalon and the central chain of the limbic system;
• neurohypophysis - consists of two parts; the anterior part is the median eminence and the posterior part is the posterior lobe of the pituitary gland proper
• adenohypophysis - anterior lobe of the pituitary gland.

In the pathology of the hypothalamic region, a symptom complex occurs, which is characterized by autonomic, endocrine, metabolic and trophic disorders and which depends on the localization of the hypothalamus lesion (in the posterior or anterior section).

The hypothalamus is a part of the brain where the integration of nervous and humoral functions takes place, which ensures the 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 an autonomic crisis.

Hypothalamic syndrome of puberty is a neuroendocrine syndrome of age-related restructuring of 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; puberty-youthful dispituitarism; transient juvenile diencephalic syndrome, juvenile hypothalamic syndrome of puberty; hypothalamic syndrome of puberty; diencephalic hyperandrogenism (code according to ICD-10 - E.33.0).

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

Hypothalamic syndrome of puberty is a neuroendocrine syndrome that occurs in the pubertal or postpubertal period due to functional endocrine disorders. In general, it is difficult to find out its main cause, since clinical manifestations in the manifest form often occur years after exposure to the causative factor.

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

• pathological course of pregnancy in the patient's mother (fetoplacental insufficiency, toxicosis or gestosis of the I and II half of pregnancy)
• complicated course of pregnancy (acute illnesses and exacerbation of chronic diseases of the mother during pregnancy, poisoning, intoxication, etc.);
• pathological or complicated childbirth (premature birth, weakness of labor activity, cord entanglement, etc.);
• birth trauma (asphyxia, traumatic brain injury)
• perinatal encephalopathy
• brain tumors that compress the hypothalamic region;
• neurotoxicosis in young children;
• traumatic brain injury in childhood (direct lesions of the hypothalamus)
• neuroinfections (meningoencephalitis, arachnoiditis and vasculitis) in children
• neurointoxication (drug addiction, alcoholism, occupational hazards, environmental problems)
• non-endocrine autoimmune diseases;
• recurrent bronchitis, acute respiratory viral infections, chronic foci of infection of the nasopharynx and paranasal sinuses, frequent tonsillitis;
• acute viral diseases (measles, parotitis, 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 of hormonal contraceptives by adolescent girls; teenage pregnancy and abortion.

Secondary GSPP develops against the background of leptin (alimentary-constitutional, hypodynamic obesity). The disease is characterized by dysfunction of the hypothalamus with impaired production of adenohypophysotropic hormones (corticoliberin, somatoliberin) and, as a result, 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 result, increased growth; violation of the production of gonadoliberin and gonadotropins, which leads to early or vice versa, late puberty; hyperfunction of basophilic cells of the adenohypophysis without their hyperplasia and functional hypercorticism. The synthesis of dopamine, serotonin, endorphins is disrupted, hyperprolactinemia develops, which is manifested by the development of gynecomastia (often false, due to gynoid obesity).

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

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

It is also possible to 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 the 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 “jump” in growth and is manifested by changes in the functioning of the adrenal glands, gonads, and thyroid gland. Predominantly in GSPP, physiological feedbacks and secretion of hormones, especially of the adrenal glands, are disturbed.

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

An increase in the secretion of gonadotropins leads to stimulation of the gonads and an increase in the level of total and free testosterone (hypertestosterone) in boys of 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. In the future, this 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 during the course of the disease.

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

With the progression of the pathology, the SAS reserves decrease, but the secretion of serotonin remains elevated. Melatonin levels are more closely related to the clinical manifestations of HS and remain low in the case of a recurrent unfavorable course of the pathology.

A significant role in the pathogenesis of GSPP is played by adipose tissue hormone leptin responsible for enhancing the feeling of satiety. The concentration of leptin in the blood of patients with HS is many times higher than the physiological parameters, especially in the abdominal type of obesity. Against this background, a leptin resistance.

Against the background of the aforementioned hormonal disorders, there is 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 the dysregulation of fat (an increase in the content of leptin in the blood is accompanied by an increase in appetite, which indicates a violation of feedback regulation of eating behavior) and carbohydrate metabolism (hyperinsulinemia leads to a rapid increase in fat and protein body mass and the development of arterial hypertension).

It is believed that hyperinsulinemia causes sodium and water retention and affects the distal 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, a violation of the metabolism of connective tissue proteins.

The main metabolic disorders in GSPP include lipid metabolism disorders. The most characteristic for patients with GSPP is type IV dyslipoproteinemia:

• increase in the concentration of triglycerides (TG);
• increased levels of cholesterol (Cholesterol) very low density lipoprotein (VLDL)
• normal total cholesterol (TC)
• an increase in the level of very low density and low density lipoproteins (LDL).

Less commonly, type II-A dyslipoproteinemia occurs when LDL levels rise with a moderate increase in total cholesterol while maintaining normal TG values.

Against the background of IR and hyperinsulinemia in HS, there is violation of carbohydrate metabolism. Patients with GSPP develop characteristic disorders of connective tissue protein metabolism. Almost a third of patients have a "flat" (hyperinsulinemic) glycemic curve. Carbohydrate intolerance is often diagnosed, especially in a typical clinical variant of HS, and it is in these patients that the index of insulin resistance HOMA-IR (homeostasis model assessment) reaches maximum values, although in other variants of the disease they significantly exceed the normative ones.

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

Hormonal imbalance leads to endocrine-metabolic disorders: fat, carbohydrate and water-electrolyte metabolism, which is joined by secondary dysfunction of the endocrine glands. After two or three years, catecholamine- and serotonin-producing structures are depleted. 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 passes into a chronic stage, which lasts at least four years - neurovegetative symptoms come to the fore.

The main pathogenetic and clinical aspect of GSPP is arterial hypertension(AG). The mechanisms underlying the relationship between hypertension and obesity are complex and multifactorial. Thus, obesity in GSPP 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 - with almost all factors. the risk of developing cardiovascular diseases and target organ damage in hypertension. All these factors play an important role in the increase in blood pressure (BP) and the development of hypertension in children and adolescents with GSPP.

At the same time, one of the leading places in the pathogenesis of GSPP belongs to hyperinsulinemia and IR, contributing to the activation of oxidative stress, tissue hypoxia, hyperproduction of insulin-like growth factor against the background of disorders of carbohydrate, lipid, protein metabolism, hemodynamic and other blood properties. Hyperinsulinemia activates the AT-I, AT-II receptors, promotes the development of hypertension and atherosclerosis, activates the SAS, and increases the level of endothelin-1. Hypertension is closely associated with high levels of plasma renin, plasminogen, 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 with excess body weight. Obesity is accompanied by a compensatory increase in cardiac output due to an increase in stroke volume and circulating blood volume. At the same time, 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 an increase in the load on the heart, which creates a vicious circle.

Hyperactivity of the SAS is crucial in the development of concomitant metabolic disorders such as insulin resistance (IR) and hyperlipidemia. Activation of the sympathetic nervous system (SNS) in GSPP is one of the pathogenetic mechanisms of the overeating chain: hyperinsulinemia - IR - increased products of fatty acid metabolism. 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 due to the 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 in puberty (12-15 years). Diagnosis can be difficult because symptoms can "mask" as other disorders.

Classification

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

According to its origin, the 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 the syndrome are distinguished:

• neuromuscular;
• violations of thermoregulation;
• hypothalamic epilepsy;
• neurotrophic;
• vegetative-vascular;
• metabolic and neuroendocrine disorders;
• pseudoneurasthenic (psychopathological);
• violation of desires and motivations.

In clinical practice, variants of the syndrome with a predominance of neurocirculation pathology, hypercortisolism (an excess of adrenal cortex hormones) or constitutional obesity are considered separately.

According to severity, mild, moderate and severe forms of pathology are distinguished.

The classification of the hypothalamic syndrome according to the type of development includes 4 forms:

1. stable.
2. Progressive.
3. Regressive.
4. Recurrent.

Causes

Note:The hypothalamus is a small area in the diencephalon responsible for homeostasis, thermoregulation, metabolism, eating and sexual behavior, and the condition of the blood vessels. With lesions of the hypothalamic structures, the regulation of the physiological reactions of the body is disturbed, and a vegetative crisis develops.

Possible causes of hypothalamic syndrome include:

Neurointoxication can be the result of occupational hazards (work with toxic compounds) or addictions (or chronic).

The presence of a vegetative component is characteristic of such chronic pathologies as, and constitutional.

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

Symptoms of hypothalamic syndrome

Pathological manifestations include:

Important:in adolescents of 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. Perhaps the formation of insulin resistance.

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

Patients experience vaso-insular crises, characterized by a feeling of heat, a rush of blood to the face, suffocation, sweating, dizziness and general weakness. Many patients complain of discomfort in the epigastric region. Urination is normal, and the volume of diuresis increases. Hypersensitivity reactions in the form of skin rashes and angioedema are not excluded. Objectively, bradycardia is detected (heart rate drops to 45-50 beats per minute). Arterial pressure drops to values ​​of 80/50 mm. rt. Art.

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

Note:before the onset of sympathetic-adrenal crises, so-called. "harbingers" - general lethargy, cephalalgia, unmotivated mood swings and stabbing.

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 has signs of both sympathetic-adrenal and vaso-insular crisis.

If thermoregulation suffers against the background of the hypothalamic syndrome, subfebrile temperature persists in patients 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 its decrease in the evening. Experts associate this symptom with physical and mental stress; it often develops during periods of active schooling and resolves during leisure.

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

Manifestations of disorders of drives and motivations:

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

With disorders of a neuroendocrine and metabolic nature, almost any metabolic process can suffer.

Possible manifestations include:

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

Ulcers of the gastrointestinal tract, dystrophic changes in the skin, muscle and bone tissue can become complications of the neuroendocrine-metabolic manifestations of the hypothalamic syndrome.

Diagnostics

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

The main criteria for verifying the diagnosis include:

• thermometry (axillary on 2 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 the drunk liquid and diuresis.

Important:to make a diagnosis, electroencephalography and the brain and an extended laboratory study of the patient's hormonal background are performed. EEG allows you to detect pathological changes in the deep structures of the brain. With the help of MRI, neoplasms and the consequences of TBI and oxygen starvation of tissues can be assessed and detected.

According to indications, doctors resort to the organs of the endocrine system - the adrenal glands and the thyroid gland.

During the diagnosis of hypothalamic syndrome, the levels of the following hormones are certainly taken:

In the daily urine, the content of 17-ketosteroids is also estimated.

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 to correct disorders of the hypothalamic structures.

First of all, the possible cause of the violations that have arisen is eliminated.. Injuries and tumors are subject to appropriate treatment, and chronic foci of infection are sanitized. When toxic lesions are detected, 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, Pyrroxane, Tofisopam, Sulpiride and agents from the group (in particular, Amitriptyline) are indicated.

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

The syndrome of post-traumatic genesis requires a cerebrospinal puncture and the use of measures to dehydrate the body.

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

Effective means for stimulating cerebral blood flow:

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

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

Important:crisis prevention is reduced to minimizing psychotraumatic factors and preventive reception

hypothalamic syndrome - this is a symptom complex of lesions of the hypothalamic region, characterized by autonomic, endocrine, metabolic and trophic disorders.

In the occurrence of hypothalamic syndrome, a significant place is occupied by various stressful situations, psychotraumatic effects, intoxication, craniocerebral trauma, vascular diseases, tumors, acute infections (flu, acute respiratory viral infections (ARI), pneumonia, viral neuroinfections), chronic infections (cholecystitis, sinusitis, tonsillitis , rheumatism, tuberculosis). Increased vascular permeability of the hypothalamus can contribute to the penetration of toxins and viruses from the blood into the brain, and the displacement of cerebrospinal fluid during traumatic brain injury can cause dysfunction of the hypothalamus. The occurrence of the hypothalamic syndrome is also facilitated by hereditary and acquired constitutional defectiveness of the hypothalamus and the structures of the limbic-reticular complex (limbic system and reticular formation) and the pituitary gland that are closely related to it. Often, the pathological course of pregnancy and childbirth can be one of the factors for incorrect laying 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) violation of sleep and wakefulness.

Hypothalamic syndrome, symptoms

The symptoms and clinic of hypothalamic disorders are very multifaceted and polymorphic, and 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 the crisis, post-crisis asthenia remains for a long time.

Sympathoadrenal crisis

Sympathoadrenal crisis with hypothalamic syndrome, it is manifested by a severe headache, pain in the region of the heart, palpitations, a feeling of fear, palpitations, a feeling of fear, shortness of breath, numbness of the extremities. The skin during a crisis is pale, dry, blood pressure (BP) is increased, 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), dilated pupils, increased rate (reaction) of erythrocyte sedimentation (ESR, ROE), hyperglycemia (increased blood glucose). The attack often ends with chills, frequent urination (pollakiuria) or a single copious separation of urine (polyuria).

Vagoinsular crisis

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

mixed crisis

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

Neuroendocrine-exchange form | hypothalamic syndrome

Neuroendocrine-exchange 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 be observed.

diabetes insipidus

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

Adiposogenital dystrophy

2) adiposogenital dystrophy- Pehkrantz-Babinski-Fröhlich syndrome (alimentary obesity, increased appetite, hypogenitalism, general weakness, various endocrine disorders);

Hyperostosis frontal

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

juvenile basophilism

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

Pituitary cachexia

5) pituitary cachexia- hypothalamic-pituitary cachexia, panhypopituitarism, Simmonds syndrome (rapid weight loss 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 unilateral, oculomotor disorders, more often external ophthalmoplegia, diplopia, keratitis, atrophy of the optic discs are possible);

precocious puberty

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

Delayed puberty

8) delayed puberty- occurs mainly in boys in adolescence and is manifested by the female type, hypogenitalism, lethargy, decreased initiative;

Gigantism

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

Acromegaly

10) acromegaly- Marie's syndrome, or Marie-Leri's syndrome is a neuroendocrine syndrome caused by significant increases 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 associated with eosinophilic pituitary adenoma, sometimes acromegaly can develop after a traumatic brain injury, intoxication, infection, stressful conditions; there is an increase in the size of the hands, feet, facial skeleton, nose, tongue, ears, internal organs;

Nanism, dwarfism

11) nanism / dwarfism/ - (nanos - dwarf) is a clinical syndrome, manifested by extremely small stature (compared to the sex and age norm), occurs relatively often, causing mental distress both in the child and in his parents, especially against the background of acceleration in other children, often manifested in combination with other malformations (hydrocephalus, microcephaly, mental retardation, eye changes), in patients with chromosomal syndromes (Down's 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 as a result of excessive secretion 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 of high doses of corticosteroids or ACTH, manifests itself with symptoms of hypercortisolism (uneven obesity, moon-shaped face, fat deposits in the neck, upper half of the body, skin trophic disorders, osteoporosis , increased blood pressure, amyotrophy in the proximal limbs, intracranial hypertension, pyramidal and stem symptoms);

Laurence-Moon-Barde-Biedl syndrome

13) Laurence-Moon-Barde-Biedl syndrome- hereditary diencephalic-retinal pathology, which includes Laurence-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 Laurence-Moon syndrome are mental retardation, pigmentary retinopathy, hypogenitalism, spastic paraplegia, Bardet-Biedl syndrome - mental retardation, pigmentary retinopathy, hypogenitalism, obesity, polydactyly.

Violation of thermoregulation, hypothalamic syndrome with violation of thermoregulation

Violation of thermoregulation hypothalamic genesis is most often manifested in the form of prolonged subfebrile condition, 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 in 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 tolerance, no changes in the blood and urine, a negative amidopyrine test, a perverted Shcherbak thermoregulatory reflex (with normal thermoregulation rectal temperature rises by 0.5 degrees Celsius after immersing hands in water at a temperature of 32 degrees and gradually increasing it to 42 degrees). Impaired thermoregulation can also be manifested by 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 which a violation of consciousness occurs, and tonic convulsions develop. On the electroencephalogram (EEG), epileptic activity (epiactivity) of the temporal localization can be detected. 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 its pure form, the neuro-trophic form is rare, and trophic disorders are included in the structure of other forms of the hypothalamic syndrome, more often in the neuroendocrine-metabolic form.

Neuromuscular form, catalepsy, narcolepsy | hypothalamic syndrome

neuromuscular form manifested by general weakness, adynamia, transient atypical attacks of catalepsy. Catalepsy (affective adynamia, emotional asthenia, affective loss of muscle tone, Lowenfeld-Enneberg syndrome) is a short-term paroxysmal loss of muscle tone that occurs more often with strong emotional influences and leads to a fall of the patient 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 between 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, and internal hydrocephalus. Attacks of drowsiness occur suddenly, often in inadequate states: while eating, walking, talking, urinating. Seizures usually last a few minutes. Depending on the external manifestations, neurologists distinguish 2 forms of narcolepsy: monosymptomatic, which manifests itself only with attacks of falling asleep, and polysymptomatic, which manifests itself with attacks of falling asleep, catalepsy, night sleep disturbances, and hypnogogic hallucinations.

Hallucinations, Pickwickian syndrome, Kleine-Levin syndrome

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

Clinical forms of hypothalamic syndrome rarely occur in isolation. So vegetative-vascular (vegetative-vascular) crises can be observed with 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 effects. Sarclinic (Saratov) treats all forms of hypothalamic syndrome. The treatment includes various methods of reflexology, methods of linear-segmental reflex massage, acupuncture techniques, laser reflexotherapy, tsubotherapy, etc.

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

Complex differentiated treatment of patients with hypothalamic syndrome with the widespread use of effective techniques, it can 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, in children, in adolescents, in adults (men and women), what is mild, moderate, severe hypothalamic pubertal juvenile neuroendocrine syndrome (neuroendocrine form) how the army is connected, wikipedia and with hypothalamic syndrome.

There are contraindications. Specialist consultation is required.
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