Discirculatory brain encephalopathy
Discirculatory brain encephalopathyhas a vascular etiology. The development of this syndrome of chronic lesions of progressive nature is associated with a permanent lack of blood supply or acute repeated circulatory disorders. In this case, the course of acute circulatory disturbances of the brain is observed in combination with the clinical course of strokes or without it. "Silent" infarcts are detected in such cases by means of neuroimaging or MRI. Discirculatory encephalopathy of the brain is clinically manifested by mental, neurological and / or neuropsychological disorders.
Taking into account the recommendations of the Scientific Research Institute of Neurology in the Russian Academy of Medical Science, three degrees of severity (or stages) of the disease are distinguished.
At the first degree there is a predominancesubjective symptoms. These include noise in the head, decreased attention, dizziness, increased fatigue, headache, sleep disturbance, and unsteadiness while walking. During the examination, pseudobulbar manifestations are detected in an easy degree, anisoreflexia, a decrease in the step length, and revival in tendon reflexes. Neuropsychological research reveals the presence of moderate cognitive impairments of the frontal-subcortical nature (impairment of cognitive activity, attention, memory) or neurosis-like disorders, mainly asthenic type. However, the patient can compensate for neurotic disorders. Thus, they do not limit its social adaptation.
Discirculatory encephalopathy of the brain inThe second stage is characterized by the formation of clear clinical manifestations. In this case, there is a significant reduction in the functional capabilities of the patient: clinically apparent cognitive impairment, which is associated with dysfunction in the frontal lobes. At the same time there is a slowing down of mental processes, a decrease in memory, a violation of thinking. The patient is not able to monitor and plan the actions. There are also pronounced vestibulo-cerebral disorders, irregularities during walking, postural instability, pseudobulbar syndrome. The second stage proceeds in the accompaniment of apathy, depression, emotional lability, increased disinhibition and irritability. In rare cases, there is parkinsonism. The disease can be accompanied by frequent urination at night. The second stage of the disease affects social and professional adaptation, while there is a significant decrease in the patient's working capacity, but the ability to self-service itself remains. Discirculatory brain encephalopathy in the second stage corresponds to the second-third group of disability.
The third stage of the disease occurs with the manifestationthe same symptoms as in the second stage. However, it is necessary to note the strengthening of their disabling effects. Cognitive disorders acquire a moderate or severe degree of dementia, accompanied by gross behavioral or affective disorders. These manifestations include apatiko-abulic syndrome, a severe decrease in criticism, and disinhibition. Walking is also accompanied by gross violations, frequent falls caused by a disorder of postural equilibrium. Cerebellar disorders become more pronounced, there is incontinence, severe parkinsonism. Violation of social adaptation is accompanied by loss of ability to self-service. At this stage of the disease, the patient is assigned the first or second group of disability.
Alcohol encephalopathy of the brain
This disease occurs most often withtoxic organ damage caused by alcohol, with eating disorders (eg, anorexia) and in persons with severe depletion.
Encephalopathy of the brain in children
This disease appears, as a rule, betweenthe twenty-eighth week of gestation and the first week after childbirth. The disease can be triggered by oxygen starvation, infection, or cord injury by the umbilical cord. The causes of the disease include premature or difficult births.
