No stress! How to cope with autonomic dysfunction

The autonomic nervous system (ANS) is one of the main control systems of the body. It is uncontrollable by the will of a person, controls the activity of smooth muscles of organs and tissues (walls of blood vessels, bronchi, secretion of glands, functions of the gastrointestinal tract, urinary tract, etc.).

The ANS maintains blood pressure and blood flow (baroreceptor and orthostatic reflex), coordinates the functions of internal organs in accordance with the needs of the body (e.g. motility and gastrointestinal secretions), participates in thermoregulation, helps maintain homeostasis in difficult conditions (increased stress, changes in homeostasis) . Any disorder of the autonomic nervous system (ICD-10 - C10.177) leads to disruption of these functions.

Autonomic nervous system disorders

Disorders and diseases of the autonomic nervous system can occur at any age, some of which are hereditary (diagnosed in newborns or adolescents). In older age, they are often part of neurodegenerative diseases such as Parkinson's disease or metabolic diseases, in particular diabetes. In general, they can be divided into several schemes.

In terms of origin:

• Primary disorders. Includes various types of dysautonomia, Shy-Dragger syndrome or multiple system atrophy, autonomic degeneration associated with Parkinson's disease.
• Secondary disorders. Caused by autoimmune inflammation in Guillain-Barré syndrome, metabolic disease, chronic renal failure, trauma, etc.

In terms of breadth:

• Localized disorders such as Horner's syndrome, sweating disorders on the upper half of the body in diabetes, swallowing disorders in diabetics, alcoholics, and Parkinson's disease.
• Generalized disorders, for example, fainting with a temporary decrease in sympathetic activity in young girls, in a hot environment, etc.

Nervous system dysfunction can arise from different mechanisms, at different levels. RVNS are divided into several groups depending on the dominant problem.

How to cope with cerebrovascular disease?

How to treat nervous system exhaustion correctly? First of all, you need to eliminate the traumatic factor. This could be stress, chronic intoxication (alcoholism), lack of sleep, or simply a period of recovery after severe pneumonia. Non-drug treatments for cerebrasthenia include :

• healthy and long sleep;

• motor mode;

• good nutrition;

• positive emotions.

Physiotherapy, massage, and sanatorium and resort treatment are used in therapy. Thalassotherapy, bathing, communication with animals, and long walks have a good effect.

What drugs are indicated for depletion of the nervous system?

Drug therapy includes the administration of adaptogens. These include such remedies as ginseng root, tincture of eleutherococcus, and lemongrass. You can drink coffee in moderation. If you have good dry wine, you can drink it, limiting yourself to one glass a day.

For cerebrovascular disease and depletion of the nervous system, vitamins are indicated . First of all, neurotropic vitamins, or B vitamins, should be prescribed. These include thiamine, pyridoxine and cyanocobalamin, or vitamins B1, B6 and B12.

In addition to these vitamins, it is important to take potassium, phosphorus and magnesium supplements to improve cardiac function.

Somatoform autonomic dysfunction

Somatoform dysfunction of the autonomic nervous system is a disorder in which a person experiences symptoms similar to those of systemic or organ diseases. Signs are largely or entirely under autonomic innervation and control.

The circulatory system (cardiac neurosis), respiratory tract (psychogenic hyperventilation and hiccups), and gastrointestinal tract (gastric neurosis, nervous diarrhea) are most often affected.

Symptoms of somatoform dysfunction of the autonomic nervous system are usually of two types, neither of which indicate physical impairment of the organ or system involved:

• In the first type of disorder, there are complaints of objective symptoms of autonomic irritation, such as heartbeat, sweating, redness, and trembling.
• The second type of disorder is characterized by more unusual and atypical signs of physical illness, such as pain, burning, heaviness, and bloating.

Symptoms are not under the person's conscious control. This is not a simulation. We could talk about it if his actions were purposefully aimed at obtaining some kind of benefit or profit. But here it is an unconscious process.

Treatment

Recommendations for the effective treatment of somatoform dysfunction of the autonomic nervous system:

• stable treatment with one psychiatrist and one therapist;
• recognition of the truth of the patient's symptoms;
• regular doctor visits;
• use of alternative and instrumental methods and means;
• psychotherapeutic assistance to switch the patient’s attention from symptoms to personal problems, tracking family history in this direction;
• attempts to interpret signs as ways of emotional communication rather than as a new disease.

Diagnostics

The diagnosis of autonomic dysfunction syndrome is made based on:

1. clinical interview;
2. objective examination of the patient;
3. instrumental research methods: ECG, EEG, MRI;
4. general clinical tests: general blood and urine analysis, biochemical blood test;
5. tests with a beta-adrenergic receptor blocker;
6. tests with dosed physical activity;
7. potassium tests;
8. hyperventilation tests.

Adi syndrome

Adi syndrome is a disease of the nervous system that has numerous manifestations. It's not very common. Adi syndrome is rarely congenital and usually occurs during life.

Causes

The cause of Adi syndrome is not fully understood; it is believed that infection (bacterial or viral) leads to damage to the nervous system, especially its autonomic component.

Manifestations

Destruction of the nerve fibers of the pupil leads to disruption of its reaction (pupilotonia). In a normal person, the pupil dilates in the dark and contracts in the light. The diseased pupil reacts slowly and ineffectively to light changes - it can narrow in the dark (rarely) or expand in the light (more often). Usually only one eye is affected. A person may experience blurred visual acuity, an inability to focus visual attention as well as healthy people.

In addition to visual impairment, the patient experiences increased sweating, also associated with dysfunction of the autonomic nervous system. Last but not least, abnormal tendon reflexes are also present in Adi syndrome. The most common disorder is the Achilles tendon. Patients suffer from unpleasant attacks of sudden drop in blood pressure and have a higher tendency to collapse.

Treatment

Treatment options are limited. Possible visual impairments can be corrected with glasses; Sometimes special drops containing pilocarpine are used. Pilocarpine is a compound that has the ability to temporarily constrict the pupil. There are practically no other therapeutic methods for RVNS.

Nervous exhaustion?

Arthur, Yerevan

January 5, 2018

Hello, at the end of August a person had an overdose of amphetamine (tachycardia, severe tremor of the whole body, increased blood pressure, blue spots on the skin, fainting conditions, hearing loss, dizziness, weakness, squeaking in the ears, sensations of electric shocks in the body and in the brain) continued this condition lasted for three days, then it got better every day and a week later the person went back to work, there were no problems with night sleep, which is surprising, the person did not call an ambulance, he was afraid of ending up in a drug treatment center (a person is not into all this). He worked for a month, feeling slightly unwell and lack of strength, until a severe PA occurred with an increase in pressure to 190/120, and a pulse of 130, after which his appetite and strength completely disappeared, he could not get out of bed, there was a feeling of severe anxiety, hopelessness, the slightest physical activity caused tachycardia and shortness of breath, every day it became worse until they were taken to the hospital (therapeutic department) after another PA, but they kept silent about amphetamine, the doctor referred to a psychiatrist because it seemed to her that it was depression, at the appointment the psychiatrist listened to everything complaints and diagnosed recurrent depressive disorder of moderate severity, prescribed Paxil, Teraligen, Phenotropil. So, after taking phenotropil, the symptoms experienced during an overdose returned to him, namely, abnormal lightness, flushes of heat or cold throughout the body, tremors, electric shocks throughout the body, tingling throughout the body, problems with sleep appeared (when relaxing and trying to fall asleep, shocks the “electric shock” became stronger and seemed to push him out of sleep), the psychiatrist was informed about this, but she just shrugged and said that he needed to drink it for thirty days, apparently it worked well, he drank it for three more days until at night the strongest tremors and severe blows began “ electric shock", waves of heat and cold, severe sweating, temperature rise to 39, an absolutely sleepless night in semi-delirium, after that they stopped drinking phenotropil, it became a little easier, but a painful reaction to sounds, light, tremor, pulsation of heartbeats throughout the body remained . Three weeks later they were discharged from the hospital, they stopped drinking everything prescribed by the doctor, the emotional state became better, but the symptoms that appeared after taking Phentropil still remained, a painful reaction to sounds (not always, rather from unexpected or loud sounds), a normal reaction to light, pulsation of heartbeats throughout the body occasionally 2-3 times during the day and before bed almost every day, tremors 2-3 times during the day, difficulty concentrating, sometimes squeaking in the ears, emotionally hypochondria and anxiety, but this is more likely from a lack of understanding of what is happening to him and what to do. Every other day he goes for a run, trying not to lie too long, but this condition greatly limits and poisons life. Tell me, what could it be? Nervous exhaustion? He doesn't drink, doesn't smoke, he's a devil! Is there a cure for this, and if so, for how long? Who to contact? We have a small town, doctors just shrug their shoulders, they did an MRI, an echocardiogram, an ultrasound of the kidneys, liver, adrenals, thyroid gland, everything is normal, blood is normal, thyroid hormones are normal, please help

The question is closed

nervous exhaustion

Autonomic dysreflexia

Autonomic dysreflexia is a serious complication affecting more than 50% of patients with spinal cord injury above the 6th thoracic region. In a disorder of the autonomic nervous system, irritation below the level of the spinal cord lesion is the source of severe vasoconstriction, causing paroxysmal hypertension.

Manifestations

An exacerbation of blood pressure may present with one or more of the following symptoms:

• A sudden and significant increase in systolic and diastolic blood pressure above the patient's normal level, usually associated with bradycardia.
• Throbbing headache.
• Significant sweating above the level of the lesion, especially on the face, neck and shoulders (rarely below the level of the lesion).
• Goose bumps above and below the level of the lesion.
• Blurred vision, spots in the field of vision.
• Hyperemia and swelling of the nasal mucosa, a feeling of nasal congestion.
• Bad feeling, fear, anxiety due to an impending insurmountable physical problem.
• Minimal or no symptoms of hypertension despite increased blood pressure.
• Cardiovascular signs (arrhythmias, extrasystoles).

Symptoms may be minimal or even absent despite the hypertensive state.

Causes

Autonomic dysreflexia has many potential causes. To eliminate an attack, it is necessary to conduct a diagnosis aimed at identifying a specific causative factor. The most common reasons:

• urinary tract infections;
• cystoscopy, urodynamic study, incorrect catheterization;
• inflammation of the testicles or their depression;
• expansion of the full colon during constipation;
• intestinal obstruction;
• gallstones;
• stomach ulcers or inflammation of the stomach lining;
• haemorrhoids;
• appendicitis or other abdominal pathology, trauma;
• menstruation;
• pregnancy, especially childbirth;
• vaginitis;
• sexual intercourse, orgasm;
• ejaculation;
• deep thrombosis;
• pulmonary embolism;
• frostbite;
• tight clothes, shoes;
• burns (including sunburn);
• fracture or other injury;
• surgical or diagnostic procedures;
• pain;
• osteochondrosis;
• temperature fluctuations;
• any painful or irritating sensations below the level of injury;
• drugs, large amounts of alcohol, etc.

Treatment

The procedure for treating an episode of autonomic dysreflexia begins with repositioning the patient using orthostatic blood pressure lowering. The next important condition is to relax the tight parts of clothing and remove compression products. The goal is to relieve symptoms and prevent complications associated with uncontrolled hypertension.

Pharmacological treatment:

• Nifedipine (Cordipine) is a calcium channel blocker that selectively inhibits the penetration of calcium ions through the cell membrane of the heart muscle and through the membrane of vascular smooth muscle without changing the concentration of calcium in the blood serum.
• Nitrates (nitroglycerin, isosorbide dinitrate) are drugs that relax vascular smooth muscle, with a vasodilator effect on peripheral arteries and veins.
• Terazosin is a long-acting drug that selectively blocks alpha-1 adrenergic receptors. Selective alpha-1 blockade causes relaxation of vascular smooth muscle.
• Prazosin is a selective alpha-adrenergic receptor antagonist that reduces total peripheral resistance associated with sympathetic activity.
• Captopril is a specific angiotensin-converting enzyme (ACE) inhibitor that blocks the renin-angiotensin-aldosterone system and causes a decrease in peripheral arterial resistance without changing cardiac output.

Complex regional pain syndrome

Complex regional pain syndrome (CRPS) is a term used to describe a variety of regionally localized pain conditions that are primarily the result of trauma. They are characterized by clinical changes with a maximum distance from the primary affected area.

Manifestations

The process of SRPS is divided into 3 stages, each of which has its own clinical picture.

Acute stage (decreased sympathetic activity):

• increased blood circulation;
• temperature increase;
• sweating;
• acceleration of body hair and nail growth;
• local swelling;
• redness;
• decreased mobility.

Dystrophic stage (increased sympathetic activity):

• decreased blood circulation and skin temperature;
• slower hair growth, brittle nails;
• expansion of edema;
• more pronounced limitation of range of motion;
• spotted osteoporosis.

Atrophic phase (irreversible):

• deepening tissue changes;
• damage to all tissues, leading to irreversible disruption of the configuration and position of the joints;
• joint deformities with severe mobility impairment;
• necrosis.

Causes

This dysfunction of the nervous system has both external and internal causes.

External factors:

• injuries (skeleton, soft tissues, nerves);
• operations;
• burns;
• frostbite;
• overload of muscles and ligaments;
• inappropriate and painful treatment methods (tight cast, painful rehabilitation, incorrectly prescribed physical therapy), especially in a child.

Internal factors:

• inflammation (nonspecific, specific);
• heart attack;
• stroke;
• tumor hyperemia;
• barbiturate intoxication;
• anti-tuberculosis therapy.

Treatment

Treatment of SRPS should be comprehensive, including regimen measures, rehabilitation, physical therapy, pharmacotherapy and invasive means. Treatment of advanced disease always requires a specialized approach in the field of neurology. Only stages 1-2 of the disease have a good prognosis (hope for a positive functional result).

The basic principle is pain relief with analgesics and physical means. The affected segment should not be overloaded even during rehabilitation.

Today there are no generally accepted criteria for the treatment of this serious disease based on medical evidence. This reflects the fact that only a few randomized treatment trials have been published in this area to date.

Horner's syndrome

Horner's syndrome is a neurotic syndrome, a combination of 3 symptoms that arise from disorders of the sympathetic nervous system in the neck area. The sympathetic nervous system is a set of nerves and nerve ganglia that regulate certain functions of the body that do not depend on the will of a person. The cervical sympathetic system also controls the eyes.

Causes

There are many causes of cervical sympathetic nerve damage. In addition to neck injuries, some locally growing tumors are involved in the genesis, such as thyroid and lung cancer growing in the upper lobe of the lung (Pancoast tumor). Symptoms consistent with Horner syndrome may also occur with disorders such as:

• multiple sclerosis;
• spinal cord damage due to syringomyelia;
• thrombosis of the cavernous canal;
• migraine (temporary).

Manifestations

The most common signs of sympathetic damage:

• constriction of the pupil (miosis);
• drooping eyelid (ptosis);
• visible slight recession of the eye into the orbital fossa (enophthalmos).

The most noticeable constriction of one pupil. There may also be facial redness on the affected side. This phenomenon is caused by the dilation of subcutaneous blood vessels in this area of ​​the skin.

Treatment

A patient with Horner's syndrome should be examined by a neurologist; As part of the diagnosis, it is important to exclude brain disease (CT or MRI), compression of the nerve structures in the neck (ultrasound, CT).

Treatment of the syndrome depends on the underlying disease. If the disease is treatable and the nerve damage is not irreversible, the condition can be corrected through strengthening techniques and medications.

Damage to the autonomic system due to poisoning

Autonomic disorder can be caused by organophosphates - substances that block the action of acetylcholisterase, an enzyme that breaks down acetylcholine. Thus, a large amount of acetylcholine accumulates in synapses, which, by binding to receptors, can cause long-term effects and various manifestations.

Organophosphates were originally developed as warfare gases under the names sarin, soman, and tabun. Today they are widely used as insecticides. The effects of organophosphates can be divided depending on the receptors on which they act:

• Nicotine. They arise due to the activation of sympathetic and parasympathetic ganglia and are manifested by changes in blood pressure, cardiac activity, metabolic disorders, and convulsions due to the presence of nicotinic receptors on the neuromuscular disc.
• Muscarinic – peripheral-parasympathetic. Manifestations include salivation, lacrimation, diarrhea, increased motility, vomiting, and bronchospasm.
• Acetylcholine occurs as a neurotransmitter primarily with excitatory effects in the central nervous system. At first the effects are irritating, then fade away. They manifest themselves as headaches, dizziness, feelings of fear, miosis, and loss of consciousness.

About prevention

Symptoms of nervous system exhaustion require mandatory treatment as soon as they appear. Chronic stress leads to aggravation of cerebrovascular disease, and it occurs due to:

• constant presence at work;

• poor and conflictual conditions in the family;

• monotonous, monotonous posture, accompanied by muscle tension;

• long-term, chronic infections, including colds.

To have strong nerves that will accurately carry out all your orders, you need to try to get more positive emotions, lead an active life, give up bad habits, and also train your mind and not let it get lazy. And in that case, cerebrovascular disease and vegetative-vascular dystonia will never be your painful and annoying companions.