Vegetative-vascular dystonia

Classification and the causes

The neuroculatory dystonic (NCD, a vegetative-vascular dystonia) has the functional nature. For it disorders of neuroendocrinal regulation of activity of cardiovascular system are characteristic. At teenagers and young men NCD it is caused by a mismatch of physical development and degree of maturity of the is excitatory-endocrine apparatus more often. At other age dystonia development can be promoted psychological attrition in an outcome of acute and chronic infectious diseases and intoxications, by a sleep loss, overfatigue, irregular diets, to sexual life, physical activity (lowered or too intensive).

The changes caused by failures in control by a tonus of sympathetic and parasympathetic systems (concern a vegetative nervous system) from the higher vegetative centres, can lead to development of a so-called vegetative dystonia. More often it shows disorder of cardiovascular activity with development of a vascular dystonia. At some humans the vegetative dystonia is observed from a birth: they badly tolerate a heat or a cold, at excitement redden or turn pale, become covered then. At children the vegetative dystonia can show a night incontience of urine. At adults (more often at women) disturbance of regulatory functions of a vegetative nervous system sometimes proceeds in the form of attacks - vegetative crises.

The vascular dystonia arises because of the excitatory overstrain or after acute and chronic infectious diseases, venenatings, vitamin insufficiency, nervous breakdowns. Symptoms of a vascular dystonia can be constants or show attacks - so-called vegetovascular paroxysms. Constant symptoms happen at congenital instability of the excitatory system is more often. Such humans badly tolerate weather changing; at physical work and emotional experiences easily turn pale, redden, test the palpitation, the raised sweating. Vegetovascular paroxysms begin either with a headache, or from a pain in the field of heart and palpitation, reddening or a blanching of the person. The blood pressure rises, sphygmus becomes frequent, the body temperature raises, the fever begins. Sometimes there is a causeless pavor. In other cases there comes the general delicacy, there is a giddiness, blackout, a sweating, a nausea, the blood pressure decreases, sphygmus decreases. Attacks last from several minutes to 2 - 3 hours, and at many pass without treatment. At an exacerbation of a vascular dystonia of a brush and autopodium become bagrovo-cyanotic, wet, cold. Blanching fields on this background give to a skin a mottled kind. In dactyls there is a numbness, sensation of crawling of jimjams, a pricking, and sometimes pains. Sensitivity to a cold raises, arms and feet strongly turn pale, sometimes dactyls become bloated, especially at a long frigorism of brushes or autopodiums. Overfatigue and excitement cause increase of attacks. After an attack for some days there can be a sense of weakness and a febricula.

One of forms of vegetovascular paroxysms is the syncope. At a syncope subitaneously darkens in eyes, the person turns pale, there comes strong delicacy. The human loses consciousness and drops. Cramps usually does not happen. The syncope passes in a prone position faster, it is promoted also by an aspiration through a liquid ammonia nose.

Symptoms and flow

Patients delicacy, fatigability disturb, sleep disorders, irritability. Depending on reaction of cardiovascular system excrete 3 types NCD: cardial, hypotensive and hypertensive. A cardial type - complaints to palpitation, faults in heart range, sometimes sensation of shortage of air, can become perceptible changes of a warm rhythm (the sinus tachycardia, the expressed respiratory arrhythmia, a supraventricular extrasystole). On an electrocardiogram of changes is not present or sometimes changes of tooth T become perceptible.

Hypotensive type - fatigability, muscular delicacy, a headache (it is quite often provoked by hunger), a chilliness of brushes and autopodiums, predilection to syncopal conditions. The skin usually acyanotic, brushes of arms cold, palms wet, becomes perceptible depression of a systolic BP more low 100 mm Hg. A hypertensive type - transient rising of arterial pressure which almost at half of patients is not combined with change of state of health is characteristic and for the first time is found during medical inspection. On an eyeground unlike an idiopathic hypertensia of changes is not present. In some cases complaints to a headache, palpitation, fatigability are possible.

Tachycardia at an insignificant exercise stress, the tendency to rising (a hypertensive type) or to dropping (a hypotonic type) arterial pressure, cold brushes, stops. Besides, "the respiratory syndrome" which consists in sensation of "a respiratory corset", a dyspnea, a shallow breathing with inspiration restriction can be observed so-called. Hypertensive type Vegetative-vascular dystonia is characterised by lifting of arterial pressure to 140/90 - 170/95 mm Hg, and a hypotonic type vegetatively - vascular (or neurocirculatory) dystonias - depression of arterial pressure to 100/50 - 90/45 mm Hg. Clinical picture Vegetative-vascular dystonia supplement: fast fatigability, working capacity depression, syncopal conditions

It is considered more lawful to survey Vegetative-vascular dystonia in frameworks not so much the independent form, how many a syndrome, and the factors causing this disease, to assort as follows: the constitutional nature, endocrine rearrangements of an organism, a primary lesion of visceral organs, primary diseases of peripheric closed glands, an allergy, an organic lesion of a great brain, neurosises.

Syndrome Vegetative-vascular dystonia of the constitutional nature - shows at early children's age and is characterised by instability of vegetative parametres. Fast change of a coloration of a skin, a sweating, fluctuations of frequency of warm reductions, arterial pressure, a pain and a dyskinesia of a gastrointestinal tract, predilection to a subfebrile condition, a nausea, bad shipping of a physical and mental strain, meteotropy becomes perceptible. Quite often these disorders have heredo-familial character.

To syndrome Vegetative-vascular dystonia arising against endocrine rearrangements of an organism in the pubertal season, insufficient vegetative maintenance (typical implications of a syndrome are vegetative disturbances against the easy or expressed endocrine disorders) concerns.

Syndrome Vegetative-vascular dystonia can arise at an organic lesion of a brain. Any form of a cerebral pathology is accompanied by vegetative disturbances. They are most expressed at a lesion of deep structures: a fulcrum, a hypothalamus and a limbic brain. At interest of caudal parts of a cerebral fulcrum hour are defined vegetatively - vestibular crises which begin with giddiness, and in the paroxysm prevail vagoinsular implications. In case of a pathology of structures of a diencephalon which are in topographical affinity and in a close functional linkage with a hypothalamus, the basic syndromes the following: neuroendocrinal (excepting a primary lesion of peripheric hemadens), motivational (hunger, thirst, a libido), thermoregulation disturbance, pathological drowsiness of paroxysmal character, vegetovascular crises (more often sympathoadrenal). The lesion of a limbic brain (intrinsic part of a temporal lobe) shows first of all a syndrome of a temporal epilepsy.

However it is frequent Vegetative-vascular dystonia acts not as a syndrome, and as the independent nosological form with various features of flow. Unlike a syndrome this form has no communication with etiotropic factors and its development in larger degree is promoted by congenital inferiority Vegetative-vascular dystonia. In many cases some factors are taped: one of them - contributing, others - realising disease. Clinical symptoms of disease are various, are characterised by prevalence of subjective implications over the objective. There are no organic changes from all systems of an organism: visceral, warm, the excitatory, endocrine etc. Meanwhile obviously define functional disturbances, especially from the cardiovascular and vegetative excitatory the systems, most accurately expressed in paroxysms.

Treatment

The prevention of a vascular dystonia should begin with tempering at children's and youthful age, the organisation of a rational regimen of work and rest. It is necessary to avoid the excitatory overstrains, at disease carefully to observe a regimen and other appointments of the doctor.

Mainly not medicamental methods: normalisation of the mode of life, tempering procedures, employment by physical culture and some kinds of sports (swimming, track and field athletics). The physiotherapy, a balneotherapy, sanatorium treatment is used. At irritability, sleep disorders - preparations of Valeriana, Leonurus, valocordin, sometimes tranquilizers. At a hypotensive type - physiotherapy exercises, Belloidum, caffeine, Phethanolum. At a hypertensive type - beta adrenoblockers, Rauwolfia preparations.

1. The balanced regimen of day, a sleep - the best rest (8-10 hours)
2. Adequate physical activity. Only teenagers from a BP 140-90 and above are engaged in preparatory sports bunch the others basically. Good effect employment in pool render, run, skis, aerobics, dances, skis. It is possible to use a bicycle.
3. A diet containing all necessary ingredients, vitamin-rich, the products keeping salts of a potassium - a potato, eggplants, cabbage, prunes, apricots, raisin, a fig, a green peas, parsley, tomatoes, a rhubarb, a beet, fennel, a string bean, a dock are shown. A part of animal Adepses to change vegetative (oils sunflower, corn, olive). With the raised BP - the products keeping salts of magnesium buckwheat, oat, wheaten groats, nuts, a soya, a string bean, carrots, a dogrose are necessary. To exclude from pickle nutrition, marinades, to confine salt to 4-5г. Strong tea, coffee, chocolate are contraindicative.
4. Psychotherapy: relaxation methods, a combination of autogenic training and direct suggestion, the permission of a psychologic problem. Family psychotherapy. The purpose - to normalise the attitude of the person to associates, putting off of psychologic intensity.
5. Massage of a head, collar region С1-С4, backs. Duration of sessions of 8-10-15 minutes, a course-18-20 of procedures. With the lowered BP massage of a trunk, extremities brushes.
6. A phytotherapy: Valeriana, Viburnum red, a peony, Leonurus, a basis a sedation, possess the same action and the soft diuretic a quince, a birch mushroom, a poppy, almonds, carrots, mint, a parsnip, a liquorice. In the absence of BP normalisation add agents about Reserpinum similar and beta adrenoblocking action: a running myrtle, a butter-bur, a vervain, a dragonhead, a magnolia, Rauwolfia, a black mountain ash, an arnica, a Labrador tea, the shepherd's ascus.
7. In the absence of effect from the described actions it is necessary to pass to medicamental therapy.

Treatment of a vascular dystonia - complex with application of medicines and physiotherapeutic procedures, is spent on doctor's orders. With a view of improvement of patients physiotherapy exercises, country walks, tourism, sanatorium treatment, the normalisation of a mode of life tempering procedures are widely applied. At irritability, sleep disorders - preparations of Valeriana, Leonurus, valocordin, sometimes tranquilizers. At a hypotensive type - physiotherapy exercises, Belloidum, caffeine, Phethanolum. At a hypertensive type - beta adrenoblockers, Rauwolfia preparations.

Bromidums, Dimedrol, Belloidum, tranquilizers, camphor Monobromidum, physiotherapy exercises (methods of autogenic training, the general tempering, psychophysical charging, self-massage) and physio procedures (pine needle baths, souls, etc.), rest on fresh air are shown.

Physiotherapy exercises

The dosed application of physical exercises counterbalances processes of excitation and inhibition in a CNS, raises its regulating role in coordination of activity of the major organs and the systems involved in pathological process.

PE normalising impact on vascular reactance makes, promoting depression of a tonus of pots at the expressed spastic reactions at patients and to asymmetry alignment in a condition of a tonus of pots. It is in turn accompanied by distinct depression of a BP. Physical exercises raise contractile ability of a myocardium. At patients venous pressure indicators are normalised, rate of a blood flow both in coronary, and in peripheric pots that is accompanied by augmentation of minute volume of heart and peripheric resistance reduction in pots is enlarged. Under the influence of the dosed physical exercises indicators of the lipide exchange, coagulabling activity of blood are normalised and the anticoagulative system is activated. Kompensatorno-adaptive reactions educe, acclimatisation of an organism of the patient to environment and various choronomic stimuluses raises. Especially beneficial effect on patients is rendered by special physical exercises. Under the influence of PE at patients the mood is enriched, the headache, the giddiness, unpleasant sensations in the field of heart etc. decrease.

Intensity and volume of employment depend on the general physical preparation and the functional condition of the cardiovascular system defined at carrying out of dosed assays with a load. Patients accept the morning hygienic gymnastics, the dosed walking, near tourism (mainly in sanatorium conditions), sports or their elements; physical exercises in water, exercises on training apparatus, massage of collar range.

The morning hygienic gymnastics is more often spent by a so-called separate method when physical exercises carry out one behind another after an explanation and display by their instructor. Music underneath promotes not only to rising of an emotional tonus of the patient, but also facilitates performance of physical exercises (a rhythm, rate). In morning hygienic gymnastics apply the elementary physical exercises covering all muscular bunches, in a combination to respiratory exercises. Duration of employment of 10-15 mines, exercises repeat 4-6 times for large muscular bunches and 10-12 times - for fine and average muscular bunches.

Physical exercises carry out rhythmically, in quiet rate, with the big voltage of movements in joints. Employment spend a little group method (4-8 humans) or individual.

To the special carry exercises on a release phenomenon of muscular bunches, on development of balance, coordination, respiratory dynamic exercises and physical exercises with the dosed effort of dynamic character. Physical exercises with the dosed effort use in the presence of preliminary training of the patient, mainly in second half of course of treatment.

It is necessary to avoid exercises with the big voltage of locomotion for a trunk and a head, and also it is sharp and expedited movements and exercises with long static effort.

Contraindications to appointment or continuation of employment by different forms PE: the general contraindications excluding application PE, BP substantial increase (over 210/120 mm hg); a condition after a hypertensive crisis, appreciable depression of a BP (on 20-30 % from initial level), accompanied by sharp deterioration of state of health of the patient; disturbances of a warm rhythm; development of an attack of a stenocardia, sharp delicacy and the expressed dyspnea.

Tables of exercises of physiotherapy exercises.

Table 1

Table 2

Described above 2 complexes of exercises spend in small bunches, exercises for each concrete case are selected taking into account specificity of an engaged contingent and level of its readiness.

Physiotherapy exercises exercises

The Cardiovascular system is one of the most important systems in an organism. Vegetative disorders can be caused the various causes, as that: shortage of oxygen, a mental overstrain, the big physical or emotional load, differences of atmospheric pressure. Constantly showing under the influence of these factors compensatory reaction of heart confines the human in many kinds of activity. Stated below exercise eliminate and relax influence of some symptoms VVD, in a case if disease does not wear a difficult character. In the latter case application of medicamental and sanatorium treatment is necessary.

Weariness

• Starting position sitting on a chair. To throw a foot on a foot, and with effort to press a foot laying from above, to laying from below, to be late for 5 seconds, then to relax effort. To change feet. To do exercise on 8 times for each foot.
• To a point at the establishment of index and big dactyls to put a nut or a ball for Ping-Pong. With circular locomotions to stimulate a point. To execute 30 circular movements for each arm. In the same way to stimulate a point in an intrinsic flexure of an elbow from the big dactyl.
• Make an inspiration through a nose, to bridge dactyls of both arms in the latch. Doing an expiration through a mouth, sharply to shunt the arms incurvated in elbows, in the parties. Thus the inferior phalanxes practically all dactyls are massed. To repeat exercise of 10 times.
• Compress both arms in fists so that the big dactyls have appeared from below. To incurvate arms in elbows before a breast. To expose one foot on a step forward. Sharply to straighten arms, having thrown out them forward and to unbend all dactyls. Thus to tolerate weight from a foot standing behind, on a foot exposed forward. A sharp expiration through a mouth to accept a starting position. To change a foot. To repeat exercise on 5 times for each foot.

Giddiness

• to Compress a wrist of one arm other arm and to make gyral locomotions by a brush, on 15 times in each party. Then to change position and to repeat exercise.
• On a palm between big and index dactyls, is closer to index, to put a nut and a palm of other arm to effect circular locomotions. To carry out exercise of 20 times for each arm.
• to Put to a nucha a stick and to roll it upwards and downwards, simultaneously turning a head to the right and to the left. Exercise to carry out 3 minutes.
• In position standing to put arms on a girdle the big dactyls forward and to expose one foot forward, having emphasised on it. To deviate back within 3 minutes, then to return to a starting position. To repeat exercise, having changed feet places. During exercise performance to shift the big dactyls so that they pressed on as it is possible the big area of a loin.
• to Mass a point on a palm, located with an underside of the establishment of a little finger. Massage to effect a small pillow of the big dactyl of other arm; it should last not less than 1 minute.
• Sitting on a chair to put feet all foot on a floor and with effort to raise socks. To execute not less than 30 movements.

Sonitus

• Having put the big dactyls of arms to the recesses located behind ears to incline a head to the right and to the left. At an inclination to do an expiration through a mouth and hardly to push a head the big dactyls upwards. Coming back in a starting position to take an inspiration through a nose. Exercise to repeat on 10 times in each party.

Palpitation, dyspnea

• to Sit down on knees, having drawn in feet. Doing a deep expiration to incline forward the top part of a trunk, having accepted "an embryos posture". Having held the breath for 1-2 seconds to return to a starting position. After that to make a quiet long inspiration. To bend back how much it it is possible, to hold the breath for 1-2 seconds, to return to a starting position. Again to make an inspiration. Exercise to repeat 10 times in each party.

Blood pressure rising

• the Starting position laying, arms are located along a trunk. Alternately to lift and alight each foot. Feet need to be held exactly, to try not to incurvate an arm in elbows. An expiration at a foot raising, an inspiration at lowering. Exercise to do on 10 times by each foot after that 10 times to lift both feet together.

Headaches

• Within 3 minutes vigorously to move the big dactyls of arms, and then carefully to massage them in the points located on an articulation of phalanxes.
• to Cross arms, having put palms on folds of elbows. Index, average and ring fingers of both arms to massage points about an elbow. Simultaneously to lift and alight arms of 30 times.
• every day to spend vibratory massage of a neck and a nucha. Massage to carry out circular locomotions, on 10 - 20 times from both parties. After that to mass reflex regions located in an average third stops.

Attention and memory disorders

• to Combine together the big and index dactyls and to press to each other, curving them. The same to carry out big and average dactyls, big and anonymous, big and a little finger, for each arm on 20 times. Then an end of the big dactyl on 20 times press on the establishment of each dactyl of each arm from lateral aspect.
• to Compress one arm in a fist, a palm of the second arm to straighten, dactyls to combine together. Average and anonymous dactyls of the straightened palm to bring to the establishment of a little finger of the arm compressed in a fist, and fast locomotion to change position of arms. To do this exercise of 10 times for each arm. At change of arms vigorously to exhale through a mouth.