Dystrophic changes in the functions of the brain are called encephalopathies. The main factors that threaten the health of the most important organ of the human body are oxygen starvation( hypoxia) and impaired blood supply to tissues. Deprived of nutrition, nerve cells die, and in the absence of treatment, the lesion becomes irreversible.
Description of the disease
Poisoning with toxins and poisons of various origins can lead to cerebral disorders under the general name of "toxic brain encephalopathies."
For substances that are capable of causing disseminated damage to the brain tissue, include:
- pesticides,
- refinery products,
- heavy metal salts,
- chemical formulations for household use,
- neurotropic medications( soporific, tranquilizers),
- carbon monoxide,
- mercury vapor,
- lead,
- arsenic,
- manganese,
- alcohol-containing liquids,
- bacterial toxins formed in botulism, measles, diphtheria.
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Species and classification
From the list of toxic substances, alcohol and manganese can be identified that cause special, widespread forms of encephalopathy.
Alcoholic toxic encephalopathy
Irreplaceable damage to brain cells occurs after several years of daily drunkenness, which the drinking person does not even consider alcoholism.
Degenerative changes are increasing due to the replacement of brain tissue with liquid, ruptured capillaries and numerous small hemorrhages in the brain.
Usually, toxic encephalopathy for alcoholism occurs at its third stage, as a result of prolonged drinking or prolonged abuse of alcohol.
Poisonings with alcohol surrogates are fixed less frequently than usual alcoholism, but they occupy one of the first places in the hierarchy of alcohol poisoning in terms of the severity of cerebral lesions.
Additional effects of toxic mixtures that are absolutely unsuitable for ingestion are added to the usual destructive effect of alcohol.
Toxic manganese encephalopathy
Manganese poisoning before the end of the 20th century was of a professional nature and was observed in people associated with the extraction and processing of manganese raw materials, and welders working with electrodes made of this metal.
Unexpected application of potassium permanganate found in the artisanal manufacture of surrogate narcotic mixtures, which have become widespread in the youth environment. Due to the use of mixtures, the number of poisonings with encephalopathic syndromes of special severity, leading to disability or death, has repeatedly increased.
Encephalopathy of toxic genesis is manifested in dystrophic changes in brain tissue caused by endogenous or exogenous factors.
Exogenous-toxic encephalopathy
Caused by factors external to the human body.
The poisoning effect from outside the person can experience:
- at work, in contact with harmful substances,
- under adverse environmental conditions,
- for alcohol abuse, intentional inhalation of toxic fumes,
- for careless handling of toxic substances in everyday life,
- in the event of technogenic emergencysituations.
Endogenous causes of encephalopathies include disorders of the endocrine system of the body, accompanied by intoxications( with diabetes, thyroid disease).The endogenous cause is considered and the failure of the liver and kidneys.
Poisoning occurs at the expense of reducing the protective and excretory abilities of these organs - the liver loses the ability to purify the blood, and the kidneys do not provide the removal of urine.
The main types of intoxication with encephalopathy
There are two main types of intoxication: acute and chronic:
- Acute toxic encephalopathy occurs as a result of a single, severe exposure to a poisonous substance on the body. An acute condition requires urgent medical care and subsequent rehabilitation measures.
- In conditions of systematic influence of poisoning, has a chronic form of damage to brain tissue. It occurs in the late stages of the development of the disease, when the body is no longer able to withstand the long-term effects of poisoning. The patient needs a long course of treatment.
There is a special encoding for dystrophic changes in the brain with a toxic origin. In the latest edition of the International Classification of Diseases( ICD 10th revision), this pathology has the code G92 and belongs to the class VI "Diseases of the nervous system", to the block G90-G99 "Other disorders of the nervous system."
The diagnosis of "toxic encephalopathy" is neurological. From this block, alcoholic intoxications of the brain are excluded, they are referred to degenerative diseases of the central nervous system and have code G31.2.
About the causes of toxic encephalopathy
The most frequent cause of cerebral damage with toxic origin is a constant or repeated exogenous toxic effect on the human body.
A consequence of this type of poisoning is chronic encephalopathy. Acute and endogenous forms are diagnosed less often.
Penetration of toxic substances occurs through the skin, the respiratory tract, mucous membranes, the digestive tract. Breathing and digestion are the shortest path for getting poisons into the bloodstream and then for the brain.
Type, multiplicity and duration of exposure to toxic elements and compounds are among the factors determining the severity of the lesion.
The brain, as the most protected organ of the human body, is not destructive in the first place. But if the symptoms of brain damage are present, then it means an extremely high degree of poisoning.
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Symptoms of the disease
Symptoms of encephalopathies of various origins have many common manifestations.
Often fixed:
- cephalgia - headaches,
- vestibular pathology - dizziness, impaired coordination, staggering and "throwing" in the sides while walking,
- speech disorders - difficulty in word selection, slurred pronunciation,
- confusion,own location,
- decreased memory functions,
- visual disorders - hazy look, phantom pulsating spots in peripheral view,
- neurasthenia, mood declinetions.
This is very important for the doctor in case of difficulties in diagnosing.
- Astonodepressive syndrome , an oppressed state bordering on deep anguish, indifference to the most important aspects of life characterize carbon disulfide and gasoline encephalopathy.
- Mercury poisoning manifests itself in a paradoxical combination of emotional arousal and attacks of confusion and uncertainty about the correctness of simple actions.
- Movement coordination disorders, sweating, trembling of limbs, hallucinations, bouts of irritation and aggression are characteristic for alcohol poisoning .
- Lead intoxications are characterized by a specific fringing of the gums of violet-aspid color, cramping pains in the abdomen.
- The heavy manganese poisonings of are manifested by the widening of the eye-slits, tremor of the tongue, the frozen grimace of a smile on the face and unnatural laughter in response to any appeal to the patient, a decrease in emotional reactions and an inability to write.
Diagnosis
The difficulty in diagnosing toxic cerebral disorders is the delineation of functional and organic manifestations of the disease.
General symptoms in the form of nervousness, memory impairment and headaches at the first stages of the disease can distract the diagnostician from an in-depth analysis of the patient's condition.
- An experienced neurologist will certainly pay attention to specific phenomena that do not fit into a clear picture of the alleged nervous disorder:
- asymmetry of the innervation of the face,
- deviations, or involuntary deviation of the tongue,
- abnormalities or lack of reflexes - tendon tenderness and extremeweakening of cutaneous, in combination with anisoreflexia.
- Anamnesis in the diagnosis of toxic conditions has peculiarities, because the patient often does not want to recognize his own possible fault in the onset of the disease and hides many circumstances from the doctor. This applies to alcoholics, drug addicts and addicts.
- It happens that the effects of poisons occur in a form that is hidden from the patient. This happens when employers fail to comply with safety rules when employees work in contact with dangerous substances or when the patient was in an environmentally hazardous area without knowing it.
Against the background of extreme emotional instability of the patient these symptoms will give the doctor grounds for suspicion of the patient having cerebral deviations caused by poisoning.
Analytical study of blood, urine, examination from an ophthalmologist and a neurosurgeon, removal of an electroencephalogram, brain imaging performed after a primary examination of a patient with signs of encephalopathy.
Treatment of toxic brain encephalopathy
Elimination of the causes of the disease is an urgent measure in the tactics of treating toxic encephalopathies.
Contact of a patient with a toxic environment should be discontinued. In most cases, the patient is offered hospitalization.
The primary appointments of a doctor consist of detoxification measures. The patient is given antidotes, which neutralize the effect of poisons.
The drug is selected according to the type of chemical agent. General measures for detoxification are in cleansing enemas, diuresis stimulation, plasmapheresis and hemodialysis.
The next stage of treatment is to improve blood circulation in the vessels of the brain and activate metabolic processes. The patient is shown intravenous and intramuscular infusions of the following drugs:
- Cavinton,
- piracetam,
- cinnarizine,
- cerebrolysin,
- nootropil.
For intramuscular administration, vitamins B, C and R are prescribed. Orally the patient takes biostimulants and adaptogens: extract of ginseng, magnolia vine, eleutherococcus, preparations based on mummies and aloe.
For symptomatic indications, tranquilizers, anticonvulsants and sedatives can be prescribed:
- Relanium,
- elenium,
- mezapam,
- midolme,
- sirdalud.
After stabilization of the state, physiotherapeutic complexes are included in the course of treatment. Effective are recognized massage, scalp and neck-collar zone, hydrotherapy, mud therapy.
Acupuncture and some other methods of alternative medicine can be used with the doctor's confidence in their effectiveness.
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Consequences and prognosis of toxic encephalopathy
Success in the treatment of patients with brain damage largely depends on the severity of the condition in which the patient began receiving medical care.
Diseased diseases can not be completely cured, and deep cerebral changes can not be corrected. Qualified assistance will be most effective in the early stages of the process.
Among the common effects of the effects of poisons on the brain are:
- memory loss,
- lesions of individual nerves and partial paresis of the muscles of the body,
- susceptibility to depressive states,
- sleep disorders,
- emotional instability.
Severe complications occur when encephalopathies enter the stage of deep brain damage. They are fraught with coma, convulsive syndromes, strokes, paralysis and death.
The presence of residual events and the progression of the disease without contact with poisonous agents is characteristic of poisoning. But this does not mean that the patient is deprived of hope for healing. Even in the case of disability, the state of health can become quite satisfactory, provided that a full course of medical procedures is carried out.
Regular rehabilitation measures should be carried out during the further life. These measures will slow down the degenerative processes in the brain tissues and restore many lost functions.
The video shows what happens to a person with toxic encephalopathy:
https: //www.youtube.com/ watch? V = OA9zsGd3GLQ