Autonomic disorders in neurosis

Vegetative disorders are obligate in case of neurosis, constituting a characteristic psycho-vegetative syndrome. It is important to emphasize that complaints of a vegetative-visceral nature often dominate the clinic of neurosis, patients give them leading importance and turn to general practitioners. With neurosis I. there is a developed syndrome of vegetovascular dystonia, and manifested by permanent and paroxysmal disorders. The latter are of the nature of outlined vegetative-vascular paroxysms. Most commonly, sympathetic adrenal and mixed crises occur . The clinic of the first consists of unpleasant sensations in the chest area, a rise in blood pressure, tachycardia, chills-like hyperkinesis, vivid anxiety- phobic manifestations, fever, increased urination with light urine (usually at the end of an attack). In mixed crises, these symptoms are combined with difficulty breathing, dizziness, nausea, increased intestinal motility. Less common are vaginal paroxysms – dizziness, nausea , decreased blood pressure and blood sugar. In the specialized literature there are still indications of the pathognomonic significance of these crises for the diagnosis of hypothalamic syndrome, which is reflected in their designation as “diencephalic”.
It should be emphasized the fallacy of this point of view. Much more often, developed vegetative crises occur in neurosis, and the role of hypothalamic formations in their implementation should not be denied.
Vegetative-visceral disorders most often occur in the cardiovascular system and are manifested by algic , dysrhythmic and dysdynamic disorders.
Cardialgic syndrome manifests itself in a variety of unpleasant pain sensations in the left half of the chest. Their peculiarity is the duration of the course, the occurrence during emotional rather than physical exertion, the lack of effect of antispasmodic therapy. Patients are usually fixed on their feelings, often go to the doctor, they are afraid to go to places where they will be deprived of medical care, they always carry medicine with them. In severe cases, a pronounced cardiophobic syndrome develops . Objectively, the lability of blood pressure, its pronounced fluctuations in the first and subsequent measurements are determined. Sinus tachycardia is characteristic, less often® bradycardia is noted. Rhythm disorders are extrasystole. ECG changes in neurosis are minimal, satisfactory tolerance to physical activity is determined. In the respiratory system, hyperventilation syndrome is characteristic , which occurs against the background of a feeling of inferiority of the inspiration and lack of air. Canine breathing attacks that mimic an asthma attack can also occur. The most manifest paroxysms of neurotic laryngospasm (spasm of the muscles of the larynx), often associated with the act of eating. In the gastrointestinal tract, there may be increased salivation, spasm of the muscles of the esophagus with difficulty; passage of food and vivid subjective sensations, aerophagia – belching as a result of ingesting air with food, neurotic regurgitation or vomiting, pain in the abdomen – gastralgia , or abdominalgia , intestinal disturbances in the form of diarrhea, diarrhea, changes in peristalsis. There is a violation of vascular permeability in the form of symmetrical or lateralized hemorrhages in the skin, erosion in the gastrointestinal tract. The extreme form is a rare “blood sweat” syndrome. Moderate neuroendocrine disorders are determined: dysfunction of the thyroid, genital, pancreas. Motivational disturbances are characteristic – changes in appetite, up to anorexia, decreased libido. 

local_offerevent_note September 23, 2019

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