Encephalopathy, unspecified: causes, diagnosis, treatment

Encephalopathy, unspecified, is a Class VI disease( a disease of the nervous system) that enters the G90-G99 block( other disorders of the nervous system) and has the disease code G93.4.

Description of the disease

Encephalopathy is a non-localized disease of the brain. Expressed by the death of nerve cells due to stopping blood circulation, oxygen starvation and disease.

To diagnose diseases, specialists need to find out the prominent site of the lesion, the localization of the disease in the gray or white matter of the brain, and the degree of disturbed blood flow. If the cause of the disease could not be established, then it is called encephalopathy, unspecified( idiopathic, ie, arising independently).The most common is vascular.

Causes of the disease

Unspecified encephalopathy( ICD-10 code of diagnosis G93.4) ​​is classified into two types: congenital and acquired. The congenital is divided into prenatal( when injuries occur even in the womb of the mother) and perinatal( in the event that the damaging factor operated in the last weeks before the birth of the baby or immediately after it).This kind of pathology is caused:

• by defects, consisting in abnormal processes of brain development;
• disorders of metabolism in the body caused by genetic factors;
• if during the pregnancy the toddler was affected by a damaging factor;
• craniocerebral trauma that occurs in the baby during childbirth.

Mitochondrial encephalopathy

Mitochondrial, unspecified encephalopathy in infants is isolated in a separate group of congenital diseases. It is formed due to violations of the functions and structures of mitochondria.

Acquired encephalopathy

Acquired encephalopathy is classified into several species due to various damaging factors:

• Post-traumatic injury is the result of craniocerebral injuries of moderate to severe severity( eg, falls from height, head injuries in athletes, accidents, etc.).With this type of disease, various lesions of the nervous tissue of the frontal and temporal lobes are observed, atrophic changes( shrinkage and shrinkage of the brain), hydrocephalus.
• Toxic encephalopathy, unspecified in adults, arises from poisoning with various toxins: alcohol, high doses of pesticides, heavy metals, gasoline and the like. Basically, various kinds of nervous and mental disorders are manifested( insomnia, anxiety, irritability, hallucinations, prolonged headaches, etc.).
• Radiation is the result of ionizing radiation of the body with radiation sickness. With this pathology, there are various neurological disorders.
• Metabolic occurs due to metabolic disorders against the background of diseases of internal organs: liver, kidneys, pancreas. It manifests itself depending on the properties of the underlying pathology.
• Vascular encephalopathy. The cause may be addiction to bad habits, old injuries, atherosclerosis, diabetes, radiation exposure and other factors that cause hypertension of the brain. Signs of this type of disease are: loss of structure and integrity of consciousness, frequent headaches, depressive states, partial loss of one's own memory.
• Hypoxic is the result of prolonged oxygen starvation. It leads to serious neuralgic complications.

And this is not all varieties.

In children

There is an encephalopathy, unspecified in children. So, due to the traumatic effects in the womb, infections or other causes, residual encephalopathy is diagnosed in older children. The venous form is a particular type of vascular, which is manifested by the stagnation of venous blood in the brain due to a violation of its outflow.

Metabolic encephalopathy is divided into several more types:

• Bilirubin is found only in newborn babies. It develops on the background of incompatibility of blood of the mother and fetus, as well as due to infectious toxoplasmosis, jaundice, diabetes maternal. It manifests a general weakness, reduced muscle tone, poor appetite, belching, vomiting.
• Encephalopathy Gaye - Wernicke is due to vitamin B1 deficiency. Adverse events can develop due to alcohol dependence, severe vitamin deficiencies, HIV, malignant neoplasms. Basically it is manifested by a hallucinogenic syndrome, anxiety states.
• Leukoencephalopathy manifests itself as a violation of white matter in the brain. The disease has a progressive nature. Appears after the transferred infection due to a decrease in the protective functions of the body.
• Atherosclerotic develops mainly due to a violation of lipid metabolism in the body. It is manifested by increased fatigue, weakness, dizziness, headaches, sleep disorders, closedness.

Scientists say that the cause of any type of unspecified encephalopathy is primarily brain hypoxia( lack of oxygen).This is due to the fact that the body begins to bleed worse than blood, there are excessive venous accumulation, edema, hemorrhage. Anoxic encephalopathy can occur due to a small intake of nutrients into neurons and to stand out as a result into a separate disease. Metabolic encephalopathy is a special case of toxic, when toxins are not eliminated, and therefore penetrate into the blood.

There are several stages in the development of this disease. Specialists stand out the following:

• In the case of the initial or the first stage, the patient's memory is reduced, he is irritable, falls asleep badly and anxiously asleep, and his headache.
• When the second character of the disease is more pronounced, all symptoms are aggravated. In addition to headache and sleep disorders, the patient can complain of apathy and lethargy.
• In the third stage, serious changes in the brain are diagnosed, there are paresis, speech is disturbed, vascular parkinsonism develops.

Symptoms of

The manifestations of unspecified encephalopathy are very diverse depending on the severity, type, age and treatment used. As a rule, at the first stages of the disease there are violations of sleep, lethargy, daytime sleepiness, absent-mindedness, tearfulness, lack of interest, increased fatigue, memory loss, cognitive abilities. Also, painful sensations, noises and ringing in the head, a decrease in auditory and visual functions, mood swings, impaired coordination, irritability can begin to appear.

What are the symptoms that occur with the progression of the disease?

In advanced cases, the symptoms may progress, resulting in Parkinsonism( slow motion in combination with the trembling of the limbs) and false-bulb paralysis( manifested by violation of speech, chewing and swallowing functions).Also, do not forget that there may develop impairments in the functions of the psyche( depression, suicidal thoughts, phobias).Consider how the diagnosis of encephalopathy, unspecified G 93.4 in infants and adults.

Diagnosis of encephalopathy, unspecified

In order to correctly establish the form of the disease, the physician should carefully analyze the patient's anamnesis for craniocerebral trauma, intoxications, atherosclerosis, kidney, liver, lung, pancreas, hypertension, radiation effects, as well as acquired or geneticmetabolic disorders.

For the diagnosis of "encephalopathy, unspecified G 93.4", the following procedures are performed:

• General blood test.
• General analysis of urine.
• Various metabolic tests( on the level of enzymes in the liver, glucose, electrolytes, ammonia, lactic acid, oxygen in the blood).
• Measurement of blood pressure.
• CT and MRI( for the detection of brain tumors, various anatomical abnormalities, infections).
• Creatinine.
• Level of drugs and toxins( cocaine, alcohol, amphetamines).
• Ultrasonic Doppler.
• EEG or encephalogram( to identify brain dysfunction).
• Assay for autoantibody.

This is far from all the tests necessary to make a diagnosis. Only the attending physician can prescribe certain tests, judging by the symptoms and the history of the patient's illness.

Treatment of encephalopathy

Treatment of unspecified encephalopathy is aimed at eliminating the underlying causes and symptoms that gave rise to the development of this disease. Basically, conservative and medicament methods are used for treatment.

If the disease is acute, the treatment is primarily aimed at reducing intracranial pressure and eliminating seizures. To do this, use artificial ventilation of the lungs, extrarenal blood purification, and also inject nutrients through the dropper.

Medications

The patient is subsequently prescribed medications that he should take for several months:

• various lipotropic drugs that help normalize the cholesterol and fat metabolism( dietary supplements with choline, methionine, carnitine, lecithin, Lipostabil);
• preparations that prevent thrombosis( "Ginkgo Biloba", "Aspirin", "Cardiomagnolo");
• angioprotectors, prescribed for various cardiac diseases for normalization of vessel walls, movement and outflow of venous blood( "Troxerutin", "Detralex", "Indovazin");
• neuroprotectors for nerve tissue nutrition( B vitamins, "Piracetam",
• tranquilizers and sedatives for rarefied nerve impulses dilution in affected neurons( "Sibazon"),
• vitamins and amino acids,
• various stimulants of operability

Also for early recovery are appointedphysiotherapeutic procedures, acupuncture, walking, gymnastics, massage, certain rest. What is the prognosis for the diagnosis of "encephalopathy, unspecified"?

Forecast of

disease For anyvarieties of encephalopathy are characterized by vomiting, nausea, dizziness and headaches. If there was a severe brain damage( or its edema), the disease develops very sharply, dizziness, very severe headache, anxiety, impaired vision, etc.

Typical complications of encephalopathy, unspecifiedgenesis are:

• coma;
• paralysis;
• convulsions.

If to follow the recommendations of the attending physician, then one can hope for favorable predictions. However, if the disease is started, then the following can develop:

• epilepsy;
• paralysis, various kinds of movement disorders;
• loss of brain functions, memory, intelligence;
• emotional instability, depression, mood swings;
• disability.