Vegetative-vascular dystonia

   Vegetative-vascular dystonia (VVD) - a symptom of diverse clinical manifestations, affecting various organs and systems, and developing as a result of abnormalities in the structure and function of the central and / or peripheral parts of the autonomic nervous system.

   Vegetative-vascular dystonia - not an independent nosological form, but in combination with other pathogenic factors, it can contribute to the development of many diseases and conditions, most often have a psychosomatic component (arterial hypertension, coronary heart disease, asthma, peptic ulcer disease, etc.). Autonomic changes determine the development and course of many diseases of childhood. In turn, somatic, and any other disease can exacerbate autonomic disorders.

   Signs of vegetative-vascular dystonia detected in 25-80% of children, especially among urban residents. They can be found in any age period, but are more common in children of 7-8 years and adolescents. This syndrome is observed more often in girls. 

Vegetative-vascular dystonia. Causes.

    The reasons for the formation of autonomic disorders are numerous. The main importance of primary, genetically caused abnormalities in the structure and functions of the various divisions of the autonomic nervous system, most often traced through the maternal line. Other factors which tend to act as triggers, causing the existing hidden manifestation of autonomic dysfunction.

• The formation of vegetative-vascular dystonia largely contribute to perinatal CNS, leading to cerebral vascular disorders, liquorodynamics, hydrocephalus, damage to the hypothalamus and other parts of the limbic-reticular complex. Damage to the central parts of the autonomic nervous system leads to emotional imbalance, neurotic and psychotic disorders in children, inadequate reactions to stressful situations, which also affects the development and course of vegetative-vascular dystonia.

• In the development of vegetative-vascular dystonia is very large role of various traumatic effects (conflicts in the family, school, family alcoholism, broken families, the isolation of the child or his parents overprotection) which lead to psychological maladjustment of children, contributing to the implementation and strengthening of autonomic disorders. The role of the repetitive acute emotional overload, chronic stress, mental tension.

• By precipitating factors include a variety of somatic, endocrine, and neurological diseases, abnormalities of the constitution, allergic conditions, adverse or drastically changing weather conditions, especially climate change, ecological trouble, upsetting the balance of trace elements, physical inactivity or excessive exercise, hormonal changes of puberty, failure of diet and etc.

• Undoubted importance are age-specific rates of maturation of the sympathetic and parasympathetic divisions of the autonomic nervous system, metabolic instability of the brain, as well as the child's body inherent ability to develop generalized reactions in response to local irritation, which determines the greater polymorphism and severity of the syndrome in children compared with adults. Disturbance caused in the autonomic nervous system to cause various changes in the functions of sympathetic and parasympathetic systems against the release of mediators (norepinephrine, acetylcholine), adrenocortical hormones and other endocrine glands, a number of biologically active substances (polypeptides, prostaglandins) and also disorders sensitivity of vascular a-and ß-adrenergic receptors.

   It is of great diversity and different expressions of subjective and objective manifestations of vegetative-vascular dystonia in children and adolescents, depending on the age of the child. Autonomic changes they are often the nature of the predominance of multiple organ dysfunction in any one system, often in the cardiovascular effects. 

Classification of vegetative-vascular dystonia

    Until now, the conventional classification of vegetative-vascular dystonia has not been developed. In formulating the diagnosis take into account:

• etiological factors;

• version of autonomic disorders (vagotonic, sympathicotonic, mixed);

• the prevalence of autonomic disorders (generalized, systemic or local form);

• organ systems most involved in the pathological process;

• the functional state of the autonomic nervous system;

• severity (mild, moderate, severe);

• nature of the flow (latency, permanent, paroxysmal).

Symptoms of vegetative-vascular dystonia

    For the vegetative-vascular dystonia characterized by multiple, often vivid subjective symptoms that do not meet much less pronounced objective manifestations of a particular organ pathology. The clinical picture of vegetative-vascular dystonia is largely dependent on the direction of autonomic disorders (prevalence of wagons or sympathic). 

Vagotonia

    Children with vagotonia peculiar set of hypochondriacal complaints, fatigue, decreased performance, memory problems, sleep disturbances (difficulty falling asleep, sleepiness), lethargy, indecision, timidity, the tendency to depression.   Characterized by loss of appetite, coupled with excess body weight, poor tolerance to cold, intolerance stuffy room, the feeling of coldness, a feeling of lack of air, periodic deep breaths, feeling of "lump" in the throat, as well as vestibular disorders, dizziness, pain in the legs (usually at night time), nausea, abdominal pain, unmotivated, marbling of the skin, acrocyanosis, expressed autographism red, high flow, sebum secretion, tendency to fluid retention, transient swelling under the eyes, frequent urination, salivation, spastic constipation, allergic reactions.   Cardiovascular disorders are manifested by pain in the heart, bradyarrhythmias, a trend toward decreased blood pressure, increased heart size by lowering the tone of the heart muscle, heart sounds mute. The ECG reveals sinus bradycardia (bradyarrhythmia), possible arrhythmia, prolongation of the interval P-Q (up to atrioventricular block I-II degree), and ST-segment above the contour lines and increase the amplitude of the T wave 

Sympathicotony

    Children with sympathicotonia inherent temperament, temper, mood variability, increased sensitivity to pain, rapid distraction, distraction, various neurotic states. They often complain of hot flashes, palpitations. When sympathicotonia often observed asthenic physique against increased appetite, pallor and dry skin, pronounced white dermographism, cold extremities, numbness and paresthesias in them in the morning, unexplained fever, poor tolerance of heat, polyuria, atonic constipation. Respiratory disorders are absent, vestibular uncommon. Cardiovascular disorders are manifested a tendency to tachycardia and increased blood pressure in the normal size of the heart and its loud colors. The ECG often reveals sinus tachycardia, shortening the interval P-Q, ST-segment lower contours, flat T wave 

Cardiopsychoneurosis

    With the prevalence of cardiovascular disorders in the complex available autonomic disorders is acceptable to use the term "cardiopsychoneurosis." Note, however, that cardiopsychoneurosis is an integral part of the broader concept of vegetative-vascular dystonia.