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The defeat of the nervous system in diseases of the liver
The defeat of the nervous system in diseases of the liver
Liver and biliary tract is often complicated by the neuro-psychiatric disorders. The clinic is determined by the shape of the weight of tons of the underlying disease - cholecystitis, cholelithiasis, obstructive jaundice, cirrhosis of the liver. Underlying all of neuropsychiatric symptoms in liver disease is an intoxication.
Because the liver - one of the principal organs of cleaning the body of toxins, the violation of its functions will inevitably lead to accumulation of toxic products of metabolism. In the biochemical analyzes of blood in the majority of liver disease may show increased bilirubin, cholesterol, bile acids, measurement of fibrinogen is broken, vitamins C and K, which leads to the pathology of blood coagulation and increased vascular permeability. This, in turn, causes swelling of the brain and spinal cord, the penetration of a toxic degradation products of bilirubin and bile acids.
The most common manifestation of this toxicity is neurasthenia. The syndrome can manifest itself in two ways - "irritable" (irritability and anger with unrestrained in emotions, emotional instability, and mobility of the motor), and "locked" (physical and mental fatigue, resentment, mistrust). For neurasthenia characterized as sleep disturbance in its various versions - or sleep disorder waking up, superficial and disturbing dream. Patients usually complain of a headache, feeling of heaviness in the head, dizziness, as well as the pressure in the heart, heart rate, disturbances in sexual sphere (impotence, menstrual disorders).
For more severe intoxication (eg, mechanical obstruction of the bile duct stone, and the development of acute jaundice) may develop encephalopathy. Its first symptoms are similar to the neurasthenic manifestations - fatigue, lethargy, irritability - but rapidly growing lethargy, reduced muscle tone and loss of reflexes, with subsequent loss of consciousness. Treatment of this condition should be as fast as, even after removal from the coma, may cause residual mental and emotional disorders as a result of poisoning by bilirubin.
Another important symptom of nervous and mental diseases of the liver lesions may be the appearance of pruritus, which usually tend to stagnation of bile in the liver or gall bladder (with cholestasis and jaundice). Burning sensation and itching in any part of the body is the desire to "remove all to himself"; may cause feelings of the electric current in the spine or hot waves through the body. Explains the sensitivity of these disorders of bilirubin toxicity. In chronic liver disease with bile stasis may be a gradual expansion of areas of sensory disturbances, as well as the gradual accession of numbness in the muscles, cooling the fingertips of the hands and feet. At the same time there is change in the shape of nails on the hands and feet - of their thickening and darkening - which means chronic liver intoxication.
Treatment of neuropsychiatric symptoms in hepatic pathology directly related to the treatment of the underlying disease - liver or biliary tract. Treatment should be directed to the elimination of intoxication (drip with glucose, gemodeza and other detoxifying solutions), the normalization of the secretory function of the liver and bile outflow, secondary prevention of inflammatory disorders of the abdominal cavity.
