A vegetative crisis or panic attack refers to paroxysmal states of a non-epileptic nature, accompanied by polymorphic autonomic disorders, which, in turn, are caused by the activation of the main (sub-segment) vegetative structures. The disease is characterized by brighter manifestations of autonomic dysfunction syndrome.
The use by the Russian doctors of the definitions of “vegetative crisis”, “neurocirculatory dystonia”, “cardioneurosis”, “sympathoadrenal crisis”, as well as “vegetovascular dystonia with a crisis course” reflect opinions that reflect the opinion from the point of view of vegetative pathologies with emphasis on the involvement of cardiovascular concept.
According to the “International statistical systematization of diseases and nosological problems; 10 revision ”(ICD-10), the disease is considered in the framework of somatoform vegetative dysfunction with stress on a psychogenic predetermined autonomic dystonia syndrome. Definitions such as “panic attack”, “panic disorder”, introduced in ICD-10, are used directly around the world.
How long does the IRR crisis last?
The frequency and nature of the clinical manifestations of vegetovascular dystonia for each patient proceeds differently, while the complexity of the disease depends on these factors. Therefore, doctors distinguish:
Mild attacks of the disease usually last no more than 15 minutes and are accompanied by a small spectrum of clinical symptoms. In this case, one organ system is most often involved. There is no post-crisis asthenia, that is, after an attack, a person quickly returns to his usual life.
Symptoms of an attack of moderate gravity last less than an hour, but are accompanied by multiple indicators with persistent post-crisis asthenia for up to one and a half days.
Severe attacks last more than an hour and are accompanied by a vivid clinical picture in combination with tics, seizures, or other hyperkinesis. Postcrisis asthenia persists for several days.
However, not only medications are used to treat such pathologies. People suffering from various types of VSD crises should independently adjust their day, normalizing physical activity and limiting themselves from psycho-emotional shocks. A person needs to provide:
- the correct mode of work and rest;
- balanced diet;
- rejection of bad habits;
- performing special therapeutic exercises;
- reduction in the number of stressful situations;
- decrease in physical activity.
In addition, physiotherapy physiotherapy, massage, breathing exercises and spa treatment have a good effect. To reduce the likelihood of developing vegetovascular dystonia, as well as reduce the frequency of manifestations of this disease, it is necessary to adhere to all the doctor’s prescriptions. All medications must be taken regularly and in a timely manner.
As a rule, there is no classification. The vegetative crisis is systematized according to severity and symptomatology, divided into types depending on changes in blood pressure, as well as in the cardiovascular system.
In terms of severity, they emphasize:
- lungs: lasts 10-15 minutes with manifest vegetative changes, as well as monosymptomatic manifestations with a lack of post-crisis asthenia;
- moderate: lasts 15-60 minutes directly with polysymptomatic manifestations and postcrisis asthenia manifested up to 24-35 hours;
- severe: polysymptomatic crises in composition with hyperkinesis, convulsions lasting more than an hour, lasting up to a couple of days.
Symptoms accent crisis:
The reasons for the initial emergence of a vegetative crisis have not been fully explored. Obtaining an anamnesis and diagnosing patients with signs of a panic attack made it possible to identify a number of pathologies of the same type:
- pathology of the cardiovascular system;
- endocrine diseases, more generally it concerns thyroid problems;
- organic non-compliance with the work of the main nervous system, provoked by a tumor, hemorrhage, injuries;
- long-term method of individual groups of pharmaceutical substances;
- psycho-emotional stress;
- hormone failure;
- social background.
The first attack of a panic attack often appears after the violence, children are exposed to this ailment in families in which physiological punishment is practiced.
It is believed that the disease is most exposed to people who use absolutely all the benefits of civilization, mentally formed, responsible, anxious by nature.
The vegetative crisis and its etiology have not yet been fully studied and do not have an exact root cause of education. But there are some clinical data that highlight the main disorders that are often found in patients:
- disruptions in the endocrine system, hormonal imbalance;
- trauma, the various nature of the formation and hemorrhage, which could lead to disruption of the normal functioning of the central nervous system;
- congenital predisposition;
- pathological disorders in the cardiovascular system;
- regular stressful situations, chronic fatigue;
- long-term use of drugs of certain groups;
- a consequence of social stress or life shocks. This may be, for example, domestic violence or abuse at a young age.
How to recognize the IRR
This pathological condition usually first occurs between the ages of 20 and 40 years. Symptoms of a vascular attack of the VSD often resemble the clinical manifestations of various diseases, but their periodic repetitions add up to a typical picture of the pathological condition.
Fear of having an IRS attack again is a serious thing that cannot be treated superficially. Therefore, it is necessary to draw up a clear plan of what to do during any type of IRR crises. It is necessary to act here adequately and as calmly as possible in order to avoid undesirable consequences.
Hypertensive vegetative-type dystonia (hypertensive crisis of the IRR) during an attack manifests itself as follows:
- the upper limit of blood pressure rises rapidly to 140-180, and at the end of the crisis it normalizes independently;
- strong, throbbing headaches appear;
- there is a rapid heartbeat;
- pulse increases to 110-140 beats per minute.
Some patients report a fever up to 39 ° C, chest pain, agitation.
An attack of vegetovascular dystonia of an antihypertensive type is accompanied by:
- lowering blood pressure to 80- (90 . 50) and slowing the pulse;
- sensation of heat in the head and face;
- asthma attacks and lack of air;
- feeling of weakness;
- the occurrence of pressing chest pain;
- discomfort in the abdomen;
Signs of cardiac VSD are:
- prolonged pain in the heart (dull or sharp);
- changes in heart rate;
- feeling that the heart is now breaking or stopping;
- asthma attacks.
The appearance of such symptoms does not depend on the presence of physical activity. Also, they do not disappear after taking preparations for angina pectoris.
An attack of vegetovascular dystonia of the visceral type is accompanied by:
- severe and frequent abdominal pain;
- disruption of the intestines (diarrhea or constipation).
Signs of an attack of an IRR of a respiratory type are:
- pressing chest pains;
- difficulty breathing;
- feeling of coma in the throat;
- inability to take a deep breath and yawning;
- dry cough.
With asthenic crises of the IRR, there are symptoms such as:
- severe fatigue;
- small trembling in the hands;
- loss of stamina for a long time.
In this case, many patients may experience an increase in temperature to 37,5 ° C.
Often, attacks of the IRR proceed on the basis of the mixed type. In this case, the clinical picture of such conditions combines the symptoms of several varieties of the disease. Such attacks are very difficult.
Each of the IRR crises is accompanied by fear and panic. In severe cases, the attack is often accompanied by a fear of death or the likelihood of losing one’s mind. However, such conditions disappear with the end of the crisis. At the end of such syndromes, the patient may still feel depressed, anxious and weak for some time. He needs some time to return to his usual way of life.
How to remove the main symptoms
What is a vegetative crisis? The source of his progress is disrupted regulation in the ANS. This condition is provoked by:
- infections that contribute to the appearance of changes in the central nervous system;
- age-related hormonal changes;
- endocrine disorders;
- diseases of the central nervous system.
Osteochondrosis or an inflammatory process is often a provocateur of infections. The main causes of dysfunction of the central nervous system include birth injuries, concussion.
The first attack of VVD often occurs against a background of physical or mental fatigue, stress, and the use of certain medications.
Vegetative crisis usually occurs in expectant mothers, as well as in women during menopause.
Various factors can provoke the occurrence of an IRR crisis. For some, the main reason is intolerance to stuffiness, for someone – a change of weather or a trip in public transport.
The exclusion of provocative situations, the correct assessment of the situation, action planning will minimize the number of possible attacks. The main thing here is to clearly understand what causes them.
No matter how often such conditions occur, the patient should always have light sedatives with him. With any hint of a stressful situation and the beginning of a crisis, it is better to play it safe. The use of such drugs helps to avoid panic attacks, normalize blood pressure and alleviate the general condition during exacerbation.
When the attack of vegetovascular dystonia has already begun, treatment with lung sedatives will no longer help. It does not matter where and in what period of time it happened. You need to lie down or sit down and try to cope with the emerging emotions. Need to get distracted. Be sure to inhale deeply through the nose, while you can count the number of breaths or exhalations, drink water in small sips. The main thing is to remember that this is just a panic attack that will end soon.
Massage of closed eyes will help to cope with a strong heartbeat, and massage of little fingers of hands, temples and neck will normalize the jumped pressure. Reduce the pressure will allow the use of appropriate drugs.
If there is a feeling of lack of air, then you should open the window and free the neck area from tight clothing.
When a headache occurs, it is necessary to move away from sources of bright light and noise. In the acute course of an attack, the Phenazepam tablet will help. A sudden attack of weakness will disappear if you eat something sweet.
The following conditions can cause a crisis:
- stressful or neurotic disorders: the easiest to treat;
- consequences of hereditary injuries, concussion, residual violation of the main nervous system;
- constant irritation of peripheral vegetative structures;
- endocrine rearrangements of the body (for example, during sexual maturation), pathology of the working process of the endocrine glands;
- taking medications (for example, Erespal).
Symptoms mainly manifest themselves in people after 30 years, but there are also early cases of manifestation – in adolescence during hormonal changes in the body.
In most cases, a vegetative crisis manifests itself in the form of disorders in the functioning of the body’s life support systems, less commonly, it is psychoemotional disorders, disorders of the central nervous system.
Neurotic autonomic crises are characterized by the following manifestations:
- severe and bursting headaches, migraines;
- sensation of pulsation in the cerebral cortex;
- pallor of the face, dry skin;
- rapid heart rate;
- jumps in body temperature, chills, fever;
- tremor of limbs, numbness, slight trembling;
- anxious feelings, fear, unreasonable experience;
- high blood glucose;
- frequent urination to urinate.
After the occurrence of asthenic syndrome, i.e. chronic fatigue, mental weakness, the following symptoms appear that may be characterized:
- a feeling of suffocation, the inability to breathe air deeply;
- malfunctions of the heart, its fading;
- blurred consciousness, dizziness;
- discomfort in the stomach, bloating, gas formation;
- rare pulse.
A vegetative crisis of any type is different, but they all have fear and bouts of anxiety and panic. Mental disorders can occur that manifest as depersonalization, loss of mind, obsessions, fear of death, or fear of harming anyone.
An atypical attack of a vegetative-vascular crisis can be expressed by the following symptoms:
- weakness in the limbs, inability to control them;
- sensation of a “coma” in the throat, trouble swallowing;
- hearing and vision impairment;
- slurred speech;
- violation of motor skills, loss of coordination;
- convulsive manifestations;
- loss of consciousness;
- nausea, vomiting.
What threatens vegetovascular dystonia
Despite the menacing course, vegetovascular dystonia usually does not cause serious complications and does not cause particular harm to human health. Nevertheless, this disease leads to a lack of oxygen in the tissues, and in chronic and severe forms it can lead to coronary heart disease.
If the patient is disturbed by regular jumps in pulse and blood pressure, chest or abdominal pain, it is necessary to consult a specialist. Diagnosis of the patient will exclude the development of other undesirable pathological conditions.
In addition to examining the patient and collecting an anamnesis in the diagnosis of VVD, the doctor will recommend that laboratory-instrumental examinations be mandatory. This is first of all:
- electrocardiogram (ECG);
- magnetic resonance imaging (MRI);
- laboratory research;
- ultrasound examinations (ultrasound).
The first attack is always a shock: both for the patient and for his relatives. It is necessary to prepare for the second crisis both mentally and physically, because in the case of the next attack you need to act confidently and calmly.
Diagnostics is easy. However, it is necessary to eliminate the likelihood of significant nervous and psychological, somatic, endocrine diseases.
Crisis is diagnosed in 3 aspects:
- by paroxysmal nature, limited time;
- in the presence of a polysystemic autonomic disorder;
- with emotionally affective processes.
Vegetative crisis treatment
To proceed to the prescription of pharmaceuticals, the doctor must evaluate the following characteristics:
- the duration of the course of the disease;
- severity of signs;
- patient awareness of the nature of the disease;
- previous use of pharmaceuticals and the response of the human body to them.
Stopping the crisis should contain the purpose of different groups of drugs, which depends on the main signs of the disease, but directly:
- If there is a violation in the work of the heart, Valocordin, Corvalol, Anaprilin are taken.
- If you experience a sense of anxiety, fear, you should chew a tablet of Relanium, Clonozepam.
As a rule, the basis of the cure scheme is the method of antidepressants prescribed by the doctor. The detected somatic diseases should also be completely treated. All these measures are used if urgent medical care is needed in case of vegetative crises.
To teach the patient true deep breathing. This type of breathing fills the body with oxygen, which prevents the formation of serious symptoms. In addition, the enrichment of the lead brain with carbon dioxide can help with the use of a paper bag, it is inhaled, then air is exhaled.
When the first properties of the attack appear, it is preferable to change the situation – to leave the premises, transport.
To neutralize the autonomic crisis, treatment is selected comprehensively. In a package of measures, you can achieve the desired result. Vegetative-vascular disorder in the body is normalized with anti-anxiety antidepressants and tranquilizers. I use the first of the list for six months, and the second for at least 2 weeks.
Antidepressants are selected taking into account the individual characteristics of the body, they are not addictive and addictive. There are two approaches to treatment, which doctor and patient decide which one to choose. If you choose a psychotherapeutic approach, then the treatment will be long with an in-depth clarification of the origin of the disease, what caused it, what reasons provoked the violation.
What follows is the neutralization of the source of the disease provocation. For people who do not want to conduct therapy for a long time and find out the origin of the disease, there is a symptomatic treatment method, characterized by self-curbing the crisis using special techniques. Simple techniques will allow you to cope with your emotions, reduce fear during an attack, reduce sensitivity and susceptibility, remove anxious thoughts.
A superficial approach studies crisis as a consequence. With an in-depth approach to the problem, the possible causes of such manifestations are identified. Since such crises are considered as deviations in the work of the psycho-emotional sphere, you need not only to learn how to cope with attacks, but also to eliminate the source of anxiety and fear, which does not allow a person to live a full life.
It is almost impossible to find the cause on your own, so you do not need to try to cope with this problem without the help of a competent specialist. In the process of treatment and recovery, the patient can be helped by such methods of self-control as auto-training, yoga, qigong, meditative practices that will allow you to set the body in a healthy mood, and soon overcome bouts of crisis.
Complications and prognosis
In the bulk of cases, an involuntary attack is not limited to one moment, for this reason the patient creates a steady expectation of a subsequent crisis, creating a restless position. In patients with a crisis, the following difficulties are observed:
- Phobias – a person seeks to avoid these places, situations that can cause a seizure.
- Depression – a prolonged anticipation of a new attack negatively functions on a single psycho-emotional background.
- Increased fatigue, decreased social activity are also considered complications of panic attacks.
The prognosis of the disease is positive, if the patient does not delay the visit to the doctor, undergoes a multilateral study and receives additional support from the therapist.
Constant anxiety is caused by the fact that a crisis is usually not limited to one panic attack and attack, they are repeated at different intervals, a person knows about it and awaits the next case of exacerbation with fear. In such people, the following complications can be found:
- depressive problems. Due to the fact that a person is constantly in tension from the expectation of a new attack, the nervous system suffers and the general psychoemotional background falls;
- phobias. In order not to provoke a crisis, the patient avoids some places, people, situations that can cause it;
- decreased social adaptation and resulting fatigue.
The prognosis will be encouraging if the patient promptly seek help and will follow all the instructions of the therapist.
As a prophylaxis during the interictal period, the following points must be observed:
- compliance with the rules of a healthy image, which exclude bad habits that provoke a crisis. The daily diet should be rich in vitamins, play sports, be active and not leave room for negative thoughts;
- the use of stress-resistant techniques;
- taking herbal remedies sedative based on valerian, motherwort, mint;
- regular walks in the fresh air.
Existing preventive measures used in the interictal period will enable the patient to avoid the next occurrence of a panic attack. It:
- Compliance with a healthy lifestyle. It is confirmed that alcohol abuse, drug addiction and smoking increase the severity of the attack.
- Taking drugs with a sedative result – motherwort, peony, peppermint, as well as valerian.
- The formation of stress resistance. This can be achieved using methods recommended by a psychotherapist. Sufficient physiological dynamism – sports, constant walks in ecologically clean regions.
To cope with a vegetative crisis is permissible, the main thing is to follow the advice of a high-class neurologist or psychiatrist.
What drugs are used
According to the international classification of ICD-10, VVD is not designated as a separate disease. Vegetovascular dystonia is considered as a complex of disorders in the range of G90 – G99. These manifestations are treated mainly with herbal preparations (tinctures of valerian, ginseng, motherwort or lemongrass). Mild sedatives can also be prescribed that strengthen the nervous system.
For the treatment of cerebrovascular accidents, drugs are used that improve blood flow and blood circulation in the vascular system. These are drugs such as:
- “Ginkgo biloba”;
- “Piracetam” and others.
You need to take medicine for a long time, most drugs must be taken for at least 3 months. These dosage forms help to eliminate symptoms such as dizziness, drowsiness, poor memory, distraction, and forgetfulness. In addition, they provide the elimination of headaches and migraine attacks. Treatment schemes most often consist of a complex of drugs, which provides the expected therapeutic effect.
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