Neurocircular dystonia (NDC)

Neurocircular dystonia (NDC) is a variant of vegetative-vascular dysfunction (see Vegetative-vascular dystonia) mainly in young people, allocated, based on the needs of medical-expert practice, as a conditional nosological form.

NDC has a functional nature and is characterized by disorders of the predominantly cardiovascular system. In adolescents and boys, NDCs are most often caused by a mismatch between the physical development and the formation of neuroendocrine regulation of autonomic functions. In people of different ages, the development of NDC can be facilitated by asthenia in the outcome of acute and chronic infectious diseases and intoxication, lack of sleep, overfatigue, improper diet, sexual activity, physical activity (physical inactivity or physical overload). In a number of patients, hereditary predisposition to pathological vasomotor reactions is important.

Clinical manifestations most often consist of symptoms of a neurosis-like state (weakness, fatigue, sleep disorders, irritability) and functional circulatory disorders, according to the predominant character of which it is common to distinguish three types of NDC: cardiac, hypotensive and hypertensive.

The cardiac type of NDC is established in the absence of significant changes in blood pressure for complaints of heartbeat, irregular heartbeats, sometimes shortness of breath during physical exertion and on objective deviations in cardiac activity - tendencies to tachycardia, severe respiratory arrhythmia, supraventricular extrasystole, paroxysms of tachycardia, inadequate load of changes Cardiac output or others; Sometimes there are ECG changes in the form of high or low voltage of the T wave.

The hypotensive NDC type is manifested by symptoms of chronic vascular insufficiency (with systolic blood pressure below 100 mm Hg), which is most often based on hypotension of the veins, less often hypotension of the arteries. In most patients, the cardiac index is reduced with increased peripheral vascular resistance (only about 25% of cases determine an increased cardiac output). In a number of patients, a decrease in the level of sympathetic activity is determined. The most frequent complaints are fatigue, muscle weakness, headache (often provoked by hunger), chilliness of the hands and feet, propensity to orthostatic disorders, down to fainting. The majority of asthenic physique patients; Skin pale, hands often cold, palms moist; In orthostasis, as a rule, tachycardia and a decrease in pulse BP.

The hypertensive NDC type is characterized by a transient increase in blood pressure, which in almost half of the patients is not combined with changes in the state of health and is first detected during medical examination. In some cases, complaints of headache, palpitation, fatigue are possible. This type of NDC almost coincides with a condition defined as borderline arterial hypertension (see Arterial hypertension).

Treatment. The advantage of non-drug treatment methods, including normalization of lifestyle, hardening procedures, physical education and some sports (swimming, athletics) are also the most important means of preventing NDC. Physiotherapy, balneotherapy, sanatorium-and-spa treatment are used. With irritability, sleep disorders, the use of sedatives - valerian preparations, motherwort, valocardin; Sometimes nosepam or other tranquilizers. In the hypotensive type of NDC with orthostatic disorders, exercises that train the muscles of the legs and abdominals are prescribed; Recommend a smooth transition from lying to the standing position through an intermediate stay in the sitting position, avoiding prolonged standing. In some cases it is advisable to use medicines containing ergot alkaloids (belloid, etc.), preventing orthostatic disorders by taking caffeine or fetanol (with severe hyposympathicotonia). In the hypertensive NDC type, non-long-term administration of beta-hadron blockers and drugs of rauwolfia can be indicated.