Asthenic neurosis (neurasthenia) is a neurotic psychogenic disease, which in most cases is caused by traumatic factors or overwork. Children are especially prone to this problem, especially with increased workload at school and lack of free time due to attending sports sections and creative clubs, which are most often encouraged by their parents.

General characteristics of the disease

Astheno-neurotic syndrome in a child consists of a persistent imbalance of the nervous system. It is characterized by high exhaustion, increased excitability, irritability and autonomic disorders. Unlike adults, children are less able to hide their emotions, so diagnosing the disease is not difficult.

Clinical forms of the disease

In the absence of proper treatment, the disease develops, the symptoms intensify and it becomes more severe. In total, there are three stages of astheno-neurotic syndrome:

1. Hypersthenic form. At the initial stage of the disease, irritability, increased excitability, and emotional instability dominate. The child begins to raise his voice without reason, scream, and use rude speech. Attention becomes distracted, which leads to problems with studying and constant distraction by external stimuli. The patient begins to be haunted by dreams related to current problems and events of the day. Having difficulty falling asleep, he does not feel rested in the morning.
2. Irritable weakness. The second stage of the disease, which occurs if adequate treatment has not been provided. Irritation intensifies, mental exhaustion increases. Having become easily excitable, the child shows bright bursts of temper, after which impotence sets in. Overexcitement gives way to grief, crying, feelings of fear or resentment. Concentration is very difficult for a child. Headaches and other discomfort occur in different parts of the body.
3. Hyposthenic form. Sometimes it occurs in people belonging to the asthenic psychotype, but more often it develops as the third phase of the astheno-neurotic syndrome. The patient suffers from lethargy, increased mental and physical exhaustion, lack of mood, apathy, and passivity. Anxiety and feelings of sadness constantly haunt the child, which is why he is prone to touchiness, tearfulness, and complains about his mood and condition. It is difficult for him to concentrate both on studies and on physical labor.

In addition to the stages described, sometimes there is a stage of protracted neurosis, which often leads to the development of neurasthenia. A child at this stage exhibits severe hypochondria, indifference to what is happening around him, and a depressive state. He is prone to a constant feeling of fear and mood disorders. Over time, the condition worsens and turns into neurotic depression.

Astheno-neurotic syndrome can be an independent disease, but sometimes it becomes a harbinger of much more complex, intractable disorders (atypical depression, schizophrenia). Therefore, it is especially important to promptly consult a specialist when the first symptoms occur.

Symptoms and signs

An experienced specialist is able to identify this disease at an early stage of its development. Symptoms largely depend on the clinical form of asthenic neurosis, but there are also general signs characteristic of all phases:

• sudden mood swings, irritability and anxiety;
• unusual mental and physical fatigue;
• problems with concentration, decreased performance;
• pressing headaches that occur in the evening;
• frequent urge to urinate;
• increased or, conversely, decreased appetite;
• sleep disorders;
• disorders of the cardiovascular system;
• dyspeptic disorders;
• dizziness associated with overexertion.

Causes of the disease

The following reasons can lead to disorders such as neurasthenia and asthenic neurosis:

• excessive intellectual or physical stress, causing exhaustion of the nervous system;
• a tense situation at school or in the family, when the child is constantly in tension due to the expectation of insult, scandal, physical violence;
• constant criticism from parents or teachers, excessive demands on their part;
• malfunctions of the autonomic system associated with endocrine diseases;
• chronic diseases;
• sedentary and far from healthy lifestyle, unhealthy diet, hormonal imbalances.

Stages of development of asthenic neurosis

In children, neurasthenia is most often associated with problems in learning, conflicts with parents who make excessive demands. When a child is faced with physical and mental overload, he realizes that under no circumstances can he achieve the results that are expected of him. This leads to a malfunction of the nervous system.

There are three stages of disease development:

• neurotic reaction;
• neurotic conditions;
• neurotic development (disorder) of personality.

Treatment methods

Before proceeding to therapy, it is necessary to undergo a full medical examination. This is primarily due to the fact that neurasthenic symptoms can accompany other serious diseases associated with mental health, endocrine and nervous systems. In some cases, neurasthenia is provoked by infectious diseases. If other highly specialized doctors have ruled out the presence of a disease related to their profile, a psychotherapist is involved in the treatment.

After the diagnosis is established, the patient requires complete emotional peace, absence of physical and intellectual stress for the entire recovery period. In most cases, complex therapy is required, including medication and psychotherapeutic approaches.

The task of a psychotherapist is to analyze the teenager’s condition, help in revealing the internal conflict and get rid of it. In some cases, in the early stages of the disease, it is possible to do without drug treatment, which involves prescribing nootropics to stabilize the brain, muscle relaxants to get rid of headaches, as well as tranquilizers to reduce the child’s daytime nervousness. In most cases, children are prescribed vitamin complexes to improve their overall health.

Sometimes consultation with a specialist is necessary for parents if one of the causes of the disease is an unhealthy atmosphere in the family. It will not be possible to completely get rid of neurasthenia if the child is subjected to emotional pressure both at school and at home. He should be isolated from constant stress, which a change of environment can help with. In some cases, additional physiotherapeutic procedures are prescribed. As an additional measure, you can try aromatherapy with soothing oils.

Neurasthenia responds well to treatment: more than 3/4 of those who contact a specialist quickly return to a normal mental and physical state and no longer encounter this disease in the future.

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A disease called aseptic necrosis of the femoral head is quite common. Women get it several times less often than men. It is typical that 2/3 of patients are young people 20-45 years old. This is a rapidly progressing disease.

In the absence of proper treatment, it can lead to dysfunction of the joint and, ultimately, loss of ability to work.

This is why it is important not to miss the first symptoms of the disease.

The main causes of the disease

Femoral head- This is a closed compartment, sensitive to circulatory disorders that change the architectonics of the bone.

The head is supplied with blood through three small arteries. When one of them stops (disturbs) the blood supply, necrosis (ischemia, necrosis) occurs in the area of ​​the head that the damaged artery supplied.

The essence of asthenic necrosis is a violation of microcirculation and further necrosis of the bone tissue zone in the head of the femur. As a result, the integrity of the cartilage covering this area is disrupted, and secondary deforming arthrosis develops.

Vascular causes

Common Causes cessation of blood supply to the femoral head by the artery:

• compression or twisting of an artery due to injury,
• its blockage with a small blood clot,
• venous stasis,
• prolonged vasospasm,
• increased blood viscosity,
• impaired venous outflow.

Vascular disorders increase intraosseous pressure, leading to mechanical destruction of bone tissue.

About mechanical theory

The vascular theory of causes is complemented by the “mechanical” theory. According to it, the head of the femur experiences “overwork.”

Impulses about this are sent to the cerebral cortex.

Return signals lead to vasospasm or blood stagnation, disruption of metabolic processes, and accumulation of decay substances in the bones.

As a result, the physicochemical and structural properties of the bone change, which is gradually destroyed with difficulty in local blood circulation.

Metabolic disorders and pathological conditions

Among them as the causes of the disease are in the lead:

• prolonged use of alcoholic beverages;
• long-term use of corticosteroids in large doses; patients with arthritis or bronchial asthma take corticosteroid hormones (metipred, prednisolone, etc.) for a long time;
• chronic pancreatitis;
• large doses of radiation exposure;
• decompression sickness;
• osteomyelitis;
• sickle cell anemia and other diseases,
• injuries (hip bruise, hip dislocation, hip fracture, etc.).

One of the causes of the disease is a congenital defect in the form of hip dislocation (hip dysplasia).

Symptoms and diagnosis of the disease

Stages aseptic necrosis of the head of the hip joint with distinctive symptoms:

1. Initial. Pain serves as the starting clinical manifestation. It grows to a maximum and becomes unbearable within the first two or three days. Usually appears in the groin, less often in the thigh, knee joint, and lower back. The joint retains its full mobility.
2. Second– impression fracture. The patient has constant severe pain in the joint even at rest. Over a period of several days to six months, vascular disorders develop. Atrophy of the thigh muscles is possible. The sore leg seems to decrease in volume. Movements are limited. There is a slight limp in the gait.
3. Third– secondary arthrosis. Over 6-8 months, the bone beams are destroyed and the head of the femur is deformed. There is severe pain in the joint. Movements are limited in three directions. When walking, there is initial pain, moderate lameness, and a desire for support.
4. Fourth. When the disease lasts more than 8 months, complete destruction of the head occurs. Constant pain in the joints of the hip and knee, in the lower back. Movements are severely limited. Atrophy of the muscles of the buttocks and thighs is severe. The affected leg becomes shorter; in the more severe version, it lengthens.

Diagnostic methods

Widely used methods of diagnosing the disease include:

1. MRI. The early stage is detected by magnetic resonance or computed tomography. This diagnostic method almost 100% detects the disease when x-rays “do not see” it. Therefore, during the first weeks of the disease, diagnosis using MRI is a priority.
2. Radiography. Aseptic necrosis becomes noticeable on an x-ray only at stages 2-3 of the disease. When the disease has been “experienced” for more than a year, its signs appear very clearly in the photographs. At this stage, a tomogram is not needed.
3. Radioisotope scanning. This method shows unequal absorption of the radioactive drug by pathological and normal bone tissue. The administered dose of the drug serves as a “tag” for the abnormal zone in the bone. The result is a two-dimensional image showing the affected areas of the bone.

Radiographs of patients with various stages of aseptic necrosis of the femoral head: from a - initial stage, to d - complete destruction of the bone.

Treatment and pain relief using conservative methods

Drug therapy

To the main groups of medications, used to treat the disease include:

• Anti-inflammatory nonsteroidal drugs, for example, indomethacin, piroxicam, butadione, etc. They help reduce pain in the hip and groin. This group of medications does not cure the disease. But due to the analgesic effect, reflex muscle spasm during pain is prevented. These medications are especially effective in the first six months of the disease.
• Vasodilators, for example, trental, theonicor. They eliminate stagnation in blood circulation. As a result, arterial blood flow is activated and spasms of small vessels are relieved. Vascular night pain in the affected joint is reduced. Effective in the first 6-8 months of the disease.
• Bone tissue regenerators. Products containing vitamin D (calcium D3 forte, oxidevit, natecal D3, etc.) help stimulate the recovery process. These drugs promote the accumulation of calcium in the head of the affected femoral bone.
• Calcitonins effectively stimulate bone formation and eliminate bone pain. These include miacalcin, sibacalcin, alostin, etc.
• Chondroprotectors(chondroitin sulfate and glucosamine) provide nutrition to cartilage tissue and restore the structure of damaged cartilage. The treatment is effective over a period of 8 months.

Therapeutic gymnastics and massage

One of the most important methods of treating necrosis of the femoral head is therapeutic exercises. Without it, it is impossible to overcome the progressive deterioration of blood circulation in the area of ​​the femoral head and the increasing atrophy of the thigh muscles.

It is necessary to choose exercises to strengthen the muscles and ligaments of the sore leg. Moreover, there should be no pressure on the head of the femoral bone without active flexion-extension of the legs.

An example of a static exercise is a small straight leg raise in a supine position. The leg is supported by weight. Fatigue will appear, although the joints do not work. The set of exercises should be carefully considered with your doctor.

Therapeutic massage used as an additional treatment method. But if you do it competently, without harsh pressure, it will bring real benefits. By massaging the thigh muscles and back, blood circulation improves.

Orthopedic rules

It is very important to follow the orthopedic regimen. Many experts are against long-term use of crutches and bed rest at the onset of the disease.

In their opinion, this threatens:

• progressive muscle hypertrophy,
• formation of persistent pain syndrome,
• violation of motor stereotypes.

For facilitating the course and shortening the duration of the disease required:

• walking up to 20 min. at an average pace,
• walking up the steps,
• swimming,
• exercises on an exercise bike,
• using a cane in the first weeks and during long walks,
• fight against excess body weight.

It is necessary to exclude inertial loads on the joint in the form of lifting heavy objects, jumping, and running.

Surgical treatment of the disease

Surgical intervention is resorted to when conservative measures are unsuccessful.

Femoral head decompression

The surgical method of decompression consists of drilling a canal into the area of ​​the femoral head with no blood flow. The drill passes along the greater trochanter and neck of the femur.

Goals of decompression:

• increased blood supply to this area due to the growth of new vessels in the formed channel (puncture),
• decrease in intraosseous pressure in the femoral head.

By reducing blood pressure, pain is reduced in 70% of patients.

Fibula autograft transplantation

Unlike decompression, a fragment of the fibula located on a vascular pedicle is transplanted into the drilled cavity. Such a transplant from one’s own body improves blood flow and strengthens the femoral neck.

Hip replacement

It consists of completely replacing the damaged hip joint with an artificial one. A titanium pin (or zirconium) with an artificial head at the edge of the joint is inserted into the formed cavity of the femur bone and fixed.

At the same time, the second articulating part of the joint is operated on, inserting a concave bed to rotate the new head in it. Correctly performed surgery eliminates pain and restores joint mobility.

Timely and competent treatment of necrosis of the head of the hip joint in most patients results in improvement within several months of therapy.

In another part of the patients, the condition stabilizes, which does not lead them to surgical measures.

Video: What systemic diseases can provoke the development of GBC necrosis

Neurasthenia is a pathological condition (mental illness) that develops against the background of prolonged stress or physical overload. The risk group mainly includes people aged 20-40 years. Asthenic neurosis manifests itself as nervous weakness caused by strong experiences, infectious diseases or other stresses on the body.

Who are neurasthenics?

Signs of neurasthenia are most often recorded in women and men over 20 years of age. Basically, the pathological condition develops in able-bodied people. The development of mental disorders in this group of patients is due to increased mental or physical activity.

There is also a reactive type of neurasthenia (asthenic neurosis). The appearance of this form of pathological condition is caused by severe stress or psychological trauma. In particular, the sudden death of a loved one can lead to asthenic neurosis. The reactive type of disorder is detected in both adults and children.

It is quite difficult to determine why a person becomes neurotic: the difference in mental disorders often lies in mild clinical symptoms.

Also, in order to diagnose pathological disorders, it is important to establish the causative factor and form of neurasthenia.

Forms of neurasthenia

Asthenic neurosis, depending on the stage of development, can take on the following forms:

• hypersthenic;
• irritable weakness;
• hyposthenic.

The hypersthenic form develops at the initial stage. This type of neuro-asthenic syndrome is difficult to diagnose, as a result of which adequate treatment is not carried out. With hypersthenic neurasthenia, the following phenomena are observed:

• emotional lability;
• increased irritability;
• excessive excitability.

With this form of neurasthenia, patients often lose their temper, regularly lash out at their own environment, and insult loved ones. Irritation is caused by common phenomena:

• conversations;
• various sounds;
• large crowds of people and more.

Patients with this type of disorder experience decreased performance. This disorder is associated with absent-mindedness and lack of concentration. Patients with the initial form of the disorder cannot perform a certain activity for a long time. They need something to distract their attention. After this, the person experiences difficulty engaging in work activities.

At the same time, cerebral neurasthenia causes sleep disturbances, manifested in the form of:

• problems falling asleep;
• disturbing dreams;
• frequent awakenings in the middle of the night.

The consequences of the described phenomena are:

The following violations may also occur:

• problems with remembering information;
• constant heaviness in the head;
• feeling of discomfort in the body.

Irritable weakness develops if appropriate treatment of the first type of neurasthenia has not been carried out. Also, this form of the disorder occurs in people with a strong nervous system. At the second stage of development of the pathological condition, increased irritability is noted, which is quickly replaced by mental exhaustion. Patients often cry after active expression of emotions.

Mental disorders manifest themselves in various situations. People with this form of nervous disorder are not able to normally enter into a working rhythm: any activity causes difficulties, which is explained by the person’s inability to concentrate on anything specific. Constant nervous tension forces sick people to leave their activities, feeling their own powerlessness.

An important feature of this form of neurasthenia is that even a long rest does not change the situation for the better.

Patients, trying to correct the current circumstances, return to work many times during the day. However, these attempts can cause the patient to become completely exhausted.

The hyposthenic form of neurasthenia in anxious and suspicious people often develops immediately, bypassing the stages described above. This stage is characterized by the following features:

• physical and mental weakness;
• lethargy;
• passive behavior;
• lack of interests;
• constantly in a bad mood.

Patients with hyposthenic neurasthenia experience persistent sadness. Patients are in a state of vague anxiety. Patients experience emotional instability and complete inability to perform work. People in this state are more focused on their own experiences and internal sensations.

In the absence of treatment, chronic neurasthenia occurs. It is also possible to develop depression. Adequate treatment can normalize sleep and eliminate attacks of neurasthenic syndrome.

Causes of nervous disorder

The causes of neurasthenia are of various types. Basically, the pathological condition develops against the background of prolonged physical or mental stress. The syndrome may also appear in people who have experienced severe stress.

Regardless of the form of neurasthenia, the reasons for the development of the pathological condition may be hidden in a malfunction of the body. Mental disorders of various types arise against the background of:

Neurasthenia is characterized by the relationship between a person’s personality and his lifestyle. More often, a mental disorder is detected in thin people who have not previously experienced intense physical or mental stress. Neurotic manifestations are often diagnosed in patients who have recently begun to live independently (separate from their parents).

Symptoms of neurasthenia

Symptoms of neurasthenia manifest themselves in the form of vegetative and mental disorders. A characteristic sign of a pathological disorder is constant pressure on the head (the so-called neurasthenic helmet). Neurosthenics in this state seem to be wearing some kind of helmet that interferes with normal life activities.

The following symptoms and signs of neurasthenic syndrome are also distinguished:

• attacks of dizziness;
• decreased performance;
• increased fatigue;
• sleep disturbance;
• memory problems;
• state of anxiety;
• unreasonable fears;
• decreased self-esteem.

These are general signs of neurasthenia, characteristic of all patients.

Mental disorders cause dysfunction of the cardiovascular system, which manifests itself in the following clinical symptoms:

• attacks of tachycardia (rapid heart rate);
• feeling of heartbeat;
• chest pain;
• blood pressure surges;
• paleness or redness of the skin.

These symptoms occur unexpectedly and are usually associated with the patient’s anxiety. In addition, patients are unable to wait long or restrain themselves.

A common occurrence is the appearance of signs of neurasthenia in women. The nature of the clinical picture in this case does not differ from that described above. The presence of mental disorders in women may be indicated by:

In men, neurasthenia manifests itself mainly as symptoms of a functional disorder. Most often, it is in this category of patients that irritable weakness is recorded, which has a chronic course. The presence of a neurotic syndrome in a man is indicated by the following phenomena:

• constant muscle pain;
• inability to concentrate on anything for more than 5-10 minutes;
• increased fatigue;
• prolonged headaches;
• inability to solve simple logical problems.

Neurasthenia occurs in the form of attacks or worries for several months or years. The likelihood of developing the second form of the pathological condition depends on the individual characteristics of the patient, the presence of concomitant diseases and other factors.

How is neurasthenia diagnosed?

Asthenic neurosis requires adequate treatment. Therefore, before selecting a treatment regimen, it is necessary to differentiate this disorder from other mental disorders.

Diagnosis of neurasthenia requires the participation of a neurologist.

The doctor assesses the patient's condition based on the patient's complaints. When making a diagnosis, it is important to exclude somatic pathologies, the initial stage of development of which causes the type of mental disorder in question:

• infectious diseases of a chronic nature;
• severe intoxication;
• brain pathologies (tumor, tissue inflammation, neuroinfections).

To assess the patient's condition, a brain examination is performed using MRI or CT. Rheoencephalography is also necessary. This method makes it possible to determine the nature of cerebral circulation, thereby eliminating organic damage to the central nervous system.

Neurasthenia requires an integrated approach to diagnosis. Therefore, if necessary, doctors of other specializations are involved in examining the patient.

How to treat neurasthenia?

With asthenic neurosis, symptoms and treatment are determined depending on the form of mental disorder. Also, when selecting a treatment regimen, it is important to take into account the causative factor. Without analyzing the occurrence of the disease, it is impossible to achieve a positive result.

Which doctor treats neurasthenia is determined based on the diagnostic results. Psychiatrists and psychotherapists deal with this disorder. Treatment of neurasthenic syndrome should be started only if all diseases of which this disorder is a symptom have been excluded.

When treating a pathological condition, it is necessary to give preference not only to sedatives, but also to other methods.

Treatment must be supplemented with lifestyle correction.

To achieve full recovery, the patient must follow a clear daily routine, sleep at least 8 hours (fall asleep before 10 pm) and consume more vitamins. The patient should also (if possible) change the environment.

Drug treatment

Treatment of neurasthenia should be carried out taking into account the current form of the pathological condition. For the hypersthenic type of disorder, tranquilizers are prescribed to eliminate anxiety and fear. Drug treatment of neurasthenia with drugs from this group improves sleep and suppresses other symptoms.

The following medications are used in the treatment of hypersthenic form:

• "Chlordiapoxide", "Diazepam" (have sedative properties);
• "Oxazepam" (alleviates fears);
• "Phenozepam", "Lorazepam" (eliminate anxiety);
• "Nitrazepam" (increases sleep quality);
• "Medazepam" (calms);
• "Afobazole" (used to restore mental state).

In the hyposthenic form of asthenic syndrome, treatment can be supplemented with antipsychotics, which have a more powerful and calming effect on the nervous system:

• "Sonapax";
• "Haloperidol";
• "Melleril";
• "Triftazine".

Antidepressants are used to improve mood:

Antidepressants relieve the main symptoms of a mental disorder. However, long-term treatment with drugs of this group suppresses sexual desire. In addition, uncontrolled use of antidepressants negatively affects the general condition of the body.

During the treatment of asthenic neurosis, side effects may occur. Therefore, it is recommended to take some medications under the supervision of a doctor. This refers to psychostimulant medications that stimulate the nervous system.

In the treatment of neurasthenia in women, drugs aimed at restoring hormonal balance are often used. The disorder of the latter often provokes mental disorders.

Psychotherapy

If neurasthenia and its symptoms appear, treatment is recommended at the initial stage of development of the pathological condition. This will avoid a number of negative consequences and quickly restore the patient’s mental activity.

Asthenic neurosis requires complex treatment. In addition to medications, psychotherapeutic intervention is necessary to eliminate nervous disorders. The following methods are used in the treatment of nervous asthenia:

Psychotherapeutic intervention helps to completely eliminate the manifestations of asthenic syndrome, including dysfunction of the cardiovascular system.

Treatment with folk remedies at home

Treatment of neurasthenia involves taking measures aimed at restoring the functioning of the nervous system. This can be achieved by using traditional medicine. There are several ways to cure neurasthenia yourself. Herbal decoctions are considered the most effective.

In the treatment of neurasthenia at home, the following are used:

There are other ways to get rid of neurasthenia. Peppermint or lemon balm teas are used to treat mental disorders.

Forecast and prevention of neurasthenia

The success of treatment (neurasthenia) directly depends on the behavior and desire of the person. This disorder is dangerous because without adequate therapy, the causes that caused the psychological disorder continue to affect the patient. As a result, the neurasthenic syndrome intensifies.

In the absence of proper and complete treatment, this disorder suppresses the immune system, as a result of which the patient becomes susceptible to the development of bacterial or infectious pathologies.