ASTHENIC SYNDROME (grech, astheneia powerlessness, weakness) — the state which is shown increased fatigue and an exhaustion, easing or loss of ability to long physical and intellectual tension.
The clinical picture
At patients is observed the irritable weakness which is expressed a hyperexcitability, easily changing mood, the irascibility amplifying in the second half of day and by the evening. Affective lability with dominance of the lowered mood with lines of a capriciousness and displeasure, and also tearfulness is inherent to patients. For Ampere-second. the hyperesthesia — intolerance of bright light, loud sounds, pungent smells is characteristic. At Ampere-second. headaches, frustration of a dream in the form of the increased drowsiness or persistent sleeplessness, vegetative disturbances are quite often observed. Depending on falling of barometric pressure at patients with Ampere-second. fatigue can increase, amplify irritable weakness, a hyperesthesia (N. I. Pirogov's symptom). At Ampere-second., developed owing to various organic diseases, also easy disturbances of memory are observed; preferential · storing of current events suffers.
Asthenic frustration, as a rule, develop gradually, accruing in the intensity. Sometimes first manifestations of Ampere-second. the increased fatigue and irritability which are combined with impatience and constant aspiration to activity, even in the situation favorable for rest are («the fatigue which is not looking for rest»). In hard cases asthenic frustration can be followed by an aspontannost, passivity, an adynamia. Clinical picture of Ampere-second. has features depending on the reasons which caused it.
Ampere-second. after somatopathies quite often accepts character of a state emotional giperesteticheskoy weaknesses [K. Bonhoeffer] at which increased fatigue and affective lability are combined with intolerance of insignificant emotional pressure, and also the phenomena of a hyperesthesia described above.
After the postponed craniocereberal injury asthenic frustration are expressed by the irritable weakness, affective lability, a mentism (flow of thoughts) which are combined with headaches and vegetative disturbances which in these cases happen very sharply expressed that allows to speak about existence astheno - a vegetative syndrome.
In the initial period of an idiopathic hypertensia of Ampere-second. accepts the nature of «the fatigue which is not looking for rest». At atherosclerosis of Ampere-second. it is shown by sharply expressed fatigue, irritable weakness, reduced mood with tearfulness. At syphilis of a brain of Ampere-second. it is characterized by an explosibility, frustration of a dream, persistent headaches. At a general paralysis the combination of increased fatigue to easy extent of devocalization (obnubilation) is observed.
At endocrinopathies of Ampere-second. it is expressed by increased fatigue, an exhaustion, slackness, is followed by sharply expressed affective lability and frustration of inclinations.
Ampere-second. at schizophrenia it is shown by dominance of a mental exhaustion and disproportion of the last with degree of intellectual tension, a combination of these frustration to decrease of the activity.
Etiology. Ampere-second. can be a consequence of a long emotional or intellectual overstrain, and also many mental diseases, often results from somatic infectious and noninfectious diseases, intoxications, and also cherepnomozgovy injuries.
Ampere-second. it is observed also in the initial (initial) period of various organic diseases of a brain (a hypertension, atherosclerosis, syphilis of a brain, a general paralysis, encephalitis). Asthenic frustration are inherent to also initial period of schizophrenia.
Studying of Ampere-second. shows that this state most often arises at people with weak or unbalanced type of higher nervous activity, however can develop also at persons with strong, excitable and brake type of higher nervous activity. The irritable weakness observed at Ampere-second., is explained by lability and a bystry exhaustion of irritable process, vegetative frustration — weakening of function of the highest vegetative centers. Emergence of Ampere-second. connect with exhaustion of nervous elements owing to excessive power consumption, a hyponutrient, disturbance of intracellular exchange, an endointoxication or toxicosis. In the whole Ampere-second. it is necessary to consider as the adaptive reaction which is followed by reduction of intensity of activity of various systems of an organism with the subsequent possibility of recovery of the broken processes.
the Diagnosis is made on the basis of set of the lines inherent in this state. Features of Ampere-second., and also a combination of asthenic frustration to other displays of a disease give the chance to diagnose the disease which caused an asthenic syndrome. Ampere-second. it is necessary to distinguish from unsharply expressed depressions which are shown not so much the lowered mood, how many subjective feeling of weakness, an adynamia, indifference to surrounding from an indisposition.
Forecast depends on the nature of a disease, about the Crimea emergence of Ampere-second is connected.
Treatment develops from causal and symptomatic; causal — is directed to elimination of the reasons causing Ampere-second., symptomatic — provides the special mode (regular alternation of a dream and rest, release from work, change of a situation, occupation as physical exercises, sport, tourism), rational psychotherapy, physical therapy and medicamentous therapy. The last includes fortifying means, vitamins, and also use of drugs like Elenium, Trioxazinum for reduction of the phenomena of irritable weakness. For treatment of Ampere-second. an insulin therapy (small doses from 8 — 12 PIECES) with the subsequent stopping of the phenomena of a hypoglycemia administration of glucose can be recommended.
Bibliography: Bamdas B. S. Asthenic states, M., 1961, bibliogr.; Kreyndler A. Asthenic neurosis, the lane from Romanians., Bucharest, 1963, bibliogr.; Examination of working capacity at nervous and mental diseases, under the editorship of N. K. Bogolepov, page 285, M., 1960; Friedman M. Etiology and pathogenesis of neurocirculatory asthenia, War Med. (Chic.), v. 6, p. 221, 1944; about N of e, Studies concerning etiology and pathogenesis of neurocirculatory asthenia, Amer. Heart J., V. 30, p. 325, 1944.