Sympathetic hypercompensatory hyperactivity

Introduction Sympathetic hyperactivity increases the sympathetic excitability caused by various causes, causing a series of syndromes exhibited by the effector. Mainly manifested as rapid heartbeat breathing, elevated blood pressure, elevated blood sugar, peripheral vasomotor disorders, excessive sweating, dilated pupils, widened eyelids, prominent eyeballs, dizziness, burning neuralgia.

Cause

1, systemic disease: hypoxia, asphyxia, infection, major bleeding and other timing in vitro stress, systemic sympathetic nervous system excitement, sympathetic - adrenal medullary system at the same time, so that the systemic sympathetic nerve release of adrenaline, , Alpha receptors are excited, producing beta effects and alpha responses.

2, local lesions:

(1) Inter-brain lesions: craniopharyngioma, pituitary tumor, thalamic tumor, inflammation, injury, poisoning, vascular disease, etc.

(2) Spinal cord lesions: tumor, traumatic hematoma, inflammation, syringomyelia, etc.

(3) mediastinal and neck diseases: mediastinal tumor, aortic arch tumor, apical lesions (especially pleural tips), cervical ribs, retropharyngeal tumors, goiter, cervical spondylosis.

(4) peripheral nerve irritative diseases: tibiofibular fracture, shoulder and elbow joint dislocation, polyneuritis, ankle arthritis, lumbar vertebra deformity (spinal fissure, atlantoaxial lumbar vertebrae, lumbar vertebrae), pelvic tumors, etc.

an examination

Related inspection

Position change test histamine test

1. Increased blood pressure and increased heart rate: more common in stress or after stimulation of the hypothalamus. During the epileptic seizures, the blood pressure suddenly rises, accompanied by facial flushing, tearing, salivation, sweating, dilated pupils, increased heart rate, disturbance of consciousness, changes in respiratory rhythm, and urinary incontinence.

2, pupil dilated: the presence of light reflection, mostly unilateral, mainly seen in the cervical sympathetic nerve irritant lesions, accompanied by enlarged eye cracks, eyeballs, sweating on the same side. This is called Pourfour clu Peitit's syndrome. Bilateral pupil dilation occurred in the posterior hypothalamic lesion or stimulation.

3, dizziness, tinnitus, headache, nystagmus, transient darkness, turning the neck can be induced, this is called posterior cervical sympathetic syndrome (Barre-lieou syndrome).

4, skin sweating, flushing: can be systemic, partial or limited. Limitations can be band, single limb, half side, distal extremities, cheeks, ankles, and the like.

5, Raynaud phenomenon: symmetry two fingers suddenly white, and then cyan, a few minutes turn tide and then return to normal. Warm local can be relieved, cold can be induced, atypical can lack one of pale, cyanosis, flushing, and severe skin dystrophies, ulcers and even necrosis.

6, the limbs are blue and purple: no increase in exposure to cold air, no relief during warmth, increased limbs when drooping, reduced when lifting, may be accompanied by swelling, numbness and hard skin-like changes.

7, burning neuralgia: shortly after trauma, the palm of the hand, the bottom of the foot is the most intense, the damaged area of the skin thinning and bright, sweating, red and purple limbs, painful limbs allergic.

Differential diagnosis

1. Vagus nerve The vagus nerve is the 10th pair of cranial nerves. It is the longest and most widely distributed pair of cranial nerves, containing sensory, motor and parasympathetic nerve fibers. The vagus nerve dominates breathing and digests most of the organs of the two systems, such as the heart's sensory, motor, and glandular secretion. Therefore, vagal nerve damage can confuse circulatory, digestive, and respiratory dysfunction.

Symptoms manifested as headache, dizziness, enlarged eyelids, blurred vision, dilated pupils, rapid heartbeat and even arrhythmia, cold and cold limbs, dyspnea and other sympathetic excitement or dizziness, drooping eyelids, tears Symptoms of sympathetic inhibition (ie, vagus nerve excitability) such as nasal congestion and bradycardia

2. Autonomic reflex autonomic nerve is the spinal nerve that is emitted by the spinal cord, mainly distributed in the trunk, limbs, and movement and sensation. The visceral nerves emitted by the brain and spinal cord are mainly distributed in the internal organs, controlling and regulating the functions of the internal organs, blood vessels and glands. Because it is not subject to human will, it is called autonomic nerve, also called autonomic nerve. Autonomic dysreflexia (AD), or autonomic hyperreflexia, refers to a group of clinical syndromes characterized by a sudden rise in blood pressure caused by spinal cord injury (SCI) in the T6 spinal cord or above. In 1860, Hilton and Bowlby in 1890 made a preliminary description of this phenomenon. Head described this syndrome for the first time in 1917. In 1947, Guttmann first confirmed that the paroxysmal hypertension is the main feature of autonomic dysreflexia through a large number of observations of SCI casualties.

3. Sympathetic hypertensive hyperhidrosis is a disease caused by excessive excitement of sympathetic nerves or high tension caused by excessive secretion of sweat glands. Sympathetic innervation dominates the body's sweating. Under normal circumstances, the sympathetic nerve regulates the body's body temperature by controlling sweating, but the patient's sweating and facial flushing completely lose normal control. Hyperhidrosis and facial flushing make the patient daily. In helplessness, anxiety or panic.

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