Hyperparathyroidism: symptoms of nervous system damage, principles of treatment

Hyperparathyroidism is a problem of the endocrine system of the body, associated with an increase in the secretion of a special parathyroid hormone( parathyroid hormone).He is responsible for the regulation of the exchange of calcium and phosphorus in the human body. Parathyroid hormone produces parathyroid glands located in the thyroid gland. Increasing the production of this hormone leads to an increase in the concentration of calcium in the blood and the excretion of phosphorus from the body. There are metabolic disorders that do not pass by virtually any body system. In addition to bone-joint, kidney, gastrointestinal problems, hyperparathyroidism can manifest itself and pathology of the nervous system. Symptoms of nervous system damage in hyperparathyroidism will be discussed in this article.

What is hyperparathyroidism?

Hyperparathyroidism is a chronic parathyroid disease. The glands are a small disc-shaped formation located in the thyroid gland. Their main function is to regulate the concentration of calcium and phosphorus in the blood by means of a special hormone. This hormone is called parathyreocrine, or parathyroid hormone. Parathyroid hormone promotes calcium absorption in the intestine, reduces its secretion in the urine, promotes the release of calcium from bone tissue into the blood. As a result of these processes, the concentration of calcium in the blood increases. Also, the parathyroid hormone provides phosphorus in the urine. Fluctuations in the content of phosphorus and calcium in the blood are captured by the parathyroid glands, and in response to these changes, the necessary amount of parathyroid hormone is produced to maintain normal parameters. The system works as follows: a little calcium in the blood - the production of parathyroid hormone increases, a lot of calcium - and the production of the hormone decreases. This is normal.

With various pathological conditions, a constant increase in the production of parathyroid hormone is possible. This situation is called "hyperparathyroidism".As a result, the concentration of calcium in the blood becomes higher than normal, and phosphorus is lost in the urine. This leads to a violation of metabolic processes in the body. Metabolic problems cause the pathology of the musculoskeletal system( osteoporosis, skeletal deformities, frequent fractures, etc.), the gastrointestinal tract( nausea and vomiting, flatulence, propensity to constipation, the formation of duodenal ulcers), vision disorders( due to depositioncalcium in the cornea decreases visual acuity) and kidney problems( stone formation).Along with this, with hyperparathyroidism, the nervous system may also suffer.

Hyperparathyroidism often occurs in people 30-50 years old, although it can be detected in children and in the elderly. More affected are female faces. In the menopause period, the predominance of women becomes particularly noticeable.

The defeat of the nervous system

The pathology of the nervous system in hyperparathyroidism is very nonspecific. Symptoms can be associated with changes in the excitability of nerve cells against the background of increased calcium concentrations in the blood, as well as with vascular problems. The fact is that a constant high concentration of calcium in the blood leads to its deposition in the walls of blood vessels, including vessels that feed the structures of the nervous system. Violation of the blood flow does not go unnoticed. Increases blood pressure. There are various symptoms that indicate problems from the central and peripheral nervous system, in severe cases the situation leads to acute impairment of cerebral circulation, that is, to a stroke.

So, the main symptoms of nervous system damage in hyperparathyroidism can be:

• problems in the emotional sphere. Increased irritability, emotional instability, tearfulness can for no reason be replaced by complete indifference to the surrounding world;
• drowsiness, which is not eliminated after a full sleep;
• general weakness and lethargy;
• persistent depression;
• muscle weakness( both in individual muscle groups and generalized). Most often, muscle weakness occurs in the lower limbs, accompanied by diffuse pain. Patients have difficulty in changing the position of the body( for example, to rise from sitting, it is necessary to lean on anything), quickly get tired even with ordinary walking, often stumble and even fall;
• decrease in muscle tone. Because of this, other symptoms may appear. For example, flat feet, which is the result of a decrease in the tone of the foot muscles, or a duck's gait due to the "looseness" of the joints;
• worsening memory of a progressive nature, a decrease in the rate of thought processes;
• confusion and even psychosis.

As you can see, none of the symptoms of nervous system damage in hyperparathyroidism is specific. Each individual symptom can not justify hyperparathyroidism, but it is the first call for a more in-depth examination of the patient.

All the symptoms described above are a consequence of an increased calcium content and impaired conduction of pulses between neurons. If the hyperparathyroidism exists for a while and the walls of the vessels are already deposited calcium, then there are problems with blood circulation. Regarding the nervous system, this is manifested by a variety of symptoms:

• noise and ringing in the ears;
• dizziness and unsteadiness in walking;
• headaches;
• flickering flies before your eyes, blurred;
• numbness of various parts of the body.

If the disturbance of blood circulation arises sharply, the clinical picture corresponds to a stroke. In such cases, patients may suddenly break their speech, may weaken and numb their limbs, face asymmetry, swallowing, urination. Symptoms of a stroke that developed against a background of hyperparathyroidism also have no specificity.

If as a result of hyperparathyroidism there is deformation of the spine, it is possible to squeeze the nerve roots leaving the intervertebral openings. In such cases, patients experience pain, numbness, a feeling of crawling, a tingling in the innervation zone of the specific root. With more severe compression, there may be a weakness in the muscles innervated by the affected spine, and even a disorder of the pelvic organs( violation of urination and defecation).It should be said that such "problems" with the peripheral nervous system as a result of hyperparathyroidism are rare.

Hyperparathyroidism is a multi-faceted disease, almost always occurring with the defeat of several organs and systems at the same time. Accordingly, the presence of one or more of the above described symptoms of nervous system damage does not yet indicate the presence of hyperparathyroidism. Complex evaluation of all available symptoms, careful examination of the patient usually reveal other signs of hyperparathyroidism, which allows to establish the diagnosis correctly.

Principles of treatment of

Since the defeat of the nervous system in hyperparathyroidism is a consequence of metabolic disturbances, the normalization of the level of calcium and phosphorus in the blood becomes the primary measure in therapeutic tactics. This statement is also valid in relation to other consequences of hyperparathyroidism.

The main principles of conservative treatment of hyperparathyroidism in mild cases are:

• increase in fluid intake;
• restriction of table salt, protein and products rich in calcium;
• intake of diuretics( thiazide diuretics are contraindicated!);
• administration of drugs that prevent the destruction of bones and the "washing away" of calcium from them( Pamidron, Ethidronic acid).

In some cases, for the treatment of hyperparathyroidism resort to surgical intervention - the removal of parathyroid glands( usually this happens in the presence of a parathyroid tumor).Selection for surgical treatment is taking into account many indicators( the concentration of total calcium in the blood serum, daily excretion of calcium in the urine, the rate of glomerular filtration, and so on).

All these principles of treatment set the main task: to get rid of hyperparathyroidism directly. Neurological disorders resulting from hyperparathyroidism may require a separate symptomatic treatment. For example, memory impairment is an indication for the appointment of nootropic drugs, dizziness - preparations of the Betagistin group, problems in the emotional sphere - various kinds of sedatives. All means of symptomatic treatment are prescribed along with the main therapy of hyperparathyroidism and are selected individually. In cases when the patient develops a stroke, apply the entire spectrum of medicines for the treatment of patients with acute impairment of cerebral circulation.

Thus, neurological disorders in hyperparathyroidism are a consequence of an increase in the content of calcium ions in the blood and a decrease in phosphorus. And this is not the only manifestation of hyperparathyroidism. To eliminate the defeat of the nervous system with hyperparathyroidism resorted to both conservative measures and surgical treatment. The volume of treatment depends on the severity of hyperparathyroidism, the degree of damage to the nervous and other body systems. With hyperparathyroidism in general and its neurological manifestations in particular, it is possible to successfully fight. This should be known to everyone who has encountered this problem.

Medical animation on the topic "Hyperparathyroidism":

Endocrinologist's report on "Treatment of hyperparathyroidism: evidence and results":