What do the manifestations of asynergia mean and how do they diagnose this pathology?

  • What do the manifestations of asynergia mean and how do they diagnose this pathology?

    The human brain is a complex structure composed of different departments, interconnected anatomically and functionally and responsible for the performance of certain activities in the human body.

    One of the most important parts of the brain, in particular its posterior part, is the cerebellum. He is responsible for the coordination of movements, regulates muscle tone, without it it is impossible to ensure a normal balance of the human body in space. In addition, the involvement of the cerebellum in mental functions has been proven. That is why the pathology in this department of the brain attracts attention not only neurologists, but also psychiatrists.

    What happens when the cerebellum is affected?

    For various reasons( swelling, trauma, abscess, hemorrhage, hereditary degenerative diseases, demyelinating diseases, alcoholic degeneration) the cerebellum ceases to function normally, which is manifested by various symptoms of motor disorders.

    The most important of these are atonia( or hypotension), ataxia and its manifestation of asynergy. The latter is expressed in a person's inability to symmetrically perform complex movements, perform actions that require the simultaneous participation of different parts of the body, that is, each movement will be performed as a sequence of individual simple reactions, and not a whole combination.

    Allocate a static ataxia( inability to stay in balance in the vertical position of the body) and dynamic( discoordinate disorders in walking, shaky gait with widely set legs).All three of the above symptoms appear with damage to any department in the cerebellum, but the degree of their expression depends on the location of the pathological focus and its size.

    In addition, characteristic manifestations of cerebellar disorders are:

    • appearance of tremors and nystagmus;
    • hypermetry( discrepancy of movements with distance to a certain point, for example, a sick person misses the nose in the palcenosal test);
    • speech disorders;
    • adiadochokinesis( impossibility of correct alternation with opposite actions).

    Clinical manifestations of asynergia

    This pathology was described by the French scientist Babinsky, according to his ideas there are:

    • frontal asynergy( in the pathology of the corresponding lobes of the brain) - disturbances in walking are manifested by the fact that the legs lag behind the trunk, which gradually deviates back and the person fallsthe back due to the displacement of the center of gravity of the body;
    • cerebellar type 1 - a person experiences difficulties when trying to get out of the horizontal position without the help of hands( with arms crossed on his chest), because of the absence of a symmetrical contraction of the buttocks muscles, the pelvis and legs do not press against the support, but rise when they rise up. Cases of unilateral violation are described - hemiasynergy.
    • Cerebellar asynergy type 2 - pathology of the cerebellar worm - the patient with a head tilt back and trying to bend, falls, losing balance, on the back, as there is no symmetrical contraction of muscles and bending of the legs in the knee and extension in the hip joints.

    It should be noted that the rapidly growing ataxia and asynergia clinic is typical for acute situations( cerebral hemorrhage, cerebral infarction), the symptom complex develops rapidly in case of a tumor, abscess of the brain, alcoholism.

    Episodic manifestations of impaired coordination may be noted when certain drugs( anticonvulsant) enter the body or in hereditary pathology. Slowly progressing ataxia and asynergia in idiopathic lesions and degenerative forms of diseases, multiple sclerosis.

    What is an asynergy test?

    They are performed by specialists with suspicion of cerebellar pathology as follows:

    1. from the starting position "lying on the back" of the patient is asked to cross his arms on his chest and climb, while a healthy person easily sits down, and in cerebellar disorders a person has up his legs or one leg while hemi-press, but he can not sit down without help;
    2. from the "standing" position to the person is offered to lean on the palm of the doctor standing in front, with a quick retraction of hands, the patient falls forward( a symptom described by Ozhekhovsky).If a person is healthy, then he will slightly bend back or stand exactly in place;
    3. the patient is unable to rise independently from the chair due to the fact that the legs are not symmetrically bent in the knee joints;
    4. in a vertical position, a person can not bend back and throw up his head, but falls on his back;
    5. , while moving, the body lags behind the legs, and the patient gradually falls on his back.

    It should be noted that all of the above refers to the manifestations of asynergia due to the presence of organic brain lesions, but there is also a functional asynergy, for example, dissociative motor disorders in patients with schizophrenia or other psychiatric diseases.

    Therapeutic measures for asynergia are reduced to finding out the cause of this condition and symptomatic therapy. Adequate treatment of the underlying disease is necessary.

    Hereditary and idiopathic forms are not treated, the issues of social adaptation of patients, medical exercises are on the foreground. The forecast is usually maloblagopriyatny.

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