Psychosomatic Approach to the Therapy of Vegetative Syndrome(Pathophysiology and Treatment of Autonomic Nervous Dysfunction)

Abstract

So called vegetative syndrome has been very popular in the daily practice. However, its clear definition is not established yet. The main reason will be focused on the vague subjective symptoms and transitional functional disorders in this syndrome, which presumably have led to the confusion of diagnosis and the retardation of the treatment. In any way, it is worthy of special mention that in most cases suffering from vegetative syndrome, acute or chronic stressful experience or life events were outstanding as a trigger or (and) prolongation of it. In another word, psychological stress as well as physical stress could be suspected as a potential impact for this pathogenesis. This may suggest the dysfunction in the central nervous system including neocortex and hypothalamus, will result in the unbalance of the function in the peripheral autonomic nervous system, i. e. vegetative syndrome may be the reflection of impaired brain function on the periphery. The main patho-physiological mechanism in the periphery will be hyper-or hyposecretion of neurotransmitters (mainly catecholamines and acetylcholine) and incidential reactions in the receptor sites, which consequently could lead to the local dysregulation of the sympathetic or (and) parasympathetic nervous system. Therefore, the therapy of this syndrome should firstly be aimed at the decrease in stress in the brain, handling very often with anxiety, depression, and distress as well as fatigue and tension. The author insists on the importance of psychotherapeutic approach, especially support and guidance for the elimination of symptoms throughout the cases. The dysrhythm in the physical level should also be readjusted in the same way. In drug therapy, psychotropic drugs, mostly enough with benzodiazepines and tricyclics should be the first choice. For the peripheral manipulation several receptor blockers (ex. β-adreno-recepter blockers and cholinergic blockers) could be recommended. The author thinks the systematic and dynamic combination of drug therapy with psychotherapy should be essential. This is why psychosomatic approach should be the best for the therapy of vegetative syndrome at this point in time.