Skobenko O. Diagnosis and differential correction of thermoregulatory disorders in primary school children with vegetative dysfunction

The thesis focuses on improving the algorithm of diagnosis and differential correction of vegetative dysfunction (VD) accompanied by thermoregulatory disorder by introducing thermometry method based on the study of clinical features, specificity of thermopathological syndrome, features of central and cerebral hemodynamics, state of the brain biorhythm and neurohumoral regulation. There were defined the features of clinical course of thermopathological syndrome in case of VD, central and cerebral hemodynamics, neuroendocrine regulation in primary school children with thermoregulatory disorder in case of VD. The increase in levels of total catecholamines and their fractions, GABA, decreased activity of acetylcholinesterase and cholinergic activity is observed during hyperthermia with paroxysmal course. At low levels of temperature more often there is observed the deficit of pressor amines (epinephrine, norepinephrine, serotonin) at high acetylcholinesterase level and marked reduction of GABA. At the same time the most unsatisfactory regulatory and adaptive processes, when the processes of excitation and inhibition suffer equally, are registered. HRV indices are highly correlated with the level of catecholamines and neurotransmitters, which provides the rapid diagnosis of early vegetative homeostasis disorders and neurohumoral regulation by non-invasive method. It is proved that complex neurophysiological examination of children with thermoregulatory disorders in case of VD objectifies functional state of the brain structures associated with the regulation of homeostasis.The efficiency of temperature determination and differential diagnosis for establishing its etiology by comparing peripheral and central values by means of infrared auricular thermometer was proved. There was scientifically grounded the efficiency of differential therapy of VD accompanied by thermoregulatory disorders taking into account initial vegetative tone, level of neurotransmitter provision and cerebral hemodynamics, resulting in the improvement of general condition of the child and normalization of the temperature values in 65.27% after the first month of treatment and 89.25% after the second month of treatment.