Polyencephalic (from the Greek. polios grey + encephalitis - inflammation of the gray matter of the brain. While some types of encephalitis selectively affects certain system of the brain.
If the inflammatory process affects grey matter, talk about polyencephalic, the electoral defeat of the white matter - of leukoencephalitis (see).
However, while various forms of leukoencephalitis exist in the form of nosologic units, isolated polyencephalic in the true sense of the word is not; it is only a part of such clinical forms, as, for example, acute poliomyelitis, spring-summer, or tick-borne encephalitis, acute poliomyelitis adults. All these diseases are essentially polioencephalomalacia.
As nosologic form of polyencephalic accepted the disease described in 1881 Wernicke (K. Wernicke) called acute upper hemorrhagic polyencephalic (polioencephalitis acuta haemorrhagica superior).
Polyencephalic Wernicke - toxic (usually alcohol) disease in which the developing process has essentially not inflammatory and vascular nature; hemorrhage observed not only in the gray matter of the middle brain, but in other areas of the cerebral cortex.
Later in the literature described as typical cases upper polyencephalic not only alcohol and other toxic nature.
Thus in 1936 Neuburger (K. Neubiirger) was described a number of cases with the localization process similar to polyencephalic Wernicke; at showdown was diagnosed with cancer of the digestive organs (especially the stomach), which was the cause of metabolic and education of toxins that affect the blood vessels and causing a characteristic picture of polyencephalic.
Campbell, Biggert (A. S. P. Campbell, J. H. Biggart) described 12 of these observations, among them only in one case the cause of the defeat was the alcohol, but in the rest of cancer of the stomach, chronic gastritis, intestinal tuberculosis, uncontrollable vomiting pregnant. Oppenheim (N. Oppenheim) has described polyencephalic in the administration of Lysol. In. A. Semenov-Tyan-Shansky described the case of chronic gastritis, when in the clinic and at autopsy had a picture of the top polyencephalic. In all these observations etiological moment was the B1 deficiency. Vitamin B1 is lying, apparently, and in the basis of alcoholic top P., as treatment with vitamin B1 sometimes gives good results.
The primary lesion is the gray matter of the brain (selview) water supply and the third ventricle. In affected areas vessels full-blooded, their walls were thickened; in perivascular spaces and in the tissues of the brain are the foci of hemorrhage; adjacent tissue edema and is in a state of collapse, flooded with grainy balls; in glioznogo tissue is found substitution growth. The process is mostly not limited gray matter, and extends to individual sections of the white matter in the trunk and even in the spinal cord, which explains the appearance along with eye disorders, speech disorders, paralysis of the facial muscles and cerebellar ataxia.
The disease is acute, although it is preceded by a more or less long period of ill health that are often seen in alcoholics, headaches, dizziness, vomiting in the morning, muscle and nerve trunks, a variety of paresthesias. The first days of the disease occurs with symptoms of delirium tremens (delirium tremens) or somnolent state motor excitation.
Soon identified various neurological symptoms and first defeat of eye muscles - strabismus, ptosis, lethargy pupillary reaction, sometimes full ophthalmoplegia.
Observed and optic neuritis first.
It becomes few lucid, appears cerebellar ataxia. Sometimes there is loss of facial nerve on the Central type. All the symptoms are increasing, and by the end of the second week most often the patients die. Recovery is usually the case with defect - paresis of eye muscles, ataxia, Korsakov amentity syndrome.