COMPREHENSIVE ASSESSMENT OF RISK FACTORS FOR AUTONOMIC DYSFUNCTIONS IN SCHOOLCHILDREN AND THE POSSIBILITIES OF THEIR MANAGEMENT(LITERATURE REVIEW)

The literature review is concerned with the analysis of current studies on the disorders of the autonomic nervous system in childhood. Autonomic dysfunction syndrome (ADS) occurs in the general child populaton in more than 20% of cases, and in some children may cause the development of many somatic diseases. Recently, there has been a tendency toward the increase in the number of children with manifestations of this pathology. This may be explained by the ambiguousness of the methodological approach, taking into account either all or markedly pronounced disorders only. The prevalence of vegetative dysfunction is obvious, even among people who consider themselves to be apparently healthy. Moreover, there are no such pathological conditions the development and course of which do not involve vegetative mechanisms. Primary dysfunction of the autonomic nervous system initially causes functional disorders, particularly those of the cardiovascular system. In fact, arterial hypertension and hypotension are the basis for the development of such serious diseases of adults as coronary heart disease and hypertension leading to the development of serious complications. The symptoms of vegetative-vascular dystonia are associated with the dysfunction and coordinated interaction of the two parts of the autonomic nervous system, rather than the pathology of any internal organ. It is important not to miss the patient's subjective complaints related to the functioning of various organs which simulate the disease, but in fact no pathology is detected, as the clinical symptoms are associated with the imbalance of the nervous system. In case of any autonomic disturbance, the etiology and nature of the disorder should be clarified; the level of involvement of the autonomic nervous system, brain structures, parasympathetic and sympathetic autonomic formations must be determined. As reported by the publications, psycho-emotional factors are among the main reasons that contribute to ADS development, especially in senior schoolchildren. In most of them, vegetative lability in puberty is unstable, but with additional exposure and a combination of other causes it stabilizes. That is why, special attention should be paid to the factors affecting children's psycho-emotional state, the phenomenon of “bullying behavior” (bullying). Well-known bullying researchers have studied the reationships between young people at school and have concluded that bullying behavior involves some negative actions leading to resentment and chronic stress. Some publications state that current stressful environment is a powerful trigger for nervous system dysfunction and can lead to negative consequences in adult life. The development of new approaches to the early diagnosis, treatment and prevention of this pathology in childhood is integral for reducing the incidence of the disease among adult population. Nowadays, the management of autonomic vegetative nervous system dysfunction is significantly difficult. Vegetative stigmatization, which accompanies any pathological process, is routinely perceived as its obligatory component, inherent in both clinical symptoms of the disease and its pathogenesis. Therefore, due attention is not always paid to the management of autonomic disorders in somatic pathology. Treatment of vegetative disturbances is based on conventional regimens, which are mostly ineffective; it is obvious that proper diagnosis and successful treatment requires individual approach to each patient.