Steroid-Wopatsa Matenda Okhudzidwa Omwe Amagwiritsidwa Ntchito ndi Odzidzidzimutsa Matenda a Chithokomiro
Nthenda yotchedwa " Hashimoto's Encephalopathy " inayamba kufotokozedwa kokha mu 1966. Pambuyo pake, madokotala anayamba kulemba malipoti, ndipo "Hashimoto's Encephalopathy" inadzakhala dzina lovomerezeka chifukwa cha matenda osagwirizana ndi Hashimoto's thyroiditis.
Chifukwa chakuti odwala ambiri omwe ali ndi Hashimoto's Encephalopathy amathandizidwa ndi mankhwala a steroids kapena chithandizo cha immunosuppressant, akatswiri ena tsopano akutchula kuti "steroid-responsive encephalopathy yokhudzana ndi autoimmune thyroiditis" (SREAT).
Nthawi zina, vutoli likhoza kutchedwanso "nonvasculitic autoimmune meningoencephalitis" (NAIM), lomwe silingagwirizane ndi mavuto okhaokha a chithokomiro komanso zovuta zina monga Sjögren syndrome ndi systemic lupus erythematosus-yogwirizana ndi meningoencephalitis. Kawirikawiri pakati pa zinthu zonsezi ndikuti amamvera mankhwala a steroid.
Mawu akuti "encephalopathy" amatanthauza matenda a ubongo omwe amasintha ubongo kapena ntchito. Chinthu chachikulu cha vuto lililonse lachisokonezo chimasintha maganizo. Ngakhale kuti zizindikiro zimadalira mtundu wa ubongo komanso momwe zimakhalire zoopsa, zizindikiro zina zomwe zimakhalapo ndi izi:
- kukumbukira kukumbukira
- zovuta kuika patsogolo
- Kutaya nzeru zamaganizo ndi ntchito
- kusintha kwa umunthu
- chilema ndi kutopa
- kutaya chidziwitso
- myoclonus (kugwedeza mwadzidzidzi kwa minofu)
- nystagmus (kuyenda mofulumira, mosasamala)
- kunjenjemera
- kuchepa kwa minofu
- matenda a maganizo
- kugunda, kugwedezeka
- zovuta kumeza
- zovuta kulankhula
Zizindikiro zina zomwe mungaone zikuphatikizapo:
- chisokonezo, kusokonezeka
- psychosis
- mutu
- kumanja kumathandiza hemiparesis - kumbali yolumikiza
- mavuto abwino oyendetsa galimoto - mavuto ndi kugwirizana kwa mikono, manja, zala
Chifukwa chakuti Hashimoto's Encephalopathy / SREAT sichimvetsetsedwa bwino, mu kafukufuku wolembedwa mu February 2006 Archives of Neurology , akatswiri adatulukira kuti adziwe zochitika zosiyanasiyana zachipatala, ma laboratory, ndi zokhudzana ndi maulendo a radiological.
Cholinga chawo ndi kuthandiza kuwongolera mphamvu za madokotala kuti azindikire ndikuzindikira matendawa.
Phunziroli linayang'ana odwala 20 (amuna 14, amuna 6) omwe anapezeka pakati pa 1995 ndi 2003. M'badwo wawo wam'mbuyomu poyamba matenda unali zaka 56, ndipo anali ndi zaka 27 mpaka 84 (zaka, 27-84).
Zomwe zimapezeka nthawi zambiri zamagulu / zizindikilo zinali:
- Kudandaula - 80%
- Zomwe zimakhala zochepa ku Asia - 80% (Aphasia ndivuta ndi chinenero, zomwe zimakhudza luso loyankhula, kuwerenga kapena kulemba)
- Myoclonus - 65% (mwadzidzidzi, kugwedeza mwadzidzidzi kwa minofu kapena gulu la minofu)
- Gawani ataxia - 65% (kuyenda kosagwirizana kapena kuyenda kovuta, kuyenda movuta)
- Kugonjetsedwa - 60%
- Kugona molakwika - 55%
Kusokonezeka kwa matenda ndizowona
Chimene chiri chodetsa nkhaŵa kwambiri ndi chakuti akatswiri adapeza kuti OTHANDIZA ONSE anali atasokonezedwa kale. Mwachitsanzo:
- Encephalitis - 25%,
- Kuvutika maganizo kwa maganizo - 20%
- Matenda a Creutzfeldt-Jakob - 15% (matenda a Creutzfeldt-Jakob ndi matenda omwe amachititsa kuti munthu asapitirire matenda a ubongo, omwe nthawi zina amawatcha "Mad Cow Disease" mwa anthu)
Zovuta ndi Zoyezetsa Zovuta mu Hashimoto's Encephalopathy / SREAT
Zambiri zosavuta zinawonetsedwa, kuphatikizapo:
- Kuchuluka kwa mavitamini a chiwindi - 55%
- Kuwonjezeka kwa mavitamini otulutsa mahomoni (TSH) - 55%
- Kuwonjezera kwa mlingo wa erythrocyte sedimentation ("sed sed") - 25%
- Mitsempha yamadzimadzi yosakanikirana yotanthauza kutupa - 25%
- Maginito ojambula malingaliro olakwika omwe amakhala okhudzidwa - 26%
Zotsatira
Ofufuzawa anapeza kuti pali zotsatizana zosiyanasiyana zomwe zimagwirizanitsidwa ndi Hashimoto's Encephalopathy / SREAT, ndipo vutoli ndilofala.
Ofufuzawa amalimbikitsa kuti Hashimoto's Encephalopathy / SREAT iyenera kuganiziridwa ngakhale ngati TSH ndi "sed sed" ndizochilendo, khungu lopanda madzi silimasonyeza umboni wa kutupa ndipo MRI ndi yachibadwa.
Kuti mudziwe zambiri
Hashimoto's Encephalopathy Information Page
> Zosowa
> Castillo, Pablo MD; ndi. al. "Steroid-Yopatsa Matenda Okhudzana ndi Kutupa Kwambiri Mogwirizana ndi Autoimmune Thyroiditis." Arch Neurol . 2006; 63: 197-202. (Vol 63 nambala 2, February 2006)
> National Institute of Neurological Disorders ndi Stroke