Kupeza Dokotala Amene Amadziwika ndi Zosokoneza Dokotala kumafuna Dokotala Kufufuza
Anthu amatanthauza zinthu zambiri zosiyana ngati akunena kuti ndizozunguza. Vertigo ndikumverera mozunguzika komwe kumayenderana ndi kuyendayenda kuzungulira mu bwalo mofulumira, kapena ngati dziko likuzungulira mozungulira iwe.
Vertigo ikhoza kukhala yosamvetsetseka ndipo nthawi zina ikhoza kubweretsa nseru kapena kusanza. Zingakhale zovuta kuchoka pa bedi, mocheperapo kuyendayenda ndikuchita ntchito zomwe tikufunikira kuti tikwaniritse tsiku lililonse.
Ngakhale zambiri zomwe zimayambitsa vutolo sizowopsya moyo, zina zimakhala zovuta kwambiri, monga kupweteka kumbuyo kwa ubongo pafupi ndi cerebellum. Komabe, mitundu yambiri ya vertigo ikhoza kusamalidwa mosavuta ndi njira zosavuta monga kutsogolera mutu.
Zomwe Zimayambitsa
Kawirikawiri, anthu omwe ali ndi chitsimikizo kapena chizungulire adzakhala ndi chimodzi mwazimene zimayambitsa.
Benign Paroxysmal Positional Vertigo (BPPV)
Kodi magetsi amachititsa kusintha kwa mutu? Ngati ndi choncho, vutoli likhoza kukhala loipa kwambiri paroxysmal positional vertigo (BPPV), chimodzi mwa zifukwa zomwe zimayambitsa vutolo. Matendawa amayamba chifukwa cha kristalo kakang'ono kamene imatchedwa otolith yomwe nthawi zambiri imakhala pakati pa khutu la pakati. Mu BPPV, kutuluka kwa otolith kumasuka ndikulowa mumtsinje umodzi womwe nthawi zambiri umasonyeza kuti thupi lathu likuzungulira. Kristalo imapangitsa kusintha kwachitsulo mumtsinje womwe umanyenga thupi kuti ukhulupirire kuti ukutembenuka, ngakhale pamene ukuima.
Kusokonezeka kumeneku kumayambitsa zitsulo.
Mtsinje wa BPPV umayamba kuchitika mwachidule ndipo umabweretsanso mutu, chifukwa kusintha kwa mutu kungachititse kuti otolith isamuke mumtsinje, zomwe zimachititsa kuti ubongo ukhale wolakwika. Uthenga wabwino ndi wakuti mndandanda wa makutu oyendetsa mutu (wotchedwa Epley maneuver ) ungagwiritsidwe ntchito kutsegula otolith kuchokera mumtsinje kumene sikungayambitsenso mavuto.
Zomwe zimatha nthawi yosachepera miniti kapena kuposa nthawi zambiri zimachokera ku BPPV. Zomwe zimakhala zovuta kwambiri pamtundu wa vertigo zingakhale chifukwa cha vuto la mkati mwa khutu la mkati, monga vuto la vestibulopathy kapena matenda a Meniere , kapena kuti pakati pa vertigo, kutanthauza vuto ndi ubongo wa ubongo womwe ukhoza kupezeka pa stroke kapena vestibular migraines.
Matenda a Meniere
Khutu lamkati lili ndi thumba lomwe limayandama mkati mwazigawo zochepa. Mkati mwa thumba limenelo muli madzi ambiri koma a mtundu wosiyana. Matenda a Meniere akuganiza kuti amayamba chifukwa cha kusamvana pakati pa madzimadzi omwe ali mkati mwa sac ndi madzi kunja kwa thumba, ndi madzi ambiri mkati mwake. Izi zimadziwika kuti endolymphatic hydrops.
Matendawa amabwera pakati pa zaka makumi atatu ndi makumi asanu ndi zisanu ndi zisanu ndi zitatu ndipo amachititsa kuti ziwonongeke, kumva kutayika, ndi kumveka m'makutu. Mosiyana ndi BPPV, zigawenga zimatha mphindi 20 mpaka maola angapo panthawi. Mofanana ndi mitundu ina yazitsulo, nystagmus ikhoza kukhalapo. Kuukira kumeneku kumatha kusiyana pakati pa kangapo pa mlungu kupitirira kamodzi pa chaka. Pambuyo pa zaka 5 mpaka 15, chizungulire chimakhala chochepa kwambiri koma nthawi zonse, komanso kutaya kumva kumatha kukhala kosatha, ngakhale kuti kumva wogontha m'makutu omwe akukhudzidwa kumakhala kosavuta.
Matenda a Meniere amatha kupezedwa ndi dokotala popanda mayeso ena, koma nthawi zina audiometry imathandiza. Palibe mankhwala omwe amapezeka kuti athetse kusintha kwapang'onopang'ono mkati mwa khutu lamkati, koma mankhwala amathandizira zizindikiro zikachitika.
Matenda a Neutitis
Matendawa amapita ndi mayina ena ambiri, kuphatikizapo neuronitis, labyrinthitis , neuro labyrinthitis, ndi zovuta zapachipatala. Matendawa nthawi zambiri amathetsa okhaokha koma amachititsa kuti pakhale zovuta zambiri pakalipano. Matendawa amaganiziridwa chifukwa cha kutupa kwa mitsempha yowonongeka ndi kachilombo - ngakhale, pali kwenikweni umboni wochepa wochirikiza chiphunzitso ichi.
Kuzindikira kuti matenda a neuritis amavala kwambiri nthawi zambiri amachitidwa ndi dokotala akukufunsani ndikukufunsani mafunso, ngakhale kuyesedwa kungathetsere zina, monga stroke. Nthawi zambiri amatha kudziletsa masiku ano, koma nthawi zina pamakhala kusalinganika kochepa kumene kumakhala kwa miyezi ingapo. Sizachidziwikire kuti mankhwala ena ali othandiza, ngakhale madokotala ambiri amapereka ndondomeko yochepa ya steroid prednisone potsata zochepa zomwe zimawathandiza kuchita.
Vestibular Paroxysmia
Nthawi zina mazembera amatha masekondi angapo panthawi koma amapezeka nthawi zambiri patsiku. Madokotala ena amakhulupirira kuti izi zikhoza kukhala chifukwa cha mitsuko ya magazi pamaganizo achisanu ndi chitatu , omwe amachititsa kuti munthu azitha kumverera.
Madokotala ena adatsutsa kuti palibe chidziwitso chabwino chothandizira mfundoyi. Mwachitsanzo, mpaka 30 peresenti ya anthu wathanzi ali ndi mitsempha ya magazi yomwe imakhudzana ndi mitsempha yotchedwa vestibulocochlear, malinga ndi nkhani ya Journal of Vestibular Research .
Ena amanena kuti opaleshoni ingagwiritsidwe ntchito kuchotsa vuto la mitsempha ndi mitsempha ya mitsempha, koma ena apeza kuti mankhwala ochepa a carbamazepine (mankhwala oletsa kulandira) angathandizenso. Chifukwa cha umboni wosadziwika wa chotengera cha magazi monga chokhumudwitsa, kugwiritsa ntchito mankhwala ndi njira yoyenera yothetsera.
Matenda a Migraine
Ngakhale zifukwa zomwe zimayambitsa vutolo zimayambitsa zomwe zimatchedwa "vertigo", zomwe zikutanthauza kuti chiwongolero chimayambitsidwa ndi chinthu china kunja kwa ubongo ndi ubongo, ndizotheka kupeza vutolo kuchokera ku ubongo, womwe umatchedwa "pakati" vertigo. Chimodzi mwa zifukwa zochepetsetsa zapakati pazimenezi ndizomwe zimayambitsa matendawa .
Migraines nthawi zambiri amaganiza kuti amayambitsa mutu, koma zachilendo zamagraines zimayambitsa matenda ena amodzi, kuphatikizapo kufooka, kumangirira, kusowa, ndi chizungulire. Komabe, kupweteka mutu kumafunikira kwenikweni kuti munthu azindikire kuti palibenso vuto. Zizindikiro zina za migraine, kapena kutuluka kwazitsulo zomwe zimayambitsa matenda a migraine , zingakhale zothandiza kupanga matendawa.
Chitetezo Chokhazikika cha Ischemic Attack (TIA)
Chiwalo cha ubongo chimalandira madzi ambiri mwazimene zimatchedwa posterior circulation. Mitsempha iwiri ya mavitre imasonkhana palimodzi kuti ipangire mitsempha ya basilar, yomwe imatumiza nthambi zomwe zimatumiza magazi opatsa ubongo ku ubongo ndi kumbuyo kwa ubongo.
Ngati mitsempha mu ubongo imatsekedwa kanthawi ndi magazi, maselo a ubongo angayambe kufa ndi njala. Ngati khungu la magazi litasungunuka, zizindikiro zimakula bwino, ndipo zochitikazo zimatchedwa kuschem ischemic . Ngati magazi amatsalira, ndiye kuti amachititsa kugwidwa ndi ziphuphu zosatha.
Chifukwa chakuti ubongo uli ndi malo omwe thupi lathu lililimbanira, kuphatikizapo kubwereza kwazomwe zimatumizidwa ku ubongo kuchokera kumutu wamkati, chidziwitso ndi chizindikiro chofala cha kusindikiza kwaseri. Zambiri zokhudzana ndi, ndizo ntchito zina zofunika za ubongo, monga kupuma, kuyenda, ndi zina. Pachifukwa ichi, zizindikiro zoganizira za TIA zimagwiritsidwa ntchito ngati chenjezo la mavuto aakulu omwe angabwere.
Mwamwayi, ndizosatheka kuti TIA iwonongeke pamtunda komanso palibe china. Chiwalo cha ubongo ndi malo ochepa kwambiri ngati chala chachikulu ndipo chimadzaza ndi mitsempha yofunikira. Ngati zowonongeka zachitika ku gawo limodzi la ubongo, ena angasokonezedwe, motsogolere ku zizindikiro zina za ubongo. Pachifukwa ichi, madokotala amafunitsitsa kupeza zizindikiro za "pakati" vertigo, kutanthauza chiwongolero chomwe chimachokera ku ubongo m'malo mozungulira mitsempha kapena mkati mwa khutu.
Zowopsa za TIA zowonongeka ndi zofanana ndi za mitundu ina ya matenda a ischemic vascular, monga stroke. Kuti mumve zambiri zokhudza kudziŵa ngati mbolo yanu ndi yovuta, werengani za chizungulire .
Zifukwa Zambiri
Nthawi zina zomwe zimayambitsa vutolo lanu ndizochepa. Ngakhale kuti izi zimayambitsa zovuta zowonjezereka, ndizofunika kudziwa zina mwazidzidzidzi kuti zizindikiro zanu zisamangidwe chifukwa cha chinthu china chofala.
Tiyeni tiyang'ane pazifukwa izi zachilendo za vertigo.
Matenda a m'makutu amkati
Nthawi zina, chitetezo cha mthupi chimapangitsa thupi lathu kukhala ndi kachilombo koyambitsa matenda. Izi zikachitika - pamene thupi limadziukira palokha - limatchulidwa ngati matenda omwe amadzipangira okhaokha. Ngati izi zimachitika kumutu wamkati, zingayambitse kupweteka kwakumva komanso kumbuyo.
Pafupifupi kotala la anthu oterowo adzakhala ndi matenda ena omwe amadzimadzimadzimadzi monga systemic lupus erythematosus , polyarteritis nodosa, kapena Wegener granulomatosis. Pafupifupi theka la anthu awa adzayankha ku corticosteroids .
Labyrinthine Kukambirana
Zokambirana zimayambitsa mutu, kunyoza, kusanza, ndi chizungulire. Kuthamanga kwazitsulo pambuyo pa kukambirana kungabwere chifukwa cha kuvulala kwa ziwalo zobvala pambuyo pa mutu. Malingana ndi chikhalidwe cha chovulalacho, pakhoza kukhala mwazi mkati mwa khutu lamkati. Ngakhale kuti kawirikawiri izi zimakhala zovuta kwambiri pambuyo pa kuvulala kwa mutu, vutolo likhoza kubwera ndikupita kwa kanthawi pambuyo pake. Nthaŵi zina, kusintha koopsa pambuyo pa zovuta za mkati mwa makutu (endolymphatic hydrops), kungachititse kuti Meniere syndrome.
Perilymphatic Fistula
Kuvulazidwa pamutu, kunyamula katundu, kapena kuvulala chifukwa cha kusintha kwa mphamvu (monga scuba diving) nthawi zina kumayambitsa kugwirizana kosagwirizana pakati pa khutu zomwe sizikutanthauza kugwirizanitsidwa. Kugwirizana kosazolowereka pakati pa zigawo ziwiri za thupi zomwe sizinagwirizanitsidwe kumatchedwa fistula.
Zizindikiro za perilymphatic fistula nthawi zambiri zimakhala zowawa chifukwa cha kusintha kwa kunja kapena mkati, monga kupopera, kupopera, kukopa, kapena kulira kwakukulu.
Kusintha kwa kukwera kungawononge zizindikilo, monga kuthawa mu ndege kapena ngakhale kukwera pa elevator.
Kuzindikira kwa perilymphatic fistula kungakhale kovuta pokhapokha ngati chochitika cholimbikitsa chikufotokozedwa. Chithandizochi chimaphatikizapo kupuma ndi mutu wokwera ndikupewa mitundu yonse ya kusokonezeka. Kwa omwe samapanga chithandizo chotero, opaleshoni ikhoza kukhala yofunikira.
Chithandizo cha Kanal
Chinthu chinanso chogwirizana ndi chosowa, chomwe kugwirizana pakati pa zipinda ziwiri sikunali kwathunthu, koma fupa lingakhale lochepa kuposa momwe likanakhalira. Chitsanzo ndi dehiscence wa ngalande yapamwamba ya khutu lamkati lomwe limayambitsa zisonyezo zodziwika ngati ngati phokoso lopangitsa munthu kumvetsera.
Pafupi theka amakhalanso ndi autophony, kutanthauza kuti amamva phokoso lamkati ngati liwu lawo, kuvutika mtima, kapena nthawi zina ngakhale kayendedwe ka maso awo pamvomveka mokweza.
Otosclerosis
Matenda a otosclerosis nthawi zina amatha kulandira mafupa, ndipo mafupa atsopano amapangidwa pakati ndi khutu lamkati. Izi kawirikawiri zimayamba pakati pa zaka ziwiri ndi makumi anai za moyo. Zotsatira zake ndizoperewera kumvetsera kwapadera . Pafupifupi 20 peresenti ya anthu omwe ali ndi matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matenda odwala matendawa Ena amatha kukhala ndi hydrocarphatic hydrops ndi Meniere syndrome. Mankhwalawa angathandize kwambiri kuti apeze matendawa.
Epileptic Vertigo
Kawirikawiri, zizindikiro za vertigo zimatha chifukwa cha kugwidwa . Anthu ambiri amadziwa zovuta zowonongeka (tonic-clonic seizures) koma pali mitundu yambiri ya zizindikiro zosiyana. Ntchito zamagetsi zosawonongeka zingathe kuchitika m'madera ena a ubongo omwe amasintha dongosolo lovala.
Electroencephalogram (EEG) ingagwiritsidwe ntchito kudziwa ngati manjenje ali ndi khunyu m'chilengedwe. Anthu ena amatha kukhala ndi aura ya khunyu asanatuluke, zomwe zingathandize kuti pakhale vutoli.
Chiari Malformation
Chiari ine malformation ndi chibadwa chosabadwa (chinachake chimene mumabadwa nacho) chomwe pansi pa cerebellum (mbali ya ubongo yomwe imayendetsa bwino ndi kugwirizanitsa) imakhala yochepa kusiyana ndi momwe iyenera kukhalira. Kawirikawiri, izi sizimayambitsa zizindikiro zilizonse, koma nthawi zina zimatha kupweteka kumutu, kusayenerera kwapadera, ndi kutayirira. Pamene chowongolera chiripo, chikhoza kukhala choipitsitsa pogwedeza khosi kumbuyo (mutu wopangitsa kuti phokoso liziyenda.)
Ngakhale nystagmus (kayendetsedwe ka diso kosayendetsedwa) kawirikawiri ilipo mwa mtundu uliwonse wa vertigo, mu chiari zolakwika, nystagmus ikhoza kugunda mmalo otsika mmalo mwa mbali, yomwe si yachilendo. Kuchita opaleshoni kungafunikire ngati zizindikiro zili zovuta ndi Chiari malformation. Izi zidati, anthu ambiri omwe ali ndi Chiari zolakwika sizifuna opaleshoni.
Episodic Ataxia
Episodic ataxia, ndi episodic ataxia mtundu wachiwiri , makamaka, ingayambitse matenda oopsa kwambiri ndi chifuwa ndi kusanza muunyamata kapena moyo wachikulire. Nystagmus ikhoza kukhalapo panthawi ndi pakati pa zovuta. Ziwopsezo zimakhala zoipira pang'onopang'ono, ndipo zizindikiro zingayambe kuchitika pakati pa ziwonongeko.
Mankhwala
Mankhwala ambiri angayambitse chizungulire, ndipo zina zimayambitsa ndodo. Maantibayotiki otchedwa aminoglycosides ali ovuta kwambiri, ndipo amatha kuwonongeka kosatha. Lithium toxicity ingayambitsenso mavitamini. Kuonjezerapo, Vertigo ndi zotheka ndi mankhwala monga:
- mankhwala osokoneza bongo (anti-seizure drugs)
- anesthetics
- anti-depressants
- Osati steroidal anti-inflammatory agents ( NSAIDs )
- mankhwala a shuga
- zokhazokha ndi zotsitsimula
Mawu Ochokera
Kawirikawiri, vertigo si chizindikiro chimene chiyenera kunyalanyazidwa. Ngakhale kuti sichifukwa chakumenyana ndi ischemic, ndikofunika kudziŵa motsimikizika kuti mavuto aakulu sakuwoneka. Kuwonjezera pamenepo, mankhwala ozunguza bongo ndi osasangalatsa, ndipo pali njira ndi mankhwala omwe angakuthandizeni ngati mukufuna malangizo abwino a zachipatala.
> Zosowa
- Chimirri S et al. Kuwongolera / kuzungulira ngati mankhwala osokoneza bongo. J Pharmacol Apasitomala. 2013 Dec; 4 (Suppl 1): chiariS104-9.
- > Fernandez, A., Guerrero, A., Martinez, M. ndi al Malformations a juncChiari mtundu wa 1 ndi syringomiaa: Kulemba, matenda, ndi chithandizo. Matenda a BMC Musculoskeletal . 2009. 10 (Suppl 1): S1.
- > Jeong SH, Kim HJ, Kim JS. Matenda a mitsempha. Semin Neurol . 2013 Jul; 33 (3): 185-94.
- > Lempert T. Nkhondo Zowonongeka Zowonongeka. Continuum (Minneap Minn). 2012 Oct; 18 (5 Neuro-otology): 1086-101.
- > Strupp M et al. Vestibular paroxysmia: Kuyeza njira. J Vestib Res . 2016; 26 (5-6): 409-15.