Myasthenia Gravis, Lambert-Eaton, ndi Botulism
Poganizira zoyambitsa zofooka, ndizothandiza kwambiri kulingalira uthenga wa magetsi wothamanga kuchokera ku khungu la ubongo kupita ku minofu yodula. Ali mkati , njirayi imayendayenda mumtsinje wa msana, kuphulika kwa mitsempha ya m'mphepete mwa mitsempha, pansi pa mitsempha ya m'mimba , ndipo potsirizira pake imayendera mphambano ya neuromuscular.
Mitsempha yotchedwa neuromuscular junction ndiyo yomwe chizindikiro cha magetsi chimayambitsa matenda opatsirana pogonana kuti atuluke ku ma vesicle kumapeto kwa mitsempha (terminal).
Mitsempha ya mitsempha imadutsa kusiyana pang'ono pakati pa mitsempha ya mitsempha ( synapse ) ndi pamwamba pa minofu. Kudikira kuti operekera kumbali ina ya mphako ndizopadera zapadera zomwe zimagwirizana ndi wotumiza ngati lolo ku fungulo. Pakakhala yoyenera, mavitoni amachititsa kuti mitsempha ikhale yopanda mphamvu.
Mitsempha yotchedwa neurotransmitter yodziwika pakati pa mitsempha ndi minofu ndi acetylcholine. Pali njira zingapo kuti kudutsa kwa acetylcholine neurotransmitter pakati pa mitsempha ndi minofu cTan kusokonezedwa. Zitsanzo zitatu mwabwino kwambiri ndi myasthenia gravis , matenda a Lambert-Eaton, ndi fetulinum poizoni.
Myasthenia Gravis
Pofala pakati pa anthu 150 mpaka 200 miliyoni, myasthenia gravis ndi matenda ambiri a neuromuscular, ndipo amodzi amadziwa bwino matenda onse a m'magazi. Nthendayi imayambitsa zofooka za mitsempha chifukwa chotsekedwa ndi mapuloteni a neurotransmitter pa minofu.
Mankhwala omwe amachititsa kuti awononge matenda opatsirana amachititsa kuti acetylcholine receptors a tizilombo toyambitsa matenda ndi tizilombo. Kuchita masewera olimbitsa thupi kumapangitsa kuti zofooka ziwonjezere. Pakati pa 60 mpaka 70 peresenti ya anthu omwe ali ndi myasthenia gravis ali ndi vuto ndi thymus , ndipo 10 mpaka 12 peresenti ali ndi thymoma. Pali mankhwala ena osiyanasiyana omwe alipo.
Lambert-Eaton Myasthenic Syndrome (LEMS)
Lambert-Eaton kawirikawiri amatchedwa matenda a paraneoplastic , kutanthauza kuti ma antibodies okhudzana ndi khansa akutsutsanso mbali ya dongosolo la manjenje. Mosiyana ndi myasthenia gravis, momwe ziwonongekozo zimakhala pa minofu, vuto la LEMS liri ndi mapeto a mitsempha yamagetsi. Mankhwala a calcium nthawi zambiri amatseguka ndipo amavomereza kuti amasulidwe, koma sangathe kutero mu LEMS chifukwa ma antibodies agonjetsa njirayo. Chotsatira chake, palibe njira yothandizira njira yotulutsidwa, ndipo wodwalayo amatha kufooka chifukwa minofu silingathe kulandira chizindikiro. Ndi kuchita masewera olimbitsa thupi, vutoli lingathe kugonjetsedwa; kotero mu LEMS, zizindikiro nthawi zina zimawongolera mwachidule ndi kuyesayesa mobwerezabwereza.
Botulism
Nthawi zina poizoni amatha kugwiritsidwa ntchito mwachipatala ndi madokotala kuti akakamize minofu kuti ipumule panthawi ya dystonia . Mu mawonekedwe ake osakanikirana, poizoni amapangidwa ndi mabakiteriya ndipo amachititsa kufooka kumene kumayambira ndi minofu ya nkhope ndi mmero ndi kubwera pamwamba pa thupi lonselo. Mofanana ndi mavuto ena a mpikisano wa neuromuscular, izi zikhoza kukhala mwadzidzidzi zamankhwala zomwe zimafuna kuti munthu azikhala mwamtendere . Mapuloteni oteteza poizoni omwe amalola zodzoladzola zodzaza ndi m'mimba mkati mwazithunzithunzi zisanafike kumapeto kwa mitsempha musanayambe kulowa pakati pa mitsempha ndi minofu.
Chithandizo ndi mankhwala otetezera poizoni, omwe ayenera kuperekedwa mwamsanga.
Mavuto Ena Okhudza Mliri wa Mphuno
Mankhwala ena, monga penicillamine ndi zina zotchedwa statins, sangachititse kuti munthu asamangodzimva yekha kuti amatsanzira myathenia gravis. Mankhwala ena amatha kupweteka kapena kubweretsa mavuto kwa wina yemwe ali ndi myasthenia gravis.
Kuyesedwa kwa Matenda a Mphuno Yachifuwa (Neuromuscular Junction)
Pambuyo poyezetsa thupi, njira yoyamba yodziwira kuti matenda a mitsempha ya neuromuscular ndi electromyogram ndi kuphunzira kwa mitsempha yopanga mitsempha. Izi sizingathandize kusiyanitsa pakati pa myasthenia gravis, botulinum poizoni, ndi Lambert-Eaton koma zingathandizenso kuthetsa mavuto ena monga motor motor neuron, kuphatikizapo amyotrophic lateral sclerosis.
Kusokonezeka kwa mpangidwe wa neuromuscular kungakhale kovuta kwambiri, kofuna kutsegula ndi mpweya wabwino kuti athandizire kupuma ngati zofooka zimakhala zolimba kwambiri. Njira za matendawa ndi zosiyana kwambiri, zomwe zimafuna mankhwala osiyanasiyana. Kupeza bwino matenda ndi njira yoyamba yowonjezera mphamvu ndi chitetezo.
Zotsatira:
Ropper AH, Samuels MA. Adams ndi Victor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
Hal Blumenfeld, Neuroanatomy Kupyolera M'zipatala. Sunderland: Sinauer Associates Publishers 2002.