Mawu akuti myelopathy amatanthauza vuto la msana wamtsempha, zomwe zingayambitse kufooka, kufooka, dysautonomia , ndi zina. Pali zovuta zambiri zomwe zimayambitsa myelopathy. Matenda siwowopsa kwambiri, koma madokotala amafunika kuzindikira kuti matendawa amafuna mitundu yosiyanasiyana ya mankhwala. Mavairasi, mabakiteriya, bowa, kapena tizilombo toyambitsa matenda tonsefe timatha kuwononga mitsempha ya msana.
Yang'anirani mitundu 10 yotsatira ya matenda a msana.
Mavairasi
Vuto la immunodeficiency virus (HIV): Matenda a ubongo wa HIV ndi ofala pa nthawi ya matenda. Zina mwa mavutowa ndi chifukwa cha matenda opatsirana omwe amagwiritsa ntchito thupi kuti lifooke chitetezo cha mthupi. Vutoli, ngakhale, lingathe kuwononga dongosolo la mitsempha, kuphatikizapo msana wa msana. Kafukufuku wopenda mitsempha ya msana wa anthu omwe anamwalira ndi kachilombo ka HIV apeza myelopathy yapadera pakati pa 11% ndi 22 peresenti ya zingwe za m'mimba. Pamene odwalawa anali ndi zizindikiro, ankadandaula za kumangirira ndi kupweteka miyendo yawo, kenako amalephera kufooka. Kawirikawiri, kutayika kwa chifuwa kapena chikhodzodzo kumatha kutsatira. Kawirikawiri, mphamvu ya kugwedezeka ndi mphamvu yapamwamba (proprioception) imachepetsedwa kuposa mphamvu zina monga kutentha kapena kupweteka. Kuphatikiza pa kuchiza kachirombo ka HIV, kupweteka kofunikira kumafunika kuti pasakhale matenda kapena matenda ena monga lymphoma .
Mankhwala a mtundu wa T-cell lymphotropic 1 (HTLV-1): Matendawa amapezeka kwambiri m'madera otentha, choncho myelopathy yomwe imayambitsidwa ndi kachilomboka imadziwika kuti tropical spastic paraparesis (TSP), kapena HTLV-1 yogwirizana ndi myelopathy (HAM ). Zofooka zimayamba pang'onopang'ono kwa zaka zambiri. Kusinthika kosavuta ndi ma dysautonomias ndizofala.
Matenda a herpes : Matenda a tizilombo a herpes ndi a varicella zoster (VZV, chifukwa cha nkhuku), herpes simplex HIV (HSV), Epstein-Barr tizilombo (EBV, chifukwa cha mononucleosis ), ndi cytomegalovirus (CMV) . Zonse zingayambitse matenda mu msana.
VZV imayambitsa shingles itayambanso kubwezeretsedwanso mumtsinje wa rootlion pafupi ndi msana, zomwe zimapweteketsa kwambiri. Myelitis ikhoza kubwera panthawi imodzimodzimodzi ngati kutukuka, komwe kumayambitsa kufooka, koma kungathenso kupita pang'onopang'ono komanso mopanda chilema mwa anthu omwe sagonjetsedwa.
Myelitis yowonongeka ndi mavairasi ena, monga HSV, ndi osowa kwambiri mwa anthu omwe ali ndi ma chitetezo oteteza thupi. Kwa omwe chitetezo chawo cha mthupi chimaonongeka, monga omwe ali ndi HIV, mavairasi monga CMV angayambitse myelitis ndi kupweteka, kufooka, ndi kusungidwa kwa mkodzo. Kuchiza ndi mankhwala opatsirana pogonana ndi njira yabwino kwambiri yothetsera vutoli, komanso kuthetsa vutoli, ngati n'kotheka.
- Enteroviruses: Enterovirus yotchuka kwambiri yotenga msana wam'mimba ndi polio, yomwe yakhala yosakondedwa kwambiri m'mayiko otukuka. Mofanana ndi amyotrophic lateral sclerosis (ALS), polio imakhudza maselo a nyanga zam'mimba a msana, zomwe zimachititsa kuti ziwalo ziwalo zisasinthe. Ngakhale kuti ziwalo za polio zimakhala zovuta kumvetsa (1 peresenti mpaka 2 peresenti), zotsatira zake ndizoopsa ndipo ndizozifukwa zambiri zomwe zimavulaza ndi kuchipatala mpaka kufika kwa katemera kumathandiza kuthetsa matendawa.
Vuto la West Nile : Vuto la West Nile limanyamula ndi udzudzu. Matenda a ubongo amapezeka pafupifupi 5 peresenti ya odwala, kuphatikizapo meningitis kapena kuuma. Monga polio, matendawa akuganiza kuti ali chifukwa cha kutaya kwa maselo a nyanga. Mpweya wabwino umakhala wofunikira ngati zizindikiro zakhala zolimba kwambiri.
Chizindikiro
Chifilasiti chimatchedwa "kutsanzira kwakukulu" mu sayansi ya zamoyo chifukwa matendawa amatha kuchita chirichonse mwa dongosolo la mitsempha. Matendawa nthawi zambiri amalowa m'kati mwa chaka cha matenda, koma pafupifupi 5 peresenti ya anthu omwe ali ndi syphilis amakhala ndi vuto la matenda.
Popeza kuti chithupsa chimagwidwa musanakhale ndi mwayi wa mavuto a ubongo, mavutowa tsopano sapezeka. Zina mwa zovuta zambiri zokhudzana ndi matenda a syphilitic, matenda a msana anali oposa khumi kuposa ena. Pambuyo pake anali meningomyelitis ndi matenda a msana. Zonse mwa izo, ndiye, kachilombo ka HIV kamatha kukhudza msana wamtunduwu m'njira zosiyanasiyana.
Mawu akuti "tabes dorsalis" amatanthauza matenda omwe amapezeka kwambiri ndi msana, ndipo nthawi zambiri amayamba zaka 10 mpaka 15 mutangoyamba kumene. Pa 70 peresenti ya odwalawa, nthawi yowawa kwambiri ndi chizindikiro choyamba. Izi zimatsatiridwa ndi kusowa mphamvu ndi mavuto ndi chikhodzodzo ndi chifuwa. Kununkhira, kugwedeza, ndi mavuto ena ndi zotsatira zotsitsimula. Gawo lotsatira likuphatikizapo ataxia wovuta miyendo, zomwe zimapangitsa kuyenda mosavuta pang'onopang'ono. Potsirizira pake, gawo lomalizira ndi kutha kwathunthu kwa miyendo.
Meningomyelitis ndi kutupa kwa minofu yozungulira mzere wa msana komanso msana wa msana. Chizindikiro choyamba ndi kulemera kwa mwendo. Kuwonongeka kochepa kumakhala kochepa, koma miyendo imafooka pang'onopang'ono.
Sipulo ikhoza kuyambitsa matenda a mitsempha omwe amachititsa kuwonongeka kwa ischemic ku msana wamtsempha mwa kudula magazi, kapena kungayambitse kukula kosazolowereka komwe kumatchedwa masamu omwe amachepetsa pang'onopang'ono mphamvu zamagetsi zamphepete mwachingwe. Mwamwayi, matendawa amayankha bwino penicillin .
Chifuwa chachikulu
Monga chifila, chifuwa chachikulu chingayambitse mitundu yambiri ya mavuto a ubongo, koma mwatsoka, sikofala m'mayiko otukuka. Matenda ambiri omwe amapezeka mumtsempha amayamba chifukwa cha zilonda zam'mimba mumsana. Kupweteka kumbuyo ndi chizindikiro chofala kwambiri, monga chingwe chimakhala ndi mafinya a vertebra.
Matenda a bakiteriya
Chiphuphu ndi kachilombo koyambidwa thupi lonse ndi chitetezo cha thupi. Zotsatira zake ndizokusungidwa kwa pus. Kukula uku nthawi zina kumakula, kumapangitsa kuti thupi likhale lopanda thupi, kuphatikizapo msana. Chomwe chimayambitsa mitsempha ya msana ndi Staphylococcus aureus. Matendawa amalekanitsidwa ndi thupi lonse, kotero kupereka mankhwala opha tizilombo kaŵirikaŵiri si njira yabwino kwambiri, popeza palibe njira yoti mankhwalawa adutsepo. Kachilombo ka khunyu kangakhale kofunika kuchotsa abscess popanda kuchiphwanya ndi kutaya kachilombo mu thupi.
Matenda a Fungal
Matenda a fungaleni omwe amachititsa kuti msana usagwire ntchito, ndipo nthawi zambiri amapezeka mwa iwo omwe ali ndi machitidwe a chitetezo cha mthupi. Ziphuphu zina, monga Aspergillus, zimatha kuwononga malo a msana, ndipo zina zingayambitse kukula komwe kumatchedwa granulomas yomwe imatha kupweteka msana.
Matenda a Parasitic
Ngakhale matenda opatsirana amtundu wa msana ndi osowa m'mayiko otukuka, matenda a Schistosoma padziko lonse ndi amodzi omwe amachititsa kuti matenda a myelopathy apatsire. Izi zimapezeka ku South America, Africa, ndi kummawa kwa Asia. Zamoyo zimakhala m'madzi atsopano, ndipo anthu akhoza kutenga kachilombo pamene akusambira mumadzi. Mphepete yamagetsi Echinococcus granulosus ikhoza kuyambitsa makoswe omwe amakakamiza msana. Kudwala matenda a mitsempha kumatanthauzanso kuti msana wam'mimba umapezeka pafupifupi 5 peresenti ya milandu. Paragonimiasis ndi mapapu a mapapu omwe amapezeka ku Asia ndipo amatha kupezeka podya nkhanu zopanda madzi. Zonsezi zingathe kukhala ndi zofooka, zofooka, zofooka, ndi mavuto ena omwe amayamba chifukwa cha myelopathy.
Ngakhale kuti matendawa angakhale ochititsa chidwi, oopsa, komanso ovuta, choonadi ndi chakuti ambiri amatha kuchiritsidwa ngati ali oyenerera, makamaka ngati atapezeka mwamsanga.
> Zotsatira:
> Goodman, BP. Njira Yodziwiritsira Njira Yopangidwira Kwambiri; Kupitiriza: Mphepete, Mzuzi, ndi Matenda a Plexus Volume 17, Number 4, August 2011.
> AH Ropper, MA Samuels. Adams ndi Victor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, 2009.