Dysautonomia ndi Matenda ndi System Autonomic Nervous System
Mankhwalawa amachititsa kuti thupi liziyenda mofanana ndi kuthamanga kwa mtima ndi kuthamanga kwa magazi zomwe zimatipangitsa kukhalabe moyo popanda kuganiza za iwo. Pafupi matenda aliwonse amathithi angakhudze dongosolo lodzidzimitsa la mitsempha mwanjira inayake, ngakhale matenda ochepa omwe amachititsa dongosolo lodzidzimitsa lokha la mantha. M'munsimu muli ena mwa mitundu yambiri ya machitidwe osokonezeka a mantha, kapena dysautonomia :
Zovuta za Autonomic Paralysis
Kugonjetsa kwadzidzidzi koyamba, koyamba kufotokozedwa mu 1975, kumakhalabe kosazolowereka koma imakhala chitsanzo chabwino cha zomwe zimachitika pamene ntchito zonse zokhudzana ndi mantha zikugonjetsedwa. Zizindikiro zimabwera patatha sabata kapena masabata angapo ndi kutayika kwathunthu kwa ntchito zodzilamulira komanso zimakhala ndi maso owuma, kutsekemera kwa thupi , kuperewera kwa msinkhu, kusowa mphamvu, chikhodzodzo chotupa komanso matumbo, komanso kupweteka m'mimba ndi kusanza. Zilonda zonse zapasympathy komanso zomvetsa chisoni zimakhudzidwa, ngakhale kuti mitsempha ina imapulumutsidwa. Kuwombera kwapopu kungasonyeze mapuloteni okwezeka mu CSF . Chifukwa chake sichipezeka kawirikawiri, ngakhale kuti mwina ndi matenda omwe amangofanana ndi Guillain-Barre matenda . Chithandizo chabwino kwambiri sichidziwika, ngakhale ena atsimikiza kusintha pambuyo pa kusinthana kwa magazi, kapena ku IVIG.
Idiopathic Orthostatic Hypotension
Matenda ochepa omwe amachititsa kuti mtima usafulumire ngati ukufunikira. Matendawa amachititsa kuti mtima usafulumire ngati ukufunikira.
Ichi ndi chosowa kwambiri; Chinthu chofala kwambiri cha preganglionic dysautonomia chimaphatikizapo kuwonongeka kwa mbali ya msana wamtundu umene umapezeka m'mimba mwachangu. Mulimonsemo, mankhwala amayamba ndi kusintha kosasintha kwa moyo, kuphatikizapo kuvala zokopa, ndikuyamba kusintha kuchokera pang'onopang'ono.
Ngati izi sizikwanira, mankhwala monga midodrine kapena florinef angafunike.
Kusakanikirana Kwambiri Kwambiri
Mu njira yofala kwambiri ya dysautonomia, matenda okhudza ubongo, monga omwe amapezeka m'thupi la shuga , amachititsanso kuti pulogalamu yamatenda yodalirika ikhale yovuta. Pali zifukwa zina zambiri, kuphatikizapo kumwa mowa mopitirira muyeso, kusowa kwa zakudya, kapenanso poizoni.
Dysautonomia omwe amatsata matenda a shuga amakhala osowa kwambiri ndipo amatha kupezeka opanda mphamvu, kutsekula m'mimba, ndi kudzimbidwa, kuphatikizapo chiphunzitso chodziwika bwino. Zizindikirozi zingakhale zovuta kapena zosakhala zovuta monga kusintha komwe kumayambitsa matenda a shuga wodwala matendawa. Tiyeneranso kudziwa kuti matendawa amayamba kutengera matenda a shuga, ndipo mayesero ena omwe amagwiritsidwa ntchito pofufuza matenda a shuga, monga hemoglobin A1c level, akhoza kukhala osiyana. Mwa kuyankhula kwina, mitsempha yazing'onoting'ono imatha kukhala yovuta kwambiri kusiyana ndi mayesero oyeza omwe amagwiritsidwa ntchito ndi madokotala kuti azindikire shuga.
Mitundu ina ya mitsempha ya m'mimba, yomwe imayambitsa amyloidosis , imakhala ndi dysautonomias. Nthenda ya ubongo yomwe imayambitsa matenda a Fabry (alpha-galactosidase yosowa) ingayambitsenso dysautonomia.
Riley-Day Syndrome
Pafupifupi theka la anthu opitirira zaka 65 ali ndi mtundu wina wa dysautonomia monga momwe amachitira ndi hythodetic orthostatic, dysautonomia sichinthu chocheperachepera kwambiri kwa achinyamata. Chinthu chimodzi chokha ndicho dysautonomia chobadwa nacho chotchedwa matenda a Riley-Day.
Riley-Day Syndrome imakhala ndi cholowa chodziwika bwino, motero kuti makolo sangakhudzidwe ngakhale kuti mwanayo ali ndi matendawa. Zizindikilo zimaphatikizapo hypotension ya postpost, mavuto a magazi osasamala, kutentha kozizira, hyperhidrosis, kusanza kwapakatikati, kuvutika maganizo, komanso kuchepetsa ululu. Zizindikirozi mwina zimayambitsidwa chifukwa cha kulephera kwa kusamuka kwa ma selo pakapita patsogolo.
Chiwawa ndi Autonomic Nervous System
Mitsempha yachisomo ikudutsa mumsana wamtsempha mu zomwe zimatchedwa kuti intermediolateral cell columns. Ngati zipilalazi zimasokonezeka chifukwa cha kupsyinjika ndi hypotension, kutayika kwa thukuta, chikhodzodzo ziwalo, ndi ubweya wa immotility zingayambitse; izi zimadziwika kuti amathamangira msana. Kupereka nangxone kumawoneka kuchepetsa zizindikiro zina: ntchito zachifundo ndi zowonongeka zidzabwerera pakapita kanthawi, koma sizidzakhalanso zolamulidwa ndi zipangizo zam'mwamba. Mwachitsanzo, ngati kuthamanga kwa magazi kugwera, mitsempha ya magazi imakhala yochepa, chifukwa izi zimadalira kulankhulana pakati pa medulla mu ubongo ndi thupi lonse pamtsempha wa msana. Ma reflexes ena, komabe, adzalimba. Ngati khungu likugwedezeka pa mkono, mwachitsanzo, mitsempha ya magazi yomwe ili m'dzanja limenelo idzakhala yowonjezereka, zomwe zimapangitsa kuwonjezeka kwa mphuno.
Anthu omwe ali ndi tetraplegic chifukwa cha kuvulala kwa msana amatha kuvutika ndi zomwe zimatchedwa autonomic dysreflexia. Kupanikizika kwa magazi kumatuluka, mtima umachepa, ndipo ziwalo zochepa pansipa zimatha kupwetekedwa ndi kutuluka mopitirira muyeso, kuphatikizapo kuphulika kwa mwendo ndi kusalabadira kwa chikhodzodzo. Autonomic dysreflexia ingakhale yowopsa ngati sichikuchitidwa mwamsanga.
Kuvulala kwa mutu kumutu kapena kupweteka kwa ubongo kungatulutsenso makatomine a adrenal ndi kuwonjezera mawu omvera. Nthawi zina masses amatha kugwiritsira ntchito ubongo, zomwe zimawopsa kwambiri, kupuma mosalekeza, ndi mtima wopepuka pa zomwe zimadziwika kuti Cushing yankho, zomwe zimakhala zovuta kwambiri kuti anthu asamapanikizidwe kwambiri.
Dysautonomia Chifukwa cha Mankhwala ndi Poizoni
Kusokonezeka kwa msana ndi kofanana ndi mavuto ena omwe amadziwika kuti "mphepo yamkuntho," yomwe ingayambitsidwe ndi kugwiritsa ntchito mankhwala ena monga cocaine. Ambiri omwe amapatsidwa mankhwala amagwira ntchito pochita zinthu zodzikongoletsa, ndipo mofananamo ndi zoona zowonjezera poizoni. Tizilombo ta tizilombo toyambitsa matenda ndi sarin, mwachitsanzo, zimayambitsa matenda osokoneza bongo.
Dyrautonomiya zina
Hyperhydrosis siopseza moyo, komabe imakhala yochititsa manyazi ya dysautonomia yomwe imayambitsa matenda aakulu. Mosiyana ndi zimenezi, anhydrosis imakhala ndi thukuta laling'ono kwambiri, lomwe lingakhale loopsa ngati likutentha kwambiri.
Zochitika za Raynaud zimapangitsa kuchepa kwa magazi kupita kwala ku chimfine ndipo nthawi zambiri zimagwirizanitsidwa ndi matenda a ubongo kapena matenda omwe amachititsa kuti thupi likhale ngati scleroderma .
Kulephera kwa chikhodzodzo ndizofala ndipo zingayambitse mavuto osiyanasiyana, kuphatikizapo dysautonomias. Kusungidwa kwa chikhodzodzo ndi chovuta, ndipo chinthu chowoneka chophweka chokonzekera kwenikweni chimadalira kugwirizana kwapakati pakati pa kudzipereka, kuchitira chifundo, ndi kupweteka kwa mitsempha. Mwina chifukwa chokonza chikhodzodzo chimadalira zigawo zambiri zosiyana, sizosadabwitsa kuti mavuto ndi ofanana, ndipo akhoza kuphatikizapo incontinence kapena kusunga mkodzo.
Ndizosatheka kuthetsa mbali zonse za dysautonomia m'nkhani imodzi. Kuphatikiza pa zomwe tavala, nthawi zina ziwalo za thupi, monga diso (monga Horner's syndrome) kapena chiwalo (monga momwe zimakhalira zomvetsa chisoni kumenyedwa kwa thupi) zingakhudzidwe. Nkhaniyi ingakhale yowonjezera, ndikulimbikitsanso kuwerenga kwa iwo amene akufuna kudziwa zambiri.
Zotsatira:
Adams ndi Victor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009
Blumenfeld H, Neuroanatomy kupyolera m'zipatala. Sunderland: Sinauer Associates Publishers 2002