I-Peripheral Neuropathy ichazwa

I-peripheral neuropathy yimeko yonyango obangelwa ngumonakalo kwinkqubo yesistim yomhlaba, inethiwekhi enkulu yokunxibelelana edlulisela ulwazi kwingqondo kunye nomthambo womthambo (oko kukuthi, inkqubo yesistim ephakathi) kuyo yonke into emzimbeni. Iimbulunga zepheripher zibuye zithumele ulwazi oluqondayo kwi-ingqondo kunye nentambo yomgogodla, njengomyalezo onokubanda ngamanqina okanye ngomnwe utshiswa.

Sibanzi

Ukulimala kwenkqubo ye-nervous system iphazamisa ezi zinto kunye nokunxibelelana. Njenga-static kumgca wefoni, i-peripheral neuropathy iphazamisa kwaye ngezinye iziphazamisa imiyalezo phakathi kwengqondo kunye nalo lonke umzimba. Ngenxa yokuba yonke imbilini yesipilisi inomsebenzi okhethekileyo kwinqanaba elithile lomzimba, kukho uluhlu olubanzi lweempawu ezinokuthi zenzeke xa izondlo zonakaliswe.

Abanye abantu banokuva:

Abanye bangabandezeleka ngakumbi, kuquka:

Kwamanye abantu, i-peripheral neuropathy inokuchaphazela amandla oku:

Kwiimeko ezigqithiseleyo, ukuphefumula kungabonakala kunzima okanye ukuhluleka kwelungu kungenzeka.

IiFom

Ezinye iindidi ze-neuropathy zibandakanya umonakalo kwimbilini eyodwa kuphela kwaye zibizwa ngokuba yi-mononeuropathies. Ngokuqhelekileyo, amaninzi amaninzi achaphazelekayo kuwo onke amagatsha achaphazelekayo, abizwa ngokuba yi-polyneuropathy. Ngamanye amaxesha, iimbilini ezimbini okanye ngaphezulu ezihlukeneyo kwiindawo ezihlukeneyo zomzimba zichaphazelekayo, zibizwa ngokuba yi-mononeuritis multiplex.

Ngama -neuropathies acacile , afana ne-Guillain-Barré syndrome (eyaziwa ngokuba yi-inflammatory inframatory demyelinating neuropathy), iimpawu zivele ngokukhawuleza, ziqhube phambili ngokukhawuleza, kwaye zixazulule ngokukhawuleza njengoko ziphazamisekile.

Kwi- neuropathies engapheliyo , iimpawu ziqala ngokuzenzekelayo kwaye zenze inkqubela phambili. Abanye abantu banokuba nexesha lokuphucula elilandelwa ngokuphindaphinda. Abanye bangafikelela kwisiteji apho iimpawu zihlala zifana neenyanga okanye iminyaka. Ezinye izifo ezingapheliyo ze-neuropathies zibuhlungu ngaphezu kwexesha, kodwa iifom ezimbalwa kakhulu zibonakalisa zibulalayo ngaphandle kokuba zinzima nezinye izifo. Ngamanye amaxesha i-neuropathy iyimpawu yesinye isifo.

Kwiindlela ezininzi eziqhelekileyo ze-polyneuropathy, iimbilini ze-nerve (iiseli nganye ezenza iimbilini) ezikude kakhulu kwingqondo kunye nomgudu womgudu ongasebenzi. Ubunzima kunye nezinye iimpawu zivame ukubonakala ngokulinganayo, umzekelo, kwiintlungu zombini zilandelwa ukuqhubela phambili kwimiyalelo yomibini. Emva koko, iminwe, izandla, kunye neengalo zingathinteka, kwaye iimpawu zingaphumelela kwinxalenye ebalulekileyo yomzimba. Abantu abaninzi abane-neuropathy abanesifo sikashukela bafumana le ndlela yokunyuka kwamantongomane.

I-Peripheral Neuropathies iyichaza njani?

Kuye kwafunyanwa iintlobo ezingaphezu kwe-100 ze-peripheral neuropathy, ngasinye sinesiqulatho seempawu, ipateni yophuhliso, kunye nokuhlaziya. Umsebenzi ongenakukhubazeka kunye neempawu kuxhomekeke kuhlobo lweentsimbi-imoto, inzwa, okanye ukuzimela-ezonakalisiweyo:

Nangona ezinye i-neuropathies zinokuchaphazela zonke iintlobo ezintathu zeentsholongwane, ezinye zichaphazela kakhulu enye okanye ezimbini iintlobo. Ngoko ke, ekuchazeni imeko yesigulane, oogqirha bangasebenzisa imiqathango efana nale:

Iimpawu

Iimpawu ze-peripheral neuropathy zihlobene nohlobo lwesigulane esichaphazelekayo kwaye lunokubonakala kwixesha leentsuku, iiveki okanye neminyaka.

Ubuthakathaka obuthathekayo bubonakalisa uphawu oluqhelekileyo lwesistim somonakalo. Ezinye iimpawu zingabandakanya:

Ukutshintshwa kwezinto eziqhelekileyo eziqhelekileyo nako kunokubangelwa ukulahleka kwentsholongwane okanye ukulawulwa kwefayibha. Umonakalo onobuchule obangelwayo unobangela obunzima buninzi beempawu kuba iimvalo zentliziyo zinomsebenzi obanzi, ophezulu ngakumbi.

AmaFibers aBanzi

Iimbumba ezininzi ezinkulu ezifakwe kwi-myelin (iprotheni enamafutha enxibayo kwaye igxininisa amaninzi amaninzi) ubhalise ukubetha, ukuchukumisa ukukhanya, kunye nesimo sengqondo. Ukulimala kwiimfono ezinkulu zentlupheko kunciphisa amandla okuvakalelwa kunye nokuthintela, okubangela ukuba umntu aphelelwe yindlala, ingakumbi kwizandla nangeenyawo.

Abantu banokuvakalelwa ngathi banxibe iiglavu kunye namasitokethi nangona bengekho. Izigulane ezininzi azikwazi ukujonga ngokuthinta kuphela izinto ezibunjwe izinto ezincinci okanye ukwahlula phakathi kohlobo oluthile. Lo monakalo kwiimbumba zengqondo kunokufaka isandla ekulahlekelweni kweengcamango (njengokuba kunokulimala kwemoto). Ukulahlekelwa kwesimo sengqondo kubangelwa ukuba abantu bangakwazi ukulungelelanisa ukuhamba okunzima njengokuhamba okanye ukukhawuleza amaqhosha okanye ukugcina ibhalansi xa amehlo abo avaliwe.

Ubuhlungu be-neuropathic bunzima ukulawula kwaye bunokuchaphazela kakhulu impilo kunye nomgangatho wobomi. Ubuhlungu be-neuropathic bubonakala bunzima ebusuku, buphazamise ubuthongo obunzima kwaye bongezeleleke kwimithwalo yemvakalelo yomonakalo wesondlo.

Fibers ezincinci

Iimbilini ezincinci ezingenazo i-myelin sheaths zidlulisa intlungu kunye neqondo lokushisa. Ukulimala kule mizobo kunokuphazamisa ukukwazi ukuva intlungu okanye utshintsho lokushisa.

Abantu banokuthi bangakwazi ukuqonda ukuba baye balinyazwa ukusuka kwinqununu okanye ukuba inxeba isifo. Abanye bangaboni iintlungu ezisixwayisayo ngokuhlasela kwentliziyo ezayo okanye kwezinye iimeko ezilukhuni. (Ukulahlekelwa kwintlungu yesifo yinkxalabo ebaluleke kakhulu kubantu abanesifo sikashukela, okubangela ukuba izinga eliphezulu lokuchithwa kwamalungu angaphantsi kwala manani.)

Iimfesane zeentlungu zesikhumba nazo zinokugqithiseleka, ukwenzela ukuba abantu babe neentlungu ezinzima (allodynia) ezivela kwi-stimuli eziqhelekileyo ezingenabuhlungu (umzekelo, abanye banokuva ubunzima obuvela kumabhedi ebhedi abakhanyisa umzimba.

I-Autonomic Nerve Damage

Iimpawu zokuzimela komonakalo wezondlo zihlukeneyo kwaye zixhomekeka kwiziphi izitho okanye izigulane ezichaphazelekayo. I-autonomic neuropathy (i-autonomic nerve dysfunction) ingasongela ubomi kwaye ingadinga unyango lwengxamisekileyo kwiimeko xa ukuphefumla kungaphumeleli okanye xa intliziyo iqala ukubetha ngokungavumelekanga. Izimpawu eziqhelekileyo zomonakalo wezondonko zikwazi ukuquka:

Ukulahleka kokulawulwa kwengcinezelo yegazi kunokubangela ukuxakeka, ukuhamba kakuhle, okanye ukuguqulwa xa umntu ehamba ngokukhawuleza ehleli kwindawo emileyo (imeko eyaziwa njenge-postural or hystension hypotension).

Izimpawu zesisu zihamba rhoqo zihamba ne-autonomic neuropathy. Amagundane alawula ukuphambana kwamathumbu emathumbu emathunjini amathumbu amaninzi asebenze ukungasebenzi, okukhokelela ekurhoxeni, ukuzithemba, okanye ukungabikho. Abantu abaninzi banenkxalabo yokutya okanye yokugwinya xa ezinye izithintelo zokuzimela zichaphazelekayo.

Izizathu

I-peripheral neuropathy inokufunyanwa okanye izuzwe njengefa. Izizathu zokufumana i-peripheral neuropathy ziquka:

Iingxaki ze-neuropathies ezifunyenweyo zihlanganiswe zibe ngamaqela ahlukeneyo amathathu:

Omnye umzekelo we-peripheral neuropathy efunyenwe yi-neuralgia ye-trigeminal (eyaziwa ngokuba yi-tic douloureux), apho umonakalo kwisigulane se-trigeminal (imbindi enkulu yentloko kunye nobuso) kubangela ukuhlaselwa ngokugqithisileyo kweentlungu ezinzima, ezinjengombane kwicala elinye ubuso.

Kwezinye iimeko, imbangela yintsholongwane yintsholongwane yangaphambili, uxinzelelo kwi-nerve esuka kwisisu okanye isitya segazi esivimbayo, okanye, ngokuthe rhoqo, i- multiple sclerosis .

Kwiimeko ezininzi, nangona kunjalo, isizathu esithile asikwazi ukuchongwa. Oogqirha badla ngokubhekisela kuma-neuropathies abangenayo isizathu esaziwayo njenge-idiopathic neuropathies.

Ukulimala ngokwasemzimbeni: Ukulimala ngokwenyama (imbandezelo) yinto ebangela kakhulu yokulimala kwimbilini. Ukulimala okanye ukukhathazeka ngokukhawuleza, ukusuka:

Ukulimala kabuhlungu kungabangela ukuba imisipha ibe yincinci okanye ihlukane ngokupheleleyo, idityaniswe, igxininiswe okanye ityululwe, ngamanye amaxesha ngamandla kangangokuthi ayinxalenye okanye ayigciniwe ngokupheleleyo kwintambo yomgogodla. Iingxaki ezincinci ezingaphantsi zingabangela umonakalo omkhulu wemisipha. Amathambo aqhekekileyo okanye ahlukanisiweyo angabangela uxinzelelo olumonakalo kumzondelelo osondelene nawo, kwaye adibanise iidiski phakathi kwama-vertebrae anokunyanzelisa i-nerve fibers apho iphuma khona emthonjeni.

Izifo zesistim: Izifo zesistim , ezibandakanya iziphazamiso ezininzi ezichaphazela umzimba wonke zivame ukudala i-neuropathies ye-metabolic. Ezi ngxaki zingabandakanya ukuphazamiseka kwemizimba kunye ne-endocrine. Iimfucu zamathambo zisengozini enkulu ekumonakaleni kwizifo eziphazamisa amandla omzimba wokuguqula izondlo kumbane, ukucwangcisa iimveliso zerhatsha, okanye ukwenza izinto ezenza izicubu eziphilayo.

Isifo sikashukela: I- diabetes mellitus , ebonakaliswe ngamanqanaba e-glucose ephakamileyo egazi, iyona nto ibangela ukuba i-peripheral neuropathy e-US ibangele malunga nama-60 ekhulwini ukuya kuma-70 ekhulwini abantu abanesifo sikashukela banomonakalo obunzima ukuya kwiimeko ezinobungozi bomonakalo.

Izifo zesibindi kunye neengxaki zesibindi: Iingxaki zeengxaki zingakhokelela kwimilinganiselo engavumelekanga yezinto ezinetyhefu egazini ezingonakalisa kakubi izicubu zomzimba. Ininzi yezigulana ezifuna i-dialysis ngenxa ye-intsilelo yokungaphumeleli kweentso kuphuhlisa i-polyneuropathy. Ezinye izifo zesibindi nazo zikhokelela kwi-neuropathies ngenxa yokungalingani kwemichiza.

IiHormones: Ukungalingani kwe-Hormonal kunokuphazamisa iinkqubo eziqhelekileyo zokuxilongwa kunye nokudala i-neuropathies. Ngokomzekelo, ukuveliswa kwe-hormone ye-thyroid kunokunciphisa isantabolism, okukhokelela ekugcinweni kwamanzi kunye nezicubu ezivuvuzayo ezinokubangela uxinzelelo kwiimbilini zomhlaba.

Ukunyuka kwe-hormone yokukhula kunokukhokelela ekubeni i-acromegaly, imeko ebonakaliswe ngokukwandiswa okungavumelekanga kweendawo ezininzi zamathambo, kuquka amanxeba. Amagulane asebenza ngala majoyina achaphazelekayo amaninzi atyathwa.

Ulwaphulo lwe-Vitamin kunye noTywala: Ukungaziphathi kwe-Vitamin kunye notywala kunokubangela umonakalo omkhulu kwiimpawu zesisindo. IiVithamini E, B1, B6, B12, kunye ne-niacin zibalulekile kwimisebenzi yesifo somdla. Ukunqongophala kwe-Thiamine, ngokukodwa, kuqhelekileyo kubantu abanxilisayo ngenxa yokuba kaninzi nabo banempilo yokutya. Ukuntuleka kwe-Thiamine kunokubangela ukuba neuropathy ebuhlungu ekupheleni.

Abanye abaphandi bakholelwa ukuba ukusela ngokweqile, ngokwalo, kungabandakanyeka ngqo kumonakalo wemisipha, imeko ebizwa ngokuba yi-alcoholic neuropathy.

Ukulimala kwe-Vascular negazi: Izidalwa ze-Vascular kunye nezifo zegazi zinganciphisa ukwenziwa kwe-oksijeni kwiimbilini ze-peripheral kwaye ngokukhawuleza zikhokelela kumonakalo omkhulu okanye ukufa kwamathambo enomdla, njengokuba ukungabikho kwe-oksijini ngokukhawuleza kwintliziyo kungabangela isifo. Isifo sikashukela sisoloko sikhokelela kwisitya segazi.

Iindidi ezahlukahlukeneyo ze- vasculitis (i-blood vessel inflammation) zisoloko zenza iindonga zeenqwelo zikhuni, zikhuphe, ziphuhlise izicubu ezinqabileyo , zinciphise ububanzi bazo kwaye zichithe ukuhamba kwegazi. Le nxalenye yomonakalo wentsholongwane (ebizwa ngokuthi i-mononeuropathy multiplex okanye i-multifocal mononeuropathy) yilapho iindawo ezihlukeneyo ezikhuselekileyo zonakaliswe.

Ukuxhatshazwa kweziTisue kunye nokuvuvukala okungapheliyo: Ukuphazamiseka kwezicubu kunye nokuvuvukala okungapheli kubangela ukulimala ngqo kwendoda. Xa iziqulatho ezininzi zezicubu ezikhuselekileyo zijikelezayo, ukuvuvukala kunokusasazeka ngokuthe ngqo kwiimbilini ze-nerve.

Ukuqhaqhazeka okungapheliyo kukukhokelela ekubhubhiseni okuqhubekayo kwezicubu ezinxibelelwano, okwenza iimbilini ezinobungozi zingakhuselekanga ukuxinzelelo kunye nokusuleleka. Iimbumbano zinokutsha kwaye zivuvule kwaye zifake iingxaki, zenze intlungu.

Iintsholongwane kunye neengqumbo: Iiscaka kunye nezicubu ezinobungozi zingena ngaphakathi okanye zenze uxinzelelo olungonakalisayo kwimibhobho yesibindi. Iimvumi nazo zinokuvela ngokuthe ngqo kwiiseli zamathambo. I-polyneuropathy edlalelekile idla ngokudibanisa ne-neurofibromatoses, izifo zofuzo apho izilonda ezininzi ezinobunzima zikhula kwiimisipha zomzimba. I-Neuromas, izihlwele ezinobunzima beethambo ezininzi ezinokukhula emva kokuba naluphi na umonakalo ochaphazelekayo ophazamisa iimbilini zeentsimbi, zivelise iimpawu zentlungu kakhulu kwaye maxa wambi ziququzelele iintsholongwane ezithandanayo, ezibangele umonakalo omkhulu nakwezinye iintlungu.

Ukubunjwa kwe-Neuroma kunokuba yinto enye yeemeko zesifo se-neuropathic esasasazekayo ebizwa ngokuba yintlungu yesifo seengingqi okanye i-reflex sympathetic syndrome, engabangelwa kukulimala okubuhlungu okanye ukuxhatshazwa.

I-Paraneoplastic syndromes, iqela leentsholongwane ezingavumelekanga zokuphazamiseka ezibangelwa yimpendulo yomzimba womntu kwisifo somhlaza, nayo ingakhokelela ngokungaqhelekanga umonakalo wesondlo.

Uxinzelelo oluphindaphindiweyo: Ukunyamezela ngokuphindaphindiweyo kukhokelela ekubambeni i-neuropathies, kwinqanaba elikhethekileyo lokulimala. Umonakalo obangelwayo unokubangelwa kwimisebenzi ephindaphindiweyo, eqinile, engabonakaliyo efuna ukuguquguquka kweliphi na iqela lamalungu amanxeba amade. Ingqungquthela eyenzekayo ingabangela iigaments, i-tendon, kunye nezihlunu ukuba zitshiswe kwaye zivuvuke, zinyanzelise ukuhamba ngendlela encinci ekudlulayo kuyo. Ezi nzakala ziba rhoqo xa zikhulelwa, mhlawumbi ngenxa yokuzuza ubunzima kunye nokugcinwa kwamanzi kunye neendlela zendlela.

Iifomsi: Iityhefu nazo zingabangela umonakalo we-nervidal wound. Abantu abavelele kwizinyithi ezinzima (i-arsenic, i-lead, i-mercury, i-thallium), iziyobisi zoshishino, okanye iibhoksi zendalo zenza i-neuropathy.

Ezinye iziyobisi zonyango, i-anticonbulsants, i-anti-antial agents, kunye ne-antibiotics zineempembelelo ezingabangela i-neuropathy yesibini kwizidakamizwa, oko kunciphisa ukusetyenziswa kwabo kwexesha elide.

Izifo kunye neengxaki zokuzimela ngokuzenzekelayo: Izifo kunye nezifo ezizimelayo zingabangela i-peripheral neuropathy. Iintsholongwane kunye neebhaktheriya ezinokuhlasela izicubu zentliziyo zibandakanya:

Ezi zintsholongwane ziwonakalisa umonakalo weengxaki, kubangela ukuhlaselwa kweentlungu ezibukhali, ezinjengombane. I-postorpetic neuralgia ivame ukuvela emva kokuhlaselwa kwee-shingles kwaye ingaba buhlungu kakhulu.

Intsholongwane ye-immunodeficiency virus (i-HIV), ebangela ukuba i-AIDS, ibangele umonakalo omkhulu kwiinkqubo zesiseko kunye neendlela zokuphazamiseka. Intsholongwane ingabangela iindidi ezahlukeneyo ze-neuropathy, ngasinye sihambelana kakhulu nesigaba esithile sentsholongwane ye-immunodeficiency. I-polyneuropathy ehamba ngokukhawuleza, ebuhlungu i-polyneuropathy echaphazela iinyawo nezandla ngokuqhelekileyo ibonakaliso lokuqala lokuqala lwe-HIV.

Izifo zebhaktheriya ezifana nesifo seLyme, i-diphtheria, neqhenqa zibonakaliswe ngumonakalo omkhulu wentsholongwane.

Ukusuleleka kwintsholongwane ka-Viral kunye ne-bacterial kungabangela ukuba umonakalo onobungozi ongabonakaliyo ngokubangela izimo ezibhekiselwe kuzo njengengxaki yokuzimela, apho iiseli ezikhethekileyo kunye namayeza omzimba omzimba ahlasela izicubu zomzimba. Ezi zihlaselo zibangelwa ukutshabalaliswa kwesibindi se-myelin okanye i-axon.

Ezinye i-neuropathies zibangelwa ukuvuvukala okubangelwa yimisebenzi yenkqubo ye-immune kunokuba yonakalise umonakalo owenziwe ngumzimba.

I-neuropathies evuthayo ingakhula ngokukhawuleza okanye ngokukhawuleza, kwaye iifom ezingapheliyo zingabonisa umzekelo wokuxolelwa okunye kunye nokuphindaphinda.

I-Neuropathies eyabelwe ifa: Ifa le-peripheral neuropathies libangelwa iimpazamo ezizalwe ngumntwana kwi-genetic code okanye ngokutshintshwa kwezinto ezintsha.

Iintlobo zeentlobo ze-neuropathies ezizuzekileyo eziqhelekileyo ziyiqela leengxaki ezibizwa ngokuba yi-Charcot-Marie-Tooth (ngenxa yeziphene ezithintekayo kwi-neurons okanye kwi-myelin sheath). Iimpawu ziquka:

Unyango

Akukho zonyango ezonyango ezikhoyo ezinokuphilisa i-peripheral neuropathy. Nangona kunjalo, kukho iindlela ezininzi zokwenza ezinye iifom. Nazi ezinye iingongoma eziphambili zonyango lwe-neuropathy.

Ngokuqhelekileyo, unyango lwe-peripheral neuropathy luquka ukuthobela imikhuba enempilo ukunciphisa imiphumo yomzimba kunye nemvakalelo, njengale:

Ezinye iindlela zonyango kwi-peripheral neuropathy ziquka:

Izifo eziSistim

Izifo eziqhelekileyo zifuna ukuba unyango olunzima. Ulawulo olunzulu lwezinga le-glucose yegazi luye lwaboniswa ukunciphisa iimpawu ze-neuropathic kwaye kunceda abantu abanentsholongwane yesifo sikashukela baphephe umonakalo omkhulu wesondlo.

Izimo ezivuthayo nezizenzekelayo zikhokelela kwi-neuropathy zinokulawulwa ngeendlela ezininzi ezibandakanya iziyobisi ezingenayo i-immunosuppressive ezifana:

I-Plasmapheresis: I- Plasmapheresis-inqubo apho igazi lisuswe khona, lihlambulule isistim e-immune system kunye namagciwane, kwaye ubuyela emzimbeni-kunokunciphisa ukuvuvukala okanye ukunciphisa umsebenzi we-immune system. Amanqanaba aphezulu e-immunoglobulins, iiprotheni ezisebenza njengezikhuselo, nazo zinokuthintela umsebenzi ongasesikweni womzimba.

Ukuxhamla ubuhlungu: Iintlungu ze- neuropathic zisoloko zinzima ukulawula. Ubuhlungu obubi ngamanye amaxesha bunokuncitshiswa ngama-analgesics athengiswa ngaphezu kwe-counter. Iiklasi eziliqela zamachiza ziye zanceda izigulane ezininzi ezijongene neentlobo ezinzima zentlungu engapheliyo ye-neuropathic. Ezi ziquka:

Izigulane ze-anesthetics zendawo, ezifana ne-lidocaine okanye i-patches echazwe nge-lidocaine, inokuthi ikhuphe intlungu engapheliyo.

Kwiimeko ezinzima kakhulu, oogqirha banokubhubhisa amaninzi; Nangona kunjalo, iziphumo zihlala zisesigxina kwaye inkqubo inokubangela iingxaki.

Izixhobo zoNcediso: Izixhobo zokuncedisa izixhobo kunye nezinye izixhobo ezincedisayo zinokunceda ukunciphisa intlungu kunye nokunciphisa impembelelo yokukhubazeka ngokomzimba.

Ugqirha: Ukungenelelo ngoncedo kunokusondeza ngokukhawuleza kwi-mononeuropathies ebangelwa ukuxinwa okanye ukulimala.

> Umthombo:

> Upapasho lwe-NIH No. 04-4853