I-Steroid-Incomphasive Encephalopathy Ehlanganiswe w / Autoimmune Thyroiditis
Lesi sifo esibizwa ngokuthi "i- Hashimoto's Encephalopathy " saqala ukuchazwa kuphela ngo-1966. Ngemva kwalesi sikhathi, odokotela baqala ukuqoqa imibiko yecala, futhi "uHashimoto's Encephalopathy" yaba yigama elamukelwe ngenxa yesimo sokucindezeleka okuhlobene neHashimoto's thyroiditis.
Ngenxa yokuthi iziguli eziningi ezine-Encephalopathy i-Hashimoto zithuthukisa ukwelashwa kwe-steroids noma ukwelashwa kwe-immunosuppressant, ezinye izazi manje zibhekisela esimweni ngokuthi "ukucindezeleka kwesifo se-steroid ehambisana ne-autoimmune thyroiditis" (SREAT).
Kwezinye izimo, lesi simo singase sabizwe nangokuthi "i-nonimuline autoimmune meningoencephalitis" (i-NAIM), engabandakanyi izinkinga ze -roid kuphela ezizenzakalelayo kodwa nezinye izifo ezizimele njengeSjögren syndrome kanye ne-systemic lupus erythematosus-ehlotshaniswa ne-meningoencephalitis. Okuvamile kuzo zonke lezi zimo ukuthi basabela ekwelapheni kwe-steroid.
Igama elithi "encephalopathy" lisho isifo sobuchopho eshintsha ukusebenza komqondo noma isakhiwo. Isici esiyinhloko sanoma yikuphi ukuphazamiseka kwengqondo kuguquke isimo sengqondo. Nakuba izimpawu zixhomeke enhlobonhlobo ye-encephalopathy nokuthi kubaluleke kangakanani, ezinye izimpawu ezivamile zihlanganisa:
- ukulahlekelwa inkumbulo
- ubunzima bokugxila
- ukulahlekelwa ikhono lokuqonda nokusebenza
- izinguquko zobuntu
- ukwehlisa nokukhathala
- ukulahlekelwa kokwazi
- i-myoclonus (i-twitching of muscular)
- i-nystagmus (ukunyakaza kwamehlo okusheshayo, okungazibandakanyi)
- ukuthuthumela
- ukubuthakathaka kwemisipha
- ukuwohloka komqondo
- ukuhlukunyezwa, ukuhlukunyezwa
- ubunzima bokugwinya
- kunzima ukukhuluma
Ezinye izimpawu ezingabonakala zifaka:
- ukudideka, ukudideka
- i-psychosis
- ikhanda
- hemiparesis kwesokudla kwesokudla - kwesokudla ukukhubazeka ngokwengxenye
- izinkinga ezinhle zokunyakaza kwezimoto - izinkinga ngokubambisana kwezandla, izandla, iminwe
Ngenxa yokuthi i-Hashimoto's Encephalopathy / SREAT ayiqondakali kahle, ocwaningweni olubikwe ngo-February 2006 Archives of Neurology , ochwepheshe bavelele ukuveza imithi ehlukahlukene yemitholampilo, i-laboratory kanye ne-radiological findings of the condition.
Inhloso yabo ukusiza ukuthuthukisa ikhono labodokotela lokuqaphela nokuhlola lesi simo.
Ucwaningo lubheke iziguli ezingu-20 (abesilisa abangu-14, amadoda ayisithupha) abatholakale bephakathi kuka-1995 no-2003. Isikhathi sabo esiphakathi kwezifo saba khona eminyakeni engu-56, eneminyaka engama-27 kuya kwangu-84 (ububanzi, iminyaka engu-27-84).
Izimpawu zomtholampilo ezitholakalayo ezivame kakhulu:
- Ukwesaba - 80%
- I-aphasia ephansi - 80% (i-Aphasia inzima ngolwimi, echaphazela ikhono lokukhuluma, ukufunda noma ukubhala)
- I-Myoclonus - i-65% (ngokuzumayo, ukuxosha okungazibandakanyi komzimba noma isisindo semisipha)
- Thola i-ataxia - 65% (ukuhamba okungahambi kahle noma okunamandla, ukuhamba nobunzima)
- Ukuhlukunyezwa - 60%
- Ukulala okungavamile - 55%
I-Misdiagnosis ijwayelekile
Yini okukhathazeka ngokuyinhloko ukuthi ochwepheshe bathola ukuthi BONKE ABANTU ABANTU ABANTU bebengaboni kahle. Ngokwesibonelo:
- I-encephalitis yama-viral - 25%,
- Ukuwohloka komqondo okucindezelekayo - 20%
- Isifo se-Creutzfeldt-Jakob - i-15% (i-Creutzfeldt-Jakob isifo esingavamile, esiyingozi, esiyingozi njalo esibulalayo, okungesinye isikhathi esibizwa nge "Mad Cow Disease" kubantu)
I-Laboratory nokuhlolwa okungajwayelekile ku-Hashimoto's Encephalopathy / SREAT
Ukungajwayelekile kokuhlolwa okungajwayelekile kuboniswe, kuhlanganise:
- Izinga le-enzyme yesibindi landa - 55%
- Ukwandisa amazinga e-hormone ye-thyroid (stimulation hormone) (TSH) - 55%
- Isilinganiso se-sedimentation se-erythrocyte (i-"sed rate sed") - 25%
- I-Cerebrospinal fluid engavamile ekhomba ukuvuvukala - 25%
- Ukuzibona nge-magnontic imaging okungavamile okuhambisana nokucindezeleka-26%
Iziphetho
Abacwaningi baphetha ngokuthi kunezinto ezihlukahlukene ezitholakalayo ezingase zihlotshaniswe ne-Hashimoto's Encephalopathy / SREAT, futhi lokho kutholakala kabi kujwayelekile.
Abacwaningi batusa ukuthi uHashimoto's Encephalopathy / SREAT kufanele icatshangelwe ngisho noma i-TSH ne "sed rate" ingavamile, uketshezi lwama-cerebrospinal alubonisi ubufakazi bokuvuvukala kanti i-MRI iyinto evamile.
Ukuze uthole olunye ulwazi
I-Hashimoto's Encephalopathy Information Page
> Imithombo
> Castillo, uPablo MD; et. al. "I-Steroid-Encephalopathy Ephendulayo Ehambisana Ne-Autoimmune Thyroiditis." Arch Neurol . 2006; 63: 197-202. (Umq. 63 No. 2, Febhuwari 2006)
> I-National Institute of Neurological Disorder and Stroke