I-peripheral neuropathy yinkinga yezokwelapha ebangelwa umonakalo ohlelweni lwezinzwa zomzimba, inethiwekhi enkulu yokuxhumana ehambisa imininingwane ebuchosheni nomgogodla (okungukuthi, isistimu yomgogodla) kuzo zonke ezinye izingxenye zomzimba. Izinga le-peripheral libuye lithumele ulwazi lokuzwa emuva ebuchosheni nasendlini yomgogodla, njengomyalezo wokuthi izinyawo ziyabanda noma umunwe ushiswa.
Sibutsetelo
Ukulimala kwesistimu yezinzwa zangaphandle kuphazamisa lezi zixhumanisi nokuxhumana. Njenge-static ocingweni lwezingcingo, i-peripheral neuropathy iphazamisa futhi ngezinye izikhathi iphazamisa imiyalezo phakathi kobuchopho nomzimba wonke. Ngenxa yokuthi zonke izinzwa zomzimba zinezici ezikhethekile kakhulu ezingxenyeni ezithile zomzimba, izimpawu eziningi zezimpawu zingenzeka uma izinzwa zonakalisiwe.
Abanye abantu bangase bahlangane:
- I-numbness yesikhashana
- Ukulinganisa
- Ukuzwela kwe-Pricking (paresthesia)
- Ukuzwela ukuthinta, noma ubuthakathaka bomzimba.
Abanye bangase bahlupheke kakhulu izimpawu, kubandakanya:
- Ubuhlungu obuvuthayo (ikakhulukazi ebusuku)
- Ukuhlukumeza ama-muscle
- Ukukhubazeka
- Ukungasebenzi komzimba noma gland
Kwamanye abantu, i-peripheral neuropathy ingathinta ikhono loku:
- Gaya ukudla kalula
- Gcina amazinga aphephile wegazi
- Vimba ngokujwayelekile
- Thola umsebenzi ovamile wocansi
Ezimweni ezimbi kunazo zonke, ukuphefumula kungase kube nzima noma isici ukwehluleka kungenzeka.
Amafomu
Ezinye izinhlobo ze-neuropathy zihilela ukulimala kwesinye sezinzwa futhi zibizwa ngokuthi i-mononeuropathies. Ngokuvamile, izinzwa eziningi ezithinta zonke izitho zithintekile, okuthiwa i-polyneuropathy. Ngezinye izikhathi, izinzwa ezimbili noma ngaphezulu ezihlukene ezindaweni ezihlukene zomzimba ziyathinteka, okuthiwa i-mononeuritis multiplex.
E -neuropathies ejulile , efana ne-Guillain-Barré syndrome (eyaziwa nangokuthi i-neuropathy ekhukhulayo yokudangala), izimpawu zivela ngokuzumayo, zithuthuka ngokushesha, futhi zixazulula kancane kancane njengoba izinzwa ezimele zipholile.
Ku- neuropathies engavamile , izimpawu ziqala ngokuncane futhi zithuthuka kancane. Abanye abantu bangase babe nezikhathi zokuphumula ezilandelwa ukubuyela emuva. Abanye bangase bafike esiteji sezintaba lapho izimpawu zihlala khona ezinyangeni eziningi noma eminyakeni. Ezinye ze-neuropathies ezingapheli ziyanda kakhulu ngokuhamba kwesikhathi, kodwa amafomu ambalwa kakhulu aqinisekisa ukuthi abulawe ngaphandle kokuba ahlolwe ezinye izifo. Ngezinye izikhathi i-neuropathy iyimpawu yesinye isifo.
Ezingxenyeni ezivame kakhulu ze-polyneuropathy, izinsimbi zomzimba (amangqamuzana ngabanye abakha isisindo) ezikude kakhulu nobuchopho kanye nomgogodla ongasebenzi. Ubuhlungu nezinye izimpawu zivame ukuvela ngokulinganayo, isibonelo, kuzo zombili izinyawo ezilandelwa ukuqhubeka kancane kancane emilenzeni yombili. Khona-ke, iminwe, izandla, nezingalo zingathinteka, futhi izimpawu zingathuthuka zibe yingxenye yomphakathi. Abantu abaningi abane-neuropathy yesifo sikashukela babhekana nalesi sibonelo sokukhuphuka komonakalo wezinzwa.
I-Neuropathies ye-Peripheral ihlukanisa kanjani?
Kunezinhlobo ezingaphezu kwezingu-100 ze-peripheral neuropathy eziye zabonwa, ngayinye ibe nesethi yezimpawu zesimpawu, iphethini yentuthuko, kanye nokubikezela. Umsebenzi ongasebenzi kahle nezimpawu zixhomeke kuhlobo lwezinzwa-ezithuthumayo, ezithintekayo, noma ezizimele-ezonakalisiwe:
- Ama-motor nerves alawula ukunyakaza kwazo zonke imisipha ngaphansi kokulawula okuqaphele, njengalabo asetshenziselwa ukuhamba, ukuqonda izinto, noma ukukhuluma.
- Izinzwa ezithandwayo zithumela ulwazi mayelana nokuhlangenwe nakho okuzwakalayo, okufana nomzwelo wokuthinta okulula noma ubuhlungu obubangelwa ukusika.
- Izindebe ezizenzekelayo zilawula imisebenzi yezinto eziphilayo abantu abangazilawula ngokucophelela, njengokuphefumula, ukugaya ukudla, nokusebenza kwenhliziyo nekhanda.
Nakuba ezinye ze-neuropathies zingathinta zonke izinhlobo ezintathu zezinzwa, ezinye zithinta kakhulu eyodwa noma ezimbili izinhlobo. Ngakho-ke, lapho echaza isimo sesiguli, odokotela bangasebenzisa imigomo efana nalokhu:
- Kunomqondo omkhulu we-neuropathy
- I-neuropathy enkulu kakhulu yezinzwa
- I-sensory-motor neuropathy
- I-autonomic neuropathy
Izimpawu
Izimpawu ze-peripheral neuropathy zihlobene nohlobo lwezinzwa ezithintekayo futhi zingabonakala esikhathini esithile sezinsuku, amasonto, noma ngisho neminyaka.
Ubuthakathaka bemisipha yilona uphawu oluvame kakhulu lokulimala kwamagciwane. Ezinye izimpawu zingabandakanya:
- Ama-cramps abuhlungu kanye nezinhlanzi (ukungahambisani nomzimba okungalawulwa ngaphansi kwesikhumba)
- Ukulahleka kwemisipha
- Ukuguqulwa kwamathambo
- Izinguquko esikhumbeni, izinwele, nezipikili
Izinguquko ezivame kakhulu zokuguqulwa nazo zingabangela ukulahlekelwa kwezinzwa ze-nerve or autonomic. Umonakalo wezinzwa ozwakalayo ubangela izinkinga eziningi eziyinkimbinkimbi ngoba izinzwa zesisindo zinezici eziningi kakhulu ezikhethekile.
AmaFibers aHlakale Okukhulu
Izindwangu ezinkulu ezinkulu ezifakwe e-myelin (amaprotheni amafutha anembathisa futhi agxilisa izinzwa eziningi) ubhalise ukudlidliza, ukuthinta okulula, nokuqonda. Ukulimala kwamagundane amakhulu okuncipha kunciphise ikhono lokuzwa ukudumaza nokuthinta, okuholela ekuboneni ukungafihli, ikakhulu ezandleni nasezinyaweni.
Abantu bangase bazizwe sengathi bagqoke amagilavu namasheya ngisho nalapho bengekho. Iziguli eziningi azikwazi ukubona ngokuthinta kuphela izimo zezinto ezincane noma ukuhlukanisa phakathi kobunjwa obuhlukene. Lo monakalo wezintambo ezizwakalayo kungabangela ekulahlekelweni kwezindlevu (njengoba kungakwazi ukulimala komzimba). Ukulahlekelwa kwemqondo ngokuvamile kwenza abantu bangakwazi ukuxhumanisa izinyathelo eziyinkimbinkimbi ezifana nokuhamba noma ukuqinisa izinkinobho noma ukugcina ibhalansi lapho amehlo abo ivaliwe.
Ubuhlungu be-neuropathic kunzima ukulawula futhi bungathinta kakhulu impilo enhle ngokomzwelo kanye nekhwalithi yonke yokuphila. Ubuhlungu be-neuropathic bubi kakhulu ebusuku, ukuphazamisa ubuthongo obunzima nokufaka umthwalo ongokomzwelo wokulimala komzimba.
AmaFibers aNcane amancane
Izindwangu ezincane ezingenangqondo ngaphandle kwama-myelin sheaths zidlulisa ubuhlungu nokushisa kwamazwi okushisa. Ukulimala kulezi zingcingo kungaphazamisa ikhono lokuzwa ubuhlungu noma izinguquko ekushiseni.
Abantu bangase bahluleke ukuzwa ukuthi balimala kusukela ekunqunyeni noma ukuthi isilonda sithinteka. Abanye bangase bangaboni ubuhlungu obuxwayisa ngokuhlasela kwenhliziyo okuzayo noma nezinye izimo eziyingozi. (Ukulahlekelwa ukuzwa ubuhlungu kuyinkinga enkulu kakhulu kubantu abanesifo sikashukela, okwenza ukuba izinga eliphezulu lokunciphisa imilenze ephansi phakathi kwalaba bantu.)
Ama-receptors ezinhlungu esikhumbeni angabuye abe namandla, ukuze abantu bazwe ubuhlungu obunzima (allodynia) kusukela ekuthandeni okuvamile okungenabuhlungu (isibonelo, abanye bangase babhekane nobuhlungu emakhakheni ombhede abagcobele umzimba).
I-Autonomic Nerve Damage
Izimpawu zokulimala kwamanoni ezimele zihlukene futhi zixhomeke kuzo iziphi izitho noma izigulane ezithintekile. I-autonomic neuropathy (i-autonomic nerve dysfunction) ingasongela ukuphila futhi ingadinga ukwelashwa okuphuthumayo uma kwenzeka ukuphefumula kungaphumeleli noma lapho inhliziyo iqala ukushaya ngokungavamile. Izimpawu ezivamile zomonakalo wezinzwa ezizimele zingabandakanya:
- Ukuhluleka ukujuluka ngokujwayelekile (okungaholela ekutheni ukungabekezelelani)
- Ukulahlekelwa ukulawula isisu (okungase kubangele ukutheleleka noma ukungabi khona)
- Ukuhluleka ukulawula imisipha eyandisa noma yokwenza imithwalo yegazi ukugcina amazinga aphephile egazi.
Ukulahlekelwa ukulawulwa kwengcindezi yegazi kungabangela ugozi, ikhanda elincane, noma ukudikibala lapho umuntu ehamba ngokuzumayo ehlezi esimweni sokuma (isimo esibizwa ngokuthi i-postural noma i-orthostatic hypotension).
Izimpawu zamathumbu zivame ukuhambisana neuropathy yokuzimela. Amagundane alawula imisipha yamathumbu emathumbu emathunjini ngokuvamile asebenze ukungasebenzi, okuholela ekuhudeni, ukuqothulwa, noma ukungaziphathi kahle. Abantu abaningi banenkinga yokudla noma yokugwinya uma izinzwa ezithile ezizimele ziphazamiseka.
Izimbangela
I-peripheral neuropathy ingase ithole noma izuzwe njengefa. Izimbangela ze-peripheral neuropathy ezitholakala zihlanganisa:
- Ukulimala ngokomzimba (ukuhlukumezeka) kuya emanzini
- Izicubu
- Ubuthi
- Izimpendulo ngokuzenzekelayo
- Ukuntuleka kokudla okunomsoco
- Utshwala
- Izinkinga ze-Vascular and metabolic
I-neuropathies ye-peripheral etholakalayo ihlukaniswe yaba izigaba ezintathu ezibanzi:
- Labo abangelwa izifo zesistimu
- Labo abangelwa ukuhlukunyezwa kusuka kuma-agent angaphandle
- Labo abangelwa ukutheleleka noma izifo ezizimele ezithinta izicubu zomzimba
Isibonelo esisodwa se-neuropathy esitholakale yochungechunge ye-peripheral neurogia (eyaziwa nangokuthi tic douloureux), lapho umonakalo we-trigeminal nerve (i-nerve enkulu yekhanda nesobuso) kubangela ukuhlaselwa kwe-episodic kokuhlungu okukhulu, okunjengombani ngakwesinye icala ubuso.
Kwezinye izimo, imbangela ingukutheleleka kwegciwane lesandulela ngculazi, ingcindezi emgogodleni ovela emzimbeni noma isithukuthezi segazi, noma, ngokuvamile, isifo se-multiple sclerosis .
Ezimweni eziningi, noma kunjalo, imbangela ethile ayikwazi ukubonakala. Odokotela bavame ukubhekisela kuma-neuropathies abangenayo imbangela eyaziwayo njenge-nedipathies idiopathic.
Ukulimala ngokomzimba: Ukulimala ngokomzimba (ukuhlukumezeka) yiyona imbangela evame kakhulu yokulimala emanzini. Ukulimala noma ukulimala okungazelelwe, kusuka:
- izingozi zezimoto
- amahlumela nokuwa
- ukulimala okuhlobene nemidlalo
Ukulimala okuthuthumayo kungabangela ukuba izinzwa zihlukaniswe noma zihlukaniswe ngokuphelele, zichotshoziwe, zicindezeleke noma zihanjiswe, ngezinye izikhathi zibe namandla kakhulu kangangokuthi zihlukaniswe kancane noma zingenwe ngokuphelele emthonjeni womgogodla. Izingozi ezincane ezimbalwa nazo zingabangela umonakalo omkhulu wezinzwa. Amathambo aqhekekile noma ahlukanisiwe angabangela ukucindezeleka okulimazayo emiphakathini engomakhelwane, futhi ama-disk ashiywe phakathi kwama-vertebrae angakwazi ukucindezela izintambo zomzimba lapho zivela khona emthonjeni womgogodla.
Izifo zesimiso: Izifo zesimiso , ezifaka iziphazamiso eziningi ezithinta umzimba wonke zivame ukudala izinzwa ze-neuropathies. Lezi zingqinamba zingabandakanya ukukhathazeka komzimba kanye ne-endocrine. Izishukela zomzimba zisengozini kakhulu ekulimazeni izifo ezonakalisa ikhono lomzimba lokuguqula izakhi zibe namandla, ukucubungula imikhiqizo yokudoba, noma ukukhiqiza izinto ezakha izicubu eziphilayo.
Isifo sikashukela: Isifo sikashukela , esichazwe ngamazinga aphezulu egazi, isisusa esiyinhloko se-peripheral neuropathy e-US Mayelana namaphesenti angu-60 kuya kuma-70% abantu abanesifo sikashukela banamafomu amancane kuya kwesimiso somonakalo wesimiso sezinzwa.
Izinkinga zezinso nesibindi: Izinkinga zezinso zingabangela inani eliphakeme ngokweqile lezinto ezinobuthi egazini ezingalimaza kakhulu izicubu zesisindo. Iningi leziguli ezidinga i-dialysis ngenxa yokuhluleka kwezinso kuthuthukisa i-polyneuropathy. Ezinye izifo zesibindi nazo ziholela ezinganeni ze-neuropathies ngenxa yokungalingani kwamakhemikhali.
Amakhomoni: Ukungalingani kwe-hormonal kungaphazanyisa izinqubo ezivamile ze-metabolic futhi kubangele ama-neuropathies. Isibonelo, ukungakhiwa kwama-hormone we-thyroid kunciphisa umzimba, okuholela ekugcineni ukugcina amanzi kanye nezicubu ezivuvukalayo ezingabangela ingcindezi emithanjeni yomzimba.
Ukwandiswa ngokweqile kwe-hormone yokukhula kungabangela ukuba i-acromegaly, isimo esibonakala ukukhuliswa okungavamile kwezinxenye eziningi zamasipha, kuhlanganise namalungu. Amagundane asebenza ngalezi zingxube ezithintekile ngokuvamile avinjelwe.
Ukwehluleka kwe-Vitamin nokuNxila: Ukuntuleka kwe-Vitamin nokudakwa kungabangela umonakalo omkhulu emathangeni. Amavithamini E, B1, B6, B12, ne-niacin abalulekile ekusebenzeni kwenzwa enempilo. Ukuntuleka kwe-thiamine, ikakhulukazi, kuvamile kubantu abanokudakwa ngokweqile ngoba kaningi futhi banemikhuba emibi yokudla. Ukuntuleka kwe-thiamine kungabangela i-neuropathy ebuhlungu emaphethelweni.
Abanye abacwaningi bakholelwa ukuthi ukuphuza utshwala ngokweqile kungase kube nomthelela ngqo ekulimaleni kwemisipha, isimo esibizwa ngokuthi i-neuropathy yokudakwa ngokweqile.
Ukulimala kwe-Vascular kanye Nezifo Zegazi: Ukulimala kwe-Vascular kanye nezifo zegazi kunganciphisa uketshezi lwe-oxygen emiphakathini yomzimba futhi ngokushesha kuholele ekulimazeni okujulile noma ekufeni kwezintuthwane zesisindo, njengokuntula okungazelelwe kwe-oksijini ebuchosheni kungabangela isifo. Isifo sikashukela sivame ukuholela e-blood constriction.
Izinhlobo ezihlukahlukene ze- vasculitis (ukuvuvukala kwesithambo segazi) zivame ukubangela izindonga zensimbi ukuba zikhuni, zinyatse, futhi zihlakulele izicubu ezibomvu , zinciphise ububanzi bazo futhi zivimbele ukugeleza kwegazi. Lesi sigaba somonakalo wezinzwa (okuthiwa i-mononeuropathy multiplex noma i-multifocal mononeuropathy) lapho izidakamizwa ezihlukanisiwe ezindaweni ezihlukene zonakalisiwe.
Izifo ezixhumene nezicubu nokuvuvukala okungapheli : Izifo ezixhumene nezicubu nokuvuvukala okungapheli kubangela ukulimala okuqondile nokungaqondile. Lapho izingxube eziningi zezicubu ezivikelayo ezizungeze izinzwa zivutha, ukuvuvukala kungasakazeka ngqo emagqeni enzwa.
Ukuvuvukala okungapheli nakho kuholela ekubhujisweni okuqhubekayo kwezicubu ezixhumeneyo, okwenza izintambo zezinzwa zisengozini enkulu ekulimaweni nasekucindezeni. Amalungu angagcwala futhi avuvuke futhi afake izinzwa, ezibangela ubuhlungu.
I-Cancers and Tumors: I- Cancers kanye nezicubu ezinobuthi zingangena ngaphakathi noma zenze ingcindezi eyingozi emagqeni enzwa. Amathumba nawo angavela ngokuqondile emangqamuzaneni omzimba wesisindo. Ukusakazeka kwe-polyneuropathy kuvame ukuhambisana nezifo ze-neurofibromatoses, izifo zofuzo lapho izicubu eziningi ezinobunzima zikhula emathisini omzimba. I-Neuromas, izixuku ezinobungozi zomzimba wezinyosi eziningi ezingathuthuka ngemva kokulimala okuphazamisayo okuphazamisa izibilini zesisindo, kudala izibonakaliso ezibuhlungu kakhulu futhi ngezinye izikhathi ziqubuzela izinzwa zomakhelwane, okuholela ekulimaleni okukhulu nakakhulu ubuhlungu obukhulu.
Ukwakheka kwe-neuroma kungaba yinto eyodwa yesimo sobuhlungu besifo se-neuropathic esasakazeka kakhulu esibizwa ngokuthi ubuhlungu besifo sezwe esiyinkimbinkimbi noma i-reflex sympathetic syndrome ezwelayo, engabangelwa ukulimala okulimazayo noma ukulimala okuhlinzayo.
I-paraneoplastic syndromes, iqembu lezinkinga ezingavamile zokuqeda amandla ezibangelwa yisimiso somzimba womuntu ukusabela kwesifo somdlavuza, futhi singabangela ukulimala komonakalo okwanda ngokungaqondile.
Ukucindezeleka okuphindaphindiwe: Ukucindezeleka okuphindaphindiwe kuvame ukuholela ekutheni i-neuropathies ingenele, isigaba esikhethekile sokulimala. Umonakalo obangelwayo ungabangela imisebenzi ephindaphindiwe, eqinile, engaqondakali edinga ukuguquguquka kwanoma yiluphi iqembu lamajoyina isikhathi eside. Ukucasuka okubangelwayo kungabangela izigulane, ama-tendon, nemisipha ukuba ivuke futhi ivuvuke, igweme imigwaqo emincane lapho kudlula khona ezinye izinzwa. Lezi zingozi ziba njalo ngesikhathi sokukhulelwa, mhlawumbe ngoba ukutholakala kwesisindo kanye nokugcinwa kwamanzi okugcoba kubuye kube nemigudu yezinzwa.
Amakhomikhali: I- Toxin nayo ingabangela ukulimala komjovo wendawo. Abantu abavezwa ezinsimbi ezisindayo (arsenic, lead, mercury, thallium), izidakamizwa zezimboni, noma izidakamizwa zemvelo ngokuvamile zihlakulela izinzwa ze-neuropathy.
Izidakamizwa ezithile ze-anticancer, ama-anticonvulsants, ama-anti-anti-antial, kanye nama-antibiotic anemiphumela emibi engabangela ukuthi i-neuropathy ibe yinkinga yezidakamizwa, ngaleyo ndlela inciphisa ukusetshenziswa kwayo kwesikhathi eside.
Izifo kanye nokuphazamiseka okuzenzakalelayo : Izifo kanye nokuphazamiseka kwe-autoimmune kungabangela i-peripheral neuropathy. Ama-virus namabhaktheriya angakwazi ukuhlasela izicubu zesisindo zihlanganisa:
- I-Herpes varicella-zoster (ama-shingles)
- I-Epstein-Barr virus
- I-Cytomegalovirus (i-CMV)
- I-Herpes simplex
Lezi amagciwane zilimaza kakhulu imizwelo yezinzwa, ezibangela ukuhlaselwa kobuhlungu obubukhali, obufana nombani. I-neuralgia yangemva kwesikhashana ivame ukuvela ngemuva kokuhlaselwa kwezingxabano futhi ingaba buhlungu kakhulu.
Igciwane lesandulela ngculazi (i-HIV), elibangela i-AIDS, liphinde lenze umonakalo omkhulu emiphakathini eyinkimbinkimbi kanye neyodwa. Igciwane lingabangela izinhlobo ezihlukahlukene ze-neuropathy, ngamunye ehlotshaniswa kakhulu nesigaba esithile sesifo esisebenzayo se-immunodeficiency. I-polyneuropathy esheshayo, ebuhlungu ehamba phambili echaphazela izinyawo nezandla ngokuvamile iwuphawu lokuqala lwe-HIV lokutheleleka.
Izifo zamabhaktheriya ezifana nesifo seLyme, i-diphtheria, nechoko zibhekene nomonakalo omkhulu wezinzwa zomzimba.
- i-diphtheria nechoko e-US ayivamile.
- Isifo se-Lyme sisanda. Isifo se-Lyme singabangela izinkinga eziningi ze-neuropathic, kuhlanganise ne-polyneuropathy ekhulayo, ephuthumayo, ngokuvamile emasontweni ambalwa ngemva kokutheleleka kokuqala ngokulunywa umuthi.
Ukutheleleka kwama-viral kanye nama-bacteria kungabangela ukulimala komzimba ngokuqondile ngezimo ezivusa ukubhekwa njengezifo ezizimele, lapho amaseli akhethekile namasosha omzimba omzimba ahlasela izicubu zomzimba. Lokhu kuhlaselwa kubangela ukubhujiswa komgogodla we-myelin noma i-axon.
Ezinye ze-neuropathies zibangelwa ukuvuvukala okuvela emisebenzini yamasosha omzimba kunokuba umonakalo oqondile yizidalwa ezithathelwanayo.
I-neuropathies yokuvuvukala ingathuthuka ngokushesha noma kancane, futhi amafomu angapheli angabonisa indlela yokwenza okunye ukubuyiswa nokuphindaphinda.
- I-Guillain-Barré syndrome (i-neuropathy evuvukalayo ekhubaza kakhulu) ingalimaza imishini, izinzwa, kanye nokuzimela komzimba. Iningi labantu lilulama kule syndrome nakuba amacala amakhulu angasongela ukuphila.
- Ukuphefumula okungapheliyo kwe-polyneuropathy (i-CIDP) okuvuthayo okungajwayelekile okuvamile okungeyona ingozi kakhulu, ngokuvamile kulimaza imizwelo yezinzwa nezisithuthuthu, futhi kushiya izinzwa ezizimele.
- I-multifocal motor neuropathy yindlela yokuvuvukala kwegazi okuthinta amagciwane kuphela; kungase kube okungapheli noma okunamandla.
I-Neuropathies Elingenayo: I- peripheral neuropathies ezuzwa ngefa elibangelwa yizipho ezizalwa ngama-gene in the genetic code noma ngokushintshashintsha kwezakhi zofuzo.
- Ezinye iziphambeko zofuzo ziholela ezincane ze-neuropathies ezinezimpawu eziqala lapho umuntu esemdala futhi kubangele ukukhubazeka okuncane.
- I-neuropathies ye-hereditary eyingozi kakhulu ibonakala ivela ebuntwaneni noma ebuntwaneni.
I-neuropathies ezuzwa kakhulu njengefa liyiqembu lezinkinga ezibizwa ngokuthi yi-Charcot-Marie-Tooth isifo (okubangelwa yiziphambeko ezakhiweni zofuzo ezithintekayo ekukhiqizeni i-neurons noma emgodleni we-myelin). Izimpawu zihlanganisa:
- Ukucindezela ngokweqile nokwehla kwemisipha emilenzeni nasezinyaweni eziphansi
- Yenza okungavamile
- Ukulahlekelwa kwe-tendon reflexes
- Ubumbulu emlenzeni ophansi
Ukwelapha
Ayikho imithi yokwelashwa ekhona manje engayiphulukisa i-neuropathy ye-peripheral neuropathy. Kodwa-ke, kunezindlela zokwelashwa kwezinye izinhlobo eziningi. Nakhu amaphuzu ayisihluthulelo ekwelapheni kwesifo se-neuropathy.
- Noma yisiphi isimo esisezingeni esivame ukuphathwa kuqala, kulandelwa ukwelashwa okuphawulekayo.
- Izinzwa zomzimba zinekhono lokuvuselela, uma nje iseli lesisindo singakaze libulawe.
- Izimpawu ngokuvamile zingalawulwa, futhi ukuqeda izimbangela zezinhlobo ezithile ze-neuropathy ngokuvamile kungavimbela umonakalo omusha.
- Izinguquko ezinempilo nemikhuba enempilo ngokuvamile zidala izimo ezikhuthaza ukuvuselelwa kwezinzwa.
- Ukwelapha okwesikhashana ukulimala kungasiza ekuvimbeleni umonakalo unomphela.
Ngokuvamile, ukwelashwa kwe-peripheral neuropathy kuhilela ukwamukela imikhuba enempilo ukunciphisa imiphumela engokomzimba nengokomzwelo, njengokuthi:
- Ukugcina isisindo esihle
- Gwema ukuvezwa kwezidakamizwa
- Ukulandela uhlelo lokuvivinya umzimba oluqondiswa udokotela
- Ukudla ukudla okulinganiselayo
- Ukulungisa ukwehluleka kwamavithamini
- Ukulinganisa noma ukugwema ukusetshenziswa kotshwala
Ezinye izindlela zokwelashwa kwe-peripheral neuropathy zihlanganisa:
- Ukuzivocavoca: izinhlobo ezisebenzayo zokuzivocavoca zinganciphisa ama-cramps, zithuthukise amandla omzimba, futhi zivimbele ukulahleka kwemisipha ezinyangeni ezikhubazekile.
- Ukudla kanye nokudla: amasu ahlukene okudla angathuthukisa izimpawu zamathumbu.
- Yeka ukubhema: ukuyeka ukubhema kubalulekile ikakhulukazi ngoba ukubhema kubamba imithwalo yegazi enikeza izakhi emiphakathini yomzimba futhi kungadala izimpawu ze-neuropathic.
- Amakhono okuzinakekela: Amakhono okuzinakekela, njengokunakekelwa kwezinyawo ngokucophelela nokuphathwa ngokucophelela kwezilonda kubantu abanesifo sikashukela nabanye abakwazi ukuzwa ubuhlungu, banganciphisa izimpawu futhi bathuthukise izinga lokuphila.
Izifo Ezivamile
Izifo zesimiso ngokuvamile zidinga ukwelashwa okuyinkimbinkimbi. Ukulawulwa okuqinile kwamazinga weglucose wegazi kuye kwaboniswa ukunciphisa izimpawu ze-neuropathic futhi kusiza abantu abane-neuropathy yesifo sikashukela ukuba bagweme ukulimala komzimba.
Izimo ezivuthayo nezizimele eziholela ku-neuropathy zingalawulwa ngezindlela eziningana ezibandakanya izidakamizwa ze-Immunosuppressive ezifana nalezi:
- I-Prednisone
- I-Cyclosporine (i-Neoral, i-Sandimmune)
- Imuran (Azathioprine)
I-Plasmapheresis: I- Plasmapheresis-inqubo lapho isuswe khona igazi, ihlanzwa amasosha omzimba omzimba namagciwane, bese ibuyela emzimbeni-ingaqeda ukuvuvukala noma ukucindezela umsebenzi wesistimu omzimba. Ukuphakama okuphezulu kwama-immunoglobulins, amaprotheni asebenza njengama-antibodies, nawo angakwazi ukuvimbela umsebenzi ongajwayelekile wesivikeli somzimba.
Ukukhululwa Kwesihlungu : Ubuhlungu be-neuropathic ngokuvamile kubukhuni ukulawula. Ngezinye izikhathi ubuhlungu obukhulu bunganciphisa ama-analgesics athengiswa phezu kwe-counter. Izigaba eziningana zezidakamizwa ziye zaba usizo ezigulini eziningi ezibhekene nezinhlobo ezimbi kakhulu zobuhlungu obungapheli be-neuropathic. Lokhu kufaka:
- I-Mexiletine, izidakamizwa ezisungulwe ukulungisa izimo zenhliziyo ezingavamile (ngezinye izikhathi zihambisana nemiphumela emibi kakhulu)
- Izidakamizwa eziningana zokulwa ne-Neurontin (gabapentin), i-Lyrica (pregabalin), i-phenytoin ne-carbamazepine
- Amanye amakilasi we-anti-depressants kuhlanganise ne-tricyclics njenge-amitriptyline (Elavil, Endep)
Ama-injection we-anesthetics yendawo, njenge-lidocaine noma ama-patches angama-topical aqukethe i-lidocaine, anganciphisa ubuhlungu obungenakwenzeka kakhulu.
Ezimweni ezinzima kunazo zonke, odokotela bangaphazamisa izinzwa; Nokho, imiphumela yilezi zesikhashana futhi inqubo ingabangela izinkinga.
Amadivaysi ezokusiza: Izinsiza zeMechanical nezinye izinto zokusiza zingasiza ukunciphisa ubuhlungu nokunciphisa umthelela wokukhubazeka ngokomzimba.
- Ukukhishwa kwesandla noma unyawo kungakhokha amandla obuthakathaka noma ukunciphisa ukucindezelwa kwesisindo.
- Izicathulo ze-Orthopedic zingathuthukisa ukuphazanyiswa kwe-gait futhi zisize ukuvimbela ukulimala kwezinyawo kubantu abalahlekelwa ukuzwa ubuhlungu.
- I-ventilation ye-mechanical ingahlinzeka ngokusekelwa kokuphila okubalulekile uma ukuphefumula kuba nokukhubazeka kakhulu.
Ukwelashwa: Ukungenelela kokuhlinzwa ngokuvamile kunganikeza usizo olusheshe luvela kuma-mononeuropathies abangelwa ukulimala noma ukulimala kokungena.
- Ukulungiswa kwediski ehlisiwe kunganciphisa ingcindezi emisipha lapho ivela khona emthonjeni womgogodla
- Ukususwa kwezicubu ezinobungozi noma ezinobungozi kunganciphisa ukucindezeleka okulimazayo emithonjeni.
- Ukuvuthwa kwegazi ngokuvamile kuvunyelwe ukukhululwa kwezigulane noma izintambo.
> Umthombo:
> I-NIH Publication No. 04-4853