I-Myasthenia Gravis, i-Lambert-Eaton, ne-Botulism
Uma ucabangela izimbangela zobuthakathaka, kuyasiza kakhulu ukuqagela umyalezo kagesi wokudubula kusukela e-cortex yobuchopho kuze kube semisipha. Njengoba sisendleleni, umfutho uhambela intambo yomgogodla uphondo lwangaphakathi , ngaphandle kwezimpande zesisu somgogodla, phansi kwezinzwa ze-peripheral , futhi ekugcineni uye ekuhlanganiseni kwe-neuromuscular.
Ihlanganiso ye-neuromuscular yilapho isignali kagesi ibangela ukuthi ama-neurotransmitter akhishwe kuma-vesicles ekugcineni kwesibindi (esibulalayo).
I-neurotransmitters iwela igebe elincane phakathi kwesiguli se-nerve (i- synapse ) nombuso wesisipha (i-endplate). Ukulinda ama-transmitter ngakolunye uhlangothi wegebe yi-receptors ekhethekile efanelana nomthumeli njengesikhiye esikhiye. Uma kunesifanele, i-cascade of ions iholela ekuqanjeni kwemisipha.
I-neurotransmitter ejwayele ukubonisa phakathi kwesisindo nesisulu i-acetylcholine. Kunezindlela eziningana ukuthi lokhu kudlula kwe-acetylcholine neurotransmitter phakathi kwe-nerve ne-muscle cTan kungaphazanyiswa. Izibonelo ezintathu ezinhle kunazo zonke i- myasthenia gravis , i-Lambert-Eaton syndrome, kanye nobuthi be-botulinum.
I-Myasthenia Gravis
Njengoba kunesisindo esiphakathi kwabantu abangu-150 kuya ku-200 ngesigidi, i-myasthenia gravis iyisifo esivame kakhulu sezinkinga ze-neuromuscular, futhi enye yezinto ezizwakala kahle kuzo zonke izifo ze-neurological. Lesi sifo sibangela ubuthakathaka bemisipha ngenxa yokuvimbela i-neurotransmitter receptors emisipha.
Ama-antibodies ngokuvamile ahlose ukuhlasela izifo ezihlaselayo iphutha i-acetylcholine receptors ye-pathogen nokuhlasela. Ukuzivocavoca kuvame ukukwenza ubuthakathaka bubi nakakhulu. Phakathi kwamaphesenti angu-60 kuya kwangu-70 abantu abane-myasthenia gravis banenkinga nge- thymus , futhi amaphesenti angu-10 kuya kwangu-12 anesifo sakho se-thymoma. Ezinye izinhlobo zokwelashwa ziyatholakala.
I-Lambert-Eaton Myasthenic Syndrome (LEMS)
ULambert-Eaton uvame ukubizwa ngokuthi i- paraneoplastic syndrome , okusho ukuthi ama-antibodies ahlobene nomdlavuza nawo ahlasele ingxenye yesimiso sezinzwa. Ngokungafani ne-myasthenia gravis, lapho izakhiwo ezihlaselwe zikhona emisipha, inkinga ku-LEMS iwukuphela kwesibindi semoto. Amashaneli ka-calcium avame ukuvula futhi aveze ukukhululwa kwama-neurotransmitters, kodwa akakwazi ukwenza kanjalo ku-LEMS ngoba ama-antibodies ahlasele isiteshi. Ngenxa yalokho, akukho-neurotransmitter ekhishwayo, futhi isiguli sibhekene nobuthakathaka ngoba imisipha ayikwazi ukuthola isignali yokuthola inkontileka. Ngokuzivocavoca okuphindaphindiwe, ukungaphumeleli kunganqotshwa; ngakho-ke nge-LEMS, izimpawu ngezinye izikhathi ziphuthuma kancane ngokuzikhandla okuphindaphindiwe.
I-Botulism
Ngezinye izikhathi umuthi we-botulinum usetshenziselwa ngamabomu odokotela ukuphoqa imisipha ukuba iphumule ezimweni ze- dystonia . Ngefomu layo elingenalutho, i-toxin ikhiqizwa amabhaktheriya futhi ingabangela ukukhubazeka okuqala ngemisipha yobuso nomphimbo bese wehla phezu komzimba wonke. Njengezinye izinkinga zomhlangano we-neuromuscular, lokhu kungaba yisimo esiphuthumayo sezokwelapha esidinga ukuthungathwa . I-toxin yokuhlasela amaprotheni evumela ama-vesicle agcwele ama-neurotransmitter ngaphakathi kwe-neuron yangaphambi kwe-synaptic ukugodla ekupheleni kwesibindi ngaphambi kokufaka isikhala phakathi kwesibindi nesisundu.
Ukwelashwa yisifo sokulwa ne-botulinum toxin, okufanele sinikezwe ngokushesha ngangokunokwenzeka.
Okunye Neuromuscular Junction Disorders
Izidakamizwa ezithile, njenge-penicillamine nezinye izisimanje, azikwazi ukudala ukusabela okuzenzakalelayo okulinganisa i-myathenia gravis. Iminye imithi eminingi ingaba yingozi noma idale inkinga kumuntu osenayo i-myasthenia gravis.
Ukuhlola Izifo Ze-Neuromuscular Junction
Ngaphandle kokuhlolwa kwangokwenyama, isinyathelo sokuqala ekutholeni isifo sohlanganiso lwe-neuromuscular i- electromyogram nesifundo sokuqhutshwa kwesisindo. Lezi azikwazi nje ukuhlukanisa phakathi kwe-myasthenia gravis, ubuthi be-botulinum, neLambert-Eaton kodwa futhi zingasiza ukulawula ezinye izifo ezifana ne-motor neuron, kuhlanganise ne-amyotrophic lateral sclerosis.
Ukuphazamiseka kombuthano we-neuromuscular kungaba yingozi kakhulu, okudinga ukuthungula nokuphuza umoya ukuze kusize ukuphefumula uma ubuthakathaka buba nzima kakhulu. Izindlela zezinkinga zihluke kakhulu, zidinga ukwelashwa okuhlukile. Ukuxilongwa ngokufanele yisinyathelo sokuqala sokuthola amandla nokuphepha.
Imithombo:
I-Ropper AH, ama-Samuels MA. Adams kanye Nemigomo kaVictor ye-Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
I-Hal Blumenfeld, i-Neuroanatomy ngokusebenzisa Izimo Zemitholampilo. I-Sunderland: Abakwa-Sinauer Associates Publishers 2002.