Ðe wò ahɔhɔ̃ kple wò aklã me kuxiwo le fu ɖem na wò zi ɖekaa? Mina míasrɔ̃ nu tso ADEM (Acute Disseminated Encephalomyelitis) ŋu!

Èse nya `ADEM` (Acute Disseminated Encephalomyelitis) ŋu nya kpɔa? Esia ate ŋu anye nu yeye na wò. Enye dɔléle si mebɔ o, si fia be edzea ame ʋɛ aɖewo ko dzi, gake ate ŋu ava kpata eye wòagblẽ nu le míaƒe lãmekawo ŋu. Mègatsi dzi o, míaƒo nu tso eŋu bɔbɔe, le mɔ si gɔme nàte ŋu ase nu.

Nukae nye ADEM? Mina míase egɔme bɔbɔe.

Kpuie ko la, ADEM nye míaƒe Central Nervous System ƒe dɔdzẽ alo vuvu kpata – si nye ahɔhɔ̃ kple aklã. Bu eŋu ale, abe alesi ne míexɔ abi , míaƒe ŋutilã vuvu ene, gake le go sia me la, vuvu le ahɔhɔ̃a kple aklã ƒe akpa aɖewo.

Dzoxɔxɔ sia ate ŋu agblẽ nu le ametakpɔnu si ƒo xlã míaƒe lãmekawo ŋu . Woyɔa akɔtaɖonu sia be myelin ƒe akɔta . Ele abe aŋe si wotsɔ tsyɔ elektrikka ŋu ene. Ekpena ɖe gbedasiwo ŋu wozɔna to lãmekawo dzi kabakaba. Eyata ne myelin- kplu sia gblẽ la, lãmekawo ƒe gbedasiwo mezɔna nyuie o. Ɣemaɣie dzesi vovovowo dzena. Ðɔkta aɖewo hã yɔa nɔnɔme sia be "demyelinating" nɔnɔme.

Nya "acute" le ADEM me fia be edzɔna zi ɖeka, zi ɖeka . Zi geɖe la, zi ɖeka koe wòdzɔna le ame ƒe agbe me. Gake ƒã hafi wòate ŋu adzɔ be wòagadzɔ ake.

Aleke gbegbee esia bɔe?

Le nyateƒe me la , ADEM nye nɔnɔme si mebɔ kura o . Numekukuwo ɖee fia be le dukɔ abe Amerika ene me la, edzena le ame siwo ade miliɔn eve kple afã ɖesiaɖe me. Eyata, esia menye dɔléle si dzea amesiame dzi o.

Nukae nye nɔnɔme sia ƒe dzesiwo?

Zi geɖe la , ADEM ƒe dzesiwo dzena le ŋkeke ʋɛ aɖewo le dɔlékui alo dɔlékui ƒe dɔléle xɔxɔ vɔ megbe . Dzesi siawo ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ, eye woanɔ te ɖe afisi dɔdzẽa le le ahɔhɔ̃a alo aklã me hã dzi.

Dzesi siwo bɔ dometɔ aɖewoe nye:

• Asrã
• Taɖuame.
• Aɖuɖɔtoe alo ʋuʋudedi
• Tɔtɔ
• Ɖeɖiteameŋu

Tsɔ kpe ɖe eŋu la, dzesi siwo do ƒome kple lãmekawo ate ŋu anye:

• Afɔ kple afɔwo ƒe ʋuʋu alo ʋuʋudedi
• Nu mimi sesẽ
• Nukpɔkpɔ ƒe bu alo eƒe ʋuʋu (optic neuritis) .
• Lãmetsiwo ƒe gbɔdzɔgbɔdzɔ
• Azɔlizɔzɔ sesẽ
• Alɔ̃madɔmadɔ

Abe alesi nàte ŋu akpɔe ene la, dzesi siawo kple woƒe sesẽme ate ŋu ato vovo ŋutɔ tso ame ɖeka gbɔ yi bubu gbɔ . Ame aɖewo ate ŋu akpɔ dzesi siwo nu mesẽ kura o, evɔ ame bubuwo ya ate ŋu agblẽ nu le wo ŋu vevie wu.

Nukatae esia dzɔna ɖo? Nukawoe hea ADEM vɛ?

Womenya nusi tututu gbɔ ADEM tso haɖe o . Gake numekukuwo ɖee fia be ne dɔlékui alo dɔlékui aɖe ge ɖe míaƒe ŋutilã me la, míaƒe dɔlélenutsiŋutete wɔa avu kplii. Gake le amesi ŋu ADEM le gome la, dɔlélenutsiŋutete dzea eya ŋutɔ ƒe lãmekawo ƒe akpa aɖewo dzi vodadatɔe . Ele abe amedzidzedze eya ŋutɔ me tɔwo dometɔ ɖeka ene, esusu be futɔe. Amedzidzedze sia si wowɔ vodadatɔe la hea dɔdzẽ (vuvu) si míeyɔ va yi vɛ, si emegbe hea dzesiawo vɛ.

Wokpɔe be ame siwo xɔa ADEM la dometɔ 70% va ɖo 80% xɔa dɔlékui alo dɔléle hafi ADEM ƒe dzesiwo dzena. Zi geɖe la, ADEM ƒe dzesiwo dzea egɔme le ŋkeke 7 va ɖo 14 le dɔlélea xɔxɔ vɔ megbe. Dɔlékui siwo bɔ dometɔ aɖewo siwo ate ŋu ado ƒome kple ADEM dometɔ aɖewoe nye:

• Dzamezã alo Dzamezã
• Aɖuɖɔtoedɔ
• Mumps ƒe dɔléle
• Rubella ƒe ŋkɔ
• Koklozi ƒe dɔléle
• Epstein Barr dɔlékui aɖe
• Dɔlékui si nye Cytomegalovirus
• Herpes simplex dɔlékui (`Herpes simplex dɔlékui`) .

Togbɔ be wogblɔ be dɔlékui vovovowo, dɔlékuiwo, kple dɔlékui bubuwo do ƒome kple ADEM hã la, edze abe menye dɔlékuiwutike ɖeka pɛ hã gbɔe wòtso o ene.

Nyitsɔ laa la, wokpɔe be nu bubu si hea ADEM vɛ, vevietɔ le ɖeviwo gome, enye Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). Wobua esia hã be enye dɔlélenutsiŋutete ƒe dɔléle. Esia fia be ŋutilãa ŋutɔ ƒe dɔlélenutsiŋutete dzea eya ŋutɔ ƒe lãmekawo dzi. MOGAD sia hã ate ŋu ahe ADEM vɛ ɣeaɖewoɣi.

Amekawoe le afɔku gã me be woaxɔ ADEM?

Ame sia ame ate ŋu axɔ ADEM. Gake ebɔ vie le ɖeviwo me wu ame tsitsiwo . Azɔ hã, ne dɔlékui aɖe dze dziwò nyitsɔ laa la, afɔku si le eme be nàxɔ ADEM ate ŋu asɔ gbɔ vie.

Nukawoe nye kuxi siwo ate ŋu ado tso ADEM me?

ADEM ate ŋu ahe kuxi aɖewo vɛ, siwo dometɔ aɖewoe nye:

• Ŋkuɖodzinu ƒe dɔmawɔmawɔ nyuie
• Sidzedze ƒe dɔwɔwɔ si tsi megbe
• Coma

Ƒã ŋutɔ la, ADEM ƒe dzesiwo ate ŋu ade ame ƒe agbe afɔku me ne wova nu sẽ. Gake ema mebɔ kura o .

Dzesi aɖewo ate ŋu anɔ ame aɖewo ŋu siwo anɔ anyi le atikewɔwɔ vɔ megbe gɔ̃ hã:

• Taɖuame sesẽ.
• Gbɔdzɔgbɔdzɔ
• Kuxi le ɖoɖowɔwɔ ɖe nu ŋu me
• Nukpɔkpɔ si me mekɔ o

Aleke wowɔna dea dzesi ADEM?

Ne ADEM ƒe dzesiwo le ŋuwò la, ɖɔkta aɖe aŋlɔ wò dɔlélea ŋutinya tsitotsito, abia wò dzesiwo, eye wòado ahɔhɔ̃mekawo kpɔ , awɔ ŋutilãmedɔdada bliboa, kple dodokpɔ bubu geɖe atsɔ anya ne ADEM le ŋuwò hã.

Wowɔa dodokpɔwo hã tsɔ léa ŋku ɖe nɔnɔme bubu siwo le eme, abe MOGAD ene, siwo ate ŋu anɔ ADEM hem vɛ ŋu. Dodokpɔ siwo bɔ tsɔ dea dzesi ADEM dometɔ aɖewoe nye ʋudodokpɔ kple:

• MRI-dɔdamɔnu aɖe
• Aɖuɖɔtoe me tsi dodokpɔ

Nukae MRI dodokpɔ dia?

MRI (Magnetic Resonance Imaging) nye nɔnɔmetatawo ɖeɖe ƒe mɔnu tɔxɛ aɖe si ate ŋu adi tɔtrɔwo le ahɔhɔ̃a ƒe gogloƒe ke. Ðɔktawo dia abi alo teƒe siwo ADEM hena vɛ le lãmekawo ƒe akpa vevi etɔ̃: ahɔhɔ̃, aklã, kple ŋku ƒe lãmekawo.

• White matter : Afi siae myelin tsyɔ lãmekawo ƒe kawo le. Esiawo dzena ɣie le MRI me.
• Grey matter : Lãmetsiŋusẽ ƒe lãmenugbagbeviwo ƒe ŋutilã le esia me. Wodzena viviti le MRI me elabena myelin mele wo me o.

Ɣleti ʋɛ aɖewo le MRI gbãtɔ wɔwɔ vɔ megbe la, ɖɔkta ate ŋu abia be woagawɔ MRI bubu be yeakpɔ alesi teƒe siawo trɔna le ɣeyiɣi aɖe megbe.

Nukae wodia le aklã me tsi dodokpɔ me?

Wogayɔa esia be akɔta ƒe ʋuʋu . Esia nye dodokpɔ vevi aɖe si wowɔna tsɔ dia nusi gbɔ ahɔhɔ̃mekawo ƒe dzesiwo tsona. Ebia be nàno wò ahɔhɔ̃mekawo me tsi (CSF) ƒe agbɔsɔsɔ sue aɖe. CSF nye tsi si me kɔ, si me amadede mele o, si ƒoa xlã wò ahɔhɔ̃ kple wò aklã, kpɔa eta, eye wònaa nunyiame.

Le ADEM me la, ʋumenugbagbevi ɣiwo , vevietɔ ʋumenugbagbevi dzĩwo, ƒe xexlẽme dzina ɖe edzi le ahɔhɔ̃mekawo me tsia me . Lãmenugbagbevi siawo nye míaƒe dɔlélenutsiŋutete ƒe akpa siwo le dɔ wɔm. Wozãa CSF ƒe kpɔɖeŋu sia tsɔ kpɔa alesi lãmenugbagbevi siawo wɔa nui ɖe dɔlékui alo dɔlékui siwo wosusu be woawoe le ADEM hem vɛ ŋu, eye woatsɔ akpɔ ahɔhɔ̃mekawo ƒe dɔléle bubuwo hã.

Nukawoe nye atike siwo wozãna na ADEM?

Taɖodzinu vevitɔ si le ADEM dada ŋue nye be woaɖe dɔdzẽ si le ahɔhɔ̃ kple aklã me dzi akpɔtɔ . Woate ŋu azã atikewɔmɔnu siwo gbɔna:

• Steroid-tikewoSteroid-tikewo: Atike gbãtɔ si wozãna na ADEM enye steroid siwo wodona ɖe ʋuka me (IV). Woate ŋu ado esia ɖe ʋuka me ŋkeke geɖe. Emegbe woate ŋu ana steroid-tike siwo woano wò ŋkeke ʋɛ aɖewo.
• Intravenous immunoglobulin (IVIG) : Esia nye atike si me dɔlékuiwutike siwo wowɔ tso ʋumenugbagbevi dzĩ me le. Wotsɔa esia hã naa ʋuka aɖe.
• Plasma exchange (alo plasmapheresis): Esia bia be nàxɔ wò ʋu aɖe, atsɔe ato mɔ̃ aɖe si ɖea akpa siwo nana wò dɔlélenutsiŋutete gbɔdzɔna la dometɔ aɖewo ɖa, eye emegbe nàgatsɔe ade wò ŋutilã me. Dɔdamɔnu sia ate ŋu axɔ gaƒoƒo geɖe eye woate ŋu awɔe zi geɖe.

Numekukuwo yi edzi le nu geɖe srɔ̃m tso nɔnɔme sia ŋu eye wole atike yeyewo dim.

Ðo ŋku edzi be wò ɖɔktae ɖoa atikewɔwɔ siawo. Atia nusi nyo na wò nɔnɔmea.

Ðe atikewɔmɔnu siawo ƒe nugbegblẽ le ame ŋu aɖewoa?

Abe alesi wòle le atikewɔwɔ ɖesiaɖe gome ene la, nugbegblẽ aɖewo ate ŋu ado mo ɖa.

Zi geɖe la, ɣeyiɣi kpui aɖe ƒe steroid zazã ƒe nugbegblẽ le ame ŋu nɔa anyi ɣeyiɣi kpui aɖe, gake woate ŋu anye:

• Sukli ƒe agbɔsɔsɔ si le ʋu me ƒe dzidziɖedzi
• Potassium ƒe agbɔsɔsɔ dzi ɖe kpɔtɔ
• Alɔ̃dɔdɔ sesẽ
• Seselelãme ƒe tɔtrɔ (dzikudodo, avifafa, dzimaɖitsitsi) .
• Kpekpeme ƒe dzidziɖedzi
• ŋgonu ƒe dzodzro
• Ga vivi aɖe sese le nu me

`IVIG` dɔdamɔnu ƒe nugbegblẽ le ame ŋu kple kuxi siwo dona tso eme :

• Nulɔdɔ ƒe dɔléle
• Dɔlékuiwo
• Yagbɔgbɔ sesẽ
• Ʋu ƒe sisi
• Ayikuwo ƒe gbegblẽ
• Taɖuame.

Kuxi siwo dona tso Plasmapheresis me :

• Dzimadzeme
• Ʋu si le dodom
• Dɔlékuiwo
• Ayikuwo ƒe gbegblẽ
• Ʋu si mesɔ gbɔ na ŋutilã ƒe akpa aɖe o (`Ischemia`) .

Ðo dze kple wò ɖɔkta tso nugbegblẽ le ame ŋu siawo ŋu. Zi geɖe la, woate ŋu akpɔ wo dzi.

Ɣeyiɣi didi kae wòxɔna hafi wòhayana le atikewɔwɔ vɔ megbe?

Ame akpa gãtɔ siwo ŋu ADEM da dɔ na la dzea egɔme ƒe lãme sẽna le ŋkeke ʋɛ aɖewo megbe tso esime woda dɔa nɛ . Gake le alesi wò dzesiawo nu sẽe nu la, ate ŋu axɔ ɣleti ade hafi wòahaya keŋkeŋ. Ƒã ŋutɔ hafi ame aɖewo mate ŋu ahaya keŋkeŋ o. Ke hã, ame akpa gãtɔ hayana nyuie.

Ðe mɔ aɖe li si dzi woato axe mɔ ɖe ADEM nua?

Mɔ aɖeke meli koŋ si dzi woato axe mɔ ɖe ADEM nu o. Gake àte ŋu aɖe wò afɔkua dzi akpɔtɔ ne èwɔ dzadzɛnyenye ƒe nɔnɔme nyuiwo be nàƒo asa na dɔlékuiwo kple dɔlékuiwo ƒe dɔlékuiwo (le kpɔɖeŋu me, asikɔklɔ enuenu kple tete ɖa tso dɔnɔwo gbɔ).

Nukae nye mɔkpɔkpɔ na ADEM? Ðe woate ŋu adaea?

Ame akpa gãtɔ siwo ŋu ADEM le la hayana keŋkeŋ alo wohayana keŋkeŋ kloe le atikewɔwɔ vɔ megbe.Ne dɔdzẽa nu sẽ ŋutɔ la, ƒã hafi ate ŋu ade ame ƒe agbe afɔku me. Wò ɖɔkta ate ŋu ana nàkpɔ wò nɔnɔmea nyuie wu.

Zi geɖe la, zi ɖeka koe ADEM ƒe dzesiwo dzena , gake ate ŋu agadzɔ ake le nusi gbɔ wòtso nu (abe MOGAD ene). Zi geɖe la, ADEM nu yina ne wowɔ atike nɛ, gake dzesiawo ate ŋu agadze ake. Ame akpa gãtɔ ƒe agbenɔƒe sɔ.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne dzesi siwo ɖi ADEM tɔ le ŋuwò, vevietɔ le dɔléle aɖe xɔxɔ vɔ megbe la , kpɔ egbɔ be yeyi ɖɔkta gbɔ. Zi alesi wokpɔe kaba la, zi nenemae woate ŋu adze atikewɔwɔ gɔme kaba.

Nya vevi siwo wòle be nàbia wò ɖɔkta

Ne wokpɔe be ADEM le ŋuwò la, àte ŋu abia nya siawo wò ɖɔkta:

• Aleke wòle be madzra ɖo ɖe dodokpɔawo ŋu?
• Atikewɔwɔ ka ƒomevie nèkafu?
• Nukawoe nye atikewɔwɔa ƒe nugbegblẽ le ame ŋu?
• Ðe nye dzesiawo anɔ anyi le atikewɔwɔ vɔ megbea?

Enye nusi sɔ be nàtsi dzimaɖi ahavɔ̃ ne kasia nèkpɔ dzesiwo abe azɔlizɔzɔ ƒe ŋutetemanɔamesi, ŋku ƒe ŋkumeʋuʋu, alo alɔ̃madɔmadɔ si womenya o ene. Wò atikewɔlawo ƒe ƒuƒoƒoa akpe ɖe ŋuwò nànɔ te ɖe esia nu. Dɔdamɔnu aɖewo ate ŋu axɔ ŋkeke ʋɛ aɖewo alo gaƒoƒo ʋɛ aɖewo gɔ̃ hã. Le ɣeyiɣi sia me la, xlẽ agbalẽ aɖe alo wɔ nane si ana wò dzi nadze eme. Ðo ŋku edzi be esia nye nusi dzɔna zi ɖeka na ame akpa gãtɔ, gake ate ŋu adzɔ ake.

Nya kpui siwo dzi wòle be míaɖo ŋkui

• ADEM nye ahɔhɔ̃ kple aklã ƒe dɔdzẽ kpata.
• Esia mebɔ kura o eye zi geɖe la, edzɔna le dɔlékui aɖe xɔxɔ vɔ megbe.
• Wosusui be esia dzɔna ne mía ŋutɔwo ƒe dɔlélenutsiŋutete dze lãmekawo dzi vodadatɔe.
• Dzesiawo to vovo eye woate ŋu anye asrã, taɖuame , lãmetutudɔ, ŋku ƒe kuxiwo, kple azɔlizɔzɔ sesẽ.
• Wotoa MRI kple aklã me tsi dodokpɔ koŋ dzi dea dzesii.
• Dɔdamɔnu aɖewo li abe steroid, IVIG, kple plasma exchange ene.
• Ame akpa gãtɔ hayana nyuie, gake woƒe hayahaya blibo ate ŋu axɔ ɣleti geɖe.
• Togbɔ be mɔ aɖeke meli si dzi woato axe mɔ ɖe enu o hã la, ele vevie be nàkpɔ ɖokuiwò ta tso dɔlékuiwo me.

Mele mɔ kpɔm be nyatakaka sia akpe ɖe ŋuwò. Ne nya bubu aɖewo gale asiwò la, mègaŋlɔ be be yeaƒo nu kple ɖɔkta o.