Amekae nye Ahɔhɔ̃ŋutinunyala? Mina míakpɔe ɖa!

Ðewohĩ èse wò ɖɔkta gblɔ be ehiã be yeayi ‘ahɔhɔ̃ŋutinunyala’ gbɔ. Alo ɖewohĩ èse ŋkɔa eye nèbia ɖokuiwò be, "Oo, ɖɔkta ka ƒomevie nye ema?" Le nyateƒe me la, togbɔ be aɖi nya sesẽ aɖe hã la, ame siawo wɔa akpa vevi aɖe ŋutɔ. Egbea, mina míaƒo nu tso amesi tututu ahɔhɔ̃ŋutinunyala nye kple alesi woate ŋu akpe ɖe wò lãmesẽ ŋui ŋu.

Amekae nye Ahɔhɔ̃ŋutinunyala? Kpuie ko la,...

Kpuie ko la, ahɔhɔ̃ŋutinunyala nye lãmesẽdɔwɔla si bi ɖe wò lãmekawo ƒe dɔwɔwɔ me, vevietɔ eƒe elektrikŋusẽ ƒe dɔwɔwɔ. Ema fia be woléa ŋku ɖe wò ahɔhɔ̃, aklã (lãmeka si le wò akɔta me), kple lãmeka bubuwo le dɔ wɔm nyuie hã. Woate ŋu awɔ dodokpɔ vovovowo atsɔ akpe ɖe wo ŋu woanya nɔnɔme siwo ate ŋu ado ƒome kple lãmekawo.

Bu eŋu kpɔ, míaƒe ŋutilã le abe mɔ̃ si gɔme sese sesẽ ŋutɔ ene. Mɔ̃ sia ƒe mɔ̃ si dzi wokpɔnae nye lãmekawo ƒe dɔwɔwɔ . Nusianu si nèsusu, nusianu si nèsena le ɖokuiwò me, nusianu si nèwɔna – tso asi ʋuʋu dzi va ɖo wò dzi ƒe tsotso dzi – la, lãmeka siae kpɔa ŋusẽ ɖe edzi. Eyata ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala kpena ɖe mía ŋu míekpɔnɛ be kuxi aɖe le ɖoɖo sia ŋu kple alesi wòwɔa dɔe hã.

Vovototo kae le ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala kple ahɔhɔ̃ŋutinunyala dome?

Esia nye nusi tɔtɔa ame geɖe. Ahɔhɔ̃ŋutinunyala nye ahɔhɔ̃ŋutinunyala bibi aɖe .

Bu eŋu ale, ahɔhɔ̃ŋutinunyala nye ɖɔkta si xɔ hehe geɖe le nusianu si ku ɖe wò lãmekawo ŋu – eƒe wɔwɔme si sɔ, eƒe dɔwɔwɔ, kple nɔnɔme siwo kpɔa ŋusẽ ɖe edzi. Woawoe nye amesiwo dea dzesi ahɔhɔ̃mekawo ƒe dɔlélewo hedaa wo zi geɖe.

Ahɔhɔ̃ŋutinunyala nye ahɔhɔ̃ŋutinunyala si bi ɖe lãmekawo ƒe *dɔwɔwɔ* me, si nye alesi wòwɔa dɔe. Wowɔa dodokpɔ vovovowo tsɔ dzidzea dɔwɔwɔ ma eye wodzroa dodokpɔa me tsonu me.

Nu vevitɔ kekeakee nye be zi geɖe la, ahɔhɔ̃ŋutinunyala meɖoa aɖaŋu be woada ahɔhɔ̃mekawo ƒe dɔlélewo o. Ahɔhɔ̃ŋutinunyala aɖee wɔa ema . Gake ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala ate ŋu akpe ɖe ame ŋu ŋutɔ le nusi tututu dɔlélea nye nyanya me, ne míagblɔe bubui la, le dɔlélea didi nyuie me .

Nuka tututue ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala wɔna?

Nɔnɔme siwo gblẽa nu le wò lãmekawo ƒe dɔwɔwɔ ŋu koŋue ahɔhɔ̃ŋutinunyala dea dzesii hedaa wo kpɔna. Dodokpɔ vovovowo koŋue wozãna tsɔ ŋlɔa elektrikŋusẽ si le wò lãmekawo me la ɖi.

Ahɔhɔ̃ŋutinunyala ƒomevi eve koŋue li:

1. Amekoko ƒe ahɔhɔ̃ŋutinunyalawo

2. Dɔnɔdzikpɔƒe ƒe Ahɔhɔ̃ŋutinunyalawo

Dɔ siwo wo ame evea siaa wɔna la to vovo vie. Ahɔhɔ̃ŋutinunyala aɖewo hã wɔa dɔ le numekuku me wu.

Amekoko ƒe Ahɔhɔ̃ŋutinunyalawo

Abe alesi ŋkɔa ɖee fia ene la, ame siawo nye amekolawo ƒe ƒuƒoƒoa me tɔwo. Wowɔa dɔ kplikplikpli ŋutɔ kple amekolawo abe atikewɔla siwo naa alɔ̃dɔdɔ kple ahɔhɔ̃mekawo ƒe amekolawo ene.

Le amekoko me la, ahɔhɔ̃ŋutinunyala sia léa ŋku ɖe wò lãmekawo ŋu heléa ŋku ɖe eŋu. Le amekoko si ƒomevi wole wɔwɔm nu la, ŋkuléle ɖe amekolawo ŋu sia ate ŋu akpe ɖe amekolawo ŋu be woaɖe kuxi sesẽwo abe lãmetutudɔ, tosese, alo ʋusɔgbɔdɔ ene ƒe afɔkua dzi akpɔtɔ. Woyɔa esia be ahɔhɔ̃mekawo ƒe dɔwɔwɔ dzi kpɔkpɔ le dɔwɔwɔ me (IONM) .

Amekoko siwo me ame siawo kpɔa gome le zi geɖe dometɔ aɖewoe nye:

• Amekoko le aklã me .
• Ahɔhɔ̃ ƒe amekoko ƒomevi aɖewo.
• To, ŋɔti, kple ŋɔti ƒe dɔwɔwɔ aɖewo (ENT ƒe dɔwɔwɔ).
• Dɔwɔwɔ na lãmeka siwo le gota.
• Ʋukawo ƒe dɔwɔwɔ, abe Carotid Endarterectomies kple Thoracic-Abdominal Aortic Aneurysms (TAAA) ene.

Esiawo nye dodokpɔ kple ŋkuléle ɖe nu ŋu ƒe ɖoɖo siwo wozãna le amekoko me la dometɔ aɖewo:

• `SSEP (Somatosensory Evoked Potentials)`: Esia bia be nàna elektrikŋusẽ sue aɖe nana lãmeka aɖe si le gota le wò alɔnu alo afɔ me. Emegbe edzidzea alesi wò ahɔhɔ̃, lãmeka, alo aklã wɔa nui ɖe eŋu. Wozãnɛ zi geɖe le aklãdɔ, ahɔhɔ̃ kple lãmeka siwo le gota ƒe amekoko aɖewo me.
• `TCeMEP (Transcranial Electrical Motor Evoked Potentials)`: Dodokpɔ sia bia be nàtsɔ elektrikŋusẽ awɔ dɔ ɖe wò ahɔhɔ̃ ƒe ``Motor Cortex`` dzi eye nàŋlɔ alesi wò aklã alo lãmeka siwo le wò abɔwo me wɔa nui ɖe eŋu. Wozãa esia zi geɖe le aklãdɔdada hã me.
• ``BSEP (Ahɔhɔ̃ ƒe Tosese Evoked Ŋutetewo)'':Esia bia be nàna nàse gbeɖiɖi aɖe, zi geɖe la, "click" to tomekawo dzi, eye nàlé ŋku ɖe alesi wò ahɔhɔ̃meka wɔa nui ŋu. Esia kpena ɖe ame ŋu wòléa ŋku ɖe ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋu eye wòkpɔa tosese ta le amekokowo me be woaɖe dɔdzẽwo abe gbeɖiɖi ƒe ahɔhɔ̃mekawo kple ahɔhɔ̃mekawo ƒe dɔdzẽwo ɖa.
• EEG (Electroencephalogram): Esia ŋlɔa ahɔhɔ̃a ƒe dzɔdzɔme elektrikŋusẽ ƒe dɔwɔwɔ ɖi. Wozãnɛ tsɔ xea mɔ na nusiwo gblẽ le ʋu ƒe agbɔsɔsɔ si dzi ɖe kpɔtɔ le ahɔhɔ̃a me (ischemia) le amekokowo abe Carotid Endarterectomies kple Aneurysm clippings ene me, eye woléa ŋku ɖe ahɔhɔ̃mekawo ƒe dɔwɔwɔ kple "lãmesẽ" ŋu.

Dɔnɔdzikpɔƒe ƒe Ahɔhɔ̃ŋutinunyalawo

Ame siawo wɔa dɔ kplikplikpli kple ahɔhɔ̃ŋutinunyalawo kple ahɔhɔ̃ŋutinunyalawo. Wodaa wò lãmekawo ƒe dɔwɔwɔ kpɔna eye wokpɔa lãmekawo kple ahɔhɔ̃mekawo ƒe nɔnɔmewo. Le wò nɔnɔmea nu la, woate ŋu awɔ dodokpɔ siawo le kɔdzi alo esime nèle kɔdzi.

Dodokpɔ siwo ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala siwo le kɔdzi zãna dometɔ aɖewoe nye esi:

• EMG (Electromyography): Esia doa wò ƒunukpeƒeŋusẽwo kpakple lãmeka siwo kpɔa wo dzi ƒe lãmesẽ kple dɔwɔwɔ kpɔna. Ate ŋu akpe ɖe ame ŋu woanya dɔléle geɖe, siwo dometɔ aɖewoe nye Peripheral Neuropathy, Carpal Tunnel Syndrome, Muscular Dystrophy, kple Amyotrophic Lateral Sclerosis (ALS).
• Lãmetsiŋusẽ Ŋuti Numekuku (NCS): Esia doa alesi wò lãmeka siwo le gota le dɔ wɔm nyuie la kpɔna. Ate ŋu anya ne lãmeka aɖe si le gota la gblẽ kple afisi wòkaka ɖo. Zi geɖe la, wowɔa EMG kple NCS dodokpɔawo siaa ɖekae.
• EEG (Electroencephalogram): Esia bia be nàtsɔ elektrikŋusẽnamɔ̃ suewo abla wò ta eye nàŋlɔ elektrikŋusẽ si tso ahɔhɔ̃mekawo me la ɖi. Wozãnɛ tsɔ dea dzesi nɔnɔmewo abe alɔ̃madɔmadɔ kple nu vovovo siwo mesɔ o le lãmekawo ƒe dɔwɔwɔ me.
• Evoked Potential Test: Dodokpɔ siawo dzidzea elektrikŋusẽ ƒe dɔwɔwɔ le wò ahɔhɔ̃ kple aklã ƒe akpa vovovowo le nusi doa ŋusẽ ame ƒe ŋuɖoɖo me. Esia ate ŋu aɖe alesi lãmekawo ƒe dzesiwo zɔa mɔ kabakaba eye wozɔna keŋkeŋ yia ahɔhɔ̃a gbɔe afia. Esiawo ƒomevi vovovowo li, abe Brainstem Auditory Evoked Response (BAER), Visual Evoked Potential (VEP), kple Somatosensory Evoked Potential (SEP) ene.
• Alɔ̃dɔdɔ Ŋuti Nusɔsrɔ̃ / Polysomnography:Wowɔa esia to alesi wò ŋutilã ƒe dɔwɔɖoɖo vovovoawo (abe dzi, gbɔgbɔ, kple ahɔhɔ̃ ƒe dɔwɔwɔ ene) le dɔ wɔm esime nèle alɔ̃ dɔm la ŋɔŋlɔ ɖi atraɖii me. Esia le vevie ŋutɔ na alɔ̃dɔdɔ ƒe kuxiwo didi.

Ðe ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala dea atikewɔsukua?

Ẽ, keŋkeŋ! Ahɔhɔ̃mekawo ŋuti nunyala nye ɖɔkta. Wodea atikewɔsuku be nunya sia nasu wo si.

Aleke ame awɔ azu ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala?

Be ame nazu ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala le kɔdzi la, ele be wòawu hehenana kple hehenana ƒe afɔɖeɖe siawo nu:

• Ele be nàwu ƒe ene ƒe hehexɔxɔ do ŋgɔ na atikewɔwɔ nu le kɔledzi alo yunivɛsiti gbã eye nàxɔ Dzesidede.
• Le ema megbe la, ele be nàsrɔ̃ nu ƒe ene le atikewɔsuku eye nàxɔ ``Doctor of Medicine - MD'' alo ``Doctor of Osteopathic Medicine - DO'' ƒe ɖaseɖigbalẽ.
• Ele be nàwu ƒe ɖeka ƒe dɔsrɔ̃ƒe le atikewɔwɔ na amewo katã me nu.
• Emegbe le ɖoɖoa nu la, ele be nàwu ahɔhɔ̃ŋutinunya ƒe ɖoɖo aɖe me nɔnɔ nu , si ate ŋu anɔ anyi ƒe ene.

Ame aɖewo, le afima nɔnɔ sia megbe la, yia hadede ƒe ɖoɖowo me be yewoakpɔ nunya deto geɖe wu le ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunya ƒe akpa aɖe koŋ me. Le kpɔɖeŋu me, woate ŋu awɔ dɔ tɔxɛ le nusiwo nye asrãdɔ, ahɔhɔ̃mekawo ƒe dɔlélewo, kple alɔ̃dɔdɔ ƒe kuxiwo me.

Eyata ne ɖɔkta aɖe susui be ahɔhɔ̃medɔ aɖe le ŋuwò, alo ne wokpɔ dɔléle aɖe le ŋuwò xoxo la, ahɔhɔ̃ŋutinunyala ate ŋu anye wò lãmesẽnyawo gbɔ kpɔha me tɔ. Wonye woƒe dɔa ŋuti nunyalawo, eye wonya dodokpɔ yeye siwo ate ŋu ada wò lãmekawo ƒe dɔwɔwɔ kpɔ nyuie. Mègahe ɖe megbe gbeɖe le nyawo biabia wò ahɔhɔ̃ŋutinunyala ŋu o. Wole afima be yewoakpe ɖe ŋuwò.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Enyo, eyata mina míalé ŋku ɖe nu vevi aɖewo siwo dzi wòle be nàɖo ŋkui tso nusiwo ŋu míeƒo nu tsoe me ŋu:

• Ahɔhɔ̃ŋutinunyala nye eŋutinunyala bibi aɖe si srɔ̃a nu tso alesi wò lãmeka siwo dome wò ahɔhɔ̃, aklã, kple lãmekawo le, wɔa dɔe ŋu. Wowɔa dodokpɔ vovovowo tsɔ kpena ɖe ame ŋu be woanya dɔlélewo.
• Zi geɖe la, ahɔhɔ̃ŋutinunyalae naa atike, gake ahɔhɔ̃ŋutinunyala wɔa akpa gã aɖe le dɔlélea didi nyuie me.
• Ame siawo zãa dodokpɔ tɔxɛ vovovowo (e.g., `EEG`, `EMG`, `NCS`, `Evoked Potentials`) tsɔ kpɔa lãmekawo ta tso nusiwo agblẽ le amekoko me ŋu eye woatsɔ akpɔ ahɔhɔ̃mekawo ƒe dɔlélewo le atikewɔnyawo me.
• Ne ɖɔkta gblɔ na wò be nàyi ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala gbɔ la, efia be wodi be yewoalé ŋku ɖe wò lãmekawo ƒe dɔwɔwɔ ŋu tsitotsito.Mègavɔ̃ o, akpe ɖe ŋuwò nàkpɔ atike nyuitɔ.
• Bia wò ɖɔkta faa nya ɖesiaɖe si le asiwò, eɖanye wò dodokpɔwo alo wò nɔnɔmea ŋu o. Gome le asiwò be nànya nusianu nyuie.

Mele mɔ kpɔm be fifia èse amesiwo nye ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala kple nusi wowɔna gɔme nyuie wu. Ne nya bubu aɖewo gale asiwò la, kpɔ egbɔ be yeƒo nu kple wò ɖɔkta.

` Ahɔhɔ̃ŋutinunya, Ahɔhɔ̃ŋutinunyala, Lãmetsiŋusẽŋutinunya, Ahɔhɔ̃ dodokpɔwo, Ahɔhɔ̃mekawo ƒe dɔlélewo didi, EEG, EMG, Amekoko ƒe ŋkuléle ɖe ame ŋu