Mina míasrɔ̃ nu tso lãmekawo ƒe gbɔdzɔgbɔdzɔ si wodzina (Congenital Myasthenic Syndrome - CMS) ŋu .

Ède dzesii kpɔ be ɖeɖi tea ɖevi sue aɖe ŋu kabakaba, ne ele fefem alo le dɔ suewo wɔm gɔ̃ hã, eye wòsena le eɖokui me abe ɖe ŋusẽ mele yewo ŋu o enea? Ðe nèsena le ɖokuiwò me ɣeaɖewoɣi be esesẽna be yeaɖu nu, aƒo nu, alo agbã ŋku gɔ̃ hãa? Ne dzesiwo abe esiawo ene le ŋuwò la, ateŋu atso lãmeka ƒe gbɔdzɔgbɔdzɔ si wodzina si ŋu míele nu ƒom tsoe egbea, si woyɔna be `(Congenital Myasthenic Syndrome)` alo `(CMS)` kpuie. Mègatsi dzi o, mina míaƒo nu tso esia ŋu tsitotsito, bɔbɔe ŋutɔ.

Nukae nye `(Vidzidzi ƒe Myasthenic Dɔléle - CMS)`?

Kpuie ko la, `(CMS)` nye nɔnɔmewo ƒe ƒuƒoƒo si nɔa anyi le vidzidzi me. Nu vevitɔ si dzɔna le esia mee nye be lãmekawo gbɔdzɔna le kamedede me, si fia ne wole nane wɔm. Nya ``dzidzime`` gɔmee nye ``dzidzime.''

Bu eŋu kpɔ, ne míewɔa kamedede nenema zi geɖe la, esɔ be ɖeɖi te mía ŋu vie. Gake le amesi ŋu `(CMS)` le gome la, ne ewɔ nu sue aɖe gɔ̃ hã, abe azɔlizɔzɔ alo fefe ene la, lãmekawo gbɔdzɔna eye wòsesẽna be woayi dɔwɔna ma dzi. Gake ne èdzudzɔ dɔ ma wɔwɔ eye nèɖi ɖe eme vie la, eganyona ɖe edzi vie.

Nɔnɔme sia gblẽa nu le mo ƒe lãmekawo ŋu wu . Eyae nye lãmeka siwo míezãna tsɔ ɖua nu, mimi, kple ŋkumeʋuʋu. Ateŋu akpɔ ŋusẽ ɖe lãmeka bubuwo hã dzi (míeyɔa esiawo be ``ƒumelãwo``) siwo kpena ɖe mía ŋu míeʋuʋuna hezɔna.

Dzesiawo ate ŋu anɔ bɔbɔe ŋutɔ na ame aɖewo, eye woate ŋu asẽ ŋutɔ na ame bubuwo. Le nɔnɔme sesẽwo me la, ate ŋu ade ame ƒe agbe afɔku me, vevietɔ ne egblẽ nu le lãmeka siwo kpena ɖe ŋuwò nègbɔa ya ŋu.

Afisi gbedasi si le lãmekawo kple lãmekawo dome tɔtɔ le!

Míaƒe lãmekawo nɔa te ɖe gbedasi siwo tso lãmekawo gbɔ dzi wɔa dɔ. Abe alesi wòhiãna be woatrɔ asi le akaɖi ŋu ene la, nenema ke lãmeka hã hiã na lãmeka ƒe gbedasi hafi wòate ŋu awɔ dɔ. Teƒe tɔxɛ aɖe li si lãmekawo kple lãmekawo ƒe lãmenugbagbevi siawo doa go hedoa ka kple wo nɔewo le. Ðɔktawo yɔa esia be ``neuromuscular junction''. Bu eŋu abe tɔdzisasrã sue aɖe si tsɔa gbedasiwo yia teƒe bubuwo ene.

Nusi dzɔna ɖe amesi ŋu `(CMS)` le dzi enye be kuxi aɖe le tɔdzisasrã ma ŋu, eyata gbedasi siwo tso lãmekawo ƒe lãmenugbagbeviwo gbɔ yi lãmeka ƒe lãmenugbagbeviwo gbɔ metoa eme nyuie o. Esia tae lãmekawo mewɔa dɔ nyuie o eye wogbɔdzɔna ɖo.

Ðe `(CMS)` ƒomevi aɖewo lia?

Ẽ, ``(CMS)`` nɔnɔme sia ƒomevi vevi geɖewo li. Ðɔktawo ɖoa esiawo ɖe hatsotsowo me le afisi tututu kuxia le le ``neuromuscular junction`` si megblɔ va yi, si nye teƒe si lãmeka kple lãmeka doa go le nu.

Ƒomevi etɔ̃ koŋue li:

1. Presynaptic congenital myasthenic syndrome: Kuxia le lãmekawo ƒe lãmenugbagbevi si ɖoa gbedasia ɖa la me.

2. Synaptic congenital myasthenic syndrome dzɔna le teƒe si le lãmeka ƒe lãmenugbagbevi kple lãmeka ƒe lãmenugbagbevi dome:Kuxi si le afisiae nye dometsotso ma si le abe tɔdzisasrã ene.

3. Postsynaptic congenital myasthenic syndrome: Kuxi si le esia me le lãmeka ƒe lãmenugbagbevi si xɔa gbedasia la me.

Gawu la, le ƒomevi siawo dometɔ ɖesiaɖe me la, ƒomevi sue bubuwo li siwo wotu ɖe nusiwo gblẽ le ƒunukpeƒea ƒe akpa aɖewo koŋ dzi, abe ``basal lamina'' alo ``acetylcholine receptor'' ene. Esiawo nye atikewɔwɔ me nya siwo gɔme sese sesẽ vie, gake susu aɖe si me kɔ wue nye esi.

Aleke gbegbee `(CMS)` ƒe nɔnɔme sia bɔe?

Le nyateƒe me la, CMS nye nɔnɔme si mebɔ kura o. Nyatakaka geɖe meli ku ɖe alesi wòbɔe ŋu o. Numekuku aɖe si wowɔ le Eŋlisiawo me ɖee fia be edzea ɖevi siwo mexɔ ƒe 18 haɖe o dometɔ siwo ade 9 le miliɔn ɖesiaɖe me.

Vovototo kae le `(CMS)` kple `(Myasthenia Gravis)` dome?

Ðewohĩ èse dɔléle si nye ``Myasthenia Gravis.`` Dɔléle siawo evea siaa hea lãmekawo gbɔdzɔna le kuxi aɖe si le alesi lãmekawo ɖoa gbedasiwo ɖe lãmekawo ŋu ta. Gake vovototo gã aɖe le wo ame evea dome.

• (Congenital Myasthenic Syndrome - CMS): Esia nye domenyiŋusẽfianu ƒe dɔléle. Eyae nye be domenyiŋusẽfianu ƒe tɔtrɔ (`mutation`) si nɔa anyi le vidzidzi me gbɔe wòtsona.
• Myasthenia Gravis: Esia nye dɔléle si dɔlélenutsiŋutete ŋutɔ wɔna . Esia fia be míaƒe ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete dzea ahɔhɔ̃mekawo ƒe kadodoa dzi vodadatɔe.

Kpuie ko la, CMS nye "kuxi si le blueprint ŋu" (le domenyiŋusẽfianuwo me). Myasthenia Gravis nye "gɔmesese totro" le ŋutilã ƒe ametakpɔnu ŋu.

Nukae nye ame aɖe si ŋu `(CMS)` le ƒe dzesiwo?

Dzesiawo ate ŋu ato vovo vie le CMS ƒe ƒomevi nu, gake dzesi siwo bɔ wu dometɔ aɖewoe nye:

• Lãmetsiwo wɔa dɔ fũu akpa eye wogbɔdzɔna ne ɖeɖi te ŋuwò le ŋutilã me. Ðeɖi tea ŋuwò ne èwɔ dɔ vi aɖe gɔ̃ hã.
• Lãmetsiwo dzi ɖuɖu alo wo dzi ɖuɖu sesẽ .
• Ŋku ƒe ʋuʋudedi (si woyɔna hã be ptosis).
• Nukpɔkpɔ eve .
• Edze abe wohe ŋkua yi axa ɖeka ene (ŋku kuviatɔ).
• Nuƒoƒo sesẽ (gbe ate ŋu atrɔ, ate ŋu azu gbeɖiɖi).
• Nuɖuɖu mimi sesẽ.

Ne dzesi siawo dometɔ ɖeka alo esi wu nenema le ɖevi aɖe ŋu la, ele vevie ŋutɔ be wòadi atikewɔlawo ƒe aɖaŋuɖoɖo.

Ƒe nenie `(CMS)` ƒe dzesiwo dzea egɔme zi geɖe?

Zi geɖe la, CMS ƒe dzesiwo dzea egɔme tso ɖevimenɔɣi, le vidzĩme alo ɖevimenɔɣi . Ne viwòa le blewu le lãmekawo ƒe dɔwɔwɔ ƒe ŋutetewo tutuɖo me (le kpɔɖeŋu me, ewɔa blewu le tsatsam, tsitrenu, alo zɔzɔ me) la, esia ate ŋu anye nɔnɔmea ƒe dzesi.

Ke hã, `(CMS)` ƒomevi aɖewo ƒe dzesiwoAte ŋu adze emegbe vie hã, le kpɔɖeŋu me, le sɔhɛmenɔɣi alo emegbe le tsitsime gɔ̃ hã.

Nukae nye nusiwo gbɔ `(CMS)` tsona?

Abe alesi megblɔe va yi ene la, nusi koŋ gbɔ `(CMS)` tsona enye domenyiŋusẽfianu ƒe tɔtrɔ, si nye `(nutation).` Nusianu si le míaƒe ŋutilã me la, domenyiŋusẽfianuwoe kpɔa ŋusẽ ɖe edzi. Eyata, ne gbɔdzɔgbɔdzɔ aɖe le domenyiŋusẽfianu siwo fiaa mɔ protein siwo kpena ɖe gbedasiwo tsɔtsɔ tso lãmekawo me yia lãmekawo gbɔ ƒe dɔwɔwɔ me la, `(CMS)` nɔnɔme sia dzɔna.

Domenyiŋusẽfianu vovovowoe kpɔa gome le esia me. Kpɔɖeŋu ʋɛ aɖewoe nye esi:

• `(CHRNE)`
• `(RAPSN)`
• `(DZƆDZƆDZƆ)`
• `(COLQ)`
• `(DOK7)`

Domenyiŋusẽfianu siawoe fiaa mɔ lãmenugbagbeviwo be woawɔ protein siwo hiã na gbedasiwo ƒe asitɔtrɔ le ahɔhɔ̃mekawo ƒe ƒoƒoƒe. Ne `(mutation)` le domenyiŋusẽfianu siawo me, si nye tɔtrɔ la, lãmenugbagbeviawo mexɔa mɔfiameawo nyuie o. Emegbe gbedasi siwo to tɔdzisasrã ma dzi la va tɔtɔna. Emae nye nusi hea `(CMS)` ƒe dzesiwo vɛ.

Ðe wònye nane si tso `(CMS)` dzidzimea mea?

Ẽ, `(CMS)` nye nɔnɔme si woate ŋu anyi tso dzidzime yi dzidzime.

Zi geɖe la, wonyinɛ le ``autosomal recessive'' ƒe nɔnɔme me. Esia fia be hafi dɔlélea nadze ɖevi dzi la, ele be dzila ŋutɔŋutɔ eveawo siaa nanyi domenyiŋusẽfianu si gblẽ la dome. Ðewohĩ dzesiawo manɔ dzilawo ŋu o, gake woate ŋu anye amesiwo tsɔa dɔlélea.

Woate ŋu anyi CMS ƒomevi aɖewo hã ƒe dome le autosomal dominant ƒe ɖoɖo nu . Le nɔnɔme ma me la, ɖevi ate ŋu axɔ dɔlélea ne wonyi domenyiŋusẽfianu si gblẽ la ƒe dome tso dzila ŋutɔŋutɔ ɖeka ko gbɔ gɔ̃ hã .

Azɔ hã, ɣeaɖewoɣi la, ame ate ŋu axɔ CMS le nugbagbevi si trɔna le vome ta , ne dɔlélea medze ƒomea me kpɔ o gɔ̃ hã.

Amekae le afɔku gã me be wòaxɔ `(CMS)`?

Ame sia ame ate ŋu awɔ CMS. Gake ne dɔlélea le wò ƒomea me tɔ aɖe ŋu (ƒome ƒe ŋutinya si wodzi le nugbagbewo me) la, ele afɔku gã aɖe me be wò hã nàxɔe.

Nukae nye kuxi siwo `(CMS)` hena vɛ?

Nɔnɔme `(CMS)` ateŋu ahe kuxi vovovowo vɛ. Wo dometɔ aɖewoe nye:

• No nono alo nuɖuɖu sesẽ (vevietɔ le vidzĩwo gome).
• Lãmetsi siwo sesẽna .
• Heheɖemegbe le tsitsi ƒe nu vevi veviwo toto me (vevietɔ le lãmekawo ƒe dɔwɔwɔ ƒe ŋutetewo me).
• Azɔlizɔzɔ ƒe ŋutetemanɔamesi nyenye.
• Gbɔgbɔtsixe ƒe ɖiɖiɖeme ɣeaɖewoɣi (yagbɔgbɔgbɔ).
• Alɔ̃madɔmadɔ ( fit-like ) .
• Susu ƒe nuwɔametɔnyenye - Esia medzɔna ɖe amesiame dzi o, ɖe ƒomevi aɖewo ko dzi.
• Lãmetsiŋusẽ ƒe dɔléle (ahɔhɔ̃mekawo ƒe dɔléle).
• Lãmetsiŋusẽ ƒe dɔmawɔmawɔ nyuie .

Menye kuxi siawo katãe dzɔna ɖe amesiame dzi o. Enɔ te ɖe CMS ƒomevi, eƒe sesẽme, kple alesi atikewɔwɔa kpɔ dzidzedzee dzi.

Aleke woawɔ ade dzesi `(CMS)` ƒe nɔnɔme?

Ðɔkta aɖe akpɔ CMS to ŋkuléle ɖe ŋuwò nyuie kple dodokpɔwo wɔwɔ le wò lãmekawo ŋu me. Abia nu tso wò dzesiwo ŋu eye wòaxɔ atikewɔwɔ ŋutinya blibo (abe nenye be dɔléle sia nɔ wò ƒomea me dometɔ aɖe ŋu ene).

Ne èsusu be CMS le ye ŋu la, wò ɖɔkta ate ŋu abia tso asiwò be nàwɔ kamedede sue aɖewo le ye ŋkume (le kpɔɖeŋu me, atrakpuiwo lialia) be nàkpɔ alesi wò ŋutilã awɔ nui.

Tsɔ kpe ɖe eŋu la, woate ŋu awɔ dodokpɔ aɖewo atsɔ aɖe nɔnɔme bubu siwo ate ŋu ahe dzesi mawo tɔgbe vɛ la ɖa:

• Ʋudodokpɔwo .
• Nerve conduction study - Dodokpɔ si dzidzea gbedasiwo ƒe duƒuƒu to lãmekawo me.
• Electromyography (EMG) - Dodokpɔ si dzidzea lãmekawo ƒe elektrikŋusẽ ƒe dɔwɔwɔ.

Domenyiŋusẽfianu dodokpɔ na `(CMS)`

Domenyiŋusẽfianu dodokpɔ nye dodokpɔ vevi aɖe ŋutɔ hena CMS didi. Ekpena ɖe ame ŋu be nànya domenyiŋusẽfianu ƒe tɔtrɔ si koŋ le wò dzesiwo hem vɛ. Wò ɖɔkta aɖe wò ʋu sue aɖe eye wòado DNA si le eme la akpɔ. CMS ƒomevi si le ŋuwò kple afisi kuxia le le ahɔhɔ̃mekawo ƒe kadodoa me nyanya ate ŋu akpe ɖe wò ɖɔkta ŋu wòawɔ ɖoɖo ɖe wò atikewɔwɔ ŋu.

Aleke wowɔa nu ɖe ​​`(CMS)` ŋui?

Fifia la, atike aɖeke meli na CMS o. Gake atikewɔmɔnu aɖewo li siwo ate ŋu akpe ɖe ame ŋu wòaɖu dzesiawo dzi eye wòana agbea nanɔ bɔbɔe.

Zi geɖe la, wozãa atikewo tsɔ léa lãmekawo ƒe dɔwɔwɔ ɖe te alo nyona ɖe edzi. Wò ɖɔkta ate ŋu aŋlɔ atikewo abe:

• Cholinergic agonists (e.g. pyridostigmine, amifampridine alo 3,4-diaminopyridine).
• Ʋu mɔxenu siwo xea mɔ na mɔ̃wo (e.g. fluoxetine alo quinidine).
• Adrenergic agonists (e.g. salbutamol alo ephedrine).

Vevietɔ: Mègazã atike siawo gbeɖe atikewɔlawo ƒe aɖaŋuɖoɖo manɔmee o. Azɔ hã, menye atikewo katãe wɔa dɔ na `(CMS)` ƒomevi ɖesiaɖe o. Eyata dɔlélea didi nyuie kple atikewɔlawo ƒe aɖaŋuɖoɖo hiã vevie.

Togbɔ be kamedede ate ŋu ana dzesiawo nagagblẽ ɖe edzi hã la, wò ɖɔkta ate ŋu aɖo wò ɖe kamededeŋutinunyala gbɔ.Kpɔ kamedede kple dɔwɔna siwo le dedie, fafa, eye wosɔ na wò ɖa. Esiawo akpe ɖe ame ŋu be lãmekawo nagasẽ o eye woalé lãmesẽ nyui me ɖe asi.

Ðewohĩ ahiã hã be ame aɖewo nazã mɔ̃ siwo kpena ɖe ame ŋu atsɔ awɔ gbesiagbedɔwo. Le kpɔɖeŋu me, bunɔkeke zazã ate ŋu akpe ɖe mía ŋu míaxe mɔ ɖe afɔkuwo nu eye wòana wòanɔ bɔbɔe be woazɔ mɔ.

Ðe atikeawo ƒe nugbegblẽ le ame ŋu aɖewo lia?

Abe atike ɖesiaɖe ene la, atike siwo wozãna na `(CMS)` ateŋu ahe nugbegblẽ aɖewo vɛ. Esiawo toa vovo le atike ƒomevi si wozãna nu. Nusiwo wògblẽna le ame ŋu zi geɖe dometɔ aɖewoe nye:

• Ƒodo ƒe ʋuʋu.
• Nulɔdɔ ƒe dɔléle.
• Yagbɔgbɔ ƒe kuxiwo.
• Dɔmetɔtrɔ.
• Ðeɖiteameŋu si gbɔ eme.
• Aɖuɖɔ alo fifia ƒe dzidziɖedzi.
• Nukpɔkpɔ trɔna.

Hafi nàdze atike ɖesiaɖe zazã gɔme la, ƒo nu tso nusiwo ate ŋu ado tso eme ŋu na wò ɖɔkta eye nànya nu tso eŋu nyuie. Emegbe àte ŋu awɔ nyametsotso siwo ŋu wonya nu tsoe le wò lãmesẽ ŋu.

Nukae nye mɔkpɔkpɔ na amesi ŋu `(CMS)` le? (Nyagblɔɖi) .

CMS ƒe dzesiwo toa vovo ŋutɔ tso ame ɖeka gbɔ yi bubu gbɔ. Dzesi siwo nu mesẽ kura o ate ŋu anɔ ame aɖewo ŋu siwo makpɔ ŋusẽ ɖe woƒe agbenɔnɔ dzi o. Ame bubuwo ate ŋu akpɔ dzesi sesẽ siwo ate ŋu ade woƒe agbe afɔku me, abe gbɔgbɔ sesẽ ene . Wò ɖɔkta ate ŋu ana nàkpɔ wò nɔnɔmea nyuie wu.

Ðe `(CMS)` kpɔa ŋusẽ ɖe agbenɔƒe dzia?

CMS ate ŋu akpɔ ŋusẽ ɖe wò agbenɔƒe dzi alo makpɔ ŋusẽ ɖe edzi o. Ne dzesi siwo mesẽ o le ŋuwò la, ɖewohĩ CMS makpɔ ŋusẽ gã aɖeke ɖe wò lãmesẽ bliboa dzi o. Gake ne dzesiawo gblẽ nu le lãmeka siwo kpɔa ŋusẽ ɖe wò gbɔgbɔ dzi la, ate ŋu akpɔ ŋusẽ ɖe wò agbenɔƒe dzi. Wò atikewɔlawo akpe ɖe ŋuwò nàkpɔ wò dzesiwo gbɔ be nàxe mɔ ɖe kuxi siwo ate ŋu ade wò agbe afɔku me nu.

Ðe woate ŋu axe mɔ ɖe `(CMS)` nua?

Vaseɖe fifia la, womekpɔ mɔnu aɖeke si woatsɔ axe mɔ ɖe ``(CMS)`` nɔnɔmea nu o.

Ne èle ɖoɖo wɔm be yeaɖo ƒome anyi la, àte ŋu ayi ɖɔkta gbɔ hena domenyiŋusẽfianu ŋuti aɖaŋuɖoɖo na wò be nànya nu geɖe tso afɔku si le vi si ŋu domenyiŋusẽfianu ƒe dɔléle le dzidzi me ŋu.

Azɔ hã, ne CMS le ŋuwò la, gblɔe na wò ɖɔkta ɣesiaɣi hafi nàdze atike yeye ɖesiaɖe zazã gɔme. Atike aɖewo (le kpɔɖeŋu me, dɔlékuiwutike aɖewo, dzidɔtikewo, kple tagbɔdɔlélawo ƒe atikewo) ate ŋu ana CMS ƒe dzesiwo nagagblẽ ɖe edzi. Ne edzɔ alea la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã atike bubuwo.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne wò alo viwòa le lãmekawo ƒe gbɔdzɔgbɔdzɔ (CMS) ƒe dzesiwo kpɔm le kamedede me la, yi ɖɔkta gbɔ enumake.

Na viwòaNe viwòa mete ŋu ɖua nu o alo wòhe ɖe megbe le eƒe tsitsi ƒe taɖodzinu veviwo gbɔ ɖoɖo me la, gblɔe na viwòa ƒe ɖɔkta.

Kpomenya! Ne gbɔgbɔ le sesẽm na ɖevia, alo ne ŋutigbalẽ, nuyiwo, alo asibidɛwo va zu blɔ eye woƒe amadede nye blɔ (`cyanosis`) la, ƒo ka na 911 enumake, alo nàkplɔ wo ayi kɔdzi si te ɖe eŋu ƒe dɔwɔƒe si kpɔa nudzɔdzɔ kpatawo gbɔ.

Nya kawoe wòle be mabia nye ɖɔkta?

Ne wokpɔe be CMS le ŋuwò alo viwòa vɔ la, nyabiase geɖe ate ŋu anɔ asiwò. Mègavɔ̃ be yeabia wò ɖɔkta tso wo ŋu o. Kpɔɖeŋu aɖewoe nye esi:

• `(CMS)` ka ƒomevie le vinye/vinye si?
• Atikewɔwɔ kawoe nèkafu?
• Nukawoe nye atike siawo ƒe nugbegblẽ le ame ŋu?
• Ne `(CMS)` le vinye ŋu la, ɖe wòate ŋu akpɔ gome le kamedefefe alo dɔwɔna bubuwo mea?

CMS ƒe dzesiwo mesɔ na amesiame o. Ɣeaɖewoɣi la, nuwo abe atrakpui lialia kple kamedede ene ate ŋu asesẽ vie. Wò ɖɔkta ate ŋu aɖo aɖaŋu na wò hã be nàzã kpekpeɖeŋunu siwo le abe bunɔkeke ene, be wòakpe ɖe ŋuwò nàxe mɔ ɖe anyidzedze alo abixɔxɔ nu.

Ðevi siwo ŋu wokpɔ dɔléle sia le ate ŋu axɔ ɣeyiɣi didi vie hafi woate ŋu abi ɖe tsitsi ƒe nu vevi veviwo me, vevietɔ lãmekawo ƒe dɔwɔwɔ abe azɔlizɔzɔ ene, ne wotsɔe sɔ kple ɖevi bubu siwo nye woƒe ƒemetɔwo. Ne ède dzesii be esia le dzɔdzɔm ɖe viwòa dzi la, ƒo nu kple wò ɖɔkta.

Mlɔeba la, nusiwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Togbɔ be Congenital Myasthenic Syndrome (CMS) nye dɔléle si mebɔ o si nana lãmekawo gbɔdzɔna si nɔa anyi le vidzidzi me hã la, ne wokpɔ dɔlélea nyuie hekpɔ egbɔ nyuie hã la, ame akpa gãtɔ ate ŋu anɔ agbe si sɔ.

• Nya dzesiwo: Lé ŋku ɖe nuwo abe ɖeviwo ƒe tsitsi ƒe megbetsitsi kple ɖeɖiteameŋu fũu akpa le kamedede me ŋu vevietɔ.
• Di atikewɔlawo ƒe aɖaŋuɖoɖo: Ne ɖikeke le ŋuwò la, ele vevie be nàyi ɖɔkta gbɔ be woakpɔ dɔlélea nyuie.
• Wɔ ɖe wò atikewɔwɔ dzi pɛpɛpɛ: Wɔ ɖe wò ɖɔkta ƒe mɔfiamewo kple atikewo dzi pɛpɛpɛ. Ne wokafu nuwo abe kamedede ene la, mègadzo le wo dzi o.
• Nɔ susu nyui me: Agbenɔnɔ kple nɔnɔme sia ate ŋu asesẽ, gake menye wò ɖeka koe o. Ðɔktawo, atikewɔlawo, kple ame vevi aɖewo li siwo ate ŋu akpe ɖe ŋuwò.

Wò atikewɔlawo ƒe ƒuƒoƒoae nye teƒe nyuitɔ si akpe ɖe ŋuwò nàse wò nɔnɔmea kple atikewɔmɔnu siwo sɔ na wò gɔme. Eya ta, mègavɔ̃ be yeabia wò nyawo ahagblɔ nusiwo ŋu nètsi dzi ɖo o.

` Congenital Myasthenic Syndrome, CMS, lãmekawo ƒe gbɔdzɔgbɔdzɔ, domenyiŋusẽfianu ƒe dɔlélewo, ahɔhɔ̃mekawo ƒe dɔlélewo, ɖeviwo ƒe dɔlélewo, vidzidzi ƒe gbɔdzɔgbɔdzɔ