Ðewohĩ mèse eŋutinunyala bibi aɖe si léa ŋku ɖe wò lãmeka siwo me wò ahɔhɔ̃, aklã, kple lãmeka siwo le wò ŋutilã katã me ƒe kadodo le la le dɔ wɔm nyuie hã ŋu nya o. Abe alesi eŋutinunyala bibi aɖe léa ŋku ɖe eŋu be ka siwo le wò aƒeme le dɔ wɔm nyuie hã, le kpuie le afi aɖe, alo ne elektrikŋusẽa le sue ene la, ɖɔkta sia hã léa ŋku ɖe wò ŋutilã ƒe "elektrikmɔ̃" ŋu. Egbea míele nu ƒom tso eŋutinunyala bibi sia, si nye Neurophysiologist ŋu.
Kpuie ko la, amekae nye Ahɔhɔ̃ŋutinunyala?
Ahɔhɔ̃ŋutinunyala nye eŋutinunyala bibi si srɔ̃a nu tso míaƒe lãmekawo ƒe dɔwɔwɔ ŋu, vevietɔ eƒe elektrikŋusẽ ƒe dɔwɔwɔ , eye wòwɔa dodokpɔwo hekpɔa dɔléle siwo do ƒome kplii.
Bu eŋu kpɔ, míaƒe ŋutilã nye mɔ̃ si gɔme sese sesẽ ŋutɔ. Mɔ̃ sia ƒe dzikpɔƒee nye lãmekawo ƒe dɔwɔwɔ. Eyae nye ahɔhɔ̃, aklã, kple lãmeka siwo tsɔa nyatakakawo yia ŋutilã bliboa me. Nuɖoanyi siae kpɔa ŋusẽ ɖe nusianu si tamesusu, sese le ɖokuiwò me, kple nusi nèwɔna dzi. Tso esime nèdo asi ɖe dzi va se ɖe esime wò dzi le ƒoƒom la, esia katã nye eƒe akpa aɖe.
Eyata ne kuxi aɖe le ɖoɖo sia ŋu, eɖanye nyatakakawo ƒe sisi ƒe kuxi alo elektrikŋusẽ ƒe dzesiwo ƒe kuxi o, ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala akpe asi ɖe eŋu woake ɖe eŋu.
Ahɔhɔ̃ŋutinunyala kple Ahɔhɔ̃ŋutinunyala - Vovototo kae le eve siawo dome?
Zi geɖe la, ŋkɔ eve siawo tɔtɔna le wo nɔewo dome. Wo ame evea siaa nye ɖɔkta siwo wɔa dɔ tso lãmekawo ƒe dɔwɔwɔ ŋu. Gake vovototo sue aɖe le wo dome. Mina míatsɔ kpɔɖeŋu aɖe ase esia gɔme.
Tsɔe be kuxi aɖe le akaɖi ƒe ɖoɖo si le wò aƒea me ŋu. Àƒo nu kple elektrikdɔwɔla si wɔa dɔ edziedzi gbã. Ate ŋu alé ŋku ɖe aƒea ƒe kaƒomɔ̃ bliboa ŋu, akpɔe ɖa be fuse la ku, switch la gblẽ, bulb la fiã, eye wòakpɔ nɔnɔmetata gã aɖe. Aleae Ahɔhɔ̃ŋutinunyala le. Enye ɖɔkta si si sidzedze geɖe le le lãmekawo ƒe akpa sia akpa, si nye eƒe wɔwɔme, dɔwɔwɔ, kple dɔléle siwo katã do ƒome kplii ŋu. Ahɔhɔ̃ŋutinunyala aɖe ŋlɔa wò atikewo na wò eye wòwɔa ɖoɖo ɖe wò atikewɔwɔ ŋu.
Azɔ bu eŋu kpɔ be kuxi sesẽ aɖe ŋutɔ li si ŋu elektrikdɔwɔla la mate ŋu ake ɖo o. Elektrikŋusẽ si le elektrikŋusẽa me dzi ɖena kpɔtɔna, edze abe tsi sue aɖe le dodom le afi aɖe ene. Emegbe ekplɔa ame aɖe si zãa mita tɔxɛwo, si nye elektrikŋusẽ ƒe sisi ŋuti nunyala bibi aɖe vɛ. Aleae Neurophysiologist le. Enye lãmekawo ƒe dɔwɔwɔ ŋuti nunyala bibi, vevietɔ le alesi elektrikŋusẽ ƒe dzesiwo zɔnae me. Nusi wòwɔnae nye be ewɔa dodokpɔ vovovowo, dzroa emetsonuwo me, eye wòkpɔa nusi tututu kuxia le le lãmekawo ƒe dɔwɔwɔ me.
Kpuie ko la, Ahɔhɔ̃ŋutinunyala dea dzesi dɔlélewo hedaa wo. Ahɔhɔ̃ŋutinunyala aɖe wɔa dodokpɔ tɔxɛwo eye wònaa nyatakaka vevi siwo hiã hena dɔléle ma didi. Gake zi geɖe la, womeŋlɔa atike na ame o.
Dɔ vevi eve siwo ahɔhɔ̃ŋutinunyala wɔna
Míate ŋu ama ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyalawo ɖe hatsotso vevi eve me, le alesi wowɔa dɔe nu.
1. Amesiwo wɔa dɔ le amekoko me (Surgical Neurophysiologists) .
2. Amesiwo dea dzesi dɔlélewo le atikewɔƒewo (Clinical Neurophysiologists) .
Mina míalé ŋku ɖe akpa si ame siawo dometɔ ɖesiaɖe wɔna ŋu ɖe vovo.
1. Akpa si Ahɔhɔ̃ŋutinunyala Wɔna le Amekoko Me
Esia nye nuto vevi aɖe ŋutɔ. Tsɔe be wole dɔ gã aɖe wɔm na ame aɖe le eƒe akɔta alo ahɔhɔ̃ ŋu. Ne amekolawo le dɔa wɔm la, ele be woalé ŋku ɖe lãmekawo ƒe gbegblẽ ŋu hã. Ne vodada sue aɖe gɔ̃ hã dzɔ la, ame ate ŋu azu lãmetututɔ, eƒe to megate ŋu sea nu o, alo ʋusɔgbɔdɔ.
Ɣemaɣie ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala aɖe va kpena ɖe amekoko ƒe ƒuƒoƒoa ŋu. Ezãa dɔwɔnu tɔxɛwo tsɔ léa ŋku ɖe dɔnɔa ƒe lãmekawo ƒe elektrikŋusẽ ƒe dɔwɔwɔ ŋu le dɔwɔwɔ nɛ katã me. Woyɔa esia be Intraoperative Neurophysiology Monitoring (IONM) . Ne lãmeka aɖe gblẽ vie gɔ̃ hã la, eƒe elektrikŋusẽ ƒe dzesiwo trɔna. Ne ahɔhɔ̃ŋutinunyala la kpɔ tɔtrɔ ma ko la, exlɔ̃a nu amekolaa. Emegbe amekolaa ate ŋu awɔ afɔɖeɖe siwo hiã hafi wòagblẽ nu le eŋu.
| Amekoko ƒomevi | Akpa si ahɔhɔ̃mekawo ƒe dɔwɔwɔ ŋuti nunyala wɔna |
|---|---|
| Amekoko le aklã me | Be woalé ŋku ɖe nusiwo gblẽ le aklãa kple lãmeka siwo dona tso eme ŋu hã. Be wòakpe ɖe ame ŋu wòaxe mɔ ɖe abɔ kple afɔ ƒe bublu nu. |
| Ahɔhɔ̃ ƒe dɔwɔwɔ | Be woakpɔe ɖa be ahɔhɔ̃a ƒe akpa vevi aɖewo, le kpɔɖeŋu me, akpa siwo do ƒome kple nuƒoƒo, nukpɔkpɔ, kple ʋuʋu, gblẽ hã. |
| To, ŋɔti, kple ŋɔti ƒe dɔwɔwɔ (ENT ƒe dɔwɔwɔ) . | Mɔxexe ɖe to ƒe dɔmawɔmawɔ nyuie nu le esi nusese ƒe lãmeka gblẽ ta, vevietɔ le to ƒe dɔwɔwɔ me. |
| Ʋukawo ƒe dɔwɔwɔ na ame | Ahɔhɔ̃ ƒe dɔwɔwɔ dzi kpɔkpɔ be woaxe mɔ ɖe nusiwo ʋu ƒe sisi yi ahɔhɔ̃a me dzi ɖeɖe kpɔtɔ hena vɛ nu (ischemia). |
2. Ahɔhɔ̃ŋutinunyala si wɔa dɔdamɔnu siwo wozãna tsɔ dia dɔlélewoe
Esiae nye Ahɔhɔ̃ŋutinunyala si míekpɔna zi geɖe, amesi míaƒe ɖɔkta ɖoa mí ɖo. Wole kɔdziwo alo atikewɔƒewo. Wowɔa dodokpɔ vovovowo tsɔ léa ŋku ɖe lãmekawo ƒe dɔwɔwɔ ŋu. Dodokpɔ siawo me tsonu dzie wò Ahɔhɔ̃ŋutinunyala anɔ te ɖo anya nɔnɔme si tututu le ŋuwò.
Esiawo nye dodokpɔ vevi siwo wowɔna la dometɔ aɖewo:
- EMG (Electromyography): Dodokpɔ sia léa ŋku ɖe wò lãmekawo ƒe lãmesẽ kple lãmeka siwo kpɔa wo dzi ŋu. Ne wò alɔnu le ʋuʋum, ʋuʋudedi, alo gbɔdzɔgbɔdzɔ le ŋuwò la, dodokpɔ sia ate ŋu akpe ɖe ŋuwò nànya nenye be lãmekaa ŋutɔ mee kuxia le loo alo lãmeka siwo naa wòe. Esia le vevie na dɔlélewo abe Carpal Tunnel Syndrome (lãmeka si le asibidɛ me si woƒo) kple Peripheral Neuropathy (lãmeka siwo gblẽ le abɔwo kple afɔwo ŋu le nɔnɔmewo abe suklidɔ ene ta) didi.
- NCS (Nerve Conduction Study): Esia dzidzea ɣeyiɣi didi si wòxɔna hafi elektrikŋusẽ ƒe dzesi aɖe zɔna to lãmeka aɖe dzi kple alesi wòzɔna kabakabae. Ne lãmeka aɖe gblẽ la, alesi dzesi ma zɔna kabakabae dzi ɖena kpɔtɔna. Zi geɖe la, wowɔa EMG kple NCS dodokpɔwo siaa ɖekae.
- EEG (Electroencephalogram): Ðewohĩ èse esia ŋu nya kpɔ. Esia bia be woatsɔ elektrikŋusẽnamɔ̃ suewo akpe ɖe ta ŋu eye woaŋlɔ ahɔhɔ̃a ƒe elektrikŋusẽ ƒe dɔwɔwɔ ɖi . Dodokpɔ sia le vevie ŋutɔ be woatsɔ anya nɔnɔmewo abe asrãdɔ ene eye woanya afisi ahɔhɔ̃a me nusi gbɔ wòtso.
- Evoked Potential Test: Esia bia be woana nusi doa ŋusẽ ame, abe kekeli ene, abe kekeli ene na ŋkuwo alo gbeɖiɖi na towo, eye woadzidze elektrikŋusẽ ƒe dɔwɔwɔ le ahɔhɔ̃a kple aklã me le esia ta. Eyae nye be edzidzea alesi nusi nèkpɔna kple wò ŋkuwo ɖoa ahɔhɔ̃a gbɔ kabakabae, kple alesi nusi nèsena kple wò towo ɖoa ahɔhɔ̃a gbɔ kabakabae.
- Alɔ̃dɔdɔ ŋuti nusɔsrɔ̃ (Alɔ̃dɔdɔ ŋuti nusɔsrɔ̃ / Polysomnography):Kuxiwo abe aɖuɖɔtoe, alɔ̃dɔdɔ, kple alɔ̃madɔmadɔ ene le ame aɖewo ŋu. Be woanya alɔ̃dɔdɔ ƒe kuxi siawo la, wotsɔa dɔnɔa dea kɔdzi eye woléa ŋku ɖe ŋutilã ƒe dɔwɔwɔ vovovowo (ahɔhɔ̃ ƒe ʋuʋu, gbɔgbɔ, kple dzi ƒe tsotso) ŋu zã bliboa. Ahɔhɔ̃ŋutinunyala aɖe hã wɔa esia.
Aleke woawɔ azu Ahɔhɔ̃mekawo Ŋuti Nunyala?
Esia nye mɔzɔzɔ didi ŋutɔ eye wotsɔ adzɔgbeɖeɖe. Ahɔhɔ̃mekawo ŋuti nunyala nye ɖɔkta. Eyata ele be nàŋlɔ ŋkɔ ɖe atikewɔsuku me gbã eye nàwu atikewɔwɔ ŋuti ɖaseɖigbalẽ (MD/MBBS) nu.
Ɣe ma ɣi:
- Ele be nàwu ƒe ɖeka ƒe dɔsrɔ̃ƒe nu.
- Le ema megbe la, ele be nàxɔ ƒe geɖe ƒe hehexɔxɔ le sukunuwuwu megbe (Residency/MD) hafi sidzedze tɔxɛ nasu asiwò le ahɔhɔ̃ŋutinunya me.
- Le hehe ma megbe la, àsrɔ̃ nu tso lãmekawo ƒe dɔwɔwɔ ŋu tsitotsito eye àxɔ hehe le dɔ tɔxɛ aɖe si woyɔna be Neurophysiology me.
Esia bia ɣeyiɣi, nusɔsrɔ̃, kple adzɔgbeɖeɖe geɖe.
Eyata ne wò ɖɔkta ɖo wò ɖa be woawɔ dodokpɔ abe EMG alo EEG ene la, fifia ènya be yeayi Ahɔhɔ̃ŋutinunyala gbɔ. Enye amesi alé ŋku ɖe wò lãmekawo ŋu tsitotsito eye wòakpe ɖe ŋuwò nànya wò nɔnɔmea nyuie wu. Eyata mègavɔ̃ o, bia nya alo nusiwo ŋu nètsi dzi ɖo la ɖɔkta ma. Wole afima be yewoakpe ɖe ŋuwò.
Gbedasi si Wotsɔ Yi Aƒeme
- Ahɔhɔ̃ŋutinunyala nye ɖɔkta si bi ɖe elektrikŋusẽ si le míaƒe lãmekawo (ahɔhɔ̃, lãmekawo) me.
- Ahɔhɔ̃ŋutinunyala daa ahɔhɔ̃mekawo ƒe dɔlélewo, gake ahɔhɔ̃ŋutinunyala ya kpena ɖe ame ŋu wòkpɔa dɔléle mawo to dodokpɔ tɔxɛwo (abe EMG, EEG ene) dzi.
- Le amekoko gãwo (aklã, ahɔhɔ̃) me la, ahɔhɔ̃ŋutinunyala ƒe kpekpeɖeŋu hiã vevie be woakpɔ egbɔ be lãmekawo megblẽ o.
- Ne woɖo wò be woawɔ dodokpɔ abe EMG, NCS, alo EEG ene la, Ahɔhɔ̃ŋutinunyala aɖe ado wò kpɔ. Mègavɔ̃ be yeabia yeƒe ɖɔkta tso eŋu o.
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