Nukae nye Parsonage-Turner Dɔléle? Ðe nèsea veve zi ɖeka le wò abɔta eye wò alɔnu le ʋuʋum?

Ðe nèfɔ le ŋdi me, alo le ŋkekea ƒe ɣeyiɣi ɖesiaɖe me, eye kasia nèse veve sesẽ aɖe le wò abɔta, tsɔ kpe ɖe wò alɔnu ƒe ʋuʋu kple gbɔdzɔgbɔdzɔ ŋu kpɔa? Ðewohĩ esia nɔ edzi yim ŋkeke alo kwasiɖa ʋɛ aɖewo, eye emegbe wò lãmekawo te gbɔdzɔgbɔdzɔ vivivi. Ne nuteƒekpɔkpɔ sia tɔgbe dzɔ ɖe dziwò kpɔ la, ele vevie ŋutɔ be nànya nɔnɔme sia si woyɔna be Parsonage-Turner Syndrome, si ŋu míele nu ƒom tsoe egbea.

Nuka tututue nye Parsonage-Turner Dɔléle?

Kpuie ko la, Parsonage-Turner Syndrome , si woyɔna ɣeaɖewoɣi be Brachial Neuritis , nye dɔléle si ku ɖe lãmekawo ŋu. Nusi dzɔnae nye be kasia nèse veve kpata, si màsusui o, si nu sẽ ŋutɔ le wò abɔta kple abɔta. Vevesese sia ate ŋu anɔ anyi ŋkeke geɖe va ɖo kwasiɖa geɖe. Ɣemaɣie kuxia ŋutɔŋutɔ dzea egɔme. Ne vevesesea nu fa la, èdzea gbɔdzɔgbɔdzɔ alo lãmeka siwo le wò abɔta, abɔ, abɔta, alo asibidɛwo ƒe lãmekawo me. Gbɔdzɔgbɔdzɔ sia ate ŋu anɔ anyi ɣleti geɖe. Bu eŋu kpɔ, lãmekawo ƒe kadodo aɖe li si tso akɔta le wò kɔ me, toa wò kɔ me, toa wò akɔta, eye wòɖina ɖe wò abɔwo me. Emae nye nusi míeyɔna be brachial plexus . Ele abe elektrikkawo ƒe ɖoɖo aɖe ene. Parsonage-Turner ƒe dɔlélea nye nɔnɔme si me abɔta ƒe lãkusi gblẽna le. Ekpɔa ŋusẽ ɖe lãmeka siwo kpɔa ŋusẽ ɖe ʋuʋu dzi kple woƒe lãkusiwo dzi koŋ . Esiae nana lãmekawo gbɔdzɔna. PTS nye nɔnɔme si mebɔ o . Esia tae ɖɔktawo tɔtɔnɛ ɣeaɖewoɣi be enye cervical radiculopathy , si nana lãmekawo tena ɖe kɔ me, alo cervical spondylosis , si nye dɔléle si bɔ ŋutɔ. Dzesiawo ɖi wo nɔewo ŋutɔ. Wotsɔ ŋkɔ nɛ be Parsonage-Turner le Britaintɔ ahɔhɔ̃ŋutinunyala eve, Maurice Parsonage kple John Turner, siwo ɖɔ nɔnɔmea zi gbãtɔ le ƒe 1948. Wotsɔ ŋkɔ bubu geɖe yɔa esia be:

• Brachial neuritis ƒe dɔléle
• Brachial plexus ahɔhɔ̃mekawo ƒe dɔléle
• Brachial plexus ahɔhɔ̃mekawo ƒe dɔléle
• Idiopathic brachial plexus ahɔhɔ̃mekawo ƒe dɔléle
• Ahɔhɔ̃mekawo ƒe amyotrophy

Nukawoe nye nɔnɔme sia ƒe afɔɖeɖewo?

Zi geɖe la, Parsonage-Turner ƒe dɔlélea ƒe akpa vevi etɔ̃e li. Na míakpɔ nusiwo wonye ɖa. 1. Akpa gbãtɔ (vevesese sesẽ ƒe akpa):Esia nye vevesese sesẽ kpata si nu sẽ ale gbegbe be womate ŋu asusui o . Zi geɖe la, edzea abɔta ɖeka dzi. Vevesese sia ate ŋu anɔ anyi tso ŋkeke ʋɛ aɖewo va ɖo kwasiɖa ʋɛ aɖewo. Wogblɔna zi geɖe be zi alesi vevesese ƒe akpa sia nɔa anyi didi la, zi nenemae wòaxɔ ɣeyiɣi didi hafi wòahaya. 2. Akpa evelia: Ne vevesesea nu fa vivivi la, àdze gbɔdzɔgbɔdzɔ gɔme le wò lãmekawo me. Vevietɔ lãmeka siwo ƒo xlã wò abɔta kple alɔnu la gbɔdzɔna. Esia ate ŋu ana lãmekawo nagblẽ, alo lãmekawo navuvu ɣeaɖewoɣi . Zi geɖe la, akpa evelia sia xɔa ɣleti 6 va ɖo 18. Gake le ame aɖewo gome la, ate ŋu anɔ anyi eteƒe nadidi wu gɔ̃ hã. 3. Akpa etɔ̃lia: Le ɣeyiɣi aɖe megbe la, ŋusẽ gaɖoa wò lãmekawo ŋu eye wodzea dɔwɔwɔ gɔme abe alesi wòle ene. Esiae nye dɔyɔyɔ ƒe afɔɖeɖea.

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, Parsonage-Turner ƒe dɔléle (brachial neuritis) nye dɔléle si mebɔ kura o . Wogblɔ be ame siwo ade etɔ̃ le ame akpe alafa ɖeka me koe xɔa dɔléle sia ƒe sia ƒe. Ate ŋu adze ame sia ame si xɔ ƒe ɖesiaɖe me. Gake wokpɔnɛ le ŋutsuwo gome wu vie . Ƒe si dɔléle sia dzea egɔme le mama dedie nu anɔ abe ƒe 41 ene.

Nukae nye Parsonage-Turner ƒe dɔlélea ƒe dzesiwo?

Nɔnɔme sia ƒe dzesi vevi evee nye vevesese kpata kple lãmekawo ƒe gbɔdzɔgbɔdzɔ emegbe . Esiawo ate ŋu akpɔ ŋusẽ ɖe wò akpa siawo dzi:

• Abɔta
• Abɔ si le etame (asi ƒe akpa si le etame) .
• Ŋgo (asi ƒe titina) .
• Asi (asi kple asibidɛwo) .

Zi geɖe la, abe ɣeyiɣi 80% ene la, alɔ ɖeka koe wòdzena (afã ɖeka). Zi geɖe la, ekpɔa ŋusẽ ɖe alɔ/axa si nèzãna wu dzi. Gake le nɔnɔme siwo ade 20% me la, ate ŋu agblẽ nu le abɔ eveawo siaa ŋu (afã eve). Ƒã ŋutɔ hafi wògblẽa nu le akɔta kple afɔ siwo le ete ŋu. Zi geɖe la, vevesesea va dona kpata. Ewɔna nam abe vevesese sesẽ aɖe si womate ŋu ado dzi atsɔ o ene , vevietɔ le zã me. Vevesese sesẽ sia ate ŋu anɔ anyi tso gaƒoƒo ʋɛ aɖewo va ɖo kwasiɖa ene. Ne vevesesea nu yi la, wò alɔ si ŋu dɔlélea le ƒe lãmekawo tea gbɔdzɔgbɔdzɔ. Anɔ eme godoo be àse le ɖokuiwò me be lãmekawo gbɔdzɔ le wò abɔta alo abɔta. Gake ate ŋu akpɔ ŋusẽ ɖe wò abɔta kple asi hã dzi. Ɣeaɖewoɣi la, gbɔdzɔgbɔdzɔa ate ŋu akpɔ ŋusẽ ɖe lãmeka siwo le wò akɔta alo diaphragm (lãmeka si ma wò akɔta kple wò ƒodo dome) dzi. Ne lãmekawo gbɔdzɔ la, le ɣeyiɣi aɖe megbe la, lãmekawo ƒe lãkusiwo vuvuna. Dzesi siawo ƒe sesẽme ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ ŋutɔ. Esia le alea elabena lãmeka siwo ŋu PTS gblẽa nu le la toa vovo tso ame ɖeka gbɔ yi bubu gbɔ. Dzesi bubu geɖewo ate ŋu anɔ eŋu:

• Le asi si ŋu wògblẽ nu le la meKuxi siwo le reflexes ŋu.
• Seselelãme siwo mesɔ o le asi me, si woyɔna be paresthesia , alo lãmetutudɔ. Esia ate ŋu ase le eɖokui me abe ʋuʋudedi, ʋuʋudedi, alo dzobibi ene.
• Abɔta ƒe akpa aɖe ƒe ʋuʋu .
• Ʋuʋu ƒe didime si mesɔ o le ƒunukpeƒe siwo ŋu dɔlélea le me.
• Nɔnɔme aɖe si woyɔna be winged scapula (si me abɔta ƒe asike dona ɖe megbe, abe aʋala ene).
• Lãmetsi alo lãkusi siwo le alɔ si ŋu dɔlélea le ƒe kpuiƒe.
• Asi siwo biã, aŋutiɖiɖi, alo esiwo me ʋuʋudedi le le ʋu ƒe sisi ƒe ɖiɖi ta .
• Asiwo ƒe vuvu .
• Yagbɔgbɔ sesẽ (gbɔgbɔtsixetsixe) . Esia mebɔ kura o.

Nukatae Parsonage-Turner ƒe dɔlélea dzɔna?

Le nyateƒe me la, numekulawo menya nusi tututu gbɔ Parsonage-Turner ƒe dɔlélea tso haɖe o. Wosusu be míaƒe ŋutilã ƒe dɔlélenutsiŋutete ƒe nuwɔna si mesɔ o, si woyɔna be dɔlélenutsiŋutete ƒe ŋuɖoɖo, ye koŋ gbɔ wòtso. Nufiafia eve li ku ɖe esia ŋu. 1. Dɔlékui, dɔlékui, alo dɔlékuiwo ƒe dɔléle gblẽa nu le wò abɔtaƒu ŋu tẽ, si hea dzesiwo vɛ. 2. Ne wò dɔlélenutsiŋutete wɔ avu kple dɔlékui, dɔlékui, alo dɔlékuiwutike siawo , egblẽa nu le wò asibidɛ ŋu abe eƒe nugbegblẽ le ame ŋu ene. Zi geɖe la, nusi koŋ gbɔ nɔnɔme sia tsonae nye dɔlékui aɖe si woxɔ nyitsɔ laa . Wode dzesi dɔlékui ƒe dɔléle siwo gbɔna be woate ŋu akpɔ gome le eme wu:

• Coxsackie B dɔlékui : Esia ate ŋu ahe nɔnɔme vovovowo vɛ, siwo dometɔ aɖewoe nye aklãdɔ , dɔgbo ƒe dɔléle, dzitodzito me dɔléle (dzi ƒe lãmeka ƒe dɔdzẽ), aseptic meningitis (ahɔhɔ̃ me dɔléle ƒomevi aɖe), tagbɔdɔ (ahɔhɔ̃ me dɔdzẽ), kple dɔlékui ƒe aklãdɔ (aklã ƒe dɔdzẽ).
• HIV (Amegbetɔ ƒe Dɔlélenutsiŋutete ƒe Dɔlékui) .
• Dɔléle atɔ̃lia (parvovirus B19) .
• Mumps ƒe dɔléle .
• Akpɔkplɔ (variola major kple minor) .

Ɣeaɖewoɣi la, ɖɔktawo mete ŋu kpɔa nusi koŋ gbɔ wòtso o. Ƒã ŋutɔ hafi Parsonage-Turner ƒe dɔlélea nyea domenyiŋusẽfianu/domenyiŋusẽfianu ƒe nɔnɔme.Ate ŋu atso domenyiŋusẽfianu ƒe ahɔhɔ̃mekawo ƒe ʋuʋu hã gbɔ.

Nukawoe nye afɔku siwo hea nɔnɔme sia vɛ?

Numekulawo xɔe se be atikewɔwɔ me nɔnɔme kple nɔnɔme aɖewo ate ŋu ana Parsonage-Turner ƒe dɔlélea xɔxɔ ƒe afɔkua nadzi ɖe edzi. Wo dometɔ aɖewoe nye esi:

• Amekoko kple/alo atike si naa alɔ̃dɔdɔ ame nyitsɔ laa .
• Le kpɔɖeŋu me, lãmeka siwo doa ka kple wo nɔewo ƒe dɔlélewo, nɔnɔmewo abe Ehlers-Danlos ƒe dɔléle ene .
• Dɔlélenutsiŋutete ƒe dɔlélewo, abe lupus (systemic lupus erythematosus - SLE) , temporal arteritis , kple polyarteritis nodosa .
• Abɔta ƒe abi si wɔ nuku ŋutɔ .
• Kamedede sesẽ si naa abɔta tea ɖeɖi ame ŋu.
• Atikewo/dɔlékuiwutikewo xɔxɔ (esia ƒã ŋutɔ, gake nyatakaka aɖewo li).
• Fufɔfɔ kple vidzidzi .
• Kekeli ƒe atikewɔwɔ xɔxɔ .
• Lumbar puncture (spinal tap) , si fia be woaɖe tsi le akɔta.
• Amadede si to vovo na wo nɔewo dodo hena nɔnɔmetatawo dodokpɔ.

Aleke wowɔna dea dzesi Parsonage-Turner ƒe dɔlélea?

Ne èyi ɖɔkta gbɔ la, woabia wò dɔlélea ƒe dzesiwo kple wò atikewɔwɔ ŋutinya. Emegbe woawɔ ŋutilãmedɔdada. Woalé ŋku ɖe wò abɔta ƒe lãmekawo ƒe ŋusẽ, woƒe dɔwɔwɔ, kple woƒe seselelãme ŋu. Woate ŋu aɖo wò ɖe ahɔhɔ̃ŋutinunyala hã gbɔ . Ne wò ɖɔkta susu be Parsonage-Turner ƒe dɔlélea le ŋuwò la, ate ŋu aɖo aɖaŋu be nàwɔ EMG (electromyography) dodokpɔ. Wozãa esia tsɔ daa wò ƒunukpeƒeŋusẽwo kpakple lãmeka siwo kpɔa ŋusẽ ɖe wo dzi ƒe lãmesẽ kple dɔwɔwɔ kpɔna. Tsɔ kpe ɖe eŋu la, woate ŋu awɔ nɔnɔmetatawo dodokpɔ siwo gbɔna atsɔ aɖo kpe dɔlélea dzi alo aɖe dɔléle bubuwo ɖa:

• MRI (magnetic resonance imaging) ƒe fotoɖeɖe .
• Lãmetsiŋusẽ ƒe ultrasound dodokpɔ .
• CT (kɔmpiuta tomography) ƒe fotoɖeɖe .

Nukawoe nye atike siwo wozãna na esia?

Ne míagblɔe tututu la, atike alo atike aɖeke koŋ meli na PTS o. Zi geɖe la, adzo le eɖokui si le ɣeyiɣi aɖe megbe. Ke hã, ele vevie be nànya dɔlélea kaba.Ne èdze atikewɔwɔ si akpe ɖe ŋuwò nàɖu wò dzesiwo dzi gɔme la, wò ŋgɔdonyawo ate ŋu anyo ɖe edzi ŋutɔ. Wò ɖɔkta aɖo aɖaŋu na wò be nàzã atike vovovowo atsɔ akpe ɖe ŋuwò nàɖu wò dzesiwo dzi. Woate ŋu aɖo wò ɖe eŋutinunyalawo ƒe ƒuƒoƒo aɖe hã be woawɔ atikewɔwɔ ƒe ɖoɖo aɖe. Ƒuƒoƒo sia ate ŋu anye:

• Ðɔkta siwo kpɔa dɔnɔwo gbɔ gbã (PCPs) .
• Ƒumeŋutinunyalawo
• Ahɔhɔ̃ŋutinunyalawo
• Ahɔhɔ̃mekawo ƒe dɔléle ŋuti nunyala bibiwo
• Lãmesẽdɔwɔlawo

Atikewɔwɔ siwo woawɔ le vevesese sesẽ ƒe ɣeyiɣia me ate ŋu anye:

• Vevesesenutsitikewo, le kpɔɖeŋu me , NSAID (atike siwo me steroid mele o siwo tsia dzodzodzoetsitsi nu) siwo woate ŋu aƒle le atikedzraƒe.
• Corticosteroid siwo woano .
• Ƒo asa na abɔa zazã fũ akpa, alo nàzã abɔtaɖonu si naa abɔta ana wòagaʋã o .
• Elektrikŋusẽ ƒe lãmekawo ƒe dɔwɔwɔ to ŋutigbalẽ me (TENS) nye elektrikŋusẽ ƒe lãmekawo ƒe dɔwɔwɔ ƒe atikewɔwɔ.
• Atikewɔwɔ na ame .

Ne vevesese sesẽ ƒe akpaa wu enu la, anɔ eme be wò ɖɔkta aɖo aɖaŋu na wò be nàwɔ atike siawo:

• Lãmesẽnyawo gbɔ kpɔkpɔ : Lãmesẽdɔwɔla afia kamedede siwo nàkeke kple ŋusẽdodo wò be wòakpe ɖe ŋuwò nàgakpɔ ŋusẽ ɖe lãmeka kple ƒunukpeƒe siwo ŋu wògblẽ nu le dzi ake.
• Vevesesenutsitike siwo kpena ɖe ame ŋu: Esiawo nye atike siwo wozãna koŋ tsɔ daa lãmekawo ƒe vevesese. Kpɔɖeŋu aɖewoe nye gabapentin , carbamazepine, kple amitriptyline .

Le nɔnɔme siwo nu sẽ ŋutɔ me la, ne naneke meɖe wò dzesiawo dzi kpɔtɔ o la, wò ɖɔkta ate ŋu aɖo aɖaŋu be nàwɔ dɔ na wò . Dɔdamɔnu siawo ate ŋu anye lãmekawo dodo alo lãkusiwo tsɔtsɔ yi teƒe bubu .

Ðe woate ŋu axe mɔ ɖe esia nu be wòagadzɔ oa?

Esi wònye be numekulawo menya nusi tututu gbɔ PTS tsona haɖe o ta la, le nyateƒe me la, naneke meli nàte ŋu awɔ atsɔ axe mɔ ɖe enu o. Gake esi dɔlékui aɖewo ate ŋu aʋãe ta la, lãmesẽ me nɔnɔ alesi nàte ŋui ate ŋu akpe ɖe ŋuwò nàɖe afɔku si le eme be nàxɔe dzi akpɔtɔ.

Nukae nye nɔnɔme sia ƒe ŋgɔdonya?

Mɔkpɔkpɔ si li be woahaya tso PTS me ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ.Zi ɖeka koe ame aɖewo xɔa PTS eye wohayana keŋkeŋ tso teƒe si dɔlélea le. Ðewohĩ gbɔdzɔgbɔdzɔ kple vevesese atraɖii anɔ ame bubuwo ŋu. Ame aɖewo hã ate ŋu axɔ PTS wu zi ɖeka (egadzɔna ake). Nu aɖewo li siwo ate ŋu aɖe alesi wòate ŋu adzɔe be woahaya dzi akpɔtɔ :

• Vevesesea nɔa anyi ɣleti etɔ̃ eye lãmekawo megahayana o.
• Ne PTS gblẽ nu le wò akɔta/ƒodo si le ete ŋu .
• Ne domenyiŋusẽfianu ƒe nɔnɔmee gbɔe wòtso la , ke dɔlélea ƒe gbugbɔgadzɔ sɔ gbɔ ŋutɔ le nɔnɔme mawo me.

Numekuku aɖe ɖee fia be PTS dɔnɔ siwo xɔ dzesiwo gbɔ kpɔkpɔ kple kamedede ƒe atikewɔwɔ na wo dometɔ 89% haya le ƒe etɔ̃ me. Le wo dome la, abe 75% haya le ƒe eve me, eye 36% haya le ƒe gbãtɔ me. Numekuku siwo wowɔ nyitsɔ laa ɖee fia be ame geɖe ate ŋu ayi edzi anɔ veve sem eye dɔwɔwɔ ƒe kuxi aɖewo hã anɔ wo ŋu. Gake ate ŋu adzɔ be ŋusẽ nagaɖo ame ŋu bliboe , togbɔ be ate ŋu axɔ ƒe enyi hã.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ele vevie ŋutɔ be woakpɔ Parsonage-Turner ƒe dɔlélea kaba eye wòade pɛpɛpɛ . Ne èle veve sem, vevietɔ ne edzɔ kpata eye wòsẽ , kpɔ egbɔ be yeyi ɖɔkta gbɔ.

Nya kawoe wòle be nàbia ɖɔktaa?

Ne èdi be yeanya nu geɖe tso nɔnɔme sia ŋu la, àte ŋu abia wò ɖɔkta nyawo abe esiawo ene:

• Nukatae Parsonage-Turner ƒe dɔlélea va dze dzinye?
• Eŋutinunyala bibi ka ƒomevie wòle be makpɔ?
• Vevesesenutsitike ka ƒomevie nèkafu?
• Aleke wòle be malé be na ɖokuinye le aƒeme?
• Aleke nèsusu be mahaya kabae?
• Atikewɔwɔ ka ƒomevie nèkafu?
• Aleke mawɔ anya ne PTS ƒe nɔnɔme sia le nyonyom ɖe edzi alo le gbegblẽm ɖe edzi?

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

Vevesese sesẽ kpata ate ŋu anye nusi dzi ŋɔ. Enye wò ŋutilã ƒe mɔ si dzi wòato agblɔ na wò be, "Nane gblẽ." Esia tae wòle vevie be nàkpɔ ɖɔkta kaba ale si nàte ŋui. Atikewɔwɔ geɖe li siwo ate ŋu akpe ɖe ŋuwò nàɖu Parsonage-Turner syndrome (PTS) ƒe dzesiwo dzi eye ɖewohĩ wòana nàhaya kabakaba. Ne nya aɖe le asiwò ku ɖe PTS ŋu la, mègavɔ̃ be yeabia wò ɖɔkta o. Wole afima be yewoakpe ɖe ŋuwò. Ðo ŋku edzi be menye wò ɖeka koe o, ame bubuwo hã le nusia me tom, eye ɖɔkta aɖewo hã li siwo ate ŋu akpe ɖe ŋuwò .