E noʻonoʻo ʻoe a i ʻole kāu keiki i loaʻa i ke anu maʻamau a i ʻole ka maʻi palū a e ola hou ana i loko o kekahi mau lā. ʻOiai e hauʻoli ana nā mea a pau, ma hope o ka emi ʻana o kēlā maʻi, hoʻomaka koke kahi maʻi hou ma kahi o hoʻokahi a ʻelua paha pule. I ka manawa koke, nalowale kou ikaika, emi kou ʻike, paʻakikī iā ʻoe ke ʻōlelo, loaʻa iā ʻoe kahi ʻeha poʻo nui a hoʻomaka ʻoe e luaʻi. Pehea lā ko kākou makaʻu inā hana ʻia kekahi mea e like me kēia? I kēia lā, ke kamaʻilio nei mākou e pili ana i kahi maʻi koʻikoʻi e hiki ke kānalua ʻia i ia manawa, ʻoiai he mea kakaikahi, pono e mālama koke ʻia. Ua kapa ʻia kēia maʻi ʻo ADEM (Acute Disseminated Encephalomyelitis) .
He aha ka ADEM (Acute Disseminated Encephalomyelitis)?
I ka ʻōlelo maʻalahi, ʻo ADEM kahi mumū koke a pehu paha o ko mākou ʻōnaehana nerve waena , ʻo ia hoʻi, ka lolo a me ke kaula iwi kuamoʻo. Ua like ia me ke kuni lolo.
E hoʻomaopopo iki kākou i kēia me ka maʻalahi iki. Ua like nā olonā aʻalolo i loko o ko kākou kino me nā uea uila. Aia kahi uhi palaki a puni nā uea uila, ʻeā? ʻO ia ka mea e hiki ai i ka uila ke hele pololei a wikiwiki a pale i ka uea. Pēlā nō, aia kahi ʻūpā pale, kahi uhi i kapa ʻia ʻo "myelin" a puni ko kākou mau olonā aʻalolo. ʻO kēia ʻūpā myelin ka mea e hiki ai i nā leka (nā hōʻailona) ke hele wikiwiki a pololei ma o nā aʻalolo mai kekahi ʻāpana o ke kino a i kekahi ʻāpana.
I loko o ADEM, hoʻouka hewa kā mākou ʻōnaehana pale ponoʻī i kēia ʻūpā myelin. A laila hoʻomaka ia e luku ʻia a hōʻino ʻia. E like me ka wehe ʻana o ka palakiko ma luna o kahi uea uila. A laila ʻaʻole hele pono nā leka aʻalolo. ʻO ia ke kumu e kū mai ai nā hōʻailona e like me ka mae ʻana o nā lālā, ka ʻike maka pōʻeleʻele, a me ka paʻakikī o ka ʻōlelo ʻana.
Ua kapa ʻia kēia maʻi he 'acute' no ka mea e ʻike koke ʻia nā hōʻailona, i loko o kekahi mau lā. Hoʻokahi wale nō manawa e ʻike ʻia ai i ke ola. Eia nō naʻe, hiki ke hoʻi hou mai i ka manawa kakaikahi loa.
He maʻi laha ʻole ka ADEM. Wahi a nā noiʻi, hoʻokahi wale nō i loko o 150,000 mau kānaka ma kahi ʻāina e like me ʻAmelika Hui Pū ʻIa e loaʻa ana i kēia maʻi. No laila, ʻaʻohe pono e makaʻu nui i kēia, akā he mea nui loa ia e makaʻala.
He aha nā hōʻailona o ADEM?
Hiki ke ʻokoʻa loa nā hōʻailona o ADEM, ma muli o ka ʻāpana o ka ʻōnaehana nerve i hoʻopilikia ʻia. Eia nō naʻe, ʻike pinepine ʻia lākou ma kahi o hoʻokahi a ʻelua paha pule ma hope o ka pau ʻana o kahi maʻi viral a bacterial paha (e like me ka maʻi flu, ka measles, a i ʻole ka chickenpox).
No ka maʻalahi o ka hoʻomaopopo ʻana, e puʻunaue kākou i kēia mau hiʻohiʻona i ʻelua ʻāpana.
| ʻAno o ka hōʻailona | Nā hōʻailona hiki ke loaʻa |
|---|---|
| Nā ʻano laulā |
|
| Nā ʻano e pili ana i ka ʻōnaehana nerve |
|
Hiki ke ʻokoʻa ke koʻikoʻi o kēia mau hōʻailona mai kēlā kanaka a kēia kanaka. No kekahi poʻe, he akahai paha lākou a nalowale wale nō, a no kekahi poʻe, he koʻikoʻi paha lākou e pono ai ke mālama ʻia i ka haukapila.
No ke aha lā e hana ʻia ai kekahi mea e like me kēia?
ʻAʻole ʻike maopopo ʻia ke kumu kikoʻī o ADEM, akā manaʻoʻiʻo nā kauka a me nā ʻepekema ua hana ʻia e kahi hana hewa i loko o kā mākou ʻōnaehana pale ponoʻī .
E hoʻomaopopo kākou i kēia ma kēia ʻano. Ua like ko kākou ʻōnaehana pale kino me ka pūʻali koa o ko kākou ʻāina. ʻO ka hana a kēia pūʻali koa, ʻo ia ke ʻike a hoʻouka i nā ʻenemi e like me nā virus a me nā bacteria e hele mai ana mai waho mai, a pale iā kākou mai nā maʻi. Akā, ʻo ka mea e hana ʻia ana ma ADEM, ʻo ia ka hana ʻana o kēia pūʻali koa i kahi hewa liʻiliʻi. Ma hope o ko lākou pau ʻana i ke kaua ʻana me kahi ʻenemi i komo mai i loko o ka ʻāina (no ka laʻana, he virus flu), hoʻomaka lākou e hoʻouka i ka ʻūpā myelin i loko o ko kākou ʻōnaehana nerve ponoʻī, me ka manaʻo he ʻenemi ia. Ua like ia me ka hoʻouka ʻana i kahi kahua koa ma kou ʻāina ponoʻī, me ka manaʻo he pūʻali koa ʻenemi ia. Ua kapa ʻia kēia he 'autoimmune reaction' . Hoʻoulu kēia hoʻouka kaua i ka mumū a me ka pehu ʻana i loko o ka ʻōnaehana nerve.
Ma waena o 70% a me 80% o nā maʻi ADEM e loaʻa ana kahi maʻi ma mua o ka ʻike ʻia ʻana o nā hōʻailona. ʻO nā maʻi maʻamau i hala ma mua o ADEM:
- Ka maʻi palū (Flu)
- Ka maʻi ahulau
- Nā ʻūpā
- ʻO Rubella
- Maʻi puʻupuʻu
- ʻO ka maʻi Epstein-Barr
ʻO kekahi mea i ʻike hou ʻia, hiki i kekahi mau keiki ke loaʻa iā ADEM.Hiki nō hoʻi ke kumu o kahi maʻi i kapa ʻia ʻo MOGAD (Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease). He maʻi kikoʻī kēia e pili ana i ka ʻōnaehana pale.
Pehea e ʻike ʻia ai ka ADEM?
E nīnau mua kāu kauka iā ʻoe i kahi nīnau kikoʻī e pili ana i kāu mau hōʻailona a hana i kahi hoʻokolokolo neurological. A laila e hana lākou i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona o ADEM a kāpae i nā kūlana ʻē aʻe e hiki ke hoʻoulu i nā hōʻailona like.
ʻO nā hoʻokolohua nui i hana ʻia:
1. MRI scan (Magnetic Resonance Imaging)
He hoʻāʻo ka MRI e hoʻohana ana i kahi kahua magnetic ikaika a me nā nalu lekiō e lawe i nā kiʻi kikoʻī loa o ko kākou lolo a me ke kaula iwi kuamoʻo. ʻAʻole ia e hoʻohana i nā kukuna X. Ma kahi scan MRI o kekahi me ADEM, hiki ke ʻike maopopo ʻia nā wahi i hōʻino ʻia i ka ʻupena myelin (nā ʻeha) ma ke ʻano he mau kiko keʻokeʻo. E nānā ke kauka i kahi a me ke ʻano o kēia mau kiko e hoʻoholo ai inā he ADEM ia.
2. Pākuʻi ʻIwi Kuamoʻo / Pākuʻi Lumbar
E hoʻoweliweli paha ka inoa i kekahi poʻe, akā he hoʻāʻo akahele loa ia e hana ai kāu kauka. Pili ia i ka hoʻohuli ʻana iā ʻoe ma kou ʻaoʻao a me ke kau ʻana i kahi nila liʻiliʻi i loko o kou kua i lalo e lawe i kahi laʻana liʻiliʻi o ka wai e hoʻopuni ana i kou lolo a me ke kaula spinal , i kapa ʻia ʻo ka wai cerebrospinal (CSF) . Loaʻa i ka poʻe me ADEM ka nui o nā pūnaewele ʻōnaehana pale, ʻoiai nā pūnaewele koko keʻokeʻo. Hiki i kēia ke kōkua nui i ka hōʻoia ʻana i ka maʻi.
Eia kekahi, hana ʻia nā hoʻāʻo koko.
He aha nā lāʻau lapaʻau no ADEM?
ʻO ka pahuhopu nui o ka mālama ʻana iā ADEM, ʻo ia ka hoʻēmi koke ʻana i ka mumū i loko o ka lolo a me ke kaula kuamoʻo a me ka pale ʻana i ka hana hewa ʻana o ka ʻōnaehana pale. Hiki i kāu kauka ke hoʻohana i kekahi mau lāʻau lapaʻau e hoʻokō ai i kēia.
| ʻAno lapaʻau | He wehewehe maʻalahi |
|---|---|
| Nā lāʻau lapaʻau steroid | ʻO kēia ka lāʻau lapaʻau nui i hāʻawi mua ʻia. Hāʻawi ʻia nā lāʻau steroid kiʻekiʻe ma ke kino no kekahi mau lā. Hoʻopau kēia i ka ʻōnaehana pale a hōʻemi koke i ka pehu. Ma hope o ka hoʻōki ʻana o ka lāʻau lapaʻau intravenous, e noi ʻia paha ʻoe e lawe i nā papa waha no kekahi manawa. |
| IVIG (Intravenous Immune Globulin) | Hāʻawi ʻia kēia lāʻau lapaʻau i nā poʻe i pane maikaʻi ʻole i nā steroids. Pili ia i ka hāʻawi ʻana i ke kino i nā antibodies i lawe ʻia mai ke koko o nā tausani o nā kānaka olakino ma o kahi aa koko. Kōkua pū kēia i ka hoʻomalu ʻana i kā mākou ʻōnaehana pale kino, kahi e hana hewa nei. |
| Hoʻololi Plasma / Plasmapheresis | He ʻano lapaʻau paʻakikī iki kēia. Hana wale ʻia no ka poʻe me nā hōʻailona koʻikoʻi. Maanei, hoʻoili ʻia ke koko o ka mea maʻi ma o kahi mīkini, a hoʻokaʻawale ʻia a wehe ʻia ka plasma koko (ka ʻāpana wai). No ka mea, aia nā antibodies hewa i loko o kēia plasma. A laila hoʻokomo hou ʻia nā hunaola koko i loko o ke kino me ka plasma maʻemaʻe. Hiki i kēia ke pale i ka ʻōnaehana pale mai ka hoʻouka ʻana. |
Pehea ka lōʻihi e hoʻōla ai? Pehea ka manaʻo?
ʻO kēia ka nīnau nui loa ma ka manaʻo o nā mea a pau. ʻO ka nūhou maikaʻi loa e pili ana iā ADEM, ʻo ka hapa nui o ka poʻe i ʻike ʻia me ka maʻi e hoʻōla piha a kokoke paha i ka piha .
Hoʻomaka ka hapa nui o ka poʻe e ʻoluʻolu i loko o kekahi mau lā o ka hoʻomaka ʻana o ka lāʻau lapaʻau. Eia nō naʻe, ma muli o ke koʻikoʻi o nā hōʻailona, hiki ke hala i kekahi mau mahina, i kekahi manawa a hiki i 6 mau mahina, e hoʻōla piha ai. He mea kākaʻikahi loa, hiki i kekahi poʻe ke hoʻomau i ka loaʻa ʻana o nā pilikia ʻike liʻiliʻi a i ʻole ka mae ʻana o ka ʻili.
He mea kākaʻikahi loa ia, a inā wale nō he koʻikoʻi loa ka mumū, he mea ia e hoʻoweliweli ai i ke ola. No laila, he mea nui e ʻimi i ke kōkua lapaʻau i ka wā e ʻike ʻia ai nā hōʻailona.
Āhea ʻoe e ʻike ai i ke kauka?
Inā loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana, ʻoi aku hoʻi he keiki, nā hōʻailona a mākou i kūkākūkā ai ma hope o ka ho'ōla ʻana mai kahi maʻi e like me ke anu a i ʻole ka maʻi palū, e ʻike koke aku i ke kauka me ka hoʻokaʻulua ʻole.
- Ka nalowale koke o ka ʻike
- ʻAʻole hiki ke hele a kuʻia paha
- Pōwehiwehi a nalowale paha ka ʻike
- Paʻakikī i ka ʻōlelo ʻana
- Nā hopu ʻana me ke kumu ʻole
Inā loaʻa iā ʻoe kēia mau hōʻailona, mai noho wale i ka home a manaʻo he mea maʻamau ia. ʻO ka mea maikaʻi loa e hana ai, ʻo ia ke hele i ka haukapila, ʻoiai hoʻi kahi Emergency Treatment Unit (ETU), i ka hikiwawe loa. No ka mea, i loko o kēia ʻano maʻi, ʻo ka wikiwiki o ka hoʻomaka ʻana o ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o ka manawa e hoʻōla ai.
Leka Lawe-Home
- ʻO ka ADEM kahi mumū koke o ka ʻōnaehana nerve e kū pinepine ma hope o kahi maʻi viral a bacteria paha.
- ʻO ke kumu o kēia, ʻo kā mākou ʻōnaehana pale ponoʻī e hoʻouka hewa ana i ka ʻūpā myelin pale o nā aʻalolo.
- ʻIke pinepine ʻia kēia ma waena o nā keiki a me nā ʻōpio.
- Inā ʻike ʻoe i nā hōʻailona e like me ka nalowale koke o ka ʻike, ka nalowale ʻana o ka ʻike, a i ʻole ka paʻakikī i ka hele wāwae, mai hoʻowahāwahā iā lākou. E ʻike koke i ke kauka.
- Hiki ke ʻike pololei ʻia ka maʻi me ka MRI a me nā hoʻāʻo wai o ka iwi kuamoʻo.
- Inā hoʻomaka mua ʻia ka lāʻau lapaʻau (e like me nā steroids), ʻo ka hapa nui o ka poʻe i loaʻa iā ADEM e hoʻōla loa.
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