Ke nāwaliwali nei ʻoe? Ke ʻūlū nei kou mau lālā? E aʻo kākou e pili ana i ka CIDP (Chronic Inflammatory Demyelinating Polyneuropathy)!

Ke luhi loa nei ʻoe i kekahi manawa, ua mae kou mau lima a me kou mau wāwae, a i ʻole he ʻano ʻūlū kou? I kekahi manawa, ʻaʻole paha ʻoe e nānā nui i kēia mau mea. Eia nō naʻe, i nā hihia kakaikahi, hiki i kēia mau hōʻailona ke hōʻailona o kahi mea ʻoi aku ka koʻikoʻi. ʻO kekahi ʻano kakaikahi akā koʻikoʻi e makaʻala ai, ʻo ia ka mea i kapa ʻia ʻo CIDP (Chronic Inflammatory Demyelinating Polyneuropathy) . ʻOiai paha he lōʻihi iki ka inoa, e mālama kākou i ka maʻalahi.

He aha ka CIDP (Chronic Inflammatory Demyelinating Polyneuropathy)?

ʻOiai paha he mea paʻakikī kēia inoa, inā mākou e wāwahi i kona manaʻo, hiki iā mākou ke loaʻa kahi manaʻo maikaʻi aʻe o kēia maʻi.

• Mau: ʻO ke ʻano kēia "lōʻihi." ʻO ke ʻano kēia, ʻaʻole hiki koke mai ka CIDP a hoʻomaikaʻi koke. Hoʻomohala mālie ia, ma luna o ka manawa o ʻewalu pule. I kekahi manawa e emi ana nā hōʻailona a laila hoʻi hou mai i nā mahina a i ʻole nā ​​​​makahiki ma hope. Ua like ia me kahi pilikia e hana hou ana.

• ʻŌhūhū: ʻO ke ʻano kēia o ka "ʻōhūhū" . Ke loaʻa iā mākou kahi ʻeha ma kekahi wahi o ko mākou kino, pehu a lilo i ʻulaʻula, ʻeā? ʻO ia ke ʻano. Akā ma CIDP, hiki mai kēia ʻōhūhū ma muli o kekahi pilikia i loko o ka ʻōnaehana pale o ko mākou kino ponoʻī. I ka ʻōlelo maʻalahi, hoʻomaka nā koa i manaʻo ʻia e pale i ko mākou kino e hoʻouka i ko mākou mau aʻalolo ponoʻī ma ka hewa. Ua kapa ʻia kēia he "Autoimmune Attack" . ʻO ka ʻōhūhū nui i hoʻokumu ʻia e kēia e hōʻino i ko mākou mau aʻalolo peripheral . ʻO kēia mau aʻalolo peripheral nā aʻalolo e hoʻonui ana mai ka lolo a me ke kaula spinal.

• Demyelinating: He ʻōlelo hohonu kēia. Loaʻa i ko kākou mau neurons kahi uhi pale a puni lākou. Ua like ia me kahi ʻūpā palakiko a puni kahi uea uila. Ua kapa ʻia kēia uhi ʻo `(Myelin Sheath)` . ʻO kēia ʻūpā myelin ka mea e hiki ai i nā leka aʻalolo ke hele wikiwiki a pololei. ʻO `(Demyelinating)` ʻo ia hoʻi ua luku ʻia a hōʻino ʻia paha ka ʻūpā myelin. A laila, e like me ka wā e wehe ʻia ai ka palakiko ma ke uea, ua liki ke au, a ʻaʻole hele pono nā leka aʻalolo.

• Polyneuropathy: ʻO "Poly" ke ʻano he "nui." ʻO "Neuropathy" ke ʻano o ka hōʻino ʻana i nā aʻalolo. ʻO Polyneuropathy ke ʻano o ka hōʻino ʻana i nā aʻalolo peripheral he nui i loko o ke kino i ka manawa like. Hiki i kēia ke hana i nā pilikia like ʻole e like me ka nāwaliwali o nā ʻiʻo, ka numbness, a me ka paresthesia.

No laila, i ka ʻōlelo maʻalahi, ʻo CIDP kahi kūlana lōʻihi kahi i hōʻino ʻia ai ka ʻūpā myelin a puni nā aʻalolo peripheral ma muli o kahi hana hewa i loko o kā mākou ʻōnaehana pale ponoʻī, e hopena ana i ka hana hewa o nā aʻalolo he nui. Maopopo iā ʻoe?

He aha ka ʻokoʻa ma waena o ka Guillain-Barré Syndrome (GBS) a me ka CIDP?

ʻO ʻoe pahaUa lohe paha ʻoe i ka `(Guillain-Barré Syndrome)` a i ʻole `(GBS) .` Ua like loa ka maʻi CIDP me GBS. Manaʻo nā kauka he ʻano lōʻihi ʻo CIDP o GBS. He maʻi laha ʻole nō hoʻi ʻo GBS kahi e hoʻouka ai kā mākou ʻōnaehana pale i nā aʻalolo peripheral.

Akā ʻo ka ʻokoʻa nui ka manawa. ʻO ka mea ʻino loa o GBS e hiki mai ana i ʻelua a ʻekolu mau pule ma hope o ka hoʻomaka ʻana o nā hōʻailona. Akā e hoʻomaikaʻi mālie ka hapa nui o ka poʻe ma hope o kēlā. Akā ʻoi aku ka lōʻihi o ka CIDP. ʻOi aku ka ʻino o nā hōʻailona ma mua o ʻewalu pule .

Pehea ka maʻamau o ka CIDP?

He maʻi laha ʻole ka CIDP. Wahi a nā kānaka noiʻi, ʻo ka nui o nā hihia hou o CIDP ma ʻAmelika Hui Pū ʻIa ma waena o 0.8 a me 8.9 no 100,000 poʻe i kēlā me kēia makahiki. He nui iki kēia pae, no ka mea, hiki i ka CIDP ke hoʻopilikia i nā poʻe like ʻole ma nā ʻano like ʻole, a no ka mea he paʻakikī ke ʻike i ka maʻi.

Hiki ke ulu ka CIDP i kēlā me kēia makahiki.

He aha nā hōʻailona o CIDP?

Hiki ke ʻokoʻa nā hōʻailona o CIDP ma muli o ke ʻano. Eia nō naʻe, ʻo ka hōʻailona maʻamau ka nāwaliwali o nā ʻiʻo e mau ana no ka liʻiliʻi o ʻewalu pule. Hoʻopilikia pinepine kēia i nā ʻaoʻao ʻelua o ke kino. ʻOi aku ka kikoʻī:

• Nā ʻiʻo o ka ʻūhā a me ka ʻūhā
• Nā ʻiʻo o ka poʻohiwi a me ka ʻāpana lima luna
• Pālima a me nā manamana lima
• Nā wāwae a me nā manamana wāwae

E noʻonoʻo, ua paʻakikī koke iā ʻoe ke ala aʻe mai kahi noho, manaʻo ʻoe ʻaʻole hiki iā ʻoe ke piʻi i kahi alapiʻi, a paʻakikī paha iā ʻoe ke kahili i kou lauoho a paʻa paha i ke kīʻaha. Hiki ke hana ʻia nā mea e like me kēia.

ʻO nā hōʻailona ʻē aʻe e ʻike ʻia paha:

• ʻO ka atrophy o nā ʻiʻo i hoʻopilikia ʻia
• ʻO ka numbness, tingling, a i ʻole ka nalowale o ka ʻike ma nā manamana lima a me nā manamana wāwae (Paresthesia)
• ʻO ka paʻakikī i ka mālama ʻana i ke kaulike o ke kino a me ka hoʻonohonoho maikaʻi ʻole (e like me ka hina ʻana)
• Ka paʻakikī i ka hele wāwae a i ʻole ka nalowale piha o ka hele wāwae
• ʻO ka nalowale a nāwaliwali paha o nā reflexes tendon hohonu (ʻo kēia ka mea a ke kauka e ho'āʻo ai ma ke kī ʻana i ke kuli me ka hāmare liʻiliʻi)
• ʻEha Neuropathic. He ʻeha kēia e like me ke kuni ʻana a i ʻole nā ​​haʻalulu uila.

I ka liʻiliʻi loa, ʻike paha ʻoe i nā hōʻailona e like me:

• Ka paʻakikī i ka moni ʻana (Dysphagia) a me ka nāwaliwali o ka ʻāʻī o luna
• ʻIke Pālua

Hiki ke loli kēia mau hōʻailona i ka hala ʻana o ka manawa. Hiki ke hoʻomaka mālie, a i ʻole e holomua koke paha. I kekahi manawa hiki ke hele mai a hele aku, e emi iho ma hope o kekahi mau lā, a laila hoʻi hou mai. Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​he mea nui e ʻike koke i ke kauka.ʻO ka ʻike mua ʻana a me ka mālama ʻana e hele lōʻihi i ka ho'ōla hou ʻana.

Aia kekahi mau ʻano CIDP like ʻole?

ʻAe, aia nā ʻano like ʻole o CIDP, a he ʻokoʻa iki ko lākou mau hōʻailona.

ʻO ke ʻano maʻamau ka CIDP maʻamau , kahi e hoʻonāwaliwali ai nā mākala a me nā hōʻailona sensory (e like me ka numbness) ma nā ʻaoʻao ʻelua o ke kino.

ʻO kekahi o nā ʻano like ʻole :

• `(Multifocal Motor Neuropathy)`: Pili wale kēia i ka nāwaliwali o nā ʻiʻo. He ʻano like ʻole hoʻi kēia nāwaliwali, ʻo ia hoʻi hiki ke hoʻopilikia i hoʻokahi wahi wale nō ma kekahi ʻaoʻao o ke kino, a i ʻole kekahi mau wahi ma nā ʻano like ʻole.
• `(Lewis-Sumner Syndrome): Pili kēia i ka nāwaliwali o nā ʻiʻo asymmetric a me nā hōʻailona sensory.
• `(Pure Sensory CIDP)`: Hiki i kēia ke hoʻoulu i ka mae ʻana o ka ʻōpū, ka ʻeha, nā pilikia kaulike, a me kahi hele wāwae ʻē. Akā, ʻaʻohe nāwaliwali o nā ʻiʻo.
• `(Pure Motor CIDP):`: Ma kēia, hiki ke ʻike ʻia ka nāwaliwali o nā ʻiʻo a me ka nalowale o nā reflexes e pili ana i nā ʻaoʻao ʻelua o ke kino, akā ʻaʻohe hōʻailona sensory.

Ke aʻo nei nā mea noiʻi i nā ʻano like ʻole o CIDP.

He aha ke kumu o ka CIDP?

E like me kā mākou i kūkākūkā ai ma mua, manaʻoʻiʻo nā kānaka noiʻi ua hana ʻia ka CIDP e kahi hana hewa i loko o kā mākou ʻōnaehana pale . ʻOiai ʻaʻole i ʻike ʻia ke kumu pololei, ʻike kā mākou ʻōnaehana pale i ka ʻūpā myelin ma ke ʻano he ʻenemi a laila hoʻomaka e hoʻouka iā ia (he hopena autoimmune).

ʻO ka ʻūpā myelin ka papa pale e puni ana i kā mākou mau hunaola nerve. Hoʻopuni ia i ka ʻāpana lōʻihi o ke olonā nerve (axon). ʻO Myelin ka mea e ʻae ai i nā impulses uila e hele pono ma ke aʻalolo. Ke hōʻino ʻia ka myelin, hele mālie loa kēia mau impulses uila, a nalowale loa paha. A laila, ʻaʻole hiki i nā "leka" i kahi e pono ai lākou e hele. ʻO ia ke kumu o nā hōʻailona o CIDP.

E noʻonoʻo i kahi uea uila i hoʻopaʻa maikaʻi ʻia. Hoʻokele maikaʻi ia i ke au. Akā he aha ka mea e hana ai inā hemo ka ʻūpā palakiko ma kēlā uea ma kekahi mau wahi? Ke kahe nei ke au, a ʻaʻole paha e kahe pono, ʻeā? ʻO ia ka mea e hana ai ke hōʻino ʻia ka ʻūpā myelin.

Pehea e ʻike ʻia ai ka CIDP?

Hiki ke paʻakikī ka ʻike ʻana i ka CIDP no ka mea he ʻokoʻa nā hōʻailona o nā ʻano like ʻole. No ka ʻike ʻana i ka CIDP, e hana kāu kauka:

• E hoʻolohe pono lākou i kāu mau hōʻailona a nīnau e pili ana i kou mōʻaukala olakino .
• Hana ʻia kahi hoʻokolohua kino a me kahi hoʻokolohua neurological .
• Hiki ke kauoha ʻia kekahi mau hoʻokolohua kūikawā e hōʻoia i ka hōʻailona a hoʻopau paha i nā kūlana ʻē aʻe.

He aha nā hoʻokolohua i hoʻohana ʻia e ʻike ai i ka CIDP?

Eia nā hoʻokolohua e hiki ke kōkua i ka hōʻoia ʻana i ka CIDP a kāpae i nā kumu ʻē aʻe:

• Nā Hoʻāʻo Electromyography (EMG) a me nā Hoʻāʻo Hoʻokele Aʻalolo: Nānā kēia mau hoʻāʻo i ke olakino a me ka hana o kou mau ʻiʻo a me nā aʻalolo e kāohi ana iā lākou. He mea pono loa kēia mau hoʻāʻo no ka ʻimi ʻana i nā loli demyelinating (ka hoʻoili lohi ʻana o nā hōʻailona aʻalolo, nā poloka, a me nā mea ʻē aʻe) e like me CIDP. Hiki i kēia ke kōkua i ka hoʻokaʻawale ʻana iā CIDP mai nā ʻano polyneuropathies maʻamau ʻē aʻe.

• Spinal Tap / Lumbar Puncture: Ma kēia hoʻāʻo, hoʻokomo ke kauka i kahi nila liʻiliʻi i loko o kou kua haʻahaʻa a lawe i kahi laʻana o kāu wai cerebrospinal (CSF) . Hoʻouna ʻia kēia laʻana i kahi lab e hoʻāʻo ʻia. Ma 85% a 90% o ka poʻe me CIDP, he maʻamau ka helu o nā cell koko keʻokeʻo, akā kiʻekiʻe ka pae protein. ʻO nā mea ʻē aʻe i loko o ka CSF e hōʻike paha i kahi maʻi ʻē aʻe.

• ʻO ke kiʻi Magnetic Resonance Imaging (MRI) o ke kua i lalo: Inā komo nā aʻa nerve i kou kua i lalo i kahi dye ʻokoʻa i ka wā o ka MRI scan, hiki iā ia ke kōkua i ka ʻike ʻana iā CIDP.

• Nā Hoʻāʻo Koko: Hiki i kāu kauka ke kauoha i nā hoʻāʻo koko e kāpae i nā kūlana ʻē aʻe e hiki ai ke hoʻoulu i ka neuropathy, e like me ka maʻi diabetes, nā hemahema vitamina, ka maʻi thyroid, ka maʻi Lyme, HIV / AIDS, a me lymphoma. Hiki iā lākou ke nānā no kekahi mau antibodies i ʻike ʻia e pili ana me CIDP.

• Biopsy Nerve: He mea kākaʻikahi loa, hiki i ke kauka ke ʻōlelo aku i kahi biopsy nerve, kahi e wehe ʻia ai kahi ʻāpana o ke aʻalolo a nānā ʻia e ʻike inā ua hōʻino ʻia ka ʻupena myelin.

He aha nā lāʻau lapaʻau no CIDP?

ʻEkolu mau lāʻau lapaʻau nui (laina mua) no CIDP:

• Corticosteroids: Kōkua nā lāʻau steroid, e like me ka prednisolone, i ka hōʻemi ʻana i ka mumū. No nā poʻe he nui, hiki i kēia mau steroid wale nō ke kōkua i ka hōʻemi ʻana i nā hōʻailona. Eia nō naʻe, hiki i nā steroid ke loaʻa nā hopena ʻaoʻao koʻikoʻi, no laila ua kaupalena ʻia ka hoʻohana lōʻihi ʻana o kēia mau lāʻau. Hiki i kāu kauka ke kuhikuhi i nā lāʻau ʻē aʻe (immunosuppressants) me nā steroid.

• Hoʻololi Plasma / Plasmapheresis: Ma kēia lāʻau lapaʻau, hoʻokaʻawale kahi mīkini i ka plasma mai kou koko, mālama iā ia, a laila hoʻihoʻi i ka plasma a me ke koko i kou kino. I ka ʻōlelo maʻalahi, kānana ia i nā antibodies ʻino i loko o ka plasma e hoʻouka nei i kou mau aʻalolo. Hana pinepine ka hoʻololi plasma no kekahi mau pule wale nō. Pono paha ʻoe e hana i kēia lāʻau lapaʻau no nā mahina, a i ʻole nā ​​​​makahiki.

• ʻO ka Intravenous Immunoglobulin Therapy (IVIG): Ma kēia lāʻau lapaʻau, hāʻawi ʻia nā protein i kapa ʻia ʻo immunoglobulins (nā protein a kā mākou ʻōnaehana pale e hana maoli ai e hoʻouka i nā mea komo hewa) ma ke ʻano intravenous (IV). Loaʻa kēia immunoglobulin mai ke koko o nā tausani o ka poʻe olakino. Hiki i ka IVIG ke hōʻemi i ka pōʻino o kāu ʻōnaehana pale i kou mau aʻalolo. Hiki ke hāʻawi ʻia ka IVIG ma nā dosis kiʻekiʻe loa i ka wā mua, a pono paha ʻoe e loaʻa i kēia lāʻau lapaʻau i kēlā me kēia manawa no nā mahina, a i ʻole nā ​​​​makahiki.

Ke aʻo nei nā kānaka noiʻi i nā lāʻau lapaʻau ʻē aʻe no CIDP. Loaʻa paha iā ʻoe ka manawa kūpono e komo i kahi hoʻokolohua lapaʻau no CIDP. E kamaʻilio me kāu kauka e pili ana i kēia.

Pehea ke ʻano o ke ola me CIDP? (Prognosis)

ʻO ka wā lōʻihi o ka maʻi e pili ana i kekahi mau kumu:

• Kou makahiki i hoʻomaka ai ʻo CIDP.
• Pehea e ulu ai ka maʻi a me ke ʻano o ka maʻi .
• Pehea ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi a me ka hoʻomaka ʻana o ka lāʻau lapaʻau .
• Pehea e pane mua ai kou kino i ka lāʻau lapaʻau.

Ma kahi o 90% o ka poʻe me CIDP hiki ke ho'ōla ʻia me ka lāʻau lapaʻau. Akā ma kahi o 50% o ka poʻe e loaʻa hou ana ka maʻi. Ma keʻano laulā, maikaʻi ka wānana lōʻihi o ka poʻe i ʻike ʻia me CIDP i ka wā ʻōpiopio. Inā ʻaʻole ʻoe e loaʻa i kekahi lāʻau lapaʻau no CIDP, hiki ke hōʻino mau ʻia ke aʻalolo, hiki ke alakaʻi i kekahi kīnā.

E hiki i kāu kauka ke hāʻawi iā ʻoe i kahi manaʻo maikaʻi o ka mea e manaʻo ai e hiki mai ana ma muli o kou kūlana kūikawā.

Ke hoʻopōkole nei anei ka CIDP i ka manaʻolana ola?

ʻAʻole he maʻi make ka CIDP. ʻO ka poʻe me kēia maʻi, ua like ko lākou ola me ka mea me ka ʻole o ka maʻi. No laila, ʻaʻohe mea e hopohopo ai.

Hiki ke pale ʻia ka CIDP?

Ma muli o ka loaʻa ʻole o nā kānaka noiʻi i kahi kumu kūpono no CIDP, ʻaʻohe ala i ʻike ʻia e pale aku ai i ka ulu ʻana o ka maʻi.

Āhea wau e ʻike ai i ke kauka? / Āhea wau e hele ai i kahi lumi pilikia?

Inā ua ʻike ʻia ʻoe me CIDP, pono ʻoe e ʻike pinepine i kāu kauka e nānā i kāu mau hōʻailona a loaʻa ka lāʻau lapaʻau. Hiki i nā hōʻailona CIDP ke hele mai a hele no nā mahina a i ʻole nā ​​​​makahiki, no laila pono paha ka lāʻau lapaʻau e hoʻomau.

I ka liʻiliʻi loa, hiki i ka CIDP ke hoʻopilikia i nā ʻiʻo e pono ai ke hanu . Inā pilikia ʻoe i ka hanu ʻana , e kelepona koke i ka 911 (a i ʻole kāu helu pilikia kūloko), a i ʻole e hele i ka lumi pilikia kokoke loa. He pilikia kēia.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

Hiki ke hopohopo ke manaʻo ʻaʻole hiki iā ʻoe ke kāohi i kou kino. Akā ʻo ka nūhou maikaʻi, hiki ke mālama ʻia nā hōʻailona o CIDP (Chronic Inflammatory Demyelinating Polyneuropathy), ʻoiai inā hoʻomaka mua ʻoe i ka mālama ʻana. E hoʻomanaʻo e hele pū ana kāu hui lapaʻau me ʻoe i kēlā me kēia ʻanuʻu e hoʻoponopono ai i kēia kūlana. No laila e hoʻoikaika a e hahai i ka ʻōlelo aʻo a kāu kauka.

CIDP , Neuropathy, Nāwaliwali o nā ʻiʻo, Heʻe, ʻŌnaehana pale ʻana, Myelin, ʻŌnaehana Nervous, Lapaʻau CIDP, Polyneuropathy Demyelinating mumū mau loa