Ke loli nei kou neʻe ʻana o kou mau maka? He pilikia paha kēia me ke aʻalolo ʻehā! (Fourth Nerve Palsy / Trochlear Nerve Palsy)

Ua manaʻo paha ʻoe ua ʻoi aku ke kiʻekiʻe o kekahi maka ma mua o kekahi? A i ʻole ke manaʻo nei ʻoe e ʻike ana i nā mea ma nā ʻaoʻao ʻelua, ʻoiai ke nānā ʻana i lalo, ka heluhelu ʻana i kahi puke, a i ʻole ke iho ʻana i lalo i nā alapiʻi? Inā ua hana ʻia kēia iā ʻoe, he pilikia paha ia me kou aʻalolo cranial ʻehā. E kamaʻilio pōkole kākou e pili ana i ia mea.

He aha kēia maʻi lolo ʻehā? (ʻO ka maʻi lolo ʻehā a i ʻole ka maʻi lolo ʻo Trochlear)

I ka ʻōlelo maʻalahi, ʻo ka Fourth Nerve Palsy (a i ʻole Trochlear Nerve Palsy) he ʻano ia e loaʻa ai kahi kīnā i loko o ke aʻalolo ʻehā i loko o ko kākou lolo (i kapa ʻia hoʻi ʻo ke aʻalolo trochlear) e hoʻoulu ai i nā pilikia me ka neʻe ʻana o nā maka i luna a i lalo. Hoʻopilikia pinepine ia i hoʻokahi maka wale nō (unilateral) , akā i kekahi manawa hiki ke hoʻopilikia i nā maka ʻelua (bilateral).

E noʻonoʻo e like me ke kāmela. Aia nā ʻiʻo liʻiliʻi e kōkua iā mākou e hoʻoneʻe i kēia kāmela i luna, i lalo, a i nā ʻaoʻao. Ke hana pono nei kēia aʻalolo ʻehā, he ʻiʻo kūikawā i loko o ka maka (ka 'ʻiʻo oblique superior') āna e hoʻomalu ai e kōkua iā mākou e nānā i lalo . Eia kekahi, kōkua kēia aʻalolo a me ka ʻiʻo iā mākou e hoʻoneʻe i ko mākou mau maka kokoke i ka ihu a mamao aku mai ka ihu. No laila, inā he pilikia me kēia aʻalolo, ʻo ia ka manawa e kū mai ai kēia mau pilikia ʻike a me ka neʻe ʻana o ka maka.

Pehea ka maʻamau o kēia ʻano?

ʻOiaʻiʻo, ʻaʻole maʻamau kēia hana hewa ʻana o ke aʻalolo ʻehā. Wahi a nā helu helu, ma kahi ʻāina e like me ʻAmelika, ulu kēia ʻano ma kahi o 5 mau kānaka mai kēlā me kēia 100,000 mau kānaka i kēlā me kēia makahiki. ʻO ia hoʻi, ma kahi o 17,100 mau maʻi hou i kēlā me kēia makahiki. Aia paha he poʻe me kēia ʻano ma Sri Lanka, akā he paʻakikī ke loaʻa nā helu helu pololei.

He aha nā hōʻailona o kēia?

ʻAe, e nānā kākou i nā hōʻailona e kū mai inā he pilikia me kēia aʻalolo ʻehā.

• ʻIke ʻana i ʻelua mau mea, ʻoi aku hoʻi i luna a i lalo paha (`vertical diplopia`): ʻO kēia ka hōʻailona nui. Ua like ia me ka ʻike ʻana i kekahi kiʻi ma luna o kekahi. Loaʻa i kekahi poʻe kēia i nā manawa a pau, aʻo kekahi poʻe wale nō ke nānā aku i kekahi mau ʻaoʻao.
• ʻIke wili a wili paha (`torsional diplopia`): Manaʻo paha ia me he mea lā ua hili iki ʻia ke ao nei. ʻO nā mea e like me nā paia a me nā puka e ʻike ʻia paha ua hili iki ʻia ma kahi o ke pololei.
• Nā pilikia me ka ʻike maka i ka nānā ʻana i lalo: Hoʻopilikia kēia i nā poʻe he nui. Eia kekahi laʻana:
• Ke heluhelu nei i kahi puke, hiki iā ʻoe ke ʻike i ʻelua a ʻekolu paha mau leka i ka manawa hoʻokahi, a i ʻole e huikau ʻoe.
• Ke iho au i lalo i ke alapiʻi , ʻaʻole hiki iaʻu ke ʻike pono i nā ʻanuʻu a manaʻo wau e nalowale ana koʻu kaulike.
• I ka wā e ʻai ai, ʻaʻole paha ʻoe e ʻike pono i ka mea ma kāu pā.
• Ke hoʻohuli nei i kou poʻo i kekahi ʻaoʻao e pale aku i ka neʻe ʻana o ka maka a i ʻole nā ​​pilikia ʻike:Hana pinepine kēia me ka ʻike ʻole. Ke hoʻāʻo ʻoe e kau i kou mau maka ma kahi hoʻokahi, e ʻoi aku ka maopopo o kou ʻike ke hoʻohuli ʻoe i kou poʻo i kekahi ʻaoʻao, a maʻa kou kino iā ia. I kekahi manawa, inā he maʻa kou e hoʻohuli i kou poʻo mai kou wā kamaliʻi mai, hiki i kēlā ke kumu no kēia.
• Strabismus (nā maka keʻa): ʻO kēia ka manawa ʻaʻole e kuhikuhi like nā maka. Hiki ke hōʻike ʻia ka Strabismus ma nā ʻano like ʻole ke hana ʻole ka aʻalolo cranial ʻehā:
• ʻO ka Hypertropia: Hoʻohuli ʻia kekahi maka i luna. I ka mea nānā, ʻike ʻia kekahi maka he ʻoi aku ke kiʻekiʻe ma mua o kekahi.
• ʻEsotropia: Hoʻohuli ʻia kekahi a i ʻole nā ​​maka ʻelua i loko (i ka ihu). ʻŌlelo mākou "nā maka keʻa".

Mea nui: Inā loaʻa iā ʻoe a i ʻole kāu keiki kekahi o kēia mau hōʻailona, ​​e ʻike pono i ke kauka no ka ʻōlelo aʻo. ʻAʻole kēia he mau mea e hoʻowahāwahā wale ʻia.

No ke aha e hana ʻia ai kēia hana hewa ʻana o ke aʻalolo ʻehā?

Hiki ke hana ʻia kēia hana ʻino e kekahi kūlana a hanana paha e hiki ai ke hōʻino i ke aʻalolo ʻehā. I kekahi manawa, ʻaʻole hiki i nā kauka ke loaʻa kahi kumu kikoʻī. Kāhea mākou i kēia he "idiopathic fourth nerve palsy".

Nā kumu hānau (`Congenital Fourth Nerve Palsy`)

ʻO ka pinepine, ʻo ke kumu nui o kēia hana hewa ʻana o ke aʻalolo ʻehā he maʻi hānau mua . Akā, ʻaʻole i ʻike pono nā kānaka noiʻi i ke kumu o ia mea. Ua kapa pū nā kauka i kēia ʻo 'congenital superior oblique palsy.' ʻO kēia 'superior oblique' e pili ana i ka ʻiʻo i kāohi ʻia e ke aʻalolo ʻehā i ʻōlelo ʻia ma luna.

He nui ka poʻe me kēia ʻano i hānau ʻia me kahi aʻalolo ʻehā i nalowale (ke aʻalolo 'trochlear'), a i ʻole nāwaliwali ka ʻiʻo 'superior oblique' i kāohi ʻia e kēlā aʻalolo ('atrophied'). Loaʻa i kekahi poʻe kahi aʻalolo ʻehā olakino, akā ʻaʻole hana pono ke aʻalolo o kēlā ʻiʻo.

ʻOiai ke kū nei kēia maʻi mai ka wā hānau mai, i kekahi manawa ʻaʻole paha e hōʻike kekahi pēpē i kekahi mau hōʻailona, ​​a i ʻole he mau hōʻailona liʻiliʻi wale nō paha . E ʻike mālie ʻia kēia mau hōʻailona i ko lākou ulu ʻana. No laila, nui ka poʻe me kēia maʻi mai ka wā hānau mai i ʻike ʻia i ka wā kamaliʻi a i ʻole ka wā ʻōpio.

Ma muli o nā ʻeha poʻo

Ma muli o ka hele ʻana o ko kākou aʻalolo ʻehā i kahi lōʻihi i loko o ke poʻo, ʻoi aku ka nui o ka hōʻino ʻia e ka trauma poʻo . ʻO ka hana ʻino o ke aʻalolo ʻehā i loaʻa pinepine ʻia e nā ulia kaʻa a me nā haʻuki e like me ka mokomoko. I ia mau hihia, ke lele koke ke poʻo a kū (he neʻe ʻana o ka "whiplash"), hiki ke hōʻino ʻia ke aʻalolo. Eia nō naʻe, i kekahi manawa ʻoiai he ʻeha poʻo liʻiliʻi paha hiki ke hōʻino i ke aʻalolo "trochlear".

Aia kekahi mau kumu ʻē aʻe?

ʻAe, aia kekahi mau maʻi olakino ʻē aʻe e hiki ke hōʻino a hoʻoulu i ka hana pono ʻole o ke aʻalolo ʻehā. ʻAʻole maʻamau kēia mau kumu, akā he mea nui e makaʻala i:

• Nā maʻi kīʻaha koko: Ka hōʻino ʻana i nā kīʻaha koko, ʻoiai ma muli o nā kūlana e like me ka maʻi diabetes mellitus .
• Kaomi mai kahi puʻupuʻu a puni: No ka laʻana, kekahi mau ʻano puʻupuʻu e hana ʻia i loko o ka lolo (e like me ka meningioma).
• Hoʻonui ʻia ke kaomi i loko o ke poʻo ('Hoʻonui ʻia ke kaomi intracranial').
• ʻO ka maʻi Lyme: He maʻi i laha ʻia e nā ʻuku.
• ʻO Guillain-Barré syndrome: He kūlana e hoʻopilikia ai i ka ʻōnaehana nerve.
• ʻO ka shingles (herpes zoster) e kū mai ma hope o ka moa.
• Nā ʻeha ulia pōpilikia i ka wā o ke ʻoki lolo.

Pehea ʻoe e ʻike ai i kēia?

Hiki i nā kauka ke ʻike maʻamau i kēia hana ʻino o ke aʻalolo ʻehā ma ka nānā ʻana i kāu mau hōʻailona a me ka hana ʻana i kekahi mau hoʻokolohua maʻalahi, e like me ka nānā ʻana i kāu ʻike a me nā neʻe ʻana o nā maka.

Pono paha ʻoe e ʻike i ke kauka maka (ophthalmologist) a i ʻole he neurologist e hoʻoholo pono i kēia. E nīnau ke kauka iā ʻoe i nā pilikia ʻike maka āu, a inā e maikaʻi a ʻino paha lākou ke nānā ʻoe i kekahi mau ʻaoʻao. E nānā lākou iā ʻoe i nā mea like ʻole a noi iā ʻoe e wehewehe i ko lākou ʻano iā ʻoe.

Inā kū mai kāu mau hōʻailona ma hope o kahi ʻeha poʻo, e ʻōlelo pinepine kāu kauka i kahi mea e like me ka MRI scan o ka lolo .

He aha nā lāʻau lapaʻau?

ʻO ke ʻano o ka lāʻau kūpono iā ʻoe e hilinaʻi ia i ke kumu o ka hana ʻino o kou aʻalolo ʻehā. Inā ua hana ʻia e kahi ʻeha a i ʻole ka pōʻino, e hoʻomaikaʻi pinepine ke ʻano iā ia iho i loko o ʻeono mahina i ka wā e ho'ōla ai ke aʻalolo .

A hiki i ka ho'ōla ʻana o ke aʻalolo ʻehā, pono paha ʻoe e komo i nā aniani prism e hoʻoponopono i ka ʻike pālua. Inā ʻaʻole kōkua kēia mau mea, hiki ke kōkua pū ke kau ʻana i kahi pale maka ma luna o ka maka i hoʻopilikia ʻia.

Inā ʻaʻole e hoʻomaikaʻi kāu mau hōʻailona ma hope o ʻeono mahina, e ʻōlelo paha kāu kauka i ke ʻoki kino . ʻO ka maʻamau, pili kēia i ka hoʻololi ʻana i ka ʻiʻo oblique kiʻekiʻe i nāwaliwali me kahi ʻiʻo maka ʻē aʻe i ʻoi aku ka hana. Hiki i kēia ke kōkua i ka hoʻoponopono ʻana i nā pilikia neʻe maka.

E wehewehe kāu kauka i kēia mau koho lapaʻau a me nā kikoʻī āpau iā ʻoe e pili ana i kou kūlana.

Pehea ka lōʻihi e hoʻōla ai? / He aha ka wā e hiki mai ana?

ʻO ka hapa nui o nā hihia o ka hana ʻino o ke aʻalolo ʻehā i loaʻa e hoʻopau koke ʻia i ka hala ʻana o ka manawa, ʻo ia hoʻi i loko o ʻeono mahina . ʻOiai inā pono ke ʻoki ʻana, maikaʻi ka nui o ka holomua.

Eia nō naʻe, hiki i kāu kauka ke hāʻawi iā ʻoe i ka manaʻo maikaʻi loa o ka mea e manaʻo ai, ma muli o kou kūlana kikoʻī.

Hiki ke pale ʻia kēia?

ʻAʻole hiki ke pale ʻia kekahi mau kumu o ka hana ʻino ʻana o ke aʻalolo ʻehā, e like me nā mea i hānau ʻia mai. Eia nō naʻe, hiki iā mākou ke hana i nā hana e hōʻemi ai i ka pilikia o ka hōʻino ʻana i ke aʻalolo ʻehā ma ka pale ʻana i nā ʻeha poʻo. ʻO kēia mau mea:

• E hoʻohana mau i ke kāʻei noho i ka wā e holo ai i loko o ke kaʻa a e hoʻohana i kahi noho kaʻa palekana no kāu keiki.
• Ke kau nei i ka mahiole i ka wā e holo paikikala ai a mokokaikala paha, a i ʻole e pāʻani ana i nā haʻuki e pili ana i nā ulia.
• Inā he pēpē liʻiliʻi a keiki liʻiliʻi paha kāu i loko o kou home, he mea nui e "pale i nā keiki" i ke kaiapuni home no lākou . ʻO ke ʻano kēia e hōʻemi i nā wahi e hiki ai iā lākou ke hāʻule a paʻi paha i ko lākou poʻo ma ke ʻano weliweli.
• Ke hoʻokumu nei i kahi nohona palekana no kāu poʻe aloha i loaʻa nā pilikia kaulike a i ʻole ka pilikia nui o ka hāʻule ʻana .

Āhea wau e ʻike ai i ke kauka?

He mea nui e mālama i nā kipa hahai a kāu kauka. ʻO kēia i hiki iā lākou ke nānā i kou kūlana a hana i nā hoʻololi i kāu lāʻau lapaʻau inā pono. ʻAʻole pilikia ka hana ʻino ʻana o ke aʻalolo ʻehā. Eia nō naʻe, he kūlana ia e pono ai ka ʻike pono a me ka mālama ʻana.

ʻAʻole pinepine mākou e noʻonoʻo nui i kā mākou ʻike a hiki i ka wā e hewa ai kekahi mea. Ke hana ʻia kekahi mea e like me kēia, hiki ke haunaele iki ke ola. Akā ʻo ka nūhou maikaʻi , hiki ke mālama pinepine ʻia a no ka manawa pōkole . Eia nō naʻe, he mea nui e ʻike koke i ke kauka e loaʻa ai kahi hōʻailona a me ka lāʻau lapaʻau. A laila hiki i kāu kauka ke ʻōlelo i nā mea kōkua ʻike e kōkua iā ʻoe e ʻike maopopo i nā mea a hiki i ka wā e ho'ōla ai kou aʻalolo ʻehā, a inā pono, e hāʻawi i ka lāʻau lapaʻau hou aku.

No laila, eia kekahi mau mea nui e pono ai mākou e hoʻomanaʻo:

ʻAe, eia nā kumu nui e pono ai mākou e noʻonoʻo mai nā mea a mākou i kamaʻilio ai:

• ʻO ka Fourth Allerve Palsy kahi pilikia me ke aʻalolo e kōkua iā ʻoe e nānā i lalo.
• ʻO nā hōʻailona nui ka ʻike ʻana i nā mea i nā pālua (ʻoi aku hoʻi i ka nānā ʻana i lalo) , ka ʻike maka pōwehiwehi, a me ke kīloi ʻana i ke poʻo e hoʻoponopono i ka ʻike.
• Hiki ke hānau ʻia nā kumu o kēia, a i ʻole hiki ke hana ʻia e nā mea e like me nā ʻeha poʻo .
• Inā loaʻa iā ʻoe nā hōʻailona, ​​e ʻike pono i ke kauka. Mai kali wale.
• I ka manawa pinepine, hoʻomaikaʻi kēia ʻano i ka hala ʻana o ka manawa , a i ʻole hiki i ka lāʻau lapaʻau ke loaʻa nā hopena maikaʻi.
• Hiki ke pale ʻia kekahi mau kumu o kēia ʻano ma ka pale ʻana i nā ʻeha poʻo.

No laila, inā loaʻa iā ʻoe a i ʻole kekahi āu i ʻike ai kēia mau hōʻailona, ​​​​mai hopohopo a e ʻimi i ke aʻo lapaʻau. ʻO ka wikiwiki o kou ʻike ʻana, ʻo ka wikiwiki o kou hoʻōla ʻana.

ʻO ka maʻi lolo o ke aʻalolo ʻehā, ka maʻi lolo o ke aʻalolo Trochlear, ʻike pālua, diplopia, strabismus, neʻe ʻana o ka maka, ke aʻalolo cranial, ka maʻi lolo hānau