Loaʻa iā ʻoe kēia mau loli ma kekahi ʻaoʻao o kou maka? (E kamaʻilio kākou e pili ana i ka Horner Syndrome)!

Ua ʻike anei ʻoe he ʻaoʻao o kou helehelena e kūlou ana ka lihilihi o ka maka, he maka ʻeleʻele liʻiliʻi ma mua o kekahi, a emi ka hou ʻana ma kēlā ʻaoʻao? A i ʻole ua ʻike anei ʻoe i kekahi āu i ʻike ai e hana ana i kēia? ʻO kēia paha nā hōʻailona nui o kahi maʻi neurological laha ʻole i kapa ʻia ʻo Horner Syndrome , a mākou e kamaʻilio ai i kēia lā. Ua kapa ʻia hoʻi ʻo oculosympathetic palsy a i ʻole Bernard-Horner syndrome . Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i kēia a ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha ka Horner Syndrome? I ka pōkole...

ʻAe, e noʻonoʻo e pili ana i kēia ʻano. Loaʻa iā mākou kahi ʻōnaehana nerve kūikawā e holo ana mai ko mākou lolo a i ko mākou mau maka a me ke alo. Kāhea mākou i kēia mau mea he mau aʻalolo sympathetic . Hoʻomalu kēia ʻōnaehana nerve i kekahi o nā mea i loko o ko mākou kino i kāohi ʻole ʻia e mākou, hana koke ʻia. No ka laʻana, nā mea e like me ka hou ʻana a me nā pōʻai ʻeleʻele i loko o ko mākou mau maka e ulu ana a emi ana.

No laila, inā ua hoʻopilikia ʻia a hōʻino ʻia paha kēia ala aʻalolo sympathetic, e kū mai kēia ʻano i kapa ʻia ʻo Horner Syndrome. ʻO kēia ka wā e hoʻopilikia ʻia ai ka maka a me nā ʻiʻo a puni ma kekahi ʻaoʻao o kou maka.

He mea hoʻoweliweli anei kēia i ke ola? He mea anei e makaʻu ai?

Eia nā mea e pono ai ʻoe e hoʻomaopopo: ʻO nā hōʻailona e pili ana me ka Horner Syndrome, e like me ka lihilihi o ka maka a me ka maka ʻeleʻele aʻu i ʻōlelo ai ma mua, ʻaʻole ia e hōʻeha nui i kou olakino a i ʻole ka ʻike.

Akā, ʻo ka mea nui loa, hiki i kēia mau hōʻailona ke hōʻike i kahi pilikia olakino ma lalo, a he pilikia koʻikoʻi paha. No laila, inā ʻike ʻoe i kēia mau hōʻailona, ​​​​he mea nui e ʻimi i ka ʻōlelo aʻoaʻo lapaʻau e hoʻoholo ai i ke kumu.

ʻO wai ka mea hiki ke loaʻa i kēia? Pehea ka maʻamau?

Hiki i ka Horner Syndrome ke hoʻopilikia i nā kānaka o kēlā me kēia makahiki. I kekahi mau hihia, ma kahi o 5 pakeneka, hiki ke hānau ʻia , ʻo ia hoʻi he kūlana ia e kū nei mai ka hānau ʻana mai.

ʻAʻole kēia he maʻi maʻamau loa. Ma ke ʻano kikoʻī, hoʻopilikia ia ma kahi o 1 i loko o 6,000 mau kānaka.

He aha nā hōʻailona o kēia? I mea e pololei ai...

ʻO ka maʻamau, ʻo nā hōʻailona o ka Horner Syndrome e pili wale i hoʻokahi ʻaoʻao o kou maka. ʻO nā hōʻailona nui āu e ʻike ai:

• Ka lihilihi o ka maka: Ua kapa ʻia kēia ma ke ʻano lapaʻau he ptosis . Hoʻohālike ia i kekahi maka me he mea lā ua haʻahaʻa iki ma mua o kekahi.
• Ka emi ʻana o ka iris: Ua kapa ʻia kēia he miosis . Hiki i kēia ke hana i nā iris ma nā maka ʻelua e like ʻole ka nui, ʻoi aku ka nui o kekahi a ʻoi aku ka liʻiliʻi o kekahi.
• Ka emi ʻana a nalowale loa paha o ka hou ʻana o ka maka: Ua kapa ʻia kēia ʻano he anhidrosis . Ua emi ka hou ʻana ma ka ʻaoʻao i hoʻopilikia ʻia.

ʻO kēia mau ʻano ʻekolu nā mea nui i ʻike ʻia.

No ke aha e kū mai ai ka Horner Syndrome? He aha nā kumu?

ʻO ka hapa pinepine, ʻo ka Horner Syndrome ka mea i hoʻopilikia ʻia ai ke ala o ke aʻalolo sympathetic e hele ana i nā maka, e like me kaʻu i ʻōlelo ai ma mua. Hiki ke ʻokoʻa loa nā kumu kumu o kēia hōʻino ʻana o ke aʻalolo. E noʻonoʻo e pili ana i ia mea, hiki i kēia mau kumu ke piʻi mai kahi maʻi pepeiao waena, i kahi dissection carotid artery , kahi kīʻaha koko nui ma ka ʻāʻī, a i ʻole kahi puʻupuʻu umauma apical .

He mea kākaʻikahi loa kēia, hiki ke lilo i maʻi hānau ʻia. ʻO ka maʻamau, hana ʻia kēia e kahi ulia i ka wā hānau, ka hōʻino ʻana i nā aʻalolo a i ʻole ke aʻa carotid. ʻOi aku ka kākaʻikahi, hiki ke hoʻoili ʻia kēia maʻi mai kēlā hanauna a i kēia hanauna, akā ʻaʻole i ʻike ʻia nā genes pololei no ia mea.

ʻEkolu mau ala aʻalolo like ʻole e hiki ke komo i ka Horner Syndrome. ʻAʻole hele pololei nā aʻalolo mai ko kākou lolo i nā maka a me ke alo. Hele lākou ma nā ala ʻekolu. Hiki ke hoʻopilikia ʻia kekahi o kēia mau ala ʻekolu. No laila, aia ʻekolu ʻano o ka Horner Syndrome, hiki ke loaʻa nā kumu like ʻole.

I kekahi poʻe, ʻaʻohe kūlana olakino maopopo e hiki ke loaʻa e hoʻokumu ai i kēia maʻi. Ua kapa ʻia kēlā mau hihia he idiopathic Horner syndrome .

Nā kumu o ka maʻi Horner mua (moderate)

Hana ʻia kēia e ka hōʻino ʻia ʻana o nā aʻalolo e holo ana mai kou hypothalamus ma o kou lolo a i lalo i kou kaula iwi kuamoʻo . Hiki ke hōʻino ʻia a ālai ʻia paha kēia mau ala aʻalolo e:

• Ka haki koke ʻana o ke koko i ke kumu o ka lolo (e like me ka hahau ʻana).
• He puʻupuʻu i loko o ka hypothalamus.
• Nā ʻeha i ke kaula kuamoʻo.
• Nā maʻi e like me ka Multiple Sclerosis (MS) .
• ʻO ke ʻano kīnā ʻole o Chiari .
• ʻEnsefalitis .
• ʻO ka maʻi ʻōpū .
• ʻO ka maʻi medullary ʻaoʻao (maʻi Wallenberg) .
• ʻO Syringomyelia .

Nā kumu o ka maʻi lua (preganglionic) Horner

Hana ʻia kēia e ka hōʻino ʻia ʻana o ke ala aʻalolo e holo ana mai kou umauma, ma o ka piko o kou mau māmā, a ma ke aʻa carotid ma kou ʻāʻī. ʻO nā kūlana e hiki ke hoʻopilikia i kēia:

• Nā puʻupuʻu e ulu ana ma ka ʻaoʻao o luna o nā māmā a i ʻole ma ka lua o ka umauma.
• Nā ʻeha ma ka ʻāʻī a i ʻole ka umauma ma muli o ke ʻoki kino a i ʻole kahi ulia.
• ʻEha ka plexus brachialKa hōʻino ʻana i ka pūnaewele neural.
• ʻO ka niho ʻūlū he puʻupuʻu i loko o ka niho ma ka ʻauwae. E noʻonoʻo wale, hiki i kahi maʻi koʻikoʻi i loko o ka niho ke hana i kēia.

Nā kumu o ka tertiary (postganglionic) Horner syndrome

Hoʻokumu ʻia kēia ʻano e ka hōʻino ʻia ʻana o ke ala o ke aʻalolo mai kou ʻāʻī a i kou pepeiao waena a me ka maka. Hiki ke hana ʻia e:

• Nā ʻeha i loko o kou aʻa carotid.
• Nā maʻi pepeiao waena.
• Nā ʻeha ma ke kumu o ke poʻo.
• Nā maʻi ʻeha poʻo koʻikoʻi e like me ka migraines a i ʻole nā ​​​​​​ʻeha poʻo cluster .
• ʻO ka maʻi paratrigeminal ʻo Raeder .
• ʻO ka ʻoki ʻana o ke aʻa carotid kūloko a i ʻole ka aneurysm o ke aʻa carotid (ka pehu ʻana o ke kīʻaha koko).
• ʻO ka Shingles (herpes zoster) kahi maʻi i hoʻoulu ʻia e kahi maʻi, e like me ka measles.
• ʻO ka arteritis temporal kahi mumū o nā aʻa.

ʻIke ʻoe, he nui nā kumu. ʻO ia ke kumu inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​pono ʻoe e ʻike koke i ke kauka.

Pehea ʻoe e ʻike ai i kēia?

ʻO ka maʻamau, ʻike nā kauka i ka Horner Syndrome ma o kahi hoʻokolohua kino. ʻO ia hoʻi, ma ka nānā ʻana iā ʻoe. Eia nō naʻe, hiki ke paʻakikī iki ka loaʻa ʻana o ke kumu kumu, no ka mea, hiki ke hana ʻia e nā ʻano maʻi he nui. Eia kekahi, aia kekahi mau ʻano ʻē aʻe e hiki ke hana i nā hōʻailona like.

E nīnau ke kauka iā ʻoe e pili ana i kāu mau hōʻailona, ​​​​kou mōʻaukala olakino, a me nā ulia pōpilikia, nā maʻi, a me nā ʻoki kino ma mua. A laila e hana ʻo ia i kahi hoʻokolokolo kino.

Ma muli o kāu mōʻaukala olakino a me nā hōʻailona ʻē aʻe āu i loaʻa ai, hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aʻe e kōkua i ka hoʻoholo ʻana i ke kumu o ka maʻi Horner. Eia kekahi laʻana:

• Nā hoʻāʻo kiʻi: ʻO kēia mau mea me ka X-ray umauma, ke kiʻi resonance magnetic (MRI) , ka computed tomography (CT scan) , a i ʻole ka ultrasound .
• Nā hoʻāʻo koko: ʻO kēia mau mea ka helu koko piha (CBC) a me ka helu sedimentation erythrocyte (ESR) .

E kōkua kēia mau hoʻokolohua iā mākou e ʻike pono i ke kumu o kēia.

He aha nā lāʻau lapaʻau?

ʻO ka mālama ʻana i ka Horner Syndrome ʻo ia hoʻi ka mālama ʻana i ke kumu kumu. No ka mea he nui nā kumu, hiki ke ʻokoʻa loa nā lāʻau lapaʻau.

Eia kekahi laʻana, inā he maʻi pepeiao waena ke kumu, hāʻawi ʻia nā antibiotics. Inā he puʻupuʻu ke kumu, pono paha ke ʻoki kino, ka radiation therapy, a i ʻole ka chemotherapy. Pēlā nō, ʻokoʻa ka lāʻau lapaʻau ma muli o ke kumu.

I kekahi manawa, inā ʻaʻohe ou ʻeha a ʻoluʻolu ʻole paha, ʻaʻole paha ʻoe e pono i kekahi lāʻau kūikawā.

ʻAʻole anei hiki ke pale ʻia kēia?

Ma muli o ka nui o nā kumu kumu e hiki ai ke hoʻoulu i ka Horner Syndrome, he paʻakikī ke ʻōlelo maopopo pehea e pale aku ai i kona ulu ʻana.

Eia nō naʻe, i kekahi mau hihia, no ka laʻana inā i hana ʻia e kahi ulia (e like me ka ʻoki ʻana o ke aʻa carotid), ʻo ka lawe ʻana i nā hana palekana e pale i kou ʻāʻī a me ka hahai ʻana i nā hana palekana e pili ana i ka dissection hiki ke kōkua i ka pale ʻana i ka ulu ʻana o ka syndrome.

Pehea ke ʻano o kēia kūlana? (Pehea ke ʻano o kēia kūlana?)

ʻO ka nānā ʻana no ka Horner Syndrome e pili ana i ke kumu kumu. ʻO nā hōʻailona maʻamau (ka lihilihi o ka maka, ka maka ʻeleʻele, ka emi ʻana o ka hou ʻana) ʻaʻole ia he hopena nui i kou ola a i ʻole ka ʻike.

Inā he maʻi mau loa ke kumu kumu, e like me ka sclerosis maha , hiki ke noho ka maʻi Horner no ka manawa lōʻihi. Eia nō naʻe, inā i hoʻokumu ʻia e kahi mea no ka manawa pōkole a hiki ke mālama ʻia, e like me ka maʻi pepeiao, e nalo paha kēia mau hōʻailona ke pau ka maʻi.

Āhea ʻoe e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe nā hōʻailona o ka Horner Syndrome, e like me ke kūlou ʻana o ka lihilihi o luna ma kekahi ʻaoʻao, ka nui like ʻole o nā pōʻai ʻeleʻele ma nā maka ʻelua, a me ka emi ʻana o ka hou ʻana o ka maka ma kēlā ʻaoʻao, e ʻike koke i ke kauka.

ʻO ka maʻi Horner kahi hōʻailona kakaikahi o ka hōʻino ʻana o ke aʻalolo. ʻOiai ʻaʻole pinepine nā hōʻailona o kēia maʻi i ka pōʻino, hiki i ke kumu kumu ke lilo i mea hoʻoweliweli i ke ola, e like me ka puʻupuʻu a i ʻole ka ʻoki ʻana o ke aʻa carotid. No laila, inā loaʻa iā ʻoe kēia maʻi, he mea nui loa ia e ʻike i ke kauka e hoʻoholo i ke kumu kumu a mālama koke iā ia.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻAe, eia nā mea nui e pono ai ʻoe e hoʻomanaʻo mai kā mākou i kamaʻilio ai i kēia lā:

• ʻO ka Horner Syndrome kahi maʻi i hōʻike ʻia e nā lihilihi e kulou ana, nā lihilihi liʻiliʻi, a me ka emi ʻana o ka hou ʻana ma kekahi ʻaoʻao o ka maka.
• ʻOiai ʻaʻole weliweli kēia mau hōʻailona, ​​​​hiki i ke kūlana kumu ke koʻikoʻi.
• Nui nā kumu; ʻo ka hōʻino ʻana i ka ʻōnaehana nerve ke kumu nui.
• Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​mai hoʻonele i ka manawa a e ʻimi i ke kōkua lapaʻau. E hoʻoholo ke kauka i ke kumu a kuhikuhi i ka lāʻau e pono ai.
• I ka hapanui o nā hihia, ke mālama ʻia ke kumu kumu, e emi ana a hoʻoholo loa paha nā hōʻailona o ka maʻi Horner.

No laila, ke lana nei koʻu manaʻo he mea pono kēia ʻike iā ʻoe. E noho olakino!

ʻO ka maʻi Horner, ka maʻi oculosympathetic palsy, ptosis, miosis, anhidrosis, ka hōʻino ʻana o nā aʻalolo, nā aʻalolo sympathetic, nā maʻi neurological, nā loli o ka helehelena, nā hōʻailona maka