Ua ʻike anei ʻoe i ke kauka e pā mālie ana i kou kuli me kahi hāmare laholio liʻiliʻi? A laila e ʻūlū koke kou wāwae, ʻeā? He mea maʻamau kēia. Akā i kekahi manawa, hiki koke a ikaika kēia ʻūlū ʻana, a i ʻole kēia hopena (reflex). ʻO ia ka mea a mākou e kapa nei iā Hyperreflexia ma ka lāʻau lapaʻau. ʻOiai paha e like kēia inoa me kahi maʻi koʻikoʻi, ʻaʻohe mea e makaʻu ai. I kēia lā, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
E nānā mua kākou, he aha kēia reflex?
I ka ʻōlelo maʻalahi, ʻo ka reflex kahi mea e hana aunoa ʻia, me ka ʻole o kā mākou kaohi. He mau ʻano hana aunoa kēia a ko mākou kino e pale ai iā mākou. E noʻonoʻo e pili ana i ia mea, ke lele kekahi mea e like me ka pepeke i kou maka, e pani koke kou mau maka, ʻeā? ʻAʻole ia he mea āu e hana ai me ka ʻike. He mea ia a ke kino e hana ai e pale iā ia iho mai ka pōʻino hiki ke hōʻino ʻia. ʻO ka reflex like ke kumu e huki koke ai mākou i ko mākou lima i hope ke hoʻopā mākou i kahi mea wela. He mea nui kēia no ko mākou ola.
No laila, ʻo Hyperreflexia ka wā e hana nui ʻia ai kēlā mau hopena aunoa, a ikaika loa paha. He mea maʻamau no kou wāwae ke wili iki i ka wā e pā ai ʻoe i kou kuli me ka hāmare. Akā inā wili wikiwiki kou wāwae ma mua o kou manaʻo, me he mea lā e hoʻolei ʻia i mua, ʻo ia paha ʻo Hyperreflexia.
No ke aha e hana ʻia ai kēia? He aha nā kumu o ka hyperreflexia?
Aia kekahi mau kumu no kēia. Pili kekahi i ka ʻōnaehana nerve, ʻaʻole kekahi.
Nā pilikia o ka ʻōnaehana nerve (Upper Motor Neuron Lesions)
ʻO ke kumu nui a maʻamau o kēia, ʻo ia ka hōʻino ʻia ʻana o nā hunaola nerve (nā neuron motor) e lawe ana i nā leka mai ko kākou lolo a i ke kaula spinal. Ma ke ʻano lapaʻau, ua kapa ʻia kēia he ʻeha Upper Motor Neuron (UMN) . I ka pololei, ʻo ko kākou lolo ke kikowaena nui e kāohi ana i nā neʻe ʻana a me nā hopena o ke kino. ʻO nā leka e puka mai ana mai kēia lolo e hele i nā ʻiʻo ma o ke kaula spinal. Ke loaʻa ka hōʻino a i ʻole ke ālai ʻia ma kekahi wahi ma ke ala e lawe ai i kēia mau leka, e hoʻopilikia ʻia ka mana o nā hopena. A laila lilo nā hopena i ikaika loa.
Ke hōʻino ʻia ka UMN, hiki ke ʻike ʻia kekahi mau hōʻailona ʻē aʻe me Hyperreflexia. Ua kapa ʻia kēia mau mea ʻo Upper Motor Neuron Syndrome. ʻO kēia mau hōʻailona:
- Nāwaliwali o nā ʻiʻo
- ʻOʻoleʻa o nā ʻiʻo (Spasticity) - Ka ʻūmiʻi koke ʻana a me ka ʻūmiʻi ʻana o kekahi mau ʻiʻo.
- Clonus - Nā ʻūmiʻi ʻiʻo mele a kāohi ʻole ʻia.
Hiki i nā kūlana olakino ma lalo nei ke hana i kēia ʻano hōʻino UMN a me ka hyperreflexia.
| Kūlana | He hoʻolauna pōkole |
|---|---|
| ʻEha o ke kaula iwi kuamoʻo | ʻEha o ke kaula kuamoʻo ma muli o kahi ulia. |
| Sclerosis lehulehu (MS) | He maʻi e hōʻino ai i ka uhi pale a puni nā hunaola aʻalolo. |
| ʻEha lolo traumatic | Ka pōʻino o ka lolo ma muli o kahi ʻeha poʻo nui. |
| ALS (Amyotrophic Lateral Sclerosis) | He maʻi kahi e luku mālie ʻia ai nā neurons motor. |
| ka maʻi o Parkinson | He maʻi e hoʻopilikia ai i nā hunaola aʻalolo o ka lolo. |
| Ka maʻi lolo (Encephalitis) | ʻO ka maʻi lolo i hoʻokumu ʻia e nā virus a i ʻole bacteria. |
| Ka nele o ka wikamina B12 | ʻO ka nele o ka wikamina B12 i ka wā lōʻihi, he mea nui ia no ke kino, hiki ke hōʻino i ka ʻōnaehana nerve. |
ʻO nā kumu ʻē aʻe i pili ʻole i ka ʻōnaehana nerve
- Nā Maʻi Hopohopo: Inā loaʻa iā ʻoe ka hopohopo a i ʻole ka maʻi panic, aia kou kino i ke kūlana o ka 'hakakā a lele paha'. Hiki i kēia ke hoʻolilo i kou mau ʻiʻo a me nā reflexes i mea naʻaupō loa. Hiki i kēia ke alakaʻi i ka hyperreflexia. Eia naʻe, ʻaʻole ia he mau loa a hele mai a hele. ʻOi aku ka maʻamau i ka wā e hopohopo ai ʻoe a kaumaha paha.
- Hyperthyroidism: Ke hana nui ʻia ke kelepa thyroid i loko o ko kākou ʻāʻī, hana ke kino i ka nui o ka hormone thyroid. Hoʻolalelale kēia hormone i ka hana o kēlā me kēia cell i loko o ko kākou kino, me nā cell nerve. Hoʻolalelale pū kēia i nā hopena. Me ka mālama kūpono, nalo loa ke ʻano o Hyperreflexia.
Pehea ʻoe e ʻike ai i kēia, e Kauka?
E hoʻāʻo ke kauka iā ʻoe no ka hyperreflexia ma ke ʻano he ʻāpana o kahi hoʻokolohua neurological. ʻO kēia ka hoʻokolohua a mākou e ʻike ai kahi e paʻi ai lākou i kou kuli me kahi mallet laholio liʻiliʻi. Ua kapa ʻia kēia he hoʻokolohua Deep Tendon Reflex (DTR) .
He mea nui loa e noho mālie a hoʻomaha ʻoe i ka wā o kēia hoʻokolohua. Inā ʻoe e noʻonoʻo ana i ia mea a i ʻole e hopohopo ana, hewa paha nā hopena. ʻO ia ke kumu e kamaʻilio pinepine ai ke kauka iā ʻoe e pili ana i kahi mea ʻē aʻe ma mua o ka hana ʻana i kēia, e hoʻohuli iā ʻoe.
Ma waho aʻe o ke kuli, hiki i ke kauka ke ho'āʻo i nā reflexes ma nā wahi ʻē aʻe.
- Ke kua o ke kuʻekuʻe lima
- I loko o ke koʻokoʻo o ka lima
- Pūlima a me ka kuʻekuʻe wāwae
He ʻelua mau mea like ʻole ʻo Hyperreflexia a me Autonomic Hyperreflexia?
ʻAe. ʻOiai ua like iki kēia mau inoa ʻelua, ua ʻokoʻa loa kēia mau kūlana ʻelua. He mea nui loa e hoʻomaopopo pono i kēia ʻokoʻa.
ʻO Autonomic Hyperreflexia (i ʻike ʻia hoʻi ʻo Autonomic Dysreflexia) he pilikia olakino koʻikoʻi loa ia, a hiki ke hoʻoweliweli i ke ola. ʻIke pinepine ʻia ia i nā poʻe maʻi me nā ʻeha o ke kaula kuamoʻo o luna (ma luna o ka T6 thoracic vertebra). He pane nui ia o ka ʻōnaehana nerve autonomic e hoʻoulu ai i ka piʻi koke ʻana o ke koko. ʻO ka hōʻailona nui he ʻeha poʻo koke a koʻikoʻi. He kūlana kēia e pono ai ka hele ʻana i ka Emergency Department (ETU).
Akā, ʻo ka hyperreflexia a mākou e kamaʻilio nei ma kēia ʻatikala he pane wikiwiki wale nō ia i nā hono. He hōʻailona ia o kahi maʻi, ʻaʻole ia he mea e hoʻoweliweli ana i ke ola i kēlā manawa.
He aha nā lāʻau lapaʻau no kēia?
ʻO ka mālama ʻana e pili wale ana i ke kūlana kumu i hoʻokumu ai. ʻO ka pahuhopu ka mālama ʻana i kēlā kumu.
- I nā kūlana neurological hiki ʻole ke hoʻōla ʻia e like me MS a me ALS, hoʻohana ʻia ka lāʻau lapaʻau e mālama i ka maʻi. ʻOiai he mau loa ka hyperreflexia, hiki i kekahi mau lāʻau lapaʻau a i ʻole physiotherapy ke hōʻemi i ke koʻikoʻi o nā hōʻailona.
- Hiki ke hoʻomalu piha ʻia nā kūlana e like me ka hyperthyroidism a me ka hopohopo me ka lāʻau lapaʻau. Ke mālama ʻia ke kūlana, e nalowale pū ka hōʻailona hyperreflexia.
Āhea wau e ʻike ai i ke kauka?
Hiki ke paʻakikī ke ʻike inā loaʻa iā ʻoe ka hyperreflexia ma kāu iho. ʻIke pinepine ʻia ia i ka wā e nānā ai ke kauka iā ʻoe.
Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona ma lalo nei, e ʻike pono i kāu kauka ʻohana.
- Inā ʻoe e manaʻo i ka nāwaliwali i kou mau ʻiʻo.
- Inā ʻoe e manaʻo i ka ʻoʻoleʻa (spasticity) i kou mau lālā.
- Inā haʻalulu nā lālā me ke kāohi ʻole (clonus).
- Inā ʻoe e hopohopo a kaumaha ma luna o nā mea liʻiliʻi loa, hiki ke kumu o kēia ma muli o ka Hopohopo a i ʻole ka Hyperthyroidism.
E hana kāu kauka i nā hoʻokolohua e pono ai, e hoʻoholo i ke kumu, a, inā pono, e kuhikuhi iā ʻoe i kahi neurologist.
Leka Lawe-Home
- ʻO ka Hyperreflexia ka wā e hana wikiwiki ai a ikaika hoʻi nā hopena hana (reflexes) o ke kino.
- ʻO ke kumu nui o kēia, ʻo ia ka hōʻino ʻana i ka UMN, ka mea e lawe ana i nā leka mai ka lolo a i ke kaula kuamoʻo. Eia nō naʻe, hiki ke loaʻa nā kumu ʻē aʻe, e like me ka hopohopo a me ka hyperthyroidism.
- Hiki ke ʻike ʻia kēia me kahi hoʻokolohua DTR, a ke kauka e hana ai me kahi mallet laholio liʻiliʻi.
- ʻElua mau kūlana ʻokoʻa loa ʻo Hyperreflexia a me Autonomic Hyperreflexia. He kūlana weliweli ʻo Autonomic Hyperreflexia e pono ai ka mālama olakino ulia pōpilikia.
- Inā loaʻa iā ʻoe kekahi mau loli i kāu hana ʻiʻo, nāwaliwali, ʻoʻoleʻa, a i ʻole ka ʻūlū ʻana i ka mana ʻole, e nīnau koke aku i kāu kauka.
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