Ua manaʻo paha ʻoe i kahi ʻoniʻoni koke a puni kou mau maka a i ʻole kou mau papālina i kou wā e ʻakaʻaka ana a i ʻole e kamaʻilio ana me kekahi, a i ʻole i kou wā e luhi iki ana? Hiki i kēia ʻoniʻoni hiki ʻole ke kāohi ʻia o nā ʻiʻo ma kekahi ʻaoʻao o kou maka ke lilo i mea hoʻonāukiuki a hilahila hoʻi. ʻOiai he nui ka poʻe e manaʻo nei he mea maʻamau kēia, i kekahi manawa hiki ke lilo i pilikia olakino. I kēia lā ke kamaʻilio nei mākou e pili ana i kekahi o ia ʻano maʻi, ʻo Hemifacial Spasm (HFS).
He aha maoli ka Hemifacial Spasm?
I ka ʻōlelo maʻalahi, ʻo ka Hemifacial Spasm (HFS) kahi maʻi neurological e hoʻoulu ai i nā ʻūlū ʻiʻo ma kekahi ʻaoʻao o kou maka. He hōʻailona kēia e lilo pinepine i mea ʻino i ka hala ʻana o ka manawa.
Inā ʻoe e nānā i ke ʻano o ka inoa, ʻo "Hemi" ke ʻano o "hapalua." ʻO "Facial" ke ʻano o "pili i ka maka." ʻO "Spasm" ke ʻano o "ka ʻūlū ʻiʻo." No laila, ʻo "Hemifacial Spasm" ke ʻano o "ka ʻūlū ʻiʻo ma ka hapalua o ka maka."
Hoʻomaka pinepine kēia ʻano i ka wā makua, ma waena o 40 a me 60 mau makahiki. Ua kapa ʻia e nā kauka he maʻi neʻe peripheral. ʻO ia hoʻi, he pilikia me ka ʻōnaehana nerve peripheral, ʻo ia ka ʻāpana o ka ʻōnaehana nerve ma waho o ko kākou lolo a me ke kaula spinal.
He maʻi laha ʻole ka Hemifacial Spasm, a ʻoi aku ka pālua o ka loaʻa ʻana o nā wāhine i ke ʻano ma mua o nā kāne.
Aia kekahi mau ʻano nui o kēia maʻi?
ʻAe, aia ʻelua ʻano nui o kēia, ma muli o ke ʻano o ka ulu ʻana o nā hōʻailona i ka hala ʻana o ka manawa. No ka hoʻomaopopo pono ʻana i kēia, e nānā i ka papa ma lalo.
| ʻAno o ka Spasm Hemifacial | Pehea e hōʻike ʻia ai nā hōʻailona |
|---|---|
| ʻO ka Spasm Hemifacial mua | I kēia ʻano, hoʻomaka mua nā ʻiʻo a puni nā maka e ʻoniʻoni. Hiki ke hala i nā mahina a i ʻole nā makahiki no ka laha ʻana o ka ʻoniʻoni i nā ʻiʻo ma ka ʻaoʻao haʻahaʻa o ka maka. |
| ʻO ka Spasm Hemifacial Lua | I kēia hihia, hoʻomaka ka ʻūlū ʻana o nā ʻiʻo ma nā ʻaoʻao o luna a me lalo o ka maka i ka manawa like. ʻOiai hiki ke hele mai a hele aku kēia ʻūlū i ka wā mua, e hoʻomaka ia e hana pinepine i ka hala ʻana o ka manawa. |
He aha nā hōʻailona o ka ʻulaʻula o ka maka?
ʻO ka hōʻailona nui o kēia maʻi, ʻo ia ka ʻūlū ʻana o nā ʻiʻo ma kekahi ʻaoʻao o ka maka. He mea makemake ʻole kēia (ʻaʻole hiki iā mākou ke kāohi). ʻOi aku ka maʻamau o kēia ʻūlū ʻana ma ka ʻaoʻao hema ma mua o ka ʻaoʻao ʻākau. Eia naʻe, he mea kākaʻikahi loa, hiki ke hana ʻia kēia ʻūlū ʻana ma nā ʻaoʻao ʻelua o ka maka.
ʻO ka maʻamau, hoʻomaka ka hōʻailona mua me ka ʻūlū ʻana o nā maka. Hele mai kēia a nalowale. I ka hala ʻana o ka manawa, hiki i nā hōʻailona ke holomua i:
- ʻImi koke ʻole ʻia: Ua like ia me ka ʻimi ʻana, akā ʻaʻole hiki iā mākou ke kaohi.
- Ka hāpai ʻana i nā kuʻemaka: Piʻi koke ke kuʻemaka i luna ma muli o ke kuʻi ʻana.
- ʻO ka pehu ʻana o ka maka haʻahaʻa: Hiki i kēia ke hana i ka waha e huki ʻia i kekahi ʻaoʻao.
- Hoʻopilikia i nā ʻiʻo āpau ma kekahi ʻaoʻao o ka maka: I kekahi mau hihia, hiki ke hoʻomau a hoʻomau ʻole kēia ʻoniʻoni.
ʻO ka mea nui, ʻaʻole ʻeha kēia ʻūmiʻi ʻiʻo. Eia nō naʻe, i kou wā i ka lehulehu, hiki iā ia ke hoʻoluhi a hilahila iā ʻoe.
Hiki ke hoʻonui ʻia kēia mau hōʻailona e nā mea e like me ke kaumaha, ka luhi, ka ʻai ʻana, a me ka hopohopo. ʻO ka mea kupanaha, hiki i kēia mau hoʻouka kaua ke hana ʻia i kou wā e hiamoe ana. Hiki i kēia ke alakaʻi i ka insomnia i kekahi poʻe.
Nā hōʻailona ʻē aʻe
Hiki i kekahi poʻe ke ʻike i nā mea ʻē aʻe ma waho aʻe o kēia mau hōʻailona nui.
- Ke lohe ʻana i ke kani "kāomi" i loko o ka pepeiao.
- ʻEha pepeiao.
- Ka pilikia o ka lohe (ʻoi aku hoʻi ma ka HFS lua).
No ke aha lā kēia e hana nei? He aha nā kumu?
ʻO ke kumu nui o ka hemifacial spasm ʻo ke kaomi lōʻihi ma luna o kekahi o ko mākou mau aʻalolo maka (ʻo ke aʻalolo cranial ʻehiku). Eia nō naʻe, aia kekahi mau kumu ʻē aʻe no kēia kaomi.
Aia ʻelua mau aʻalolo nui ma kēlā me kēia ʻaoʻao o ko kākou maka. Hoʻomaka kēia aʻalolo ma ko kākou lolo a lālā aku ma kekahi ʻaoʻao o ka maka. Hoʻomalu ia i nā mea e like me nā ʻiʻo e hoʻomalu i nā ʻano helehelena, nā kelepa salivary i loko o ka waha, nā kelepa waimaka i loko o nā maka, a me nā ʻono ma nā hapakolu ʻelua o mua o ke alelo.
Hiki ke ʻokoʻa nā kumu ma muli o ke ʻano o HFS.
Nā kumu o ka Spasm Hemifacial Mua
ʻO kēia ke kumu maʻamau. ʻO ka mea e hana ʻia ma ʻaneʻi, he kīʻaha koko i kū ʻole i ke ʻano maʻamau.(ke kīʻaha koko) e hele mai a kaomi ma luna o ke aʻalolo maka a mākou i ʻōlelo ai. Ma muli o kēia kaomi ʻana, e mae mālie ana ka uhi pale (myelin sheath) o ke aʻalolo. A laila, ʻaʻole hele pono nā hōʻailona aʻalolo, hewa lākou a hoʻomaka nā ʻiʻo e ʻoni.
Nā kumu o ka Spasm Hemifacial Lua
ʻO kēia ka manawa e hoʻopilikia ʻia ai ke aʻalolo maka e kekahi maʻi a pilikia paha. ʻO kekahi o nā kumu:
- He ulia a ʻeha paha kokoke i ke aʻalolo maka.
- ʻO ke ʻano maʻi lolo o Bell.
- ʻO ka hōʻino ʻana i ka lolo, no ka laʻana, nā kūlana e like me ka sclerosis maha a i ʻole ka hahau.
- Nā pilikia me nā kīʻaha koko i loko o ka lolo, e like me nā aneurysms o ka lolo a me nā puʻupuʻu kīʻaha koko ʻaʻole maʻi (angiomas).
- Nā pilikia pepeiao. Nā kūlana e like me nā maʻi pepeiao waena (otitis media), mastoiditis.
- ʻO nā puʻupuʻu e kū mai ana i loko o nā kelepa salivary (parotid glands).
- Nā pilikia kūkulu e kū mai ana ma ke kua a me ka ʻaoʻao haʻahaʻa o ke poʻo.
Pehea e ʻike ai ke kauka i kēia?
Inā loaʻa iā ʻoe kēia mau hōʻailona, ke ʻike ʻoe i ke kauka, e nānā mua ʻo ia iā ʻoe ma ke kino a hana i kahi hoʻokolohua neurological.
A laila, ua ʻōlelo pinepine ʻia kahi scan MRI e kāpae i nā kumu ʻē aʻe o kāu mau hōʻailona a e ʻike i ke kumu pololei o kāu HFS. I ka HFS mua, hiki i kahi scan MRI ke ʻike i ke kīʻaha koko ʻē aʻe e kaomi ana i ke aʻalolo.
I kekahi manawa hiki i kēia mau ʻūmiʻi ʻiʻo ke like me nā ʻano ʻē aʻe o nā ʻūmiʻi maka (e like me ka blepharospasm) a i ʻole nā hopu ʻana. No laila, inā ʻaʻole hiki i kāu kauka ke ʻike pololei i ke ʻano o ka ʻūmiʻi, hiki iā ia ke paipai i kahi hoʻāʻo electromyography (EMG) .
He aha nā lāʻau lapaʻau no kēia?
ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka hoʻēmi ʻana i ke alapine (pinepine) a me ke koʻikoʻi o ka ʻulaʻula o ka maka. Aia nā koho lapaʻau i ke kumu a me ke koʻikoʻi o ke kūlana. E nānā kākou i nā koho lapaʻau nui.
| ʻAno lapaʻau | Wehewehena |
|---|---|
| Nā inikini botulinum toxin (Botox®) | ʻO kēia ka lāʻau lapaʻau laina mua i hoʻohana pinepine ʻia. Pili ia i ka hāʻawi ʻana i kahi inikini e hoʻonāwaliwali i nā ʻiʻo e hoʻoulu ai i nā spasms. ʻO ka maʻamau, he 3-4 mau mahina ka lōʻihi, a ma hope o ia mea, pono e hana hou ʻia ka inikini. |
| Nā lāʻau lapaʻau waha (nā pila) | Hāʻawi ʻia kēia mau mea i ka poʻe makemake ʻole i nā inikini Botox a i ʻole ʻaʻole hiki ke hana ʻoki kino. ʻO kēia mau mea nā lāʻau lapaʻau e like me nā anticonvulsants a me nā relaxants muscle. |
| ʻoki kino | ʻO kēia wale nō ka hopena mau loa no HFS. ʻO ke kaʻina hana ʻoki kino i kapa ʻia ʻo Microvascular Decompression e wehe i ke kīʻaha koko e kaomi ana ma ke aʻalolo a hoʻokomo i kahi pad. Manaʻo ʻia kēia no nā hihia koʻikoʻi wale nō. |
Nā Inikini Botox (Nā Inikini Toxin Botulinum)
Ua manaʻo ʻia nā inikini Botox ʻo ia ka lāʻau lapaʻau mua no HFS ma muli o ko lākou pono a me nā hopena ʻaoʻao haʻahaʻa. Hiki ke hoʻemi ʻia nā hōʻailona i loko o ʻekolu a ʻeono lā o ka inikini. Eia nō naʻe, mau nā hopena no kahi o ʻekolu a ʻehā mahina. Ma hope o kēlā, pono ʻoe e loaʻa hou i ka inikini e kāohi i nā tics.
Hiki ke loaʻa nā hopena ʻaoʻao liʻiliʻi ma hope o kēia inikini:
- Ka huhū o ka maka
- Ke kulou nei ka lihilihi o ka maka
- Ka nāwaliwali o ka helehelena no ka manawa pōkole
Nā lāʻau lapaʻau waha
Hiki i ke kauka ke kuhikuhi i nā lāʻau lapaʻau e like me kēia:
- nā lāʻau antiepileptics e like me ka carbamazepine a i ʻole gabapentin.
- ʻO nā benzodiazepines e like me clonazepam.
- Nā lāʻau hoʻomaha ʻiʻo e like me ka baclofen.
ʻOiai hiki i kēia mau lāʻau lapaʻau ke kōkua i ka hoʻēmi ʻana i ka helu o ka puʻuwai, ʻaʻole lākou e hana no nā mea āpau. Eia kekahi, hiki i ka hoʻohana lōʻihi ke hana i nā hopena ʻaoʻao e like me ka hiamoe a me ka luhi.
ʻoki kino
E like me kā mākou i ʻōlelo ai ma mua, ʻo ke ala wale nō e ho'ōla mau ai iā HFS ma o ke ʻoki kino. Eia nō naʻe, ke paipai wale nei nā kauka i kēia inā he koʻikoʻi loa ke kūlana a ʻaʻole pono nā inikini Botox.
ʻO ke ʻoki kino maʻamau i kapa ʻia ʻo ka microvascular decompression . Pili kēia i ka hoʻokuʻu ʻana i ke kīʻaha koko e ʻomi ana i ke aʻalolo mai ke aʻalolo a kau i kahi pad Teflon liʻiliʻi ma waena o nā mea ʻelua.
Inā holomua kēia ʻoki kino, ʻaʻole ʻoe e ʻeha hou mai ka HFS. Akā e like me nā ʻoki kino āpau, aia kekahi mau pilikia.
- Nā hopena i ka anesthesia.
- Ka hōʻeha mau loa a i ʻole ka pōʻino o ke aʻalolo maka no ka manawa pōkole.
- Ka hemahema o ka lohe.
- Ka liki ʻana o ka wai Cerebrospinal (CSF).
He kūlana weliweli anei kēia? Pono anei au e makaʻu?
ʻAʻole. ʻAʻole ia he mea weliweli ka Hemifacial Spasm i kou olakino kino. Eia nō naʻe, i kekahi manawa hiki i ke kūlana olakino kumu ke kumu o ia mea (e.g., kahi puʻupuʻu lolo, hōʻino ʻana o ka lolo) ke lilo i mea weliweli.
No laila he mea nui e ʻike i ke kauka i ka wā e ʻike ai ʻoe i kēia mau hōʻailona a ʻike i ke kumu pololei.
Eia kekahi, hiki iā ʻoe ke loaʻa nā pilikia e like me:
- Nā pilikia hiamoe.
- Nā pilikia olakino noʻonoʻo, e like me ka noho kaʻawale ʻana o ka nohona, ka hopohopo, a me ke kaumaha.
- Ka pani ʻana o nā maka me ke kāohi ʻole ʻia no ka manawa lōʻihi. Hiki ke lilo i mea weliweli inā hana ʻia, e like me ka wā e hoʻokele ana.
He ʻano hoʻonāukiuki a hilahila loa ka Hemifacial Spasm. ʻAʻole maikaʻi ka manaʻo o ka hiki ʻole ke kaohi i kou kino no kekahi. Akā ʻo ka nūhou maikaʻi, aia nā lāʻau lapaʻau kūpono no ia mea, e like me nā inikini Botox, nā lāʻau lapaʻau, a me ke ʻoki kino. Inā ʻike pinepine ʻoe i nā spasms maka a manaʻo ʻoe e ʻoi aku ka ʻino, e ʻike pono i ke kauka. E hana ʻo ia i nā hoʻokolohua e pono ai a hāʻawi iā ʻoe i ka hoʻolālā lapaʻau kūpono loa.
Leka Lawe-Home
- ʻO ka Hemifacial Spasm (HFS) kahi maʻi neurological e hoʻoulu ai i nā mākala ma kekahi ʻaoʻao o kou maka e ʻoniʻoni me ka hiki ʻole ke kāohi.
- Hoʻokumu pinepine ʻia kēia e ke kaomi ʻana o ke kīʻaha koko ma luna o ke aʻalolo maka, akā hiki ke loaʻa nā kumu koʻikoʻi ʻē aʻe.
- ʻOiai ʻaʻole ʻeha kēia ʻeha, hiki iā ia ke hoʻopilikia i ke ola o kēlā me kēia lā a me ke olakino noʻonoʻo.
- Aia nā lāʻau lapaʻau kūpono loa no kēia, e like me nā inikini Botox, nā lāʻau lapaʻau, a me ke ʻoki kino.
- Inā loaʻa iā ʻoe nā hōʻailona e like me kēia, he mea nui loa ia ʻaʻole e hopohopo, akā e ʻike koke i ke kauka no ka ʻike kūpono a me ka mālama ʻana.
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