ʻAʻole paha ʻoe i lohe i kahi loea e nānā ana inā e hana pono ana kāu ʻōnaehana nerve, ʻo ia hoʻi kou lolo, ke kaula spinal, a me ka pūnaewele o nā aʻalolo e holo ana ma kou kino. E like me kahi loea e nānā ana inā e hana pono ana nā uwea i loko o kou home, he pōkole ma kekahi wahi, a inā paha ua haʻahaʻa ke au, nānā pū kēia kauka i ka "ʻōnaehana uila" o kou kino. I kēia lā, ke kamaʻilio nei mākou e pili ana i kēia loea, he Neurophysiologist.
I ka ʻōlelo maʻalahi, ʻo wai kahi Neurophysiologist?
He loea ka neurophysiologist e aʻo ana i ka hana o kā mākou ʻōnaehana nerve, ʻoiai kāna hana uila , a hana i nā hoʻokolohua a me ka nānā ʻana i nā maʻi e pili ana.
E noʻonoʻo, he mīkini paʻakikī loa ko kākou kino. ʻO ka lumi hoʻomalu o kēia mīkini ka ʻōnaehana nerve. ʻO ia hoʻi, ka lolo, ke kaula iwi kuamoʻo, a me nā aʻalolo e lawe ana i ka ʻike ma ke kino holoʻokoʻa. ʻO nā mea āpau āu e noʻonoʻo ai, manaʻo ai, a hana ai, ua kāohi ʻia e kēia ʻōnaehana. Mai ka manawa āu e hāpai ai i kou lima a hiki i ka manawa e kuʻi ai kou puʻuwai, he ʻāpana ia o ia mea.
No laila, inā he pilikia me kēia ʻōnaehana, inā he pilikia me ke kahe o ka ʻike a i ʻole he pilikia me nā hōʻailona uila, e kōkua kahi neurophysiologist e ʻike iā ia.
ʻO ka neurologist a me ka neurophysiologist - he aha ka ʻokoʻa ma waena o kēia mau mea ʻelua?
Hoʻohuihui pinepine ʻia kēia mau inoa ʻelua kekahi i kekahi. He mau kauka ʻelua e hana ana ma ka ʻōnaehana nerve. Akā, aia kahi ʻokoʻa iki. E hoʻomaopopo kākou i kēia me kahi laʻana.
E noʻonoʻo he pilikia me ka ʻōnaehana kukui i loko o kou hale. E kamaʻilio mua ʻoe me kahi mea uila maʻamau. Hiki iā ia ke nānā i ka ʻōnaehana uea holoʻokoʻa o ka hale, ʻike inā ua puhi ʻia ka fuse, ua hewa ke kuapo, ua pau ke kukui, a loaʻa kahi kiʻi nui. Pēlā ke ʻano o kahi Neurologist . He kauka ʻo ia i ʻike nui i kēlā me kēia ʻano o ka ʻōnaehana nerve, ʻo ia hoʻi, kona ʻano, kāna hana, a me nā maʻi āpau e pili ana iā ia. Hoʻonohonoho kahi Neurologist i kāu lāʻau lapaʻau a hoʻolālā i kāu lāʻau lapaʻau.
I kēia manawa, e noʻonoʻo ʻoe aia kahi pilikia paʻakikī loa i hiki ʻole i ka mea uila ke loaʻa. Ke emi nei ka voltage o ke au, me he mea lā he liʻiliʻi ka leaka ma kekahi wahi. A laila lawe mai ʻo ia i kahi mea e hoʻohana ana i nā mika kūikawā, he loea i ke kahe ʻana o ke au. Pēlā ke ʻano o kahi Neurophysiologist . He loea ʻo ia i ka hana o ka ʻōnaehana nerve, ʻoi aku hoʻi i ke ʻano o ka hele ʻana o nā hōʻailona uila. ʻO kāna hana, ʻo ia ke hana i nā hoʻokolohua like ʻole, kālailai i nā hopena, a ʻike pono i ka pilikia o ka hana o nā aʻalolo.
I ka ʻōlelo maʻalahi, ʻike a mālama kahi Neurologist i nā maʻi. Hana kahi Neurophysiologist i nā hoʻokolohua kūikawā a hāʻawi i ka ʻikepili koʻikoʻi e pono ai no kēlā ʻike. Akā, ʻaʻole lākou e kuhikuhi pinepine i ka lāʻau lapaʻau.
ʻO nā kuleana nui ʻelua o kahi neurophysiologist
Hiki iā mākou ke hoʻokaʻawale i nā neurophysiologists i ʻelua mau ʻāpana nui, ma muli o ke ʻano o kā lākou hana.
1. ʻO ka poʻe e hana ana i ke ʻoki kino (Neurophysiologists Surgical)
2. ʻO ka poʻe e ʻike i nā maʻi ma nā keʻena lapaʻau (Clinical Neurophysiologists)
E nānā kākou i ke kuleana o kēlā me kēia poʻe.
1. Ke Kūlana o ka Neurophysiologist ma ke ʻoki kino
He wahi koʻikoʻi loa kēia. E noʻonoʻo e hana ʻia ana kekahi ma kahi ʻoki nui ma ko lākou iwi kuamoʻo a lolo paha. I ka wā e hana ana i ke ʻoki, pono nā kauka lapaʻau e nānā i ka hōʻino ʻia o ke aʻalolo. Inā he hewa liʻiliʻi wale nō, hiki i ke kanaka ke lilo i lolo, nalowale ka lohe, a i ʻole ka hahau ʻana.
ʻO ia ka manawa e hui pū ai kekahi neurophysiologist i ka hui ʻoki kino. Hoʻohana ʻo ia i nā lako kūikawā e nānā i ka hana uila o ka ʻōnaehana nerve o ka mea maʻi i ka wā o ke hana. Ua kapa ʻia kēia ʻo Intraoperative Neurophysiology Monitoring (IONM) . Ke hoʻopilikia iki ʻia kahi aʻalolo, loli kāna mau hōʻailona uila. I ka ʻike koke ʻana o ka neurophysiologist i kēlā loli, e hoʻomaopopo ʻo ia i ke kauka ʻoki kino. A laila hiki i ke kauka ʻoki kino ke hana i nā hana e pono ai ma mua o ka hiki ʻana mai o ka hōʻino.
| ʻAno o ke ʻoki kino | Ke kuleana o ka neurophysiologist |
|---|---|
| ʻO ke ʻoki ʻana o ka iwi kuamoʻo | No ka nānā ʻana i ka hōʻino ʻana o ke kaula kuamoʻo a me nā aʻalolo e puka mai ana mai ia mea. No ke kōkua ʻana i ka pale ʻana i ka nalowale ʻana o nā lālā. |
| ʻO ke ʻoki lolo | No ka ʻike ʻana inā ua hōʻino ʻia nā ʻāpana koʻikoʻi o ka lolo, e like me nā ʻāpana e pili ana i ka ʻōlelo, ka ʻike, a me ka neʻe ʻana. |
| Nā ʻoki pepeiao, ihu, a me ka ʻāʻī (nā kaʻina hana ENT) | Ke pale ʻana i ka nalowale o ka lohe ma muli o ka hōʻino ʻia ʻana o ke aʻalolo auditory, ʻoiai i ka wā o ke ʻoki pepeiao. |
| Nā ʻoki kino koko | Ke nānā ʻana i ka hana o ka lolo e pale aku i ka pōʻino i hana ʻia e ka emi ʻana o ke kahe koko i ka lolo (ischemia). |
2. ʻO ka neurophysiologist nāna e hana i nā hōʻailona lapaʻau
ʻO kēia ke Neurophysiologist a mākou e ʻike pinepine ai, ʻo ia ka mea a kā mākou kauka e kuhikuhi mai ai iā mākou. Aia lākou ma nā haukapila a i ʻole nā keʻena lapaʻau. Hana lākou i nā hoʻokolohua like ʻole e nānā i ka hana o ka ʻōnaehana nerve. Ma muli o nā hopena o kēia mau hoʻokolohua e hoʻoholo ai kāu Neurologist i ke ʻano o kou maʻi.
Eia kekahi o nā hoʻokolohua nui a lākou e hana ai:
- EMG (Electromyography): Nānā kēia hoʻāʻo i ke olakino o kou mau ʻiʻo a me nā aʻalolo e kāohi ana iā lākou. Inā he ʻeha kou, ʻūlū, a nāwaliwali paha i kou lima, hiki i kēia hoʻāʻo ke kōkua i ka hoʻoholo ʻana inā aia ka pilikia i loko o ka ʻiʻo ponoʻī a i ʻole i loko o nā aʻalolo e hoʻolako ana iā ia. He mea nui kēia no ka ʻike ʻana i nā maʻi e like me ka Carpal Tunnel Syndrome (ʻūlū i loko o ka pulima) a me ka Peripheral Neuropathy (hōʻino ʻia nā aʻalolo i loko o nā lima a me nā wāwae ma muli o nā maʻi e like me ka maʻi diabetes).
- NCS (Nānā Hoʻokele Aʻalolo): Ke ana kēia i ka lōʻihi o ka hele ʻana o kahi hōʻailona uila ma ke aʻalolo a me ka wikiwiki o kona hele ʻana. Inā ua hōʻino ʻia kahi aʻalolo, e emi ana ka wikiwiki o ka hele ʻana o kēlā hōʻailona. I ka manawa pinepine, hana pū ʻia nā hoʻāʻo EMG a me NCS.
- EEG (Electroencephalogram): Ua lohe paha ʻoe i kēia. Pili kēia i ka hoʻopili ʻana i nā electrodes liʻiliʻi i ke poʻo a me ka hoʻopaʻa ʻana i ka hana uila o ka lolo . He mea nui kēia hoʻāʻo no ka ʻike ʻana i nā kūlana e like me ka maʻi epilepsy a me ka ʻike ʻana i kahi o ka lolo ke kumu.
- Hoʻāʻo Mana Hoʻāla ʻia: Pili kēia i ka hāʻawi ʻana i kahi mea hoʻoulu, e like me ke kukui i nā maka a i ʻole ke kani i nā pepeiao, a me ke ana ʻana i ka hana uila i loko o ka lolo a me ke kaula kuamoʻo i ka pane ʻana iā ia. ʻO ia hoʻi, ke ana nei ia i ka wikiwiki o ka hiki ʻana o ka mea āu e ʻike ai me kou mau maka i ka lolo, a me ka wikiwiki o ka hiki ʻana o ka mea āu e lohe ai me kou mau pepeiao i ka lolo.
- Haʻawina hiamoe (Haʻawina hiamoe / Polysomnography):Loaʻa i kekahi poʻe nā pilikia e like me ka hāhā ʻana, ka hiamoe ʻana, a me ka hāhā ʻana i ka wā hiamoe. No ka ʻike ʻana i kēia mau maʻi hiamoe, ua hoʻokomo ʻia ka mea maʻi i ka haukapila a nānā ʻia nā hana kino like ʻole (nā nalu lolo, ka hanu ʻana, a me ka helu o ka puʻuwai) i ka pō. Hana ʻia kēia e kahi Neurophysiologist.
Pehea e lilo ai i neurophysiologist?
He huakaʻi lōʻihi loa kēia a hoʻolaʻa ʻia. He kauka ka neurophysiologist. No laila, pono ʻoe e kākau inoa mua i ke kula lapaʻau a hoʻopau i kahi kekelē lapaʻau (MD/MBBS).
A laila:
- Pono ʻoe e hoʻopau i kahi internship hoʻokahi makahiki.
- Ma hope o kēlā, pono ʻoe e hele i kekahi mau makahiki o ke aʻo postgraduate (Residency/MD) e loaʻa ai ka ʻike loea i ka neurology.
- Ma hope o kēlā hoʻomaʻamaʻa ʻana, e aʻo hohonu ʻoe i ka hana o ka ʻōnaehana nerve a loaʻa iā ʻoe ke aʻo ʻana ma kahi subspecialty i kapa ʻia ʻo Neurophysiology.
Pono kēia i ka manawa nui, ke aʻo ʻana, a me ka hoʻolaʻa.
No laila, inā kuhikuhi kāu kauka iā ʻoe no kahi hoʻokolohua e like me ka EMG a i ʻole EEG, i kēia manawa ua ʻike ʻoe e ʻike ʻoe i kahi Neurophysiologist. ʻO ia kekahi e nānā hohonu i kāu ʻōnaehana nerve a kōkua iā ʻoe e hana i ka hōʻailona pololei loa no kou kūlana. No laila, mai makaʻu, e nīnau i kēlā kauka i nā nīnau a hopohopo paha āu e loaʻa ai. Aia lākou ma laila e kōkua iā ʻoe.
Leka Lawe-Home
- He kauka loea ka neurophysiologist i loea i ka hana uila o kā mākou ʻōnaehana nerve (lolo, nā aʻalolo).
- Hoʻōla ka neurologist i nā maʻi neurological, ʻoiai ke kōkua nei ka neurophysiologist i ka ʻike ʻana i kēlā mau maʻi ma o nā hoʻokolohua kūikawā (e like me EMG, EEG).
- I ka wā o nā ʻoki kino nui (kuʻiwi, lolo), he mea nui ke kōkua o kahi neurophysiologist e hōʻoia i ʻole e hōʻino ʻia nā aʻalolo.
- Inā ua kuhikuhi ʻia ʻoe no kahi hoʻokolohua e like me ka EMG, NCS, a i ʻole EEG, e nānā ʻia ʻoe e kahi Neurophysiologist. Mai makaʻu e nīnau i kāu kauka e pili ana i ia mea.
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