Ke manaʻo nei ʻoe i kekahi manawa i kahi ʻeha wela ma kou mau lima a i ʻole kou mau wāwae, he ʻano ʻūlū, a i ʻole he ʻeha ʻōʻō? Ke manaʻo nei ʻoe i ka ʻeha hiki ʻole ke hoʻomanawanui ʻia ʻoiai ke kuʻi ka pepa moe i kou wāwae? Inā paha ʻoe e manaʻo he mau mea wale nō kēia mau mea, aia paha he kumu lapaʻau ma hope o kēia. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi i kapa ʻia ʻo Small Fiber Neuropathy (SFN), ka mea e hoʻoulu ai i kēia mau hōʻailona. ʻOiai he inoa lōʻihi kēia, e hoʻomaopopo maʻalahi kākou.
He aha ka Neuropathy Fiber Liʻiliʻi (SFN)?
I ka ʻōlelo maʻalahi, ʻo Small Fiber Neuropathy (SFN) kahi maʻi o ka ʻōnaehana nerve peripheral. ʻAe, he paʻakikī iki kēlā kani, ʻeā? E wehewehe kākou.
E noʻonoʻo ua uhi ʻia ko mākou kino i kahi pūnaewele o nā aʻalolo, e like me kahi ʻōnaehana uea uila. He lahilahi loa nā olonā aʻalolo, ʻaʻole mānoanoa ma mua o ka lauoho. ʻO kēia nā mea e lawe i nā manaʻo e like me ka wela, ke anu, a me ka ʻeha a ko mākou ʻili e ʻike ai i ka lolo. ʻO SFN ka wā e hōʻino ʻia ai kēlā mau olonā aʻalolo liʻiliʻi no kekahi kumu.
Ke hōʻino ʻia kēia mau aʻalolo, ʻaʻole lākou e hana pono. Hoʻomaka lākou e hoʻouna i nā hōʻailona hewa i ka lolo. ʻO ia ke kumu e manaʻo ai ʻoe i ka ʻeha wela, ʻūlū, a ʻūlū paha i kou mau lima a me kou mau wāwae me ke kumu ʻole.
ʻAʻole wale kēia kūlana e pili ana i nā aʻalolo i loko o ka ʻili, akā, i nā aʻalolo palupalu ʻē aʻe hoʻi e kaohi ana i nā hana koʻikoʻi i loko o ko mākou kino (no ka laʻana, ke koko, ka helu o ka puʻuwai). ʻAʻole hoʻoweliweli ka SFN i ke ola, akā i kekahi manawa hiki ke lilo i hōʻailona o kekahi maʻi koʻikoʻi ʻē aʻe.
He aha nā hōʻailona nui o kēia?
Hiki ke ʻokoʻa nā hōʻailona o ka SFN mai kēlā kanaka a kēia kanaka. Akā ʻo ka hōʻailona maʻamau, ʻoiai i nā pae mua, ʻo ia ka ʻeha ma nā lima a me nā wāwae. I kekahi manawa hele mai kēia ʻeha a hele aku, i kekahi manawa mau. Hiki nō hoʻi ke ʻoi aku ka ʻino i ka hala ʻana o ka manawa.
E nānā kākou i nā hōʻailona nui.
| Hōʻailona | He Wehewehe Maʻalahi |
|---|---|
| ʻEha ʻā a ʻeha paha | He ʻano wela a ʻōʻō hoʻi ma nā lima a me nā wāwae. ʻO kēia ka hōʻailona maʻamau. |
| Pōʻino a i ʻole ka nawaliwali | Manaʻo poniuniu a poʻo paha ke kū i luna, a hiki paha ke hiolo. Hiki ke hana ʻia kēia ke ala aʻe mai kahi noho. |
| Nā Palpitations | Ke manaʻo nei i ka wikiwiki o ka paʻi ʻana o kou puʻuwai, a i ʻole ke manaʻo nei e paʻi wikiwiki ana kou puʻuwai. |
| Māʻule | ʻO ka numinumi a me ka nalowale o ka ʻike ma kekahi mau wahi. |
| Ka nalowale o ka ʻike ʻana i ka ʻeha a me ka mahana | Ka nalowale ʻana o ka ʻike ʻana i ka wela, ke anu, a i ʻole ka ʻeha ma nā wahi liʻiliʻi o ke kino. Eia kekahi laʻana, ʻaʻole paha ʻoe e manaʻo i kekahi mea ʻoiai inā ʻoe e hoʻopā i kahi mea wela. |
| ʻeha ka ʻōpū | ʻEha a ʻūlū paha ka ʻōpū me ke kumu ʻole. |
| Nā loli i ka hou ʻana | Ka hou ʻana ma mua o ka maʻamau a i ʻole ka nele loa o ka hou ʻana. |
No ke aha e kū mai ai ka Small Fiber Neuropathy (SFN)?
He nīnau koʻikoʻi loa kēia. Ma kahi o ka hapalua o ka poʻe me SFN, ʻaʻohe kumu i loaʻa . Ua kapa nā kauka i kēia kūlana ʻo "Idiopathic Small Fiber Neuropathy." ʻO ia hoʻi, "SFN o ke kumu i ʻike ʻole ʻia."
Eia nō naʻe, aia kekahi mau kumu e hiki ke helu no ka hapalua i koe.
Ma muli o nā kūlana olakino ʻē aʻe
I ka manawa pinepine, ʻo SFN kahi hopena ʻaoʻao o kahi maʻi ʻē aʻe.
- Maʻi diabetes: ʻO ke kumu nui a maʻamau o SFN, ʻo ia ka maʻi diabetes. ʻO nā pae kō koko i kāohi ʻole ʻia ma luna o kahi manawa lōʻihi e hōʻino i kēia mau aʻalolo palupalu.
- ʻO ka hoʻomanawanui ʻole i ka glucose: He mea kēia e hōʻike ai i ka maʻi diabetes. Maanei pū kekahi, hiki ke hōʻino ʻia nā aʻalolo.
- Nā maʻi o ka ʻōnaehana pale:ʻO nā maʻi e like me ka maʻi Celiac, ka maʻi Sjögren, a me Sarcoidosis hiki ke hoʻoulu i ka ʻōnaehana pale ponoʻī o ke kino e hoʻouka i kēia mau aʻalolo.
- Nā maʻi: ʻO nā maʻi e like me ka Hepatitis C a i ʻole HIV hiki ke hana i ka SFN.
- Ka nele o ka wikamina B: ʻO ka hemahema o ka wikamina B12 ma ke ʻano kūikawā hiki ke hōʻino i nā aʻalolo.
- Ka maʻi hoʻohana ʻona
- Maʻi thyroid
- ʻO ka maʻi metabolic
Nā maʻi hoʻoilina
I kekahi manawa hiki ke hoʻoulu ʻia kēia maʻi e nā kumu hoʻoilina. ʻO ke ʻano kēia ua loaʻa i kekahi o kou ʻohana a hiki iā ʻoe ke loaʻa pū kekahi. ʻO 'Fabry disease' a me 'Familial amyloidosis' kekahi o ia mau laʻana.
Ma muli o kekahi mau lāʻau lapaʻau a me nā mea ʻawahia
Hiki ke hōʻino ʻia kēia mau aʻalolo ma muli o ka hopena ʻaoʻao o kekahi o nā lāʻau lapaʻau a mākou e lawe ai.
- ʻO kekahi mau lāʻau chemotherapy no ka maʻi kanesa
- kekahi mau lāʻau antibiotic (e.g. metronidazole, nitrofurantoin)
- Nā lāʻau lapaʻau e like me nā 'mea hoʻopale i ka tumor necrosis factor'
He aha nā pilikia o kēia?
ʻElua mau pilikia nui i hoʻokumu ʻia e SFN.
1. Ka nalowale ʻana o ka ʻike ʻeha: ʻO kekahi o nā pilikia nui o kēia, ʻo ia ka nalowale ʻana o ka ʻike ʻeha. E noʻonoʻo e hoʻopā ana ʻoe i kahi ipu wela ma luna o ke kapuahi, akā inā ʻaʻole ʻoe e manaʻo i ka wela, hiki iā ʻoe ke puhi i kou lima. Kiʻekiʻe ka manawa e hiki mai ai kēlā mau pōpilikia. No laila, he mea nui i kekahi me SFN e nānā mau i ko lākou mau lālā no kekahi mau ʻeha.
2. Hāʻule: ʻO ka poniuniu, ka paʻakikī i ka hele wāwae, a me ka nalowale o ke kaulike e hoʻonui i ka pilikia o ka hāʻule ʻana.
Pehea e ʻike ai ke kauka i kēia?
Ke wehewehe ʻoe i kāu mau hōʻailona, e nānā kāu kauka iā ʻoe a nīnau iā ʻoe i nā nīnau. ʻAʻohe hoʻāʻo hoʻokahi e hōʻoia i ka SFN, no laila pono paha ʻoe e loaʻa i kekahi mau hoʻāʻo.
- Biopsy ʻili: ʻO kēia ka hoʻāʻo koʻikoʻi loa e ʻike ai i kēia maʻi. Maanei, lawe ʻia kahi ʻāpana ʻili liʻiliʻi loa (ma kahi o 3 milimita) a nānā ʻia ma lalo o kahi microscope e ʻike i ke ʻano o ka mānoanoa o nā olonā aʻalolo maikaʻi.
- Hoʻāʻo reflex axon sudomotor quantitative (QSART): Hoʻāʻo kēia i ka hana ʻana o nā aʻalolo e pili ana i ka hou ʻana.
- Nā haʻawina Electromyography (EMG) a me nā haʻawina hoʻoili aʻalolo: Nānā pinepine kēia mau hoʻokolohua i ka hana o nā olonā aʻalolo nui. He mea maʻamau kēia mau hoʻokolohua ma SFN. Eia nō naʻe, he kōkua lākou i ka hoʻoholo ʻana i nā kūlana neurological ʻē aʻe.
- Nā hoʻāʻo koko: Hana ʻia nā hoʻāʻo koko e ʻimi i nā kumu kumu, e like me ka maʻi diabetes, nā hemahema o ka huaora, a me nā pilikia thyroid.
- Nā hoʻāʻo hoʻoilina: Hiki ke hana i kēia hoʻāʻo inā he kānalua no kahi kumu hoʻoilina.
He aha nā lāʻau lapaʻau?
Ke nānā nei nā kauka i ʻelua mau pahuhopu nui i ka wā o ka mālama ʻana.
1. E mālama i ke kumu kumu: ʻO kēia ka mea nui loa. Inā ma muli o ka maʻi diabetes, a laila ua kāohi maikaʻi ʻia ka maʻi diabetes. Inā he nele i ka wikamina, a laila hāʻawi ʻia nā wikamina e pono ai. Ke mālama pono ʻia ke kumu, hiki ke hoʻōki a hoʻemi ʻia paha ka hōʻino ʻana i nā aʻalolo.
2. Ke kāohi ʻana i ka ʻeha a me nā hōʻailona ʻē aʻe: Aia nā lāʻau lapaʻau kūikawā e kāohi i ka ʻeha o ke aʻalolo.
He mea nui: ʻAʻole maikaʻi loa nā lāʻau ʻeha maʻamau (e like me Paracetamol lāua ʻo Ibuprofen) no kēia ʻano ʻeha aʻalolo. No laila, he mea nui e hoʻohana wale i ka lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka.
Aia ma lalo nei kekahi o nā ʻano lāʻau lapaʻau nui i hoʻohana ʻia.
| Māhele Lāʻau Lapaʻau | Nā laʻana a me nā memo |
|---|---|
| Nā lāʻau lapaʻau antiseizure | ʻOiai he mau lāʻau lapaʻau kēia i hoʻohana ʻia no ka maʻi epilepsy, he mea maikaʻi loa nō hoʻi lākou i ka kaohi ʻana i ka ʻeha o ke aʻalolo. Eia kekahi laʻana: ʻo 'Gabapentin', 'Pregabalin' |
| Nā lāʻau hoʻēmi kaumaha | ʻOiai he mau lāʻau lapaʻau kēia i hāʻawi ʻia no ke kaumaha, hoʻohana maikaʻi ʻia lākou e kāohi i ka ʻeha i hoʻokumu ʻia e ka hōʻino ʻana o ke aʻalolo. Eia kekahi laʻana: ʻAmitriptyline, Nortriptyline, Desipramine |
| Nā lāʻau anesthetics topical | ʻO nā kirīmi, gels, a i ʻole nā plasters i hoʻopili ʻia i ka ʻili. Hoʻomāʻū kēia i ka ʻeha a hōʻemi i ka ʻeha. Eia kekahi laʻana: 'Lidocaine', 'Capsaicin' |
Āhea wau e ʻike ai i ke kauka?
Inā loaʻa iā ʻoe kekahi o nā hōʻailona i ʻōlelo ʻia ma kēia ʻatikala, ʻoiai ke kuni, ka mae ʻana, a i ʻole ke kani ʻana o kou mau lālā, mai hoʻowahāwahā wale iā lākou me he mea lā e hana wale ʻia ana, akā e ʻike pono i ke kauka. No ka mea, he hōʻailona paha ia o kahi maʻi koʻikoʻi a hiki ke mālama ʻia e like me ka maʻi diabetes.
Inā ua ʻike mua ʻia ʻoe me SFN e ke kauka, e ʻike hou i kāu kauka inā ʻike ʻoe i nā loli aʻe:
- He aha inā e laha aku ka ʻeha ma koʻu mau wāwae i koʻu mau lima?
- Inā piʻi ka alapine (frequency) a i ʻole ke koʻikoʻi o ka ʻeha.
- Inā ʻike ʻia nā hōʻailona hou, e like me ka poniuniu a i ʻole ka paʻakikī i ka hele wāwae.
Ke ʻike ʻoe i kāu kauka, hiki iā ʻoe ke nīnau i kēia mau nīnau.
- "No ke aha lā wau i loaʻa ai kēia mau hōʻailona?"
- "E ʻoi aku ka ʻino o kēia mau hōʻailona?"
- "He aha nā lāʻau lapaʻau maikaʻi loa e hiki iaʻu ke loaʻa?"
- "E loaʻa anei iaʻu kēia maʻi a mau loa aku?"
Leka Lawe-Home
- ʻO ka Small Fiber Neuropathy (SFN) kahi maʻi i hoʻokumu ʻia e ka hōʻino ʻia ʻana o nā olonā lahilahi loa o ko mākou ʻili.
- ʻO nā hōʻailona nui ka ʻeha, ka ʻā ʻana, a me ka nawaliwali ma nā lima a me nā wāwae.
- ʻO ka maʻi diabetes i kāohi ʻole ʻia ke kumu nui o kēia maʻi, no laila ʻo ka nānā ʻole ʻana i kēia mau hōʻailona he mea weliweli ia.
- Inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻike koke i kāu kauka e ʻike i ke kumu a loaʻa ka lāʻau kūpono.
- He mea nui loa ka mālama ʻana i ke kumu nui a me ka kaohi ʻana i ka ʻeha i ka mālama ʻana.
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