Ke ʻā nei kou mau lima a me kou mau wāwae? He Small Fiber Neuropathy paha kēia!

Ua ʻike anei ʻoe i kahi ʻano ʻūlū ma kou mau lima a me kou mau wāwae, a i ʻole kahi ʻano wela e like me nā ʻanuʻu e kolo ana a puni i loko o kou mau lima a me kou mau wāwae? Mai hoʻokuke wale i kēia mau hōʻailona me he mea lā e hana wale ʻia, ʻeā? No ka mea, i kekahi manawa aia paha kekahi kūlana ma hope o kēia mau hōʻailona e pono ai ka nānā ʻana. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana i kapa ʻia ʻo Small Fiber Neuropathy (SFN) , kahi e hana ʻia i ka wā e hōʻino ʻia ai nā olonā liʻiliʻi o ko mākou kino.

No laila, he aha ka Small Fiber Neuropathy?

I ka ʻōlelo maʻalahi, he ʻano aʻalolo kēia e pili ana i ka mahele o ka neuropathy peripheral . Hana ʻia kēia ʻano i ka wā e hōʻino ʻia ai nā olonā aʻalolo palupalu loa i loko o ko kākou ʻili no kekahi kumu. ʻO kēia mau olonā aʻalolo liʻiliʻi ka mea e hoʻouna i nā hōʻailona i ka lolo e pili ana i ka ʻeha a me ka mahana o ko kākou kino. No laila, i ka wā e hōʻino ʻia ai kēia mau mea, e like me ka mea i ʻōlelo ʻia ma mua, hiki ke loaʻa ka ʻeha ʻā a me ka ʻeha ʻana i nā lima a me nā wāwae.

Eia naʻe, ʻaʻole kēia e hoʻopilikia wale i nā lima a me nā wāwae. Hiki iā ia ke hoʻopilikia i nā olonā aʻalolo liʻiliʻi ʻē aʻe e kaohi ana i nā hana koʻikoʻi i loko o ko mākou kino, e like me ke koko a me ka helu o ka puʻuwai .

Hiki i kēia mau hōʻailona SFN ke koʻikoʻi loa i kekahi manawa, a hiki ke loaʻa ka hopena koʻikoʻi i kou ʻano ola . ʻOiai ʻaʻole kēia he kūlana koʻikoʻi a hoʻoweliweli i ke ola, hiki i kekahi manawa ke lilo i hōʻailona o kekahi kūlana koʻikoʻi ʻē aʻe. ʻO ia ke kumu e hoʻāʻo ai nā kauka e ʻimi i ke kumu o kēia kūlana, mālama iā ia, a kuhikuhi pū i nā lāʻau lapaʻau e kāohi i kēia mau hōʻailona ʻeha.

Pehea ka maʻamau o kēia ʻano?

ʻO kaʻoiaʻiʻo, ʻaʻole kēia he maʻi maʻamau loa. Wahi a kekahi noiʻi, ma kahi o 53 mau kānaka no 100,000 poʻe ma ka honua holoʻokoʻa he neuropathy fiber liʻiliʻi. Eia nō naʻe, manaʻoʻiʻo nā kānaka noiʻi he ʻoi aku ka nui o ka helu. Manaʻo lākou ʻaʻole i ʻike pono ʻia nā kānaka a pau me ke ʻano. No laila, ʻoi aku paha ka nui o ka poʻe i loaʻa i kēia pilikia ma mua o ko mākou manaʻo.

He aha nā hōʻailona o ka neuropathy fiber liʻiliʻi (SFN)?

Hiki ke ʻokoʻa nā hōʻailona o kēia maʻi mai kēlā kanaka a kēia kanaka. Eia nō naʻe, ʻo nā hōʻailona mua loa he ʻeha "pins-and-needles" a i ʻole ka wela ʻana i nā lima a me nā wāwae. I kekahi manawa hele mai kēia mau hōʻailona a hele aku, i kekahi manawa mau lākou, a pinepine lākou e ʻoi aku ka ʻino i ka hala ʻana o ka manawa.

ʻO nā hōʻailona ʻē aʻe e ʻike ʻia paha:

• Ke poniuniu nei , a i ʻole me he mea lā e kokoke ana ʻoe e hiolo.
• Ke manaʻo nei e like me ka wikiwiki o ka paʻi ʻana o kou puʻuwai (nā palpitations o ka puʻuwai) .
• Ka mae ʻana o ka ʻōpū .
• Ka hiki ʻole ke ʻike i ka ʻeha, ka wela, a i ʻole ke anu ma kahi ʻāpana liʻiliʻi o ke kino.
• ʻŌpū ʻeha , ʻai ʻole.
• Ke hou nui nei ma mua o ka maʻamau.

E noʻonoʻo i ka hoʻonāukiuki inā manaʻo ʻoe e hou ʻia ana kou mau lima a me kou mau wāwae me nā lāʻau, a i ʻole ke ahi, ʻoiai ʻoe e noho wale ana ma laila.

No ke aha e loaʻa ai iā mākou ka neuropathy fiber liʻiliʻi (SFN)? He aha nā kumu?

ʻO ka mea kupanaha, ma kahi o ka hapalua o nā hihia neuropathy fiber liʻiliʻi e kū mai me ke kumu ʻole . Ua kapa ʻia kēia e nā kauka he " idiopathic small fiber neuropathy." ʻO ia hoʻi, ʻaʻole hiki ke loaʻa ke kumu pololei.

Eia nō naʻe, ua ʻike ʻia e ka noiʻi hiki i nā maʻi like ʻole, kekahi mau kūlana hoʻoilina, a me ka ʻike ʻana i kekahi mau mea ʻawahia ke hana i kēia.

Hiki ke hana ʻia kēia ʻano e kekahi mau maʻi.

ʻO ka maʻi Diabetes Mellitus ka maʻi nui a maʻamau e hoʻopilikia nei i kēia. Ma waho aʻe o kēlā, ʻo kēia mau maʻi kekahi e hiki ke hoʻoulu i ka SFN:

• Ka pilikia o ka hoʻohana ʻana i ka waiʻona .
• ʻO nā maʻi i hoʻokumu ʻia e ka ʻōnaehana pale kino nāwaliwali, no ka laʻana , ka maʻi Celiac , Sarcoidosis , a i ʻole Sjögren's syndrome .
• Ka hoʻopilikia ʻana o ka metabolism glucose (Ka hoʻopilikia ʻole ʻana i ka glucose) .
• ʻO kekahi mau maʻi lele, no ka laʻana ʻo Hepatitis C a i ʻole HIV (Human Immunodeficiency Virus) .
• ʻO ka maʻi metabolic .
• Ka maʻi thyroid .
• He maʻi koʻikoʻi ka Sepsis .
• Ka nele o ka wikamina B.

Hiki paha ke kumu o kekahi mau kūlana hoʻoilina.

ʻO nā hoʻololi genetic i loko o nā genes e kōkua i kā mākou mau cell e hana a hoʻouna i nā hōʻailona uila ma o ka ʻōnaehana nerve hiki ke hana i ka SFN. ʻO kekahi mau maʻi hoʻoilina ʻē aʻe:

• ʻO ka maʻi ʻo Ehlers-Danlos
• Maʻi Fabry
• ʻO ka amyloidosis ʻohana
• Maʻi Pompe
• Porphyria
• Maʻi Wilson

ʻO kekahi mau lāʻau lapaʻau a me nā mea ʻawahia ...

Hiki ke hoʻonui ʻia ka pilikia o ka hoʻomohala ʻana i ka neuropathy fiber liʻiliʻi i ka wā e hoʻohana ai i kekahi mau lāʻau lapaʻau.

• ʻO kekahi mau lāʻau antibiotic , no ka laʻana , Metronidazole , Nitrofurantoin, a me Linezolid .
• Nā lāʻau lapaʻau chemotherapy , e like me Bortezomib , Thalidomide , a me Vincristine (Oncovin) .
• Nā mea hoʻopale i ka tumor necrosis factor , no ka laʻana , ʻo ia hoʻi ʻo etanercept .

He aha nā mea e hoʻonui ai i ka ʻino o nā hōʻailona? (Nā mea hoʻonāukiuki)

ʻO ka maʻamau, ʻo nā mea e hiki ke hoʻoulu i kēia mau hōʻailona he ea anuanu e pā ana i ka ʻili , a i ʻole kahi ʻāpana lole e hamo ana i ka ʻili . E noʻonoʻo, inā ʻoe e hiamoe ana i ka pō a e hamo ana nā pepa moe i kou mau wāwae, e ʻike ʻoe i ka mae ʻole a me ka ʻeha ... ʻOiai kahi mea liʻiliʻi e like me ia hiki ke hōʻeha nui i kēia poʻe.

He aha nā pilikia o kēia maʻi? Pono anei au e makaʻu?

Hiki i ka neuropathy fiber liʻiliʻi ke hōʻemi i kou hiki ke ʻeha. No ka laʻana, inā ʻoe e hoʻopā hewa i kahi mea wela, ʻoi aku ka nui o kou puhi ʻia me ka ʻike ʻole. Hiki iā ia ke hoʻolilo iā ʻoe i poniuniu a hoʻopilikia i kou hele ʻana . No laila, ʻoi aku ka nui o kou hāʻule ʻana, ʻeā? No laila pono ʻoe e makaʻala i kēia mau mea pū kekahi.

Pehea e ʻike ai ke kauka i kēia? (Diagnosis)

E hana mua ke kauka i kahi hoʻokolokolo kino a nīnau e pili ana i kou mōʻaukala olakino . ʻAʻohe hoʻokolohua hoʻokahi e hiki ke ʻike pololei i ka neuropathy fiber liʻiliʻi. Eia nō naʻe, aia kekahi mau hoʻokolohua i hana pinepine ʻia:

• Electromyography (EMG) : Hoʻāʻo kēia i ka hana uila o nā aʻalolo a me nā ʻiʻo.
• Nā hoʻāʻo hoʻoilina : E nānā i nā kumu hoʻoilina.
• Nā hoʻāʻo kiʻi : Nā mea e like me nā scan CT a i ʻole nā ​​​​scan MRI .
• Nā haʻawina hoʻoili aʻalolo : E nānā i ka wikiwiki o ka hele ʻana o nā hōʻailona ma o nā aʻalolo.
• ʻO ka biopsy ʻili - nā hoʻāʻo mānoanoa o ke aʻalolo : Lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻili a nānā ʻia ma lalo o kahi microscope e ʻike i ka nui o nā aʻalolo.
• Hoʻāʻo Quantitative Sudomotor Axon Reflex (QSART) : Hoʻāʻo kēia i ka hana o nā aʻalolo e kaohi ana i ka hou ʻana.

Eia kekahi, hiki i nā kauka ke ho'āʻo no nā kumu ʻē aʻe, e like me ka maʻi diabetes, hiki ke hana i ka neuropathy fiber liʻiliʻi.

He aha nā lāʻau lapaʻau no kēia? Hiki ke ho'ōla ʻia?

I ka mālama ʻana i kēia kūlana, kau nui nā kauka i ka hoʻēmi ʻana i ka ʻeha i hoʻokumu ʻia e ia.Loaʻa nā lāʻau lapaʻau a me nā lāʻau lapaʻau ʻē aʻe. ʻO ka neuropathy fiber liʻiliʻi he pilikia pinepine ia o kahi maʻi ʻē aʻe, no laila he mea nui e mālama pū i ke kūlana kumu .

Nā lāʻau ʻeha

Aia kekahi mau ʻano lāʻau lapaʻau e hiki ke hoʻohana ʻia e kāohi i ka ʻeha:

• Hiki i kekahi mau lāʻau antiseizure , e like me Gabapentin , Pregabalin , a me Topiramate , ke kōkua i ka hōʻemi ʻana i ka ʻeha o ke aʻalolo.
• ʻO kekahi mau lāʻau antidepressants , e like me ka amitriptyline , nortriptyline , a me desipramine , he mea maikaʻi nō hoʻi no ka ʻeha o ke aʻalolo.
• Nā lāʻau hoʻomaha ʻeha : No ka laʻana , nā kirīmi lidocaine a i ʻole nā ​​​​kīmina capsaicin . Hāʻawi kēia i ka hōʻoluʻolu ke kau ʻia ma ka wahi ʻeha.

E hoʻomanaʻo, he mea nui loa ka hoʻohana ʻana i ka lāʻau lapaʻau e like me ke kauoha a ke kauka.

He aha kāu e manaʻo ai i ka wā e noho ai me kēia maʻi?

Lohi loa ka ulu ʻana o ka neuropathy fiber liʻiliʻi. I kekahi manawa e ʻoi aku ka ʻino o nā hōʻailona a laila e like mau no nā makahiki. Ua ʻike ʻia kekahi noiʻi ma waena o 13% a me 36% o ka poʻe me ka neuropathy fiber liʻiliʻi e loaʻa i ka neuropathy fiber nui, kahi kūlana e hoʻopilikia ai i nā olonā nerve nui . Hiki i kēia ke kumu i ka nalowale o ka ʻike, e like me ka manaʻo ʻana i ka pā a me ka haʻalulu, me he mea lā e ʻaʻahu ana ʻoe i nā mīkina lima.

ʻO kou wānana ma hope o ka mālama ʻana e pili ana i ke kumu o kāu SFN. No ka laʻana, inā he maʻi diabetes kou, pono ʻoe e lawe i ka lāʻau maʻi diabetes no ke koena o kou ola. No laila, e kamaʻilio me kāu kauka e pili ana i kou kūlana a pehea e hiki ai i ka mālama ʻana ke kōkua i ka kaohi ʻana i kou ʻeha a me nā hōʻailona ʻē aʻe.

He hopena anei kēia i ke ola o ke kanaka?

ʻAʻole, ʻaʻole e hoʻopōkole ka neuropathy fiber liʻiliʻi i kou ola . Eia nō naʻe, inā he maʻi kumu e hoʻokumu ai, e like me ka maʻi diabetes a i ʻole HIV, hiki iā ia ke hoʻopilikia i ka lōʻihi o kou ola.

Pehea wau e mālama ai iaʻu iho?

ʻO kekahi o nā mea nui loa āu e hiki ai ke mālama iā ʻoe iho, ʻo ia ka hoʻokele ʻana i ka ʻeha i hoʻokumu ʻia e ka neuropathy fiber liʻiliʻi. E kuhikuhi paha kāu kauka i nā lāʻau ʻeha, akā makemake paha ʻoe e noʻonoʻo i nā papahana hoʻokele ʻeha . Hiki i kēia ke komo pū me ke aʻo ʻana a me ka hoʻōla ʻana, ka hoʻoikaika kino, a me ka lomilomi a i ʻole ka hoʻōla kino.

Āhea wau e ʻike hou ai i ke kauka?

Hiki i nā hōʻailona neuropathy fiber liʻiliʻi ke loli a ʻoi aku ka ʻino i ka hala ʻana o ka manawa. Inā loaʻa iā ʻoe ʻo SFN, e haʻi i kāu kauka inā ʻike ʻoe i nā hōʻailona i hoʻomaka ma kekahi ʻāpana o kou kino a laila ʻike ʻia ma kahi ʻāpana ʻē aʻe. Eia kekahi laʻana:

• Inā wale nō e hiki ke ʻike ʻia ka ʻeha "e like me ka lāʻau" ma koʻu mau wāwae ma koʻu mau lima.
• Inā ua piʻi ke alapine (frequency) o nā hōʻeha ʻeha, a inā paha ua ʻoi aku ka koʻikoʻi o ka ʻeha.
• Inā ʻike ʻia nā hōʻailona hou, e like me ka poniuniu a i ʻole ka paʻakikī i ka hele wāwae.

He mea maikaʻi ke ʻike koke i ke kauka i nā manawa e like me kēia.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Ke hele ʻoe e ʻike i ke kauka, e hoʻomanaʻo e nīnau i kēia mau nīnau:

• He aha ke kumu o koʻu mau hōʻailona?
• E ʻoi aku ka ʻino o koʻu mau hōʻailona?
• He aha nā lāʻau lapaʻau i ʻōlelo ʻia noʻu?
• E loaʻa anei iaʻu kēia maʻi no ka wā pau ʻole?

ʻO ka ʻike ʻana i nā pane i kēia mau nīnau e hāʻawi iā ʻoe i ka mālamalama nui.

No laila, he aha kā kākou e hoʻomanaʻo ai mai kēia? (Leka Lawe-Home)

ʻO ka neuropathy fiber liʻiliʻi (SFN) kahi maʻi mau loa e hoʻoulu ai i ka mae ʻana, ka wela, a me ka ʻeha ma nā lālā e hiki ke hoʻopilikia i kou ʻano ola. ʻIke pinepine ʻia ia he hōʻailona o kekahi maʻi ʻē aʻe, hiki ke koʻikoʻi.

Hoʻōla nā kauka i ka SFN ma ka mālama ʻana i ke kūlana kumu. Aia kekahi mau lāʻau lapaʻau a me nā papahana e kōkua i ka mālama ʻana i ka ʻeha a me nā hōʻailona ʻē aʻe e hele pū me ia. Inā ʻike ʻoe i ka mae ʻana a i ʻole ka wela ʻana i kou mau lima a me kou mau wāwae, mai hoʻowahāwahā iā ia a e ʻike i ke kauka. Hiki i kēia mau hōʻailona ke lilo i mau hōʻailona mua o kahi kūlana koʻikoʻi. Mai hopohopo, inā ʻike ʻia a mālama ʻia ʻoe i ka wā mua, hiki iā ʻoe ke kāohi i ke kūlana.

ʻO ka Neuropathy Fiber Liʻiliʻi, SFN, ʻeha aʻalolo, ʻūlū, mae wale, maʻi diabetes, neuropathy