He aha ka Central Pontine Myelinolysis? E hoʻomaopopo maʻalahi kākou.

Inā maʻi kekahi a hoʻokomo ʻia i ka haukapila me ka wai kino haʻahaʻa a me ka paʻakai, e hāʻawi nā kauka iā lākou i ka saline e hoʻopiha ai i ka hemahema. He mea maʻamau kēlā. Akā ua ʻike anei ʻoe i kekahi manawa, inā piʻi koke a wikiwiki nā pae sodium haʻahaʻa o ke kino, hiki iā ia ke hōʻino i ka lolo? ʻO ia ka mea a mākou e kapa nei he ʻano kakaikahi akā koʻikoʻi i kapa ʻia ʻo Central Pontine Myelinolysis. ʻOiai he paʻakikī iki ka inoa, e kamaʻilio maʻalahi kākou e pili ana.

I ka ʻōlelo maʻalahi, he aha ke ʻano o kēia kūlana?

He maʻi kēia e pili ana i ka ʻōnaehana nerve. Hele nā ​​​​hōʻailona uila e pono ai ke kino ma o nā ʻāpana nerve (neurons) i loko o ko kākou lolo. Aia kahi uhi pale a puni kēia mau ʻāpana nerve. Kapa mākou iā ia ʻo ka ʻupena myelin . Ua like ia me ka ʻupena plastik a puni kahi uea uila . ʻO kēia ʻupena myelin ka mea e hiki ai i nā hōʻailona uila ke hele wikiwiki me ka ʻole o nā keʻakeʻa.

ʻO ka Central Pontine Myelinolysis (CPM) ke hōʻino ʻia nā ʻūpā myelin ma kahi kikoʻī o ka lolo, ʻo ia hoʻi nā pons . Hiki i kēia hōʻino ke hoʻopilikia i ka hana o nā ʻāpana like ʻole o ke kino.

I kekahi manawa, ma kahi o 10% o nā hihia, hiki i kēia hōʻino ke hoʻopilikia ʻaʻole wale i nā pons, akā i nā ʻāpana ʻē aʻe o ka lolo. No laila, ua ʻike ʻia kēia ʻano ma kahi inoa ākea ʻē aʻe. ʻO ia hoʻi ʻo Osmotic Demyelination Syndrome (ODS) .

ʻAʻole maʻamau kēia ʻano, akā ua ʻike ʻia aia ma kahi o 2.5% o nā maʻi i hoʻokomo ʻia i nā keʻena mālama koʻikoʻi (ICU) e pilikia ana i ka hoʻomohala ʻana i ka ODS.

He aha ke kumu o kēia kūlana?

ʻO ke kumu nui o kēia, ʻoiai ke haʻahaʻa loa ka pae sodium o ke kino (ʻo ia ka mea i loko o ka paʻakai a mākou e ʻai ai), e piʻi koke a wikiwiki loa ia. Hoʻonui nui ʻia kēia pilikia ke haʻahaʻa ka pae sodium o ke kino no nā lā ʻelua a ʻoi aku a ke hāʻawi ʻia nei ka lāʻau.

E noʻonoʻo i kēia ʻano. Ua nui ka luaʻi ʻana o kekahi kanaka no nā lā, a i ʻole he maʻi diarrhea. A laila, ʻaʻole wale ka wai, akā, ua nalowale nā ​​paʻakai e like me ka sodium mai ko lākou kino. Ke hiki mai lākou i ka haukapila, ua haʻahaʻa loa ko lākou pae sodium. I kēia manawa, ke hāʻawi nei nā kauka iā lākou i ka saline e hoʻāʻo e hoʻihoʻi i ko lākou pae sodium i ka maʻamau. Eia naʻe, inā ʻaʻole lākou i ʻike i nā kumu pilikia ʻē aʻe o ka mea maʻi, hiki paha iā lākou ke hoʻonui iki i nā pae sodium.

Ke hana ʻia kēlā, kahe koke ka wai i loko o nā hunaola lolo mai loko mai o nā hunaola. Hoʻemi nā hunaola e like me ka hua waina maloʻo. ʻO kēia loli koke ka mea e hōʻino ai i nā ʻūpā myelin a mākou i ʻōlelo ai.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia?

ʻAʻole loaʻa i nā kānaka a pau kēia maʻi ke piʻi koke ka nui o ko lākou pae sodium , akā aia kekahi poʻe i ka pilikia nui aʻe.

He aha nā hōʻailona o kēia maʻi?

Hoʻomaka pinepine nā hōʻailona e ʻike ʻia i loko o ʻelua a ʻekolu mau lā o ka hoʻoponopono ʻana i nā pae sodium o ke kino. Aia nā hōʻailona e ʻike mua ʻia, a me nā hōʻailona e ʻike ʻia i nā pule ma hope.

Akā, mai makaʻu. ʻOiai ua manaʻo mua ʻia he kiʻekiʻe ka nui o ka make, ua hoʻoholo ʻia kēlā e ka autopsy. Wahi a ka ʻikepili hou, 94% o ka poʻe i loaʻa i ke kūlana e ola ana . Eia kekahi, ma waena o 25% a me 40% o lākou e ho'ōla piha ʻia . Eia nō naʻe, ma waena o 25% a me 30% paha e waiho ʻia me kekahi kīnā mau loa.

Pehea e ʻike ai nā kauka i kēia?

ʻO ke ala maikaʻi loa e ʻike ai i kēia maʻi me ka MRI (Magnetic Resonance Imaging) . E nānā kāu kauka i nā kiʻi MRI o kou lolo a nānā i nā loli kikoʻī e hōʻike ana i ka hōʻino ʻia ʻana o nā ʻōpala myelin.

I kekahi manawa, ʻaʻole ʻike koke ʻia kēia pōʻino ma kahi MRI, no laila e noi paha kāu kauka iā ʻoe e hana hou i kahi MRI i hoʻokahi a ʻelua paha pule.

Hiki i ka CPM ke like me kekahi mau kūlana ʻē aʻe ma nā kiʻi MRI. No laila, makaʻala loa nā kauka i ʻole e huikau i kēia kūlana me nā maʻi ma lalo nei.

• Sclerosis lehulehu
• ʻO ka encephalitis autoimmune a i ʻole ka encephalitis infectious (ka mumū o ka lolo)
• ʻO ka vasculitis o ka ʻōnaehana nerve waena
• Kekahi mau ʻano maʻi ʻaʻai

Inā ʻaʻole hiki i ka MRI wale nō ke hōʻike maopopo i ka pōʻino, e hana ke kauka i kahi hoʻokolohua neurological hohonu aʻe. Hiki i kēia ke komo pū me nā hoʻokolohua e ana i nā hōʻailona uila i loko o ka lolo, e like me ka EEG (electroencephalography).

Pehea e mālama ai? ʻO ka pale ʻana ka mea maikaʻi loa!

ʻO ka mea ʻoiaʻiʻo, ʻo ka lāʻau nui no ka Central Pontine Myelinolysis ʻo ia ka pale ʻana i ke kūlana mai ka hanana ʻana .

Inā loaʻa iā ʻoe kēia maʻi, e hilinaʻi ka lāʻau lapaʻau i nā hōʻailona āu e ʻike nei. I nā hihia he nui, pono nā mahina o ka hoʻōla kino a me nā lāʻau hoʻōla hou ʻē aʻe.

Inā loaʻa iā ʻoe nā hōʻailona like me ka maʻi o Parkinson, e like me ka haʻalulu, hiki i kāu kauka ke kuhikuhi i nā lāʻau dopaminergic .

I kou noho ʻana ma ka haukapila, ʻo ka pale ʻana i nā pilikia lua hou aʻe he ʻāpana koʻikoʻi nō hoʻi ia o ka mālama ʻana. E nānā mau ana ke kime lapaʻau i nā mea e like me:

• Hilinaʻi ʻana i kahi ventilator
• Nā maʻi ʻōpū mimi
• Pneumonia
• ʻO ke koko i loko o ke aʻa (Deep vein thrombosis)
• Ka emi ʻana o nā ʻiʻo

Aia kekahi mau hoʻokolohua lapaʻau e hana ʻia nei no kēia maʻi, a hiki i kāu kauka ke ʻōlelo aku i hoʻokahi.