Koj lub qhov muag puas txav mus los hloov pauv? Qhov no yuav yog teeb meem nrog lub paj hlwb plaub! (Fourth Nerve Palsy / Trochlear Nerve Palsy)

Koj puas tau xav tias ib lub qhov muag siab dua lwm lub me ntsis? Los yog koj puas xav tias koj pom tej yam hauv ob sab, tshwj xeeb tshaj yog thaum saib mus rau hauv qab, nyeem ntawv, lossis nqis ntaiv? Yog tias qhov no tau tshwm sim rau koj, nws yuav yog teeb meem nrog koj lub paj hlwb cranial thib plaub. Cia peb tham txog nws luv luv.

Kab mob plawv thib plaub no yog dab tsi? (Fourth Nerve Palsy lossis Trochlear Nerve Palsy)

Hais yooj yim xwb, mob Fourth Nerve Palsy (los yog Trochlear Nerve Palsy) yog ib qho mob uas muaj qhov tsis zoo ntawm cov hlab ntsha plaub hauv peb lub hlwb (tseem hu ua trochlear nerve) uas ua rau muaj teeb meem nrog kev txav mus los ntawm lub qhov muag thiab kev pom kev. Feem ntau nws tsuas cuam tshuam rau ib lub qhov muag xwb (unilateral) , tab sis qee zaum nws tuaj yeem cuam tshuam rau ob lub qhov muag (bilateral).

Xav txog nws zoo li lub koob yees duab. Muaj cov leeg me me uas pab peb txav lub koob yees duab no mus rau saum, nqis, thiab mus rau sab. Thaum cov hlab ntsha thib plaub no ua haujlwm zoo, ib cov leeg tshwj xeeb hauv lub qhov muag (cov leeg 'superior oblique') uas nws tswj hwm pab peb saib mus rau hauv qab . Tsis tas li ntawd, cov hlab ntsha thiab cov leeg no pab peb txav peb lub qhov muag kom ze rau lub qhov ntswg thiab deb ntawm lub qhov ntswg. Yog li, yog tias muaj teeb meem nrog cov hlab ntsha no, qhov ntawd yog thaum cov teeb meem pom kev thiab kev txav mus los ntawm lub qhov muag tshwm sim.

Tus mob no feem ntau tshwm sim li cas?

Qhov tseeb, qhov teeb meem ntawm cov hlab ntsha thib plaub no tsis yog ib qho uas pom ntau . Raws li cov ntaub ntawv suav, hauv lub tebchaws zoo li Asmeskas, muaj li ntawm 5 tus neeg ntawm txhua 100,000 tus neeg mob ib xyoos. Qhov ntawd txhais tau tias muaj li ntawm 17,100 tus neeg mob tshiab ib xyoos. Tej zaum yuav muaj cov neeg mob no hauv Sri Lanka thiab, tab sis nws nyuaj rau nrhiav cov ntaub ntawv tseeb.

Cov tsos mob ntawm qhov no yog dab tsi?

Zoo, tam sim no cia peb saib seb cov tsos mob twg tshwm sim yog tias muaj teeb meem nrog cov hlab ntsha thib plaub no.

• Pom ob yam, tshwj xeeb yog sab saud lossis sab hauv qab ('vertical diplopia'): Qhov no yog qhov tsos mob tseem ceeb. Nws zoo li pom ib daim duab nyob rau saum lwm daim. Ib txhia neeg muaj qhov no txhua lub sijhawm, thaum lwm tus tsuas muaj nws thaum saib rau qee qhov kev taw qhia.
• Pom kev tsis meej los yog tsis pom kev zoo ('torsional diplopia'): Tej zaum yuav zoo li lub ntiaj teb tig me ntsis. Tej yam xws li phab ntsa thiab qhov rooj yuav zoo li tig me ntsis es tsis ncaj.
• Teeb meem nrog kev pom kev thaum saib rau hauv qab: Qhov no cuam tshuam rau ntau tus neeg. Piv txwv li:
• Thaum nyeem ib phau ntawv, koj tuaj yeem pom ob lossis peb tsab ntawv ib zaug, lossis koj yuav tsis meej pem.
• Thaum kuv nqis ntaiv , kuv pom tsis tau cov kauj ruam zoo thiab kuv xav tias kuv poob kuv qhov sib npaug.
• Thaum noj mov, tej zaum koj yuav tsis pom dab tsi nyob rau ntawm koj lub phaj kom raug.
• Tig koj lub taub hau mus rau ib sab kom tsis txhob txav lub qhov muag lossis teeb meem pom kev:Qhov no feem ntau tshwm sim tsis paub txog. Thaum koj sim tsom koj lub qhov muag rau ib qho chaw, koj qhov kev pom kev yuav pom tseeb dua thaum koj tsa koj lub taub hau mus rau ib sab, thiab koj lub cev yuav siv rau nws. Qee zaum, yog tias koj muaj tus cwj pwm tsa koj lub taub hau txij li thaum yau, qhov ntawd kuj tuaj yeem yog ib qho laj thawj rau qhov no.
• Strabismus (qhov muag sib tshuam): Qhov no yog thaum ob lub qhov muag tsis taw tes rau tib qho kev taw qhia. Strabismus tuaj yeem tshwm sim ntau txoj kev thaum cov hlab ntsha cranial thib plaub tsis ua haujlwm:
• `Hypertropia`: Ib lub qhov muag tig mus rau saum ntuj. Rau tus neeg saib, ib lub qhov muag zoo li siab dua lwm lub.
• `Esotropia`: Ib lossis ob lub qhov muag tig mus rau hauv (mus rau lub qhov ntswg). Peb hais tias "qhov muag sib tshuam".

Tseem Ceeb: Yog tias koj lossis koj tus menyuam muaj cov tsos mob no, nco ntsoov mus ntsib kws kho mob kom tau txais kev qhia. Cov no tsis yog tej yam uas yuav tsum tsis txhob quav ntsej.

Vim li cas qhov teeb meem ntawm cov hlab ntsha thib plaub no thiaj tshwm sim?

Qhov kev ua tsis zoo no tuaj yeem tshwm sim los ntawm txhua yam mob lossis xwm txheej uas tuaj yeem ua rau lub paj hlwb plaub puas tsuaj. Qee zaum, cov kws kho mob tsis tuaj yeem nrhiav tau qhov ua rau tshwj xeeb. Peb hu qhov no tias "idiopathic fourth nerve palsy" (idiopathic fourth nerve palsy).

Cov ua rau muaj mob nkeeg txij thaum yug los ('Congenital Fourth Nerve Palsy')

Feem ntau, qhov ua rau muaj qhov teeb meem ntawm cov hlab ntsha plaub no yog ib qho mob uas muaj txij thaum yug los . Tab sis cov kws tshawb fawb tseem tsis tau paub meej tias yog vim li cas nws thiaj tshwm sim. Cov kws kho mob kuj hu qhov no ua 'congenital superior oblique palsy.' Qhov 'superior oblique' no yog hais txog cov leeg nqaij uas tswj hwm los ntawm cov hlab ntsha plaub uas tau hais los saum toj no.

Muaj coob tus neeg uas muaj tus mob no yug los nrog ib txoj hlab ntsha plaub uas ploj lawm (lub 'trochlear nerve'), lossis cov leeg nqaij 'superior oblique' uas tswj hwm los ntawm txoj hlab ntsha ntawd tsis muaj zog ('atrophied'). Lwm tus muaj ib txoj hlab ntsha plaub uas noj qab nyob zoo, tab sis cov leeg ntawm cov leeg nqaij ntawd tsis ua haujlwm zoo.

Txawm hais tias tus mob no muaj txij thaum yug los, qee zaum tus menyuam mos yuav tsis muaj tsos mob dab tsi, lossis tsuas yog muaj cov tsos mob me me xwb . Cov tsos mob no maj mam pom tseeb dua thaum lawv loj hlob tuaj. Yog li ntawd, ntau tus neeg uas muaj tus mob no txij thaum yug los raug kuaj pom thaum lawv tseem yog menyuam yaus lossis cov tub ntxhais hluas.

Vim yog raug mob taub hau

Vim tias peb cov hlab ntsha plaub mus deb heev hauv lub taub hau, nws yuav raug puas tsuaj ntau dua los ntawm kev raug mob taub hau . Kev ua haujlwm tsis zoo ntawm cov hlab ntsha plaub feem ntau yog tshwm sim los ntawm kev sib tsoo tsheb thiab kev ua si xws li kev sib tw ntaus nrig. Hauv cov xwm txheej zoo li no, thaum lub taub hau co thiab nres tam sim ntawd (kev txav 'whiplash'), cov hlab ntsha tuaj yeem raug puas tsuaj. Txawm li cas los xij, qee zaum txawm tias qhov raug mob taub hau me me tuaj yeem ua rau cov hlab ntsha 'trochlear' puas tsuaj.

Puas muaj lwm yam laj thawj?

Yog, muaj lwm yam mob uas ua rau lub paj hlwb thib plaub puas thiab ua rau lub paj hlwb thib plaub tsis ua haujlwm. Cov laj thawj no tsis tshua muaj, tab sis tseem ceeb heev uas yuav tsum paub txog:

• Cov kab mob ntawm cov hlab ntsha: Kev puas tsuaj rau cov hlab ntsha, tshwj xeeb yog vim muaj cov mob xws li ntshav qab zib mellitus .
• Kev nyem los ntawm ib qho qog nqaij hlav nyob ib puag ncig: Piv txwv li, qee hom qog nqaij hlav uas tsim nyob rau hauv lub hlwb (xws li meningioma).
• Muaj kev siab ntxiv hauv lub taub hau ('Increased intracranial pressure').
• 'Kab mob Lyme': Ib yam kab mob uas kis tau los ntawm cov kab zuam.
• Guillain-Barré syndrome: Ib qho mob uas cuam tshuam rau lub paj hlwb.
• Kab mob shingles (herpes zoster) tshwm sim tom qab mob qaib ntxhw.
• Kev raug mob thaum lub sijhawm phais hlwb.

Koj paub qhov no li cas?

Feem ntau cov kws kho mob tuaj yeem kuaj pom qhov teeb meem thib plaub no los ntawm kev saib koj cov tsos mob thiab ua ob peb qhov kev sim yooj yim, xws li saib koj qhov muag pom kev thiab kev txav ntawm lub qhov muag.

Tej zaum koj yuav tsum tau mus ntsib kws kho qhov muag (kws kho qhov muag) lossis kws kho mob hlwb kom paub tseeb qhov no. Tus kws kho mob yuav nug koj seb koj muaj teeb meem pom kev zoo li cas, thiab seb lawv puas zoo dua lossis phem dua thaum koj saib mus rau qee qhov kev taw qhia. Lawv yuav kom koj saib cov khoom sib txawv thiab nug koj piav qhia seb lawv zoo li cas rau koj.

Yog tias koj cov tsos mob tshwm sim tom qab raug mob taub hau, koj tus kws kho mob feem ntau yuav pom zoo kom ua ib yam dab tsi zoo li kev luam theej duab MRI ntawm lub hlwb .

Cov kev kho mob yog dab tsi?

Txoj kev kho mob uas zoo rau koj yuav nyob ntawm seb qhov ua rau koj cov hlab ntsha plaub tsis ua haujlwm zoo. Yog tias nws yog los ntawm kev raug mob lossis kev puas tsuaj, feem ntau qhov mob yuav zoo dua li ntawm rau lub hlis thaum cov hlab ntsha kho tau zoo .

Ua ntej cov hlab ntsha plaub kho tau zoo, tej zaum koj yuav tsum tau hnav tsom iav prism los kho qhov muag ob sab. Yog tias cov no tsis pab, hnav daim ntaub thaiv qhov muag rau saum lub qhov muag uas raug mob kuj yuav pab tau.

Yog tias koj cov tsos mob tsis zoo dua tom qab rau lub hlis, koj tus kws kho mob yuav pom zoo kom phais . Qhov no feem ntau yuav tsum hloov cov leeg nqaij oblique sab saud uas tsis muaj zog nrog lwm cov leeg nqaij ntawm lub qhov muag uas ua haujlwm ntau dua. Qhov no tuaj yeem pab kho cov teeb meem kev txav ntawm lub qhov muag.

Koj tus kws kho mob yuav piav qhia txog tag nrho cov kev xaiv kho mob no thiab cov ntsiab lus rau koj raws li lawv cuam tshuam rau koj tus mob.

Yuav siv sijhawm ntev npaum li cas los kho kom rov zoo? / Yav tom ntej yog dab tsi?

Feem ntau cov teeb meem ntawm kev ua haujlwm tsis zoo ntawm cov hlab ntsha plaub uas tau txais yuav zoo li qub, feem ntau yog li ntawm rau lub hlis . Txawm tias thaum yuav tsum tau phais mob los xij, feem ntau qhov kev vam meej zoo.

Txawm li cas los xij, koj tus kws kho mob tuaj yeem muab lub tswv yim zoo tshaj plaws rau koj txog yam koj yuav tsum tau xav txog, raws li koj qhov xwm txheej tshwj xeeb.

Qhov no puas tiv thaiv tau?

Qee yam ua rau cov hlab ntsha plaub tsis ua haujlwm zoo, xws li cov uas muaj txij thaum yug los, peb tsis tuaj yeem tiv thaiv tau. Txawm li cas los xij, peb tuaj yeem ua cov kauj ruam los txo qhov kev pheej hmoo ntawm kev puas tsuaj rau cov hlab ntsha plaub los ntawm kev zam kev raug mob taub hau. Cov no suav nrog:

• Siv txoj siv sia thaum caij tsheb thiab siv lub rooj zaum hauv tsheb uas muaj kev nyab xeeb rau koj tus menyuam.
• Hnav lub kaus mom hlau thaum caij tsheb kauj vab lossis maus taus, lossis ua si kis las uas muaj kev sib tsoo.
• Yog koj muaj ib tug me nyuam mos lossis ib tug me nyuam yaus nyob hauv koj lub tsev, nws yog ib qho tseem ceeb uas yuav tsum ua kom lub tsev tsis muaj menyuam yaus . Qhov no txhais tau tias yuav tsum txo qhov chaw uas lawv yuav ntog lossis ntaus lawv lub taub hau kom tsawg.
• Tsim kom muaj ib qho chaw nyob nyab xeeb rau cov neeg koj hlub uas muaj teeb meem sib npaug lossis muaj feem yuav poob .

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Nws yog ib qho tseem ceeb uas yuav tsum mus ntsib kws kho mob tas li. Qhov no yog kom lawv thiaj li saib xyuas koj tus mob thiab hloov koj txoj kev kho mob yog tias tsim nyog. Kev ua haujlwm tsis zoo ntawm cov hlab ntsha plaub tsis yog xwm txheej ceev. Txawm li cas los xij, nws yog ib qho mob uas xav tau kev kuaj mob thiab kev kho mob kom zoo.

Feem ntau peb tsis xav ntau txog peb qhov kev pom kev kom txog thaum muaj qee yam tsis raug. Thaum muaj qee yam zoo li no tshwm sim, lub neej yuav muaj kev ntxhov siab me ntsis. Tab sis qhov xov xwm zoo yog tias nws feem ntau kho tau thiab ib ntus xwb . Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum mus ntsib kws kho mob sai li sai tau kom tau txais kev kuaj mob thiab kev kho mob. Koj tus kws kho mob tuaj yeem pom zoo cov khoom pab pom kev uas yuav pab koj pom tej yam meej meej kom txog thaum koj lub paj hlwb plaub kho tau, thiab yog tias tsim nyog, muab kev kho mob ntxiv.

Yog li ntawd, ntawm no yog qee yam tseem ceeb uas peb yuav tsum nco ntsoov:

Zoo, ntawm no yog cov ntsiab lus tseem ceeb uas peb yuav tsum xav txog los ntawm qhov peb tau tham txog:

• Kab mob Fourth Nerve Palsy yog ib qho teeb meem nrog ib txoj hlab ntsha uas pab koj saib rau hauv qab.
• Cov tsos mob tseem ceeb yog pom tej yam ua khub (tshwj xeeb tshaj yog thaum saib rau hauv qab) , pom tsis meej, thiab tsa taub hau kom kho qhov pom kev.
• Cov ua rau qhov no tuaj yeem yog los ntawm noob neej los, lossis nws tuaj yeem yog los ntawm tej yam xws li raug mob taub hau .
• Yog koj muaj cov tsos mob, mus ntsib kws kho mob. Tsis txhob tos xwb.
• Feem ntau qhov mob no zoo dua raws sijhawm , lossis kev kho mob tuaj yeem ua rau muaj txiaj ntsig zoo.
• Qee qhov ua rau muaj tus mob no tuaj yeem zam tau los ntawm kev zam kev raug mob taub hau.

Yog li ntawd, yog tias koj lossis ib tus neeg koj paub muaj cov tsos mob no, tsis txhob ntshai thiab nrhiav kev pab kho mob. Thaum koj paub sai npaum li cas, koj yuav rov zoo sai npaum li ntawd.

Kab mob plawv thib plaub, kab mob plawv Trochlear, pom ob sab, diplopia, strabismus, qhov muag txav, hlab ntsha cranial, kab mob plawv txij thaum yug los