Kei te pāngia koe e ngā raruraru ohorere o tō roro me tō taurakira? Me ako tātou mō te ADEM (Acute Disseminated Encephalomyelitis)!

Kua rongo kē koe i te kupu `ADEM` (Acute Disseminated Encephalomyelitis)? Tērā pea he mea hou tēnei ki a koe. He mate onge tēnei, arā, he iti noa iho ngā tāngata e pāngia ana, engari ka pā ohorere mai pea, ka pā ki tō tātou pūnaha io . Kaua e manukanuka, ka kōrerohia e mātou he mea ngāwari, i roto i te huarahi e mārama ai koe.

He aha te ADEM? Kia mārama tātou.

He whakarāpopototanga noa iho, ko te ADEM he mumura ohorere, he pupuhi rānei o tō tātou Pūnaha Io Matua – arā, te roro me te tuaiwi. Whakaarohia pēnei, pērā i te wā e whara ana tātou, ka pupuhi te tinana, ka pupuhi ētahi wāhi o te roro me te tuaiwi.

Ka taea e tēnei mumura te kino i te hipoki tiaki e karapoti ana i ō tātou muka io. Ka kiia tēnei hipoki ko te hipoki myelin . He rite ki te kirihou e hipoki ana i te waea hiko. Ka āwhina i ngā karere kia tere ake te haere i roto i ngā io. Nō reira, ina pakaru tēnei hipoki myelin , kāore e pai te haere o ngā karere io. Koinei te wā ka puta ai ngā tohu rerekē. Ka karangahia hoki tēnei āhuatanga e ētahi tākuta he āhuatanga "demyelinating".

Ko te tikanga o te kupu "kōkī" i roto i te ADEM he mea ohorere te puta . I te nuinga o te wā, kotahi noa te wā e puta ai i te oranga. Heoi, he mea tino onge te hokinga mai.

He pēhea te noa o tēnei?

He tino onge te mate ADEM. E whakaatu ana ngā rangahau, i roto i tētahi whenua pēnei i Amerika, ka pāngia te kotahi i roto i te rua miriona me te hawhe tāngata. Nō reira, ehara tēnei i te mate e pāngia ana e te katoa.

He aha ngā tohu o tēnei mate?

Ko ngā tohu ADEM ka puta i ngā rā torutoru i muri i te mate huaketo, kitakita rānei . Ka rerekē ēnei tohu i ia tangata, i ia tangata, ā, ka whakawhirinaki anō hoki ki te wāhi kei reira te mumura i roto i te roro, i te taurakira rānei.

Ko ētahi o ngā tohu noa ko:

• Kirika
• Te mamae o te upoko.
• Whakapairuaki, ruaki rānei
• Pōhēhētanga
• Ngenge

Hei tāpiri, ko ngā tohu e pā ana ki te pūnaha io ko:

• Te ngenge, te ngau rānei o ngā peka
• Te uaua ki te horomi
• Te ngaronga, te pōuri rānei o te tirohanga (neuritis whatu)
• ngoikore o te uaua
• Te uaua ki te hikoi
• Ngā mate hopuhopu

Ka kitea, ka rerekē rawa atu ēnei tohu me tōna kaha i ia tangata, i ia tangata . Tērā pea ka pāngia ētahi e ngā tohu tino māmā, engari ko ētahi ka pāngia kinotia.

He aha tēnei ka tupu ai? He aha ngā take o te ADEM?

Kāore anō kia mōhiotia te tino take o te ADEM . Heoi, e kī ana ngā rangahau, ina uru mai he huaketo, he huakita rānei ki roto i tō tātou tinana, ka whawhai tō tātou pūnaha ārai mate ki a ia. Heoi, i roto i te tangata whai ADEM, ka whakaeke hē te pūnaha ārai mate i ngā wāhanga o tōna ake pūnaha io matua . He rite ki te whakaeke i tētahi o ōna ake mema, me te whakaaro he hoariri. Mā tēnei whakaeke hē ka puta te mumura (te pupuhi) i whakahuatia i mua ake nei, ā, ka puta ngā tohu.

Kua kitea kei waenganui i te 70% me te 80% o te hunga e pāngia ana e te ADEM kua pāngia e te mate, kua pāngia rānei i mua i te putanga mai o ngā tohu o te ADEM. Ko te tikanga ka tīmata ngā tohu o te ADEM i roto i ngā rā e 7 ki te 14 i muri i te pangia. Ko ētahi o ngā mate noa e pā ana ki te ADEM ko:

• Rewharewha, rewharewha rānei
• rewharewha
• Ngā matepukupuku
• Rubella
• rewharewha
• Te huaketo Epstein Barr
• Cytomegalovirus
• Te huaketo Herpes simplex ('Huaketo Herpes simplex')

Ahakoa kua honoa ngā momo huakita, huaketo me ētahi atu mate ki te ADEM, te āhua nei kāore i puta mai i tētahi mate urutā kotahi.

Nō nā tata nei, kua tautuhia tētahi atu take o te ADEM, inā koa i roto i ngā tamariki, ko te Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). E kiia ana hoki tēnei he mate pūnaha ārai mate. Ko te tikanga o tēnei ka whakaekea e te pūnaha ārai mate o te tinana tōna ake pūnaha io. Ka taea hoki e tēnei MOGAD te whakaputa i te ADEM i ētahi wā.

Ko wai kei te nui ake te mōrearea ki te whakawhanake i te ADEM?

Ka pāngia te tangata katoa e te ADEM. Heoi, he iti ake te kitea o tēnei mate i roto i ngā tamariki i ngā pakeke . Waihoki, ki te mea kua pāngia koe e te mate hou, tera pea ka paku teitei ake tō tupono ki te pāngia e te ADEM.

He aha ngā raruraru ka pā mai i te ADEM?

Ka taea e te ADEM te whakararu i ētahi raruraru, tae atu ki:

• Ngaronga o te mahara
• Te whakaroa i te tukatuka hinengaro
• Koma

He tino onge, ka taea e ngā tohu ADEM te whakararu i te ora mēnā ka kaha rawa. Engari he tino onge tēnā .

Ahakoa te maimoatanga, tera pea ka mau tonu ētahi tohumate ki ētahi tāngata:

• Te mamae nui o te upoko.
• te ngoikore
• He raruraru ki te taunga
• Te tirohanga pōuri

Me pēhea te tautuhi i te ADEM?

Mena kei a koe ngā tohu o te ADEM, ka tangohia e te tākuta he hītori taipitopito mō tō āhua, ka pātai atu mō ō tohu, ā, ka whakahaerehia he whakamātautau io , he whakamātautau tinana whānui, me ētahi atu whakamātautau hei whakatau mena kei a koe ADEM .

Ka mahia hoki ngā whakamātautau hei tirotiro mō ētahi atu mate pūtake, pērā i te MOGAD, e puta ai pea te ADEM. Ko ngā whakamātautau noa hei tautuhi i te ADEM ko ngā whakamātautau toto me:

• He matawai MRI
• Te whakamātautau wai tuaiwi

He aha te mea e tirohia ana e te whakamātautau MRI?

He tikanga whakaahua motuhake te MRI (Magnetic Resonance Imaging) e taea ai te rapu i ngā huringa hohonu i roto i te roro. Ka rapu ngā tākuta i ngā whara, i ngā ira rānei i puta mai i te ADEM i ngā wāhanga matua e toru o te pūnaha io matua: te roro, te taurakira, me ngā io whatu.

• Matū mā : Koinei te wāhi e kapi ana ngā muka io ki te myelin. He mā te āhua o ēnei i te MRI.
• Matū hina : Kei roto i tēnei ko ngā tinana o ngā pūtau io. He mangu te āhua i te MRI nā te mea kāore he myelin i roto.

I muri i ētahi marama i te MRI tuatahi, ka tono pea te tākuta i tētahi atu MRI kia kite ai me pēhea te hurihanga o ēnei wāhi i te roanga o te wā.

He aha ngā mea e rapuhia ana i roto i te whakamātautau wai o te tuaiwi?

Ka kiia hoki tēnei he pokanga lumbar . He whakamātautau nui tēnei hei kimi i te pūtake o ngā tohumate io. Ko te tikanga he tango i tētahi wāhanga iti o tō wai cerebrospinal (CSF). He wai mārama, kāore he tae te CSF e karapoti ana, e tiaki ana, e whāngai ana hoki i tō roro me tō taurakira.

I roto i te ADEM, he nui ake te maha o ngā pūtau toto mā kei roto i te wai cerebrospinal, inā koa ko ngā lymphocytes . He wāhanga hohe ēnei pūtau o tō tātou pūnaha ārai mate. Ka whakamahia tēnei tauira CSF hei tirotiro i te urupare a ēnei pūtau ki ngā huakita, ki ngā huaketo rānei e whakaarohia ana ko rātou te take o te ADEM, me te tirotiro hoki mō ētahi atu mate neuroinflammatory.

He aha ngā maimoatanga mō te ADEM?

Ko te whāinga matua o te rongoā i te ADEM he whakaiti i te mumura i roto i te roro me te taurakira . Ka taea te whakamahi i ēnei maimoatanga:

• Ngā rongoā steroidNgā rongoā steroids: Ko te rongoā tuatahi mō te ADEM ko ngā steroids intravenous (IV). Tērā pea ka hoatu mā roto i te uaua mō ētahi rā. Kātahi ka hoatu pea he pire steroid ā-waha ki a koe mō ētahi rā.
• Immunoglobulin intravenous (IVIG) : He maimoatanga tēnei kei roto ngā paturopi i hangaia mai i te plasma toto kaituku. Ka tukuna hoki tēnei ki roto i te uaua.
• Te whakawhiti toto (plasmapheresis rānei): Ko te tango i ētahi o ō toto, ka rere mā roto i tētahi mīhini hei tango i ētahi o ngā wāhanga e ngoikore ai tō pūnaha ārai mate, kātahi ka whakahokia ki roto i tō tinana. E maha ngā hāora te roa o tēnei maimoatanga, ā, ka maha ngā wā ka mahia.

Kei te haere tonu ngā rangahau ki te ako atu mō tēnei mate me te kimi i ngā maimoatanga hou.

Kia maumahara, ko tō tākuta te kaiwhakatau i ēnei maimoatanga. Māna e whiriwhiri te mea e pai ana mō tō āhua.

He pānga taha kei roto i ēnei maimoatanga?

Pērā i ngā maimoatanga katoa, ka puta pea ētahi pānga taha.

He wā poto noa iho ngā pānga taha o te maimoatanga steroid poto , engari ka uru atu pea ki:

• Te pikinga o ngā taumata huka toto
• Ngā taumata pāhare pāporo kua heke
• Te uaua ki te moe
• Ngā huringa wairua (te riri, te tangi, te manukanuka)
• Te pikinga o te taumaha
• Te whero o ngā paparinga
• Te rongo i te reka whakarewa i roto i te mangai

Ngā pānga taha me ngā raruraru o te maimoatanga `IVIG` :

• Tauhohenga mate pāwera
• Ngā mate urutā
• Te uaua ki te manawa
• Ngā toto totoka
• Te pakaru o te whatukuhu
• Te mamae o te upoko.

Ngā raruraru o te Plasmapheresis :

• Ngā raruraru
• Te toto
• Ngā mate urutā
• Te pakaru o te whatukuhu
• Te korenga o te toto e rere ki tētahi wāhanga o te tinana ('Ischemia')

Kōrero ki tō tākuta mō ēnei pānga taha. I te nuinga o te wā, ka taea te whakahaere.

Kia pēhea te roa o te wā e ora ai i muri i te maimoatanga?

Ko te nuinga o te hunga e rongoatia ana mō te ADEM ka tīmata te pai ake i roto i ngā rā torutoru o te maimoatanga . Heoi, i runga i te kaha o ō tohu, ka roa pea te ono marama ki te ora katoa. He tino onge, ka kore pea ētahi tāngata e ora katoa. Heoi, ko te nuinga o te iwi ka ora pai.

He ara anō hei ārai i te ADEM?

Kāore he huarahi motuhake hei ārai i te ADEM. Heoi, ka taea e koe te whakaiti i tō mōrearea mā te mahi i ngā tikanga akuaku pai hei karo i ngā mate huaketo me ngā mate kitakita (hei tauira, te horoi pinepine i ō ringaringa me te noho tawhiti atu i te hunga mate).

He aha te tirohanga mō te ADEM? Ka taea te rongoā?

Ko te nuinga o te hunga whai ADEM ka ora katoa, ka tata rānei ki te ora katoa i muri i te maimoatanga.Mena he tino kino te mumura, kāore e maha ngā wā ka mate koe. Ka taea e tō tākuta te hoatu ki a koe te whakaaro pai rawa atu mō tō āhuatanga.

Kotahi noa te wā ka puta ngā tohumate ADEM, engari ka taea te hoki anō i runga i te take matua (pērā i te MOGAD). Ka memeha te ADEM mā te rongoā, engari ka taea te hoki anō ngā tohumate. He roa te oranga o te nuinga o te tangata.

Āhea ahau me toro atu ki te tākuta?

Mena kei a koe ngā tohu e rite ana ki te ADEM, inā koa i muri i te mate , me toro atu ki te tākuta. Ko te wawe o te kitenga, ko te wawe hoki o te tīmatanga o te maimoatanga.

Ngā pātai nui hei pātai atu ki tō tākuta

Mena kua tāpaetia koe kei te pāngia e te ADEM, me pātai atu pea koe ki tō tākuta i ēnei pātai:

• Me pēhea taku whakarite mō ngā whakamātautau?
• He aha te momo maimoatanga e taunaki ana koe?
• He aha ngā pānga taha o te maimoatanga?
• Ka mau tonu rānei aku tohu i muri i te maimoatanga?

He mea noa te manukanuka me te mataku ina pāngia koe e ngā tohu pēnei i te kore e taea te hikoi, te ngaro o tō tirohanga, te pāngia rānei e te mate haurangi kāore i te whakamāramatia. Mā tō rōpū hauora koe e āwhina ki te whakatau i tēnei. Tērā pea ka roa ētahi maimoatanga mō ētahi rā, tae noa ki ngā hāora. I tēnei wā, pānuihia he pukapuka, mahi rānei i tētahi mea hei whakamarie i a koe. Kia mahara, he mea kotahi noa iho tēnei mō te nuinga o te tangata, engari ka taea anō te tupu.

Ngā kōrero poto hei maumahara

• Ko te ADEM he mumura ohorere o te roro me te taurakira.
• He tino onge tēnei, ā, ka puta pinepine i muri i te mate.
• E whakaarohia ana ka puta tēnei ina whakaekea hētia e tō tātou ake pūnaha ārai mate te pūnaha io.
• He rerekē ngā tohu, ā, ka uru atu ki te kirika, te ānini , te ngoikore, ngā raruraru tirohanga, me te uaua ki te hikoi.
• Ka kitea te mate mā te MRI me te whakamātautau wai o te tuaiwi.
• Kei reira ngā maimoatanga pēnei i te steroids, te IVIG, me te plasma exchange.
• He pai te ora o te nuinga o te tangata, engari he maha ngā marama ka roa pea te ora katoa.
• Ahakoa kāore he huarahi motuhake hei ārai i tēnei mate, he mea nui kia tiakina koe i ngā mate urutā.

Ko tāku tumanako ka kitea e koe he whai hua ēnei mōhiohio. Mēnā he pātai anō āu, kaua e wareware ki te kōrero ki te tākuta.