Ingabe ukunyakaza kwamehlo akho kuyashintsha? Lokhu kungaba yinkinga nge-fourth nerve! (Fourth Nerve Palsy / Trochlear Nerve Palsy)

Wake wazizwa sengathi iso elilodwa liphakeme kancane kunelinye? Noma uzizwa sengathi ubona izinto ngezindlela ezimbili, ikakhulukazi uma ubheka phansi, ufunda incwadi, noma wehla izitebhisi? Uma lokhu kuye kwenzeka kuwe, kungaba yinkinga nge-fourth cranial nerve yakho. Ake sixoxe ngakho kafushane.

Iyini le nerve palsy yesine? (I-Fourth Nerve Palsy noma i-Trochlear Nerve Palsy)

Kalula nje, i-Fourth Nerve Palsy (noma i-Trochlear Nerve Palsy) yisimo lapho kukhona khona iphutha emsipheni wesine ebuchosheni bethu (obizwa nangokuthi i-trochlear nerve) elibangela izinkinga ngokunyakaza kwamehlo nokubona phezulu naphansi. Ngokuvamile kuthinta iso elilodwa kuphela (eliyi-unilateral) , kodwa ngezinye izikhathi kungathinta amehlo womabili (amabili).

Cabanga ngakho njengekhamera. Kunemisipha emincane esisiza ukuhambisa le khamera phezulu, phansi, nangaseceleni. Uma le nzwa yesine isebenza kahle, imisipha ekhethekile ngaphakathi kweso ('imisipha eqondile ephezulu') eyilawulayo isisiza ukuthi sibheke phansi . Futhi, le nzwa nemisipha kusisiza ukuthi sihambise amehlo ethu eduze nekhala futhi kude nekhala. Ngakho-ke, uma kunenkinga ngale nzwa, yilapho kuvela khona lezi zinkinga zokubona nokunyakaza kwamehlo.

Sivame kangakanani lesi simo?

Empeleni, lokhu kungasebenzi kahle kwemizwa kwesine akuvamile kangako . Ngokwezibalo, ezweni elifana neMelika, lesi simo sivela kubantu abangaba ngu-5 kwabangu-100,000 ngonyaka. Lokho kusho ukuthi iziguli ezintsha ezingaba ngu-17,100 ngonyaka. Kungase kube nabantu abanalesi simo eSri Lanka, kodwa kunzima ukuthola izibalo eziqondile.

Ziyini izimpawu zalokhu?

Kulungile, manje ake sibone ukuthi yiziphi izimpawu ezenzekayo uma kunenkinga ngale nerve yesine.

• Ukubona izinto ezimbili, ikakhulukazi phezulu noma phansi (`vertical diplopia`): Lolu uphawu oluyinhloko. Kufana nokubona isithombe esisodwa phezu kwesinye. Abanye abantu banakho lokhu ngaso sonke isikhathi, kanti abanye banakho kuphela uma bebheka ngezindlela ezithile.
• Umbono osontekile noma osontekile (`i-torsional diplopia`): Kungase kuzwakale sengathi umhlaba utshekile kancane. Izinto ezifana nezindonga neminyango zingase zibonakale zitshekile kancane esikhundleni sokuba ziqonde.
• Izinkinga ngokubona lapho ubheka phansi: Lokhu kuthinta abantu abaningi. Isibonelo:
• Uma ufunda incwadi, ungabona izinhlamvu ezimbili noma ezintathu ngesikhathi, noma udideke.
• Uma ngehla ezitebhisini , angikwazi ukubona kahle izitebhisi futhi ngizizwa sengathi ngilahlekelwa yibhalansi yami.
• Uma udla, ungase ungakwazi ukubona kahle ukuthi yini esesitsheni sakho.
• Ukutshekisa ikhanda lakho eceleni ukuze ugweme ukunyakaza kwamehlo noma izinkinga zokubona:Lokhu kuvame ukwenzeka ungaqondile. Uma uzama ukugxila amehlo akho endaweni eyodwa, ukubona kwakho kuyacaca uma uthambekisa ikhanda lakho ohlangothini olulodwa, futhi umzimba wakho uyajwayela. Ngezinye izikhathi, uma unomkhuba wokuthambekisa ikhanda lakho kusukela ebuntwaneni, lokho kungaba yimbangela yalokhu.
• I-Strabismus (amehlo ahlanganisiwe): Lokhu kwenzeka lapho amehlo engabhekiseli ohlangothini olufanayo. I-Strabismus ingabonakala ngezindlela ezahlukene lapho inzwa yesine ye-cranial ingasebenzi kahle:
• `I-Hypertropia`: Iso elilodwa libheke phezulu. Kumuntu obukayo, iso elilodwa libonakala liphakeme kunelinye.
• `I-Esotropia`: Iso elilodwa noma womabili aphendukela ngaphakathi (ngakwempumulo). Sithi "amehlo ahlanganisiwe".

Okubalulekile: Uma wena noma ingane yakho ninayo noma iyiphi yalezi zimpawu, qiniseka ukuthi ubona udokotela ukuze uthole iseluleko. Lezi akuzona izinto okufanele uzishaye indiva nje.

Kungani lokhu kungasebenzi kahle kwemizwa yesine kwenzeka?

Lokhu kungasebenzi kahle kungabangelwa yinoma yisiphi isimo noma isenzakalo esingalimaza inzwa yesine. Ngezinye izikhathi, odokotela abakwazi ukuthola imbangela ethile. Lokhu sikubiza ngokuthi "i-idiopathic fourth nerve palsy".

Izimbangela zokuzalwa (`Congenital Fourth Nerve Palsy`)

Ngokuvamile, imbangela eyinhloko yalokhu kungasebenzi kahle kwemizwa yesine yisimo sokuzalwa . Kodwa abacwaningi abakakatholi ukuthi kungani kwenzeka. Odokotela babiza lokhu ngokuthi 'i-congenital superior oblique palsy.' Lokhu 'superior oblique' kubhekisela emsipheni olawulwa yi-fourth nerve eshiwo ngenhla.

Abantu abaningi abanalesi simo bazalwa bene-fournev engekho (i-'trochlear nerve'), noma i-'superior oblique' muscle elawulwa yi-lornev ebuthakathaka ('atrophied'). Abanye bane-fournev enempilo, kodwa i-tendon yalowo muscle ayisebenzi kahle.

Ngisho noma lesi simo sikhona kusukela ekuzalweni, ngezinye izikhathi ingane ingase ingakhombisi zimpawu, noma ingaba nezimpawu ezingabonakali kakhulu . Lezi zimpawu ziya ngokuya zibonakala njengoba zikhula. Ngakho-ke, abantu abaningi abanalesi simo kusukela ekuzalweni batholakala besebancane noma besebancane.

Ngenxa yokulimala ekhanda

Ngenxa yokuthi inzwa yethu yesine ihamba ibanga elide ngaphakathi ekhanda, kungenzeka kakhulu ukuthi yonakale ngenxa yokulimala ekhanda . Ukungasebenzi kahle kwenzwa yesine okutholakale kuvame ukubangelwa izingozi zezimoto nemidlalo efana nebhokisi. Ezimweni ezinjalo, lapho ikhanda ligxumagxuma futhi lime ngokuzumayo (ukunyakaza kwe-'whiplash'), inzwa ingalimala. Kodwa-ke, ngezinye izikhathi ngisho nokulimala okuncane ekhanda kungalimaza inzwa ye-'trochlear'.

Ingabe zikhona ezinye izizathu?

Yebo, kunezinye izimo zempilo ezingalimaza futhi zibangele ukungasebenzi kahle kwenzwa yesine. Lezi zimbangela azivamile, kodwa kubalulekile ukuzazi:

• Izifo zemithambo yegazi: Ukulimala kwemithambo yegazi, ikakhulukazi ngenxa yezimo ezifana nesifo sikashukela .
• Ukucindezeleka okuvela esimilaneni esizungezile: Isibonelo, ezinye izinhlobo zezimila ezakheka ebuchosheni (njenge-meningioma).
• Ukwanda kwengcindezi ngaphakathi kogebhezi (`Ukwanda kwengcindezi yangaphakathi kobuchopho`).
• `Isifo seLyme`: Isifo esidluliselwa ngamakhizane.
• I-Guillain-Barré syndrome: Isimo esithinta isimiso sezinzwa.
• Ama-shingles (i-herpes zoster) ayenzeka ngemva kwe-chickenpox.
• Ukulimala ngengozi ngesikhathi sokuhlinzwa kobuchopho.

Ukubona kanjani lokhu?

Odokotela bavame ukuxilonga lokhu kungasebenzi kahle kwemizwa yesine ngokubheka izimpawu zakho nokwenza izivivinyo ezimbalwa ezilula, njengokubheka ukubona kwakho kanye nokunyakaza kwamehlo.

Cishe kuzodingeka ubonane nodokotela wamehlo (ochwepheshe bamehlo) noma udokotela wezinzwa ukuze aqinisekise lokhu. Udokotela uzokubuza ukuthi yiziphi izinkinga zokubona onazo, nokuthi ziya ziba ngcono noma zimbi uma ubheka ngezindlela ezithile. Bazokubuza ukuthi ubheke izinto ezahlukene futhi bakucele ukuthi uchaze ukuthi zibukeka kanjani kuwe.

Uma izimpawu zakho ziqala ukuvela ngemva kokulimala ekhanda, udokotela wakho uvame ukuncoma okuthile okufana ne-brain MRI scan .

Yiziphi izindlela zokwelapha?

Ukwelashwa okufanele kuzoncika esibangweni sokungasebenzi kahle kwenzwa yakho yesine. Uma kubangelwa ukulimala noma umonakalo, isimo sizoba ngcono ngokwaso zingakapheli izinyanga eziyisithupha njengoba inzwa iphola .

Kuze kube yilapho inzwa yesine iphola, kungadingeka ukuthi ugqoke izibuko zamehlo ze-prism ukuze ulungise ukubona okukabili. Uma lokhu kungasizi, ukufaka i-eye patch phezu kweso elithintekile nakho kungasiza.

Uma izimpawu zakho zingathuthuki ngemva kwezinyanga eziyisithupha, udokotela wakho angase akuncome ukuhlinzwa . Lokhu kuvame ukuhilela ukufaka esikhundleni semisipha ebuthakathaka eqondile ngomunye umsipha wamehlo osebenza kakhulu. Lokhu kungasiza ekulungiseni izinkinga zokunyakaza kwamehlo.

Udokotela wakho uzochaza zonke lezi zindlela zokwelapha kanye nemininingwane kuwe njengoba zihlobene nesimo sakho.

Kuzothatha isikhathi esingakanani ukululama? / Liyini ikusasa?

Iningi lamacala okungasebenzi kahle kwemizwa yesine acquired acquired acquired acquired ngokuhamba kwesikhathi, ngokuvamile zingakapheli izinyanga eziyisithupha . Ngisho noma kudingeka ukuhlinzwa, izinga lempumelelo ngokuvamile lihle.

Kodwa-ke, udokotela wakho angakunikeza umbono ongcono kakhulu walokho ongakulindela, kuye ngesimo sakho esithile.

Ingabe lokhu kungavinjelwa?

Ezinye izimbangela zokungasebenzi kahle kwemizwa yesine, njengalezo ezizalwa nazo, azinakuvinjelwa. Kodwa-ke, singathatha izinyathelo zokunciphisa ingozi yokulimala kwemizwa yesine ngokugwema ukulimala ekhanda. Lokhu kufaka phakathi:

• Sebenzisa ibhande lesihlalo njalo uma ugibele imoto futhi usebenzise isihlalo semoto esiphephile sengane yakho.
• Ukugqoka isigqoko sokuzivikela uma ugibela ibhayisikili noma isithuthuthu, noma udlala imidlalo ehilela ukushayisana.
• Uma unengane encane noma ingane encane ekhaya lakho, kubalulekile 'ukuvikela izingane' endaweni yasekhaya . Lokhu kusho ukunciphisa izindawo lapho zingawela khona noma zishayeke khona ngekhanda ngendlela eyingozi.
• Ukudala indawo yokuhlala ephephile yabathandekayo bakho abanezinkinga zokulinganisela noma abasengozini enkulu yokuwa .

Kufanele ngimbone nini udokotela?

Kubalulekile ukuqhubeka nokuhlolwa udokotela wakho. Lokhu kwenzelwa ukuthi bakwazi ukuqapha isimo sakho futhi benze izinguquko ekwelashweni kwakho uma kudingeka. Ukungasebenzi kahle kwemizwa yesine akuyona into ephuthumayo. Kodwa-ke, kuyisimo esidinga ukuxilongwa nokwelashwa okufanele.

Ngokuvamile asicabangi kakhulu ngokubona kwethu kuze kube yilapho kukhona okungahambi kahle. Uma kwenzeka into efana nale, impilo ingaba yisiphithiphithi kancane. Kodwa izindaba ezinhle ukuthi ivame ukwelapheka futhi yesikhashana . Kodwa-ke, kubalulekile ukubona udokotela ngokushesha ngangokunokwenzeka ukuze uthole ukuxilongwa nokwelashwa. Udokotela wakho angabe esencoma izinsiza zokubona ezizokusiza ubone izinto ngokucacile kuze kube yilapho inzwa yakho yesine iphola, futhi uma kudingeka, unikeze ukwelashwa okwengeziwe.

Ngakho-ke, nazi izinto ezibalulekile okudingeka sizikhumbule:

Kulungile, nanka amaphuzu ayinhloko okudingeka siwacabangele kulokho esikhulume ngakho:

• I-Fourth Nerve Palsy iyinkinga ye-nerve ekusiza ukuthi ubheke phansi.
• Izimpawu eziyinhloko ukubona izinto ngazimbili (ikakhulukazi uma ubheka phansi) , ukubona okufiphele, kanye nokutshekisa ikhanda ukuze kulungiswe umbono.
• Izimbangela zalokhu zingaba ukuzalwa nazo, noma zingabangwa izinto ezifana nokulimala ekhanda .
• Uma unezimpawu, qiniseka ukuthi ubona udokotela. Ungalindi nje.
• Ngokuvamile lesi simo siyathuthuka ngokuhamba kwesikhathi , noma ukwelashwa kungaletha imiphumela emihle.
• Ezinye izimbangela zalesi simo zingagwenywa ngokugwema ukulimala ekhanda.

Ngakho-ke, uma wena noma othile omaziyo enalezi zimpawu, ungesabi futhi ufune iseluleko sezokwelapha. Uma usheshe ukuqaphela, kulapho ungalulama khona ngokushesha.

I- Fourth Nerve Palsy, i-Trochlear Nerve Palsy, ukubona okuphindwe kabili, i-diplopia, i-strabismus, ukunyakaza kwamehlo, i-cranial nerve, i-congenital palsy