Ake sifunde ngezinkinga ze-Neuromuscular ngendlela elula.

Ingabe ngezinye izikhathi uzizwa sengathi awunawo amandla, kunzima ukuphakamisa ingalo noma umlenze, noma izitho zakho zomzimba ziyaba ndikindiki uma uhamba, futhi imisipha yakho iyabuthaka kancane kancane? Lezi akuzona nje izinto ezingahleliwe. Mhlawumbe ngemuva kwalezi zimpawu kukhona izifo zemizwa nemisipha esizokhuluma ngazo namuhla, okungukuthi, isimo esibizwa ngokuthi "Izinkinga Zezinzwa Nemisipha". Ungakhathazeki, akukho okufanele ukwesabe ngemva kokuzwa lokhu. Ake sixoxe ngakho konke ngokucacile nangokulula.

Ziyini Izinkinga Zezinzwa Nemisipha?

Kalula nje, leli yiqembu lezifo ezithinta izingxenye zesimiso sethu sezinzwa, ikakhulukazi izinzwa ezingaphandle ( izinzwa eziphuma ebuchosheni nasentanjeni yomgogodla), imisipha, noma ukuxhumana phakathi kwalokhu okubili. Cabanga ngakho, ukunyakaza komzimba wethu kwenzeka lapho imiyalezo evela ebuchosheni ihamba ngemithambo ukuze isebenze imisipha. Uma kukhona iphutha endaweni ethile kuleyo nqubo, lezi zifo zingavela.

Lezi zimo zivame ukubangela ubuthakathaka bemisipha , ukuphelelwa amandla kwemisipha noma ukuphelelwa amandla (ukuwohloka kwemisipha) , kanye nezinguquko ekuzweni (njengokungazweli noma ukuqaqamba). Kodwa-ke, ezinye izimpawu zingase zivele, kuye ngohlobo lwesifo.

Ziyini lezi zifo? Zithinta kanjani imizimba yethu?

Izifo ze-neuromuscular azisona isifo esisodwa. Ziyiqembu lezifo futhi iqembu ngalinye lihlanganisa izimo ezahlukahlukene. Zingathinta izingxenye ezilandelayo zesistimu yethu ye-neuromuscular:

• Amaseli ophondo angaphambili entambo yomgogodla
• Izimpande zemizwa (kufaka phakathi ne-dorsal root ganglia)
• Amanethiwekhi emizwa `(Ama-Plexuses)` (isb. `(i-brachial plexus)` - ehlobene namahlombe, `(i-lumbosacral plexus)` - ehlobene nentamo)
• Izinzwa ze-peripheral
• Ukuhlangana kwemisipha ye-neuromuscular
• Imicu yemisipha

Manje ake sibheke izifo ezithinta ingxenye ngayinye yalezi zingxenye ngemininingwane ethe xaxa.

Izifo ezihlobene namaseli ezinzwa ezinyakazayo (amaseli empondo angaphambili) omgogodla

Lezi zivame ukuba yizifo eziqhubekayo ezibhubhisa ama-motor neuron . Ama-motor neuron awuhlobo lweseli ebuchosheni bethu nasemgogodleni elisisiza ukuthi sinyakaze, njengokuhamba, ukukhuluma, nokuphefumula. Lawa maseli athwala imiyalezo esuka ebuchosheni iye emisipheni.

Ikakhulukazi, "amaseli empondo angaphambili" angamaseli ezinzwa ezihambayo endabeni empunga yomgogodla. Abalulekile ekunyakazeni kwemisipha yethu yamathambo. Lapho la maseli ebhujiswa, imisipha ilahlekelwa ukuphakelwa kwemizwa (ukuncipha kwemisipha) bese iba buthakathaka.

Izifo eziyinhloko ezikulesi sigaba yilezi:

• I-ALS (i-Amyotrophic Lateral Sclerosis - ALS) noma isifo sikaLou Gehrig
• Ukuwohloka Kwemisipha Yomgogodla (SMA)
• Ukuwohloka kwemisipha yomgogodla (SBMA) noma isifo sikaKennedy
• Uvendle

Izinkinga ezihlobene ne-Plexus (i-Plexopathy)

Imizwa ephuma emgogodleni wethu ngamazinga ahlukene igcina ihlangana ndawonye ukuze yakhe inethiwekhi eyinkimbinkimbi, noma i-plexus . Sine-plexus ye-brachial ezingalweni zethu ezingaphezulu, kanye ne-plexus ye-lumbar noma i-plexus ye-lumbosacral ezingalweni zethu ezingezansi, ezitholakala entanyeni yethu.

Lezi zinhlayiya zemizwa zingalimala, zicindezelwe, noma zivuvuke, okungabangela ubuhlungu, ukungazweli, ukuqaqamba, kanye nobuthakathaka engalweni noma emlenzeni othintekile.

Izifo ezihlobene nezimpande zemizwa

Izimpande zemizwa zingamagatsha amafushane enzwa yomgogodla. Imizwa yomgogodla ivela emathanjeni omgogodla (amathambo) eduze kwentambo yethu yomgogodla. Inzwa ngayinye yomgogodla inezimpande zemizwa yokunyakaza kanye nezimpande zemizwa yokuzwa. Izimpande zemizwa yokunyakaza yilapho imiyalezo evela ebuchosheni kanye nentambo yomgogodla ihamba khona iye emisipheni ngemizwa engaphandle.

Uma lezi zimpande zemizwa zicindezelwa yizicubu ezizungezile, ubuhlungu kanye nokuba ndikindiki kungavela ezingxenyeni ezahlukene zomzimba. Lokhu kubizwa ngokuthi 'i-radiculopathy' . Uma izimpande zemizwa ezinyakazayo zicindezelwa, imisipha iba buthakathaka.

Kunezinhlobo ze-radiculopathy kuye ngokuthi i-spinal nerve icindezelwe kuphi:

• I-radiculopathy yomlomo wesibeletho
• Kusukela maphakathi kuya engxenyeni engenhla yesifuba (`(thoracic radiculopathy)`)
• I-Lumbar noma i-lumbosacral radiculopathy (ehlobene nentamo kanye nomhlane ongezansi)

Izifo ezihlobene nezinzwa zangaphandle

I-peripheral neuropathy yigama elijwayelekile lanoma yisiphi isifo esithinta imizwa engaphandle kobuchopho kanye nomgogodla (imizwa engaphandle). Kunezinhlobo eziningana nezimbangela zalokhu. Uma imizwa engaphandle ingasebenzi kahle, asikwazi ukushukumisa imisipha yethu. Yingakho lezi zifo ziyingxenye yeqembu elikhulu lezifo ze-neuromuscular.

Izifo ze-peripheral neuropathies zingathinta izingxenye ezithile zomzimba kuphela, noma zingathinta wonke umzimba. Uhlobo oluvame kakhulu lwe-peripheral neuropathy yilolo oluthinta izandla nezinyawo, ikakhulukazi izinzipho zeminwe. Isibonelo, abanye abantu abanesifo sikashukela banama-numbness ezinyaweni zabo, njengokungathi abakwazi ukuzwa umhlabathi. Leso yisibonelo salokhu.

Nazi ezinye izibonelo:

• Ukulimala kwemizwa okubangelwa yisifo sikashukela
• Ngenxa yokusebenzisa utshwala ngokweqile (inkinga yokusebenzisa utshwala)
• Ukungondleki kahle
• Isimo esibizwa ngokuthi 'i-Amyloidosis'
• Izimbangela zofuzo noma zofuzo (isib. isifo sikaCharcot-Marie-Tooth)
• Izimbangela zokuzivikela komzimba noma zokuvuvukala (isb., `(Chronic Inflammatory Demyelinating Polyneuropathy - CIDP)`, `(Guillain-Barré syndrome)`)
• Ukuchayeka ezintweni ezinobuthi (isb., amakhemikhali anobuthi njengoketshezi lokuhlanza, izibulala-zinambuzane)

Izifo ze-neuromuscular junction

I-neuromuscular junction (NMJ) iwukuxhumana (i-synapse) phakathi kwe-terminal ye-motor nerve kanye ne-muscle. Ukuze kuxhunyanwe ne-muscle, i-motor nerve ikhipha ikhemikhali ebizwa ngokuthi i-acetylcholine ngale nhlanganisela. Uma kukhona iphutha kulokhu kuxhumana, kuvela izifo ezihlobene ne-neuromuscular junction.

Izifo eziyinhloko ezithinta leli lunga yilezi:

• `I-Botulism` (isimo esingase senzeke ngenxa yobuthi bokudla)
• `I-Lambert-Eaton myasthenic syndrome (i-LEMS)`
• `I-Myasthenia Gravis`

Izifo zemisipha (i-Myopathies)

I-Myopathies yizifo ezithinta ngqo imisipha yethu yamathambo (imisipha enamathela emathanjeni ethu). Lezi zifo zilimaza imicu yemisipha futhi zibuthakatha imisipha. Kunezinhlobo eziningana ze-myopathies. Ezinye zizalwa nazo (ezakhi zofuzo noma ezizuzwe njengefa). Ezinye zingakhula kamuva ekuphileni.

Kodwa-ke, ukulimala okuqondile njengokudabula, ukudonsa, noma ukuklwebheka kwemisipha akungeni kulesi sigaba se-"myopathies".

Ukungasebenzi Kwemisipha

I-Muscular dystrophy iyiqembu lezifo ezingaphezu kwamashumi amathathu ezithinta ukusebenza kwemisipha ngenxa yezimbangela zofuzo (ezizuzwe njengefa). Ezinye zezinhlobo eziyinhloko yilezi:

• I-Duchenne muscular dystrophy (DMD) - Lolu uhlobo oluvame kakhulu.
• "I-Becker muscular dystrophy (BMD)"
• `I-Myotonic dystrophy`
• "Ukungasebenzi kahle kwemisipha ye-Oculopharyngeal (OPMD)"

Ama-Myopathies e-Autoimmune kanye ne-Inflammatory

Lezi yizifo eziphazamisa ukusebenza kwemisipha ngenxa yokukhubazeka ohlelweni lwethu lokuzivikela komzimba. Izibonelo:

• `Isifo sesikhumba`
• `I-Polymyositis`
• "I-myopathy ebangela ukubola kwamasosha omzimba"

Ezinye izifo ze-Myopathies

Izifo zemisipha zingavela ngenxa yezinye izizathu ezahlukene:

• Ukungalingani kwama-electrolyte : Isibonelo, i-calcium ephezulu egazini (i-hypercalcemia) noma i-potassium ephezulu egazini (i-hyperkalemia) kungabangela izinkinga zemisipha.
• I-Endocrine myopathies : Ukungalingani kwama-hormone okuphazamisa ukusebenza kwemisipha. Isibonelo,Lokhu kungabangelwa izinkinga ngendlala yegilo, izindlala ze-parathyroid , noma izindlala ze-adrenal .
• I-Metabolic myopathies : Lokhu kubangelwa ukukhubazeka kwezakhi zofuzo ezifundisa imisipha ukuthi ikhiqize ama-enzyme. Izibonelo: izifo zokugcina i-glycogen, izinkinga zokugcina amafutha.
• I-Mitochondrial myopathies : Lokhu kubangelwa ukukhubazeka ku-mitochondria, izingxenye zamaseli ezikhiqiza amandla.
• Ukukhubazeka okuvamile : Leli yiqembu lezifo zezinzwa ezizuzwe njengefa. Kulokhu, imisipha iba buthakathaka ngezikhathi ezithile futhi ingakwazi ukufinyela.
• I-myopathies enobuthi: Lokhu kubangelwa ubuthi noma umuthi ophazamisa isakhiwo noma ukusebenza kwemisipha.

Yiziphi izifo ezivame kakhulu zezinzwa nemisipha?

Eqinisweni, i-peripheral neuropathy yiyona evame kakhulu kulezi zimo. Lokho kungenxa yokuthi inezinhlobo eziningi ezahlukene kanye nezimbangela. Abacwaningi balinganisela ukuthi abantu abangaphezu kwezigidi ezingu-20 e-United States banohlobo oluthile lwe-peripheral neuropathy.

Kodwa abantu abaningi abacabangi nge-`(peripheral neuropathies)` njenge-`(neuromuscular disorders)`, ngoba banesigaba esihlukile. Kodwa-ke, `(izifo ze-neuromuscular)` esesizizwile sonke, kodwa empeleni ezingavamile, yi -`(ALS) ` kanye ne -`Muscular Dystrophy` .

Yiziphi izimpawu ezivamile zalezi zifo?

Izimpawu zezifo zemisipha zingahluka, kuye ngohlobo oluthile lwesifo. Kodwa-ke, izimpawu ezivamile ezihambisana nemisipha zifaka:

• Ubuthakathaka bemisipha (ubunzima bokuphakamisa ingalo noma umlenze, ukungakwazi ukuphakamisa izinto ezisindayo)
• Ukuwohloka kwemisipha ( ukuncipha kwemisipha nokuphela kwayo)
• Ukuqhaqhazela kwemisipha (ukuvuvukala kwemisipha), ukuqaqamba kwemisipha, noma ukuqaqamba kwemisipha
• Ubuhlungu bemisipha
• Ukuqina kwemisipha (i-Spasticity)
• Ubunzima bokuhamba
• Izinkinga zokulinganisela nokuhlanganisa
• Amajwabu amehlo awela phansi noma ezinye izingxenye zobuso
• Ubunzima bokukhuluma (i-dysarthria) ngenxa yobuthakathaka bemisipha yolimi noma yomlomo/yobuso
• Ubunzima bokugwinya (i-dysphagia) ngenxa yobuthakathaka bemisipha ye-pharynx
• Ubunzima bokuphefumula ngenxa yobuthakathaka bomsipha we-diaphragm

Ezinye izimpawu zingase zihlanganise:

• Ukukhathala
• Ukuba ndikindiki
• Imizwa engavamile efana nokuhamba kwezintuthwane noma izikhonkwane nezinaliti (i-paresthesia)

Okubalulekile: Uma unesinye noma ngaphezulu salezi zimpawu zilandelana, ikakhulukazi uma ubuthakathaka bemisipha buvela ngokuzumayo noma kancane kancane, qiniseka ukuthi ubona udokotela.

Kungani lezi zifo zenzeka? Ziyini izimbangela?

Kunezimbangela eziningi zezifo ze-neuromuscular. Kodwa-ke, ezinye ziyizakhi zofuzo . Lokhu kusho ukuthi zingabangelwa izakhi zofuzo ezizuzwe kubazali noma ushintsho olungahleliwe ku-gene (ukuguqulwa). Lezi zifo zingabangelwa ukukhubazeka ku-gene eyodwa noma ukukhubazeka ku-gene eziningana.

Ezinye izifo ze-neuromuscular ziyizifo ezizimele . Lokhu kusho ukuthi amasosha ethu omzimba ahlasela amangqamuzana ethu. Ezinye zingabangelwa ingozi, ukuntuleka kokudla okunempilo, ukuphazamiseka kwe-metabolic, ukuchayeka ebuthi, noma ukuvuvukala. Ngezinye izikhathi, akukho sizathu esingatholakala.

Udokotela uzihlonza kanjani lezi zifo?

Uma ubona udokotela, uzokubuza ngomlando wakho wezokwelapha, ukuthi ukhona yini emndenini wakho oke waba nalesi simo, ukuthi imiphi imithi oyiphuzayo, nokuthi yiziphi izimpawu onazo. Ngemuva kwalokho, bazokwenza ukuhlolwa okujwayelekile komzimba kanye nokuhlolwa kwezinzwa . Lokhu kuhlolwa kungabheka izinkinga zobuchopho, umgogodla, kanye nohlelo lwezinzwa oluseceleni (kufaka phakathi imisipha).

Ungathunyelwa futhi kudokotela wezinzwa ukuze uthole ukuhlolwa okwengeziwe. Ezinye izivivinyo ezingasiza ukuqinisekisa lezi zimo zifaka:

• I-Electromyography (EMG) : Lokhu kuhlola impilo kanye nokusebenza kwemisipha yakho yamathambo kanye nemizwa eyilawulayo.
• Ukuhlolwa kokuqhuba kwemizwa : Lokhu kuhlola ukusebenza kwezinzwa zakho ezingaphandle.
• Ukuhlolwa kwegazi : Lokhu kungahlola izinto ezahlukahlukene, njengokungasebenzi kahle kwama-enzyme kanye nezimpawu zezimo zokuzivikela komzimba.
• Ukuhlolwa kwezithombe : Ukuhlolwa okufana ne -MRI , i-CT scan , kanye ne-neuromuscular ultrasound kungabona ukuthi kukhona yini izinkinga ngobuchopho, umgogodla, kanye/noma imizwa.
• I-biopsy yemisipha: Kulolu vivinyo , kuthathwa isampula encane yemisipha yakho bese udokotela wezifo ewuhlola ngaphansi kwe-microscope ukuze abone ukuthi kukhona yini ukukhubazeka.
• Ukuhlolwa kwezakhi zofuzo : Lokhu kuhlolwa kusiza ukuqinisekisa ezinye izifo zezakhi zofuzo zemisipha.

Yiziphi izindlela zokwelapha lezi zifo?

Ukwelashwa kwezifo zemisipha kuyahlukahluka kakhulu kuye ngohlobo oluthile lwesifo. Ngokuvamile, izifo eziningi zemisipha azikwazi ukwelashwa ngokuphelele. Kodwa-ke, kunezindlela zokwelapha ezingasiza ekunciphiseni izimpawu, kumise ukuqhubeka kwesifo, noma kunciphise ukuqhubeka kwaso. Uhlelo lwakho lokwelashwa lungafaka:

• Imithi
• Ukwelashwa ngokomzimba kanye nokwelashwa emsebenzini
• Ukwelashwa ngenkulumo
• Ukwelashwa kokudla okunempilo
• Amadivayisi okusiza alula ukunyakaza
• Ezinye izinqubo zezokwelapha, okuhlanganisa nokuhlinzwa

Ngokuvamile, udokotela wezinzwa (ikakhulukazi uchwepheshe wezinzwa nemisipha) uzoba udokotela wakho oyinhloko wokunakekelwa kwalezi zimo. Kodwa-ke, kuye ngohlobo lwesimo, ungadinga usizo kwabanye ochwepheshe kanye nabahlinzeki bezempilo. Lokhu kungafaka:

• Abelaphi bomzimba kanye nabelaphi bomsebenzi
• Odokotela be-rheumatology
• Odokotela bezifo zamaphaphu kanye nabelaphi bokuphefumula
• Izazi zezifo
• Odokotela abahlinzayo
• Odokotela bamathambo
• Izazi zezifo zolimi lokukhuluma
• Ochwepheshe bezokudla
• Izazi zengqondo
• Izisebenzi zezenhlalakahle

Yini ongayilindela uma uphila nalolu hlobo lwesifo?

Izifo eziningi zemizwa nemisipha zihlala isikhathi eside (ezingapheli) . Lokhu kusho ukuthi zingahlala impilo yonke. Nakuba kungekho ikhambi, imithi kanye nezinye izindlela zokwelapha zingasiza ekulawuleni izimpawu, kumise ukuqhubeka kwesifo, noma kusenze sihambe kancane. Udokotela wakho angakunikeza umbono ongcono walokho ongakulindela, kuye ngesimo sakho esithile.

Izifo zemisipha ziyisigaba esibanzi sezimo ezithinta kakhulu ukusebenza kwezinzwa nemisipha engaphandle. Uma ubhekene nobuthakathaka bemisipha obungazelelwe noma obungachazeki, khuluma nodokotela. Angahlola izimpawu zakho futhi ancome ukuhlolwa ukuze kutholakale imbangela.

Okokugcina, into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

Ungesabi ukuzwa igama elithi Neuromuscular Disorders. Eziningi zalezi zimo zingalawulwa ngokutholakala kusenesikhathi, ukwelashwa okufanele, kanye nokuphathwa. Into ebalulekile ukuthi, uma unezimpawu ezingavamile (ikakhulukazi ubuthakathaka bemisipha, ukungazweli, ubunzima bokuhamba),Ungazinaki bese ucela iseluleko sezokwelapha ngokushesha.

Khumbula, awuwedwa. Kukhona odokotela abanekhono, abelaphi, namaqembu okusekelana angakusiza ukubhekana nalezi zimo. Ukuthola ulwazi olufanele nokuthatha isinyathelo kusenesikhathi kuyindlela engcono kakhulu yokuphila impilo enempilo.

Izifo ze-neurological, izifo zemisipha, Izinkinga ze-Neuromuscular, i-ALS, i-Muscular Dystrophy, i-Peripheral Neuropathy, i-Myasthenia Gravis