Ataxia - ndichiyani, njira zake ndi ziti ndipo zimathandizidwa bwanji?

Zomwe zatsimikiziridwa

Gawo losasunthika, vuto lokhala bwino kapena kusalankhula bwino nthawi zambiri limalumikizidwa ndi kuchita zinthu mutamwa mowa kwambiri kapena zida zina zoledzeretsa. Ndipotu, zizindikirozi zikhoza kukhala chizindikiro cha matenda aakulu monga ataxia. Chofunikira chake ndikulumikizana kolakwika kwa minofu, kuvutikira kukhalabe bwino komanso kulumikizana kwamagalimoto, komanso mavuto olankhula bwino komanso masomphenya olondola. Kodi ataxia ndi chiyani? Kodi chingayambitse chiyani komanso momwe mungachizindikire?

Kodi ataxia ndi chiyani?

Ataxia, yomwe imadziwikanso kuti kusagwirizana, imachokera ku liwu lochokera ku Chigriki lotanthauza "popanda dongosolo". Ataxia ndi vuto la locomotor system chifukwa cha kuwonongeka kwa zomanga zomwe zimagwirizanitsa magalimoto.

Ataxia imayambitsa mavuto pakusunga bwino komanso kuyenda bwino komanso molondola. Kugwirizana kwa kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe kake Chinthu chofala kwambiri chomwe chimapangitsa kuti ataxia awoneke ndi kuwonongeka kwa msana kapena cerebellum.

Msana umatumiza uthenga kuchokera ku zolandilira zomwe zili mu minofu kupita ku cerebellum. Amapangidwa kuti azilamulira ntchito zamagulu osiyanasiyana a minofu. Kuwonongeka kwa dongosolo lililonse kumayambitsa ataxia, ndiyeno kugwirizana kwa minofu kumasokonekera, koma osati mphamvu zawo. Ataxia ndi vuto lomwe limatha kulepheretsa kwambiri ntchito za tsiku ndi tsiku za odwala. Zochita zosavuta monga kugwira zinthu, kuyenda kapena kuyankhula zimakhala zosatheka ndipo zimakhala zazikulu zovuta kwa munthu yemwe ali ndi ataxia.

Ngati mukufuna kudziwa kuti ndi luso lanji lamagalimoto ndikuphunzira za zovuta zake, onani: Maluso abwino agalimoto - mawonekedwe, zovuta komanso zolimbitsa thupi

Kodi zimayambitsa ataxia ndi chiyani?

Ataxia ngati chizindikiro cha minyewa imatha kukhala ndi zifukwa zambiri. Magulu a minofu amatha kugwira ntchito bwino chifukwa cha kugwirizana kwa mitundu yosiyanasiyana ya mitsempha ya mitsempha. Kuwonongeka kwa chinthu chimodzi kungayambitse kusokonezeka kwa kayendetsedwe kabwino komanso mawonekedwe a ataxia. Kuyamba kwa ataxia ndi zotsatira za kuwonongeka kwa ubongo, msana, kapena mitsempha, koma chifukwa chofala kwambiri ndi kuwonongeka kwa cerebellum.

Zifukwa zake achina cerebar makamaka ndi:

1. chotupa mu cerebellar kapena metastasis kuchokera ku chiwalo china monga medulloblastoma, astrocytoma ndi hemangioma;
2. kuwonongeka kwa mitsempha ya cerebellum, ndiko kuti, sitiroko;
3. matenda a chithokomiro - hypothyroidism;
4. mavairasi kutupa ndi matenda a cerebellum Mwachitsanzo: HIV;
5. multiple sclerosis, matenda a demyelinating a dongosolo lamanjenje;
6. matenda a celiac;
7. subacute sclerosing encephalitis vuto la chikuku;
8. Matenda a Wilson, omwe amatsimikiziridwa mwachibadwa, ndipo chifukwa chake ndi kusintha kwa jini ya ATP7B. Matendawa amachititsa pathological mkuwa mafunsidwe mu thupi;
9. poizoni kuwonongeka kwa cerebellum kumwa mowa wambiri, mankhwala osokoneza bongo kapena mankhwala enaake, kapena poizoni wa carbon dioxide;
10. kusowa kwa vitamini E, mavitamini B1 ndi B12 m'thupi.

Kutengera pa sensory ataxia zifukwa zazikulu ndi izi:

1. kuwonongeka kwa msana chifukwa cha kuwonongeka kwa msana kapena kuvulala kwa makina;
2. kuwonongeka kwa ganglia yomverera chifukwa cha matenda a khansa
3. Matenda a Guillain-Barry - matenda okhudzana ndi chitetezo cha mthupi omwe amakhudza mitsempha yotumphukira;
4. matenda a shuga, mwachitsanzo, hypoglycemia, chifukwa chake minyewa imawonongeka, zomwe zimatchedwa diabetesic neuropathy;
5. kuwonongeka kwa mitsempha chifukwa cha mankhwala ndi vincristine ntchito mankhwala amphamvu kapena odana ndi TB mankhwala isoniazid;
6. heavy poizoni zitsulo;
7. matenda ofoola ziwalo.

Kufotokozera mwachidule zonse zomwe zimayambitsa ataxia, akhoza kugawidwa m'magulu atatu akuluakulu:

1. matenda a neurodegenerative kuwononga maselo a mitsempha;
2. zobadwa nazozomwe zitha kukhala chibadwa kapena cholowa
3. matenda kagayidwe monga, mwachitsanzo, hypoglycemia. 

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Mitundu ya ataxia

Chimodzi mwa magawo a ataxia ndi chifukwa chake. Tikuwunikira apa cerebellar ataxia ndi sensory ataxia.

Yoyamba ikugwirizana ndi kuwonongeka kwa cerebellum, yomwe ili mbali ya hindbrain. Cerebellum ili ndi udindo wowongolera luso lamagetsi la thupi ndipo imayang'anira kulondola, kulondola komanso kutalika kwa kayendetsedwe kake. Chifukwa cha kugwira ntchito bwino kwa cerebellum, magulu a minofu amawongoleredwa ndipo kayendetsedwe kameneka kakuchitidwa moyenera.

Mtundu wachiwiri wa ataxia, kapena kumverera, umayamba chifukwa cha kusokonezeka kwa njira zomwe zimachititsa chidwi kwambiri kapena kuwonongeka kwa zingwe zam'mbuyo za msana. Kumverera kozama kumakhala ndi udindo wodziwitsa za malo a thupi lathu, pamene zingwe zakumbuyo zimakhala ndi udindo wa kumverera kwa tsankho komwe kumaphatikizapo kusiyanitsa zinthu ziwiri zomwe zimagwira thupi lathu panthawi imodzi.

Chifukwa cha zinthu zitatu zofunika, titha kusiyanitsa ndi ziti mtundu wa ataxia tikuchita. Yoyamba ndi nystagmus, yomwe ndi kayendedwe ka diso kosadziwika komanso kamvekedwe. Chizindikiro ichi ndi khalidwe la cerebellar ataxia.

Chinthu china ndi vuto la kulankhula ntchito, zomwe sizichitika pa nkhani ya ataxia zomverera, koma ndi khalidwe chizindikiro cha cerebellar ataxia.

Chinthu chotsiriza ndi lingaliro la kuyika thupi lanu, mwachitsanzo, kutengeka kwakukulu, kusokonezeka komwe kumakhala ndi chidziwitso cha ataxia ndipo sichichitika ngati cerebellar ataxia.

Kugawanika kwina kwa ataxia kumalankhula za mitundu iwiri - yobadwa nayo komanso yopezedwa. Congenital ataxia zimagwirizana ndi chibadwa cholemetsa. Chimodzi mwa izo ndi Heredoataxia, yomwe imatha kuchitika m'njira zosiyanasiyana. Pankhani ya majini akuluakulu, spinocerebellar ataxia ndi episodic ataxia amatengera. Mosiyana ndi zimenezi, majini recessive ali ndi udindo Friedreich ataxia.

Friedreich's ataxia ndi matenda obadwa nawo omwe amawononga dongosolo lamanjenje ndi minofu ya mtima. Zizindikiro zoyamba zimatha kuwoneka asanakwanitse zaka 20 ndipo poyambilira zimawonekera ndi gait ataxia, mwachitsanzo, zovuta ndikuyamba kuyenda mochedwa mwa ana, ndipo kenako, kusokonezeka kwa magalimoto. Childs, matenda akhoza kugwirizana ndi optic atrophy ndi maganizo retardation, ndipo moyo wa wodwalayo nthawi zambiri sapulumutsidwa pambuyo matenda.

Mtundu wina wa ataxia ndi mtundu 1 spinocerebellar ataxia. Kupezeka kwake kumachitika chifukwa cha kusintha kwa jini ya ATXN1, yomwe ili ndi malangizo opangira ataxin-1. Cerebellar ataxia imadziwonetsa ngati vuto pakusunga bwino, makamaka ndikuyenda kosakhazikika, kuvutikira kukhalabe oongoka m'thupi, mayendedwe amutu. Chifukwa cha kupitirira kwa matendawa, pangakhale kumasuka kwathunthu kwa minofu, dyssynergy, mwachitsanzo, kusokonezeka kwa kayendedwe ka madzi, dysmetria - kulephera kusiya nthawi iliyonse, kunjenjemera kwa miyendo, kupweteka kwa minofu, mavuto a maso ndi nystagmus.

Mtundu womaliza wa ataxia ndi ataxia telangiectasia, mwachitsanzo, Louis-Bar syndrome. Matendawa ndi cholowa, zimadalira recessive majini ndi akufotokozera mu ubwana. Chizindikiro chodziwika bwino cha telangiectasia ataxia ndi kusalinganika, kufutukuka kwa makutu ndi conjunctiva, nystagmus, kulankhula momveka bwino, kuchedwa kutha msinkhu, komanso matenda opatsirana pafupipafupi. Kuti muzindikire mtundu uwu wa ataxia, kuyesa kwa AFO (Alpha-fetoprotein) kumachitidwa kapena khalidwe la maselo oyera a magazi chifukwa cha X-ray.

Ndi chiyani chomwe chili choyenera kudziwa za kukula koyenera? Onani: Physiology ya kutha msinkhu

Kodi ataxia imawonetsedwa bwanji?

Kuzindikira ataxia nthawi zambiri zimakhala zovuta kwambiri chifukwa mu gawo loyamba sizimayambitsa nkhawa mwa munthu wodwala ndipo zimasokonezeka ndi kusayenda bwino. Nthawi zambiri, kupita kwa dokotala kumapangitsa kuti adziwe za ataxia komanso kuzindikira kwa wodwalayo za vuto lomwe lamukhudza. Ngakhale kuti zizindikiro za ataxia ndizosavuta kuziwona, makamaka kumayambiriro kwa matendawa, ndi bwino kuphunzira za zizindikiro zachikale zomwe zingatichenjeze kukhala maso.

Chizindikiro choyamba chomwe chikuwonekera pakuyamba ndi kusokonezeka kwa gait. Izi nthawi zambiri zimawonekera mu zomwe zimatchedwa kuyenda kwapanyanja, mwachitsanzo, kuyenda pamtunda waukulu chifukwa cha kutalika kwa miyendo. Kusokonezeka kwa gait kungawonetsedwenso ndi kulephera kuyenda molunjika kapena kugwa kumbali imodzi.

Chizindikiro china ndizovuta kupanga mayendedwe osinthasintha mwachangu, otchedwa anachedwetsa chokineza. Mwachitsanzo, zovuta kugunda bondo mkati ndi kunja kwa dzanja mosinthana.

Anthu omwe ali ndi ataxia nthawi zambiri amakhala ndi vuto lakulankhula momveka bwino, zomwe zimatchedwa dysarthria ndi mawu olakwika, amakumana ndi zovuta zomveka komanso mawu.

Kuonjezera apo, odwala amakumana ndi vuto la maso monga nystagmus, mwachitsanzo, kayendetsedwe ka maso kosasamala komanso kosalamulirika komanso kusokonezeka kwa maso.

Chizindikiro china chomwe chimalola dokotala kuti azindikire vuto pakugwira ntchito bwino kwa cerebellum ndi dysmetry, yomwe imalumikizidwa ndi kuwunika kolakwika kwa mtunda ndi wodwalayo. Pamene akumuyeza, munthuyo amavutika kugwira mphuno ndi chala cholozera pamene maso ali otsekedwa nthawi yomweyo.

Anthu omwe ali ndi vuto la ataxia amavutika kuti asunthike bwino, ndipo nthawi zambiri amakhala ndi hypotension, mwachitsanzo, kuchepa kwa minofu ndi kulimba. Odwala omwe ali ndi ataxia nthawi zambiri amavutika kuti agwire zinthu kapena kumangirira ndi kumasula mabatani chifukwa cha kugwedezeka kwa manja kowonjezereka komanso kusuntha kwa manja kosagwirizanitsa.

Pankhani ya ataxia yomverera, wodwalayo akhoza kukhala ndi vuto lopeza ziwalo za thupi lake, osamva malo ndi malo awo. Ataxia imathanso kukhudza kusintha kwachidziwitso m'malingaliro ndikusintha kusintha kwamalingaliro komwe kumayambitsa kusakhazikika kwamalingaliro.

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Kodi ataxia imazindikiridwa bwanji?

Gawo loyamba la matenda a ataxia ndiko kuona thupi la wodwalayo. Ngati muwona zinthu zilizonse zomwe zingasonyeze kuwonongeka kwa dongosolo lamanjenje, monga kuyenda movutikira, kusokonezeka kwa magalimoto, vuto la kulankhula, mavuto akugwira zinthu, muyenera kuwona dokotala mwamsanga.

Ngati zizindikiro zomwe zili pamwambazi zikukula, pang'onopang'ono, mukhoza kupita kwa dokotala wanu wamkulu yemwe angakulozereni kwa katswiri wa zaubongo kuti akudziweni bwino. Komabe, zizindikiro zikachitika mwadzidzidzi, ndikofunikira kuyimbira ambulansi nthawi yomweyo kapena kupita ku dipatimenti yodzidzimutsa.

Ulendo woyamba wopita kwa katswiri wa zamaganizo udzayamba ndi kuyankhulana bwino ndi wodwalayo. Dokotala adzakufunsani za kukhalapo kwa zizindikiro zofanana m'banja lanu lapafupi, za nthawi ya zochitika za zizindikiro, zochitika zawo, kapena zinthu zomwe zimakulitsa. Dokotala adzafunsanso za matenda ena omwe amatsagana nawo kapena mankhwala omwe mumamwa tsiku ndi tsiku, komanso kugwiritsa ntchito zolimbikitsa monga mowa, mankhwala osokoneza bongo kapena zinthu zina zamaganizo.

Pambuyo kuyankhulana mwatsatanetsatane, dokotala adzachititsa kufufuza mwatsatanetsatane za minyewa. Mungapemphedwe kuti muyende pang'ono kuzungulira ofesi yomwe dokotala wanu adzayang'ane momwe mumayendera, kukhazikika, ndi madzimadzi, kapena mukhoza kufunsidwa kulemba malemba afupiafupi kapena kuyesa mayesero omwe angathandize kuzindikira ataxia.

Pakati pa mayesowa, pali 5 zoyambira:

1. bondo - chidendenekumene wodwalayo akugona ndipo akufunsidwa kuti aike chidendene chake pa bondo la mwendo wina ndikuchitsitsa pansi pa msana wa tibial;
2. chala - mphuno, wodwalayo ayenera kukhudza mphuno yake ndi chala chake, ndiyeno agwire dokotala ndi maso ake otseka;
3. masewera olimbitsa thupikumene dokotala amafunsa wodwalayo kuti apindule mwamsanga manja onse awiri panthawi imodzi;
4. psychodiagnoza - mwachitsanzo, kuunika kwapang'onopang'ono kwapang'onopang'ono kwa wodwalayo;
5. electromyogram- yomwe ndi phunziro la kayendedwe ka mitsempha.

Pambuyo posonkhanitsa kuyankhulana ndi pambuyo pa kufufuza kwa mitsempha, malingana ndi zotsatira zake, dokotala akhoza kuyitanitsa mayesero owonjezera.

Mayesero omwe angathandize popanga matenda ndi awa: kuyezetsa magazi m'ma labotale, mkodzo, cerebrospinal fluid, kujambula zithunzi monga: computed tomography of the brain (CT) kapena kujambula kwa maginito a ubongo (MRI) ndi msana. Mayesero wamba omwe akulimbikitsidwa ndi katswiri wa zamitsempha akamaganiziridwa ataxia amaphatikizapo kuyezetsa ma genetic, kuyesa kwa neuropsychological, kuyesa kwa mitsempha, ndi electromyography (ENG / EMG).

Mayesero omwe amachitidwa amalola katswiri wa minyewa kuti apange matenda omwe, ngati atsimikizira ataxia, amalola kudziwa mtundu wake ndi zomwe zingayambitse. Zizindikiro za ataxia siziyenera kunyalanyazidwa, chifukwa zingasonyeze matenda aakulu monga multiple sclerosis, cerebellar stroke.

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Kodi ataxia amachiritsidwa bwanji?

Wodwala akapezeka kuti ali ndi ataxia, ndikofunikira kumvetsetsa chomwe chidayambitsa. Nthawi zambiri, chithandizo cha ataxia chimaphatikizapo kuthetsa zomwe zimayambitsa matendawa.

Pamene ataxia ndi chifukwa cha kumwa mankhwala osokoneza bongo kapena kuwononga thupi ndi poizoni, nthawi zambiri kumakhala kokwanira kuti asiye kuwatenga kuti achepetse zizindikiro za ataxia. Mofananamo, kuchiza ataxia chifukwa cha kusowa kwa vitamini komanso matenda a autoimmune, khansa kapena kagayidwe kachakudya kumatha kusintha magwiridwe antchito a thupi ndikuchepetsa zizindikiro. Pankhani ya ataxia yopezeka, mutazindikira zomwe zimayambitsa, mutalandira chithandizo choyenera, nthawi zambiri ndizotheka kuthetsa zizindikiro zake.

Komabe, pankhani ya congenital ataxia, matendawa sakhala otsimikiza kwambiri, ndipo nthawi zina chithandizo chokhacho chikhoza kukhala chochepa pofuna kuletsa kapena kuchepetsa zizindikiro. Physiotherapists ndi olankhula kulankhula amagwira ntchito yofunika kwambiri pano, komanso kuthandizidwa ndi katswiri wa zamaganizo, banja ndi okondedwa. Nthawi zambiri, chithandizo cha ataxia chimaphatikizapo kukonzanso ndikugwira ntchito ndi katswiri wamawu, omwe amatha kusintha kwambiri magwiridwe antchito a ziwalo zoyenda, zolankhula, masomphenya komanso kusintha moyo wa wodwalayo.

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Zochita zolimbitsa thupi kwa anthu omwe ali ndi ataxia

Pochiza ataxia, njira yokonzanso ndi yofunika kwambiri ndipo iyenera kupangidwa ndi kuyang'aniridwa ndi physiotherapist. Palinso masewera olimbitsa thupi omwe mungathe kuchita mothandizidwa ndi munthu wachiwiri mu chitonthozo cha nyumba yanu.

Gulu loyamba la masewera olimbitsa thupi limachitidwa pogwiritsa ntchito mphasa zolimbitsa thupi. Kuchita masewera olimbitsa thupi kumodzi kumaphatikizapo kugona chagada miyendo yoweramira pa bondo ndi mapazi pansi. Kumayambiriro, timatembenukira kumbali, ndiye, kutsamira pa chigongono, kwezani chiuno ndi dzanja laulere mmwamba, tikugwira mpweya wathu kwa masekondi 5.

Zochita zina zomwe zimakuthandizani kuti mukhalebe bwino ndi kayendetsedwe kake, komwe kumaphatikizapo kusuntha kuchoka ku chizolowezi mpaka kugwada pamiyendo inayi pamene mukutambasula dzanja limodzi ndi mwendo wina kumbuyo nthawi yomweyo. Muyenera kukhala pamalo awa pafupifupi masekondi asanu.

Zochita zolimbitsa thupi zothandizira ataxia zitha kuchitikanso mutakhala. Pazochita izi, mutha kugwiritsa ntchito mpando kapena mpira wokhala ndi masewera olimbitsa thupi. Mukakhala pampando kapena mpira, yendani pang'onopang'ono poyimirira ndi msana wanu wowongoka komanso mimba yanu ikugwedezeka.

Zochita zina zomwe tidzafunika tepi ndi pamene tikhala pampando kapena mpira, timakulunga tepiyo kuzungulira chikhatho cha dzanja lanu. Zigongono zathu ziyenera kukhala pafupi ndi thupi. Kenako, tambasulani tepiyo posuntha manjawo kunja, kenaka jambulani mwendo umodzi pamimba ndikuugwira motere kwa masekondi pafupifupi 5.

Zochita zolimbitsa thupi za ataxia zitha kuchitidwanso mutayima. Kuyimirira ndi mimba yanu ndi msana wanu molunjika, tambasulani tepiyo pamwamba pa mutu wanu, kenaka muyitenge kumbuyo kwa mutu wanu, kukoka mapewa anu pansi, ndikubwerera pang'onopang'ono kumalo oyambira.

Zochita zina zomwe mungachite mutayima ndi maukonde ndikudziyika nokha ndi mwendo umodzi kutsogolo kwa mwendo wina kumbuyo. Tepi, kumbali ina, imayikidwa pansi pa mwendo wakutsogolo. Ndi mkono wotsutsana ndi mwendo, timayamba kutambasula tepiyo ngati tikufuna kukhudza pamwamba pamutu ndi iyo.

Kumbukirani kuti kukonzanso ndi kuchita masewera olimbitsa thupi kumagwira ntchito pokhapokha ngati mukuchita nthawi zonse. Ndikofunikiranso kuchita masewera olimbitsa thupi moyang'aniridwa ndi katswiri yemwe adzatha kukonza mayendedwe athu. Izi zipangitsa kuti zolimbitsa thupi zomwe zachitika ziwongolere bwino kulumikizana kwathu kwamagalimoto.

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