Umboni wa kusintha kwa zinthu zoyera zomwe zimazungulira ma neuron, kupita patsogolo kwa multifocal leukoencephalopathy ndi matenda a minyewa omwe amakhudza nthawi imodzi zigawo zingapo zaubongo ndipo amapita pang'onopang'ono. Zoyambitsa zake ndi zambiri. 

Neurons (maselo a mitsempha mu ubongo) amawonjezedwa ndi mitsempha ya mitsempha, yotchedwa axon, yomwe idzalumikizana ndi ena mu ubongo kudzera mu synapses (mapeto a axon). Mitsempha iyi imazunguliridwa ndi sheath (myelin) yomwe imawalekanitsa wina ndi mzake ndipo ndi mbali ya chinthu choyera cha ubongo.

Progressive multifocal leukoencephalopathy (PML) ikuchitira umboni za kusintha kwa malo angapo a ubongo wa sheath iyi yomwe imazungulira ma axon, zomwe zimapangitsa kuti pakhale mafupipafupi pakati pawo. Maulendo afupiafupiwa ndi pomwe amayambira kusokonezeka kwaubongo pokhudzana ndi kusuntha kwa minofu, ntchito yaubongo (lingaliro kapena kuzindikira) komanso minyewa yamanjenje. Chifukwa chake kuchitika kwa ziwalo, kusokonezeka kwa malingaliro ndi chidwi.

Matenda osokonekera a minyewawa nthawi zambiri amapita patsogolo, akuyenda pang'onopang'ono kapena pang'onopang'ono ndipo nthawi imodzi amakhudza malo angapo a ubongo (multifocal). Zomwe zimayambitsa zimakhala zambiri ndipo zizindikiro zake zimadalira malo omwe akhudzidwa.

Zomwe zimayambitsa kukula kwa multifocal leukoencephalopathy (PML) ndizosiyanasiyana komanso zosiyanasiyana:

Cholowa kapena chibadwa

Nthawi zina, kuyambira koyambirira kwa ma syndromes kapena matenda ena monga matenda a Cadasil okhudzana ndi kusintha kwa majini, Childhood Ataxia syndrome pa chiyambi cha mapanga mu ubongo woyera ndi kuwonongeka kwa myelin, multiple sclerosis (MS) yomwe imachitika pa. kutengera cholowa komanso nthawi zina kumayambitsa ma cavities (mtundu wa cavitary wa MS), kapena matenda osokonekera muubongo monga osalimba a X syndrome kapena matenda a mitochondrial.

Chiyambi cha mitsempha

Ndi matenda a dementia omwe amayamba chifukwa cha kuwonongeka kwa mitsempha yaing'ono ya ubongo (microangiopathy), yokhudzana ndi ukalamba, ukalamba ndi kusalinganika kwa kuthamanga kwa magazi kapena matenda a shuga.

Zachiyambi chapoizoni 

Mwa kumwa mankhwala ena monga methotrexate omwe amagwiritsidwa ntchito pochiza khansa zina kapena matenda a autoimmune (rheumatoid arthritis kapena RA, etc.), nitric oxide poisoning (kuwotcha ndi mpweya wolakwika) kapena kutulutsa mpweya wa heroin (kugwiritsa ntchito mankhwala osokoneza bongo). Chithandizo cha radiation chingathenso kusintha zinthu zoyera mu ubongo.

Za chiyambi chosachiritsika

Zimalumikizidwa ndi njira zotupa zomwe zimakhudza dongosolo lamanjenje monga MS, leucoaraiosis, kapena matenda a Alzheimer's, omwe nthawi zina amachokera ku cholowa koma osati nthawi zonse, ndi matenda omaliza a ma depositi omwe amasokoneza kufalikira kwa ma neuronal (ma amyloid deposits ndi kuwonongeka kwa neurofibrillary komwe kumakhudzana ndi kufalikira kwa magazi). kukhalapo kwa mapuloteni mu ubongo, beta-amyloid peptide ndi tau protein).

Chiyambi chopatsirana

Nthawi zambiri pamatenda a virus monga papillomavirus (JC virus) kapena Edzi (2 mpaka 4% ya HIV + anthu).

Zizindikiro za kupita patsogolo kwa multifocal leukoencephalopathy (PML) zimasiyana malinga ndi madera omwe akhudzidwa komanso zomwe zimayambitsa kuwonongeka kwa ubongo:

• kumva kufooka, kuvutika kulankhula kapena kuganiza kumayambiriro kwa matendawa;
• kunjenjemera mwadala (cerebellar syndrome) ndi kusokonezeka kwakuyenda mu X syndrome yosalimba kapena matenda a mitochondrial, kusokonezeka kwa kulumikizana mwakufuna, zizindikiro zowonekera koyambirira kwa matenda obadwa nawo kapena ma genetic ndikupita patsogolo pang'onopang'ono komanso mosapeŵeka ...;
• matenda amisala pa kuwonongeka kwa mitsempha chiyambi, nthawi zambiri zimachitika kenako okalamba ndi kusokonezeka maganizo, chidziwitso matenda (temporo-spatial disorientation, kukumbukira kukumbukira), nthawi zina chinyengo ndi chisokonezo;
• tcheru opuwala ndi galimoto luso mu alibe chiyambi poizoni;
• kuchepa kwachidziwitso pakuwonongeka kwaubongo monga matenda a Alzheimer's omwe ali ndi vuto la kukumbukira, malingaliro, chidwi, kuthetsa mavuto, kukonzekera ndi kukonza, kuganiza;
• chiwopsezo cha ngozi ya cerebrovascular (stroke) chimachulukitsidwa mukupita patsogolo kwamitundu yambiri ya leukoencephalopathy;
• migraines ndi khunyu.

Zizindikiro zachipatala zikuwonetsa kale za matendawa, koma kudzakhala kujambula muubongo monga Magnetic Resonance Imaging (MRI) komwe kumapangitsa kuti athe kupeza zotupa zomwe zimawonetsa kuyera kwaubongo.

Kuzindikirika kwa kachilombo ka JC ndi lumbar puncture nthawi zina kumasonyezedwa ngati kukayikira kwapang'onopang'ono kwa multifocal leukoencephalopathy ya ma virus.

Kuzindikira kwa Edzi nthawi zambiri kumapangidwa kale ndipo ngati sichoncho, kuyenera kufufuzidwa.

Kuchiza kwapang'onopang'ono multifocal leukoencephalopathy ndizomwe zimayambitsa:

• fufuzani zomwe zimayambitsa poizoni (mankhwala osokoneza bongo, heroin, ndi zina zotero) ndikuzithetsa; 
• kutsimikizira kwa matenda a ubongo kuwonongeka kwa Alzheimer's matenda, MS, leukoaraiosis, dementia wa mitsempha chiyambi.

Zilonda za chinthu choyera zidzakhalabe zosasinthika ndipo chithandizo chamaganizo ndi chidziwitso cha chidziwitso chidzachedwetsa kupitirira kwa matendawa omwe nthawi zina amasanduka zaka zingapo.