Opisthotonus ndi mgwirizano wokhazikika wa minofu yam'mbuyo ya thupi, yomwe imakakamiza thupi kuti ligwedezeke mwamphamvu, mutu kuponyedwa kumbuyo ndi miyendo mu hyperextension. Izi pathological maganizo opezeka angapo matenda okhudza mantha dongosolo. 

Ma opisthotonos angayerekezedwe ndi malo omwe ali mu arc ya bwalo lotengedwa, muzojambula zakale, ndi anthu ogwidwa ndi mdierekezi. 

Minofu yam'mbuyo ya thupi, makamaka kumbuyo ndi khosi, imakhala yogwirizana kwambiri moti thupi limadzikweza lokha, likukhazikika pamtunda wake ndi zidendene ndi mutu. Mikono ndi miyendo ndi yotambasula komanso yolimba. Izi pathological, zopweteka maganizo si olamulidwa ndi wodwalayo.

Opisthotonos amapezeka m'matenda angapo omwe amakhudza dongosolo lamanjenje, makamaka:

• Kafumbata: pambuyo kuvulala, spores wa bakiteriya Clostridium tetani kulowa m'thupi ndi kutulutsa neurotoxin, yomwe m'masiku ochepa imayambitsa tetany yopita patsogolo ya minofu ya thupi. Mwamsanga, wodwalayo akudandaula kuti ali ndi vuto lolankhula, nsagwada zake zimatsekedwa. Kenako khosi lake limauma, kenako thupi lonse limalumikizana. Ngati matendawa sanasamalidwe panthawi yake, munthuyo sangathe kupuma ndi kufa. Mwamwayi, chifukwa cha katemera mokakamizidwa wa makanda motsutsana ndi kafumbata, amene anayambitsa mu 1952, matenda pafupifupi mbisoweka mu France. Koma imakhudzabe anthu ochepa chaka chilichonse omwe sanatemedwe kapena omwe sali ogwirizana ndi zikumbutso zawo;
• zovuta za psychogenic osadwala khunyu (CPNE) : zingakupangitseni kuganiza za khunyu, koma sizigwirizana ndi ubongo womwewo. Zomwe zimayambitsa zimakhala zovuta, zomwe zimakhala ndi zigawo za neurobiological (zoyambitsa ubongo kuti zichite motere) komanso psychopathological. Nthawi zambiri, pali mbiri ya kupwetekedwa mutu kapena kusokonezeka kwapambuyo;
• kudzipatula khunyu, chifukwa cha kuvulala mutu kapena neuroleptic mankhwala, ikhoza kuwonetsa motere;
• matenda a chiwewe, nthawi zina;
• pachimake ndi kwambiri hypocalcemia : calcium yochepa kwambiri m'magazi nthawi zambiri imagwirizanitsidwa ndi vuto la glands la parathyroid, lomwe limayang'anira kupezeka kwa mcherewu m'thupi;
• kupweteka kwa ubongo : kutupa komwe kumachitika chifukwa cha meningitis, kuwonongeka kwa minyewa yaubongo ndi encephalopathy, kapenanso kukhudzidwa kwa ma tonsils mu bokosi la cranial, kungayambitse opisthotonos.

Zochitika zapadera za opisthotonos mwa makanda

Atabadwa, azamba nthawi zonse amawunika minofu ya khanda. Kupyolera m'njira zosiyanasiyana, amatha kuona kukanika kwa minofu kumbuyo kwa thupi. Ngati sanena zosokoneza, zonse zili bwino.

Ngati mayi alibe katemera wa kafumbata, ndipo opisthotonus amawonekera atangobadwa kumene, kugwirizana ndi kulephera kuyamwa ndi kuseka kwa nkhope, mwana wakhanda ayenera kuganiziridwa. Mkhalidwewu umapezeka kwambiri m'mayiko omwe mulibe katemera wa matendawa, komanso kumene kubadwa kwa mwana kumakhala kosabala.

Pambuyo pake, nthawi zambiri zimachitika kuti mwanayo amatenga udindo wa opisthotonos kusonyeza mkwiyo wosasunthika: amadzuka ndikubwerera kumbuyo m'njira yochititsa chidwi, chifukwa cha kusinthasintha kwake kwakukulu. Ngati ndi kwakanthawi ndipo ngati miyendo yake ikhalabe kusuntha, si pathological. Komano, mukhoza kulankhula ndi dokotala wa ana za izi: maganizo amenewa akhoza kusonyeza ululu wamphamvu, wokhudzana mwachitsanzo ndi reflux yofunika kwambiri ya gastroesophageal ndi asidi.

Ngati kuukira kwa kafumbata kumapitirira kapena kubwerezedwa, ndi thupi lolimba kwambiri moti likhoza kugwidwa ndi mutu ndi mapazi okha, ndi miyendo yowonjezereka, ndizodzidzimutsa zachipatala, zokhudzana ndi kupweteka kwa thupi. ubongo. Tikhoza kukumana ndi:

• matenda a meningitis ;
• mwana wodwala ;
• neonatal hypocalcemia ;
• matenda a mapulo manyowa : matenda osowa majini awa (osakwana 10 milandu pa 1 miliyoni obadwa) ali ndi vuto losauka ngati silingasamalidwe panthawi yake. Iwo amakhala ndi fungo la mapulo madzi mu khutu ndiyeno mkodzo, kudyetsa mavuto, ulesi ndi spasms. Ngati sichitsatiridwa, imatsatiridwa ndi matenda a encephalopathy komanso kulephera kwapakati kupuma. Kuchiza pa nthawi, ndi yotheka koma amafuna okhwima zakudya moyo;
• mitundu ina ya matenda a Gaucher : mtundu 2 wa matenda osowa majini amaonekera m'miyezi yoyamba ya khanda, poyamba ndi yopingasa oculomotor ziwalo kapena mbali ziwiri fixed strabismus. Imakula mwachangu kukhala encephalopathy, yomwe imakhala ndi vuto la kupuma komanso kumeza, komanso kuukira kwa opisthotonos. Pathology iyi ili ndi tanthauzo loyipa kwambiri.

Opisthotonus, zilizonse, ziyenera kutsogolera ku zokambirana. Monga tawonera pamwambapa, zitha kuwulula zovuta, komanso zowopsa, zamatenda amitsempha yamanjenje.

Kupweteka kwapang'onopang'ono kumeneku, chifukwa kumapangitsa wodwalayo kugwa mwadzidzidzi, kungayambitsenso kuvulala kwakuthupi: akhoza kudzivulaza yekha pansi kapena pamipando pamene akugwa. Kuonjezera apo, kugwedezeka kwa minofu yam'mbuyo nthawi zina kumakhala kotero kuti kungayambitse kupsinjika kwa msana.

Thandizo la vuto la kafumbata limaphatikizapo mankhwala amphamvu, ngakhale ma curariants (mankhwala opuwala a curare), kuti athetse mgwirizano. 

Ngati n'kotheka, matenda omwe akufunsidwa amachiritsidwa. Zizindikiro zake zina zimasamalidwanso. Choncho, ngati kafumbata, mankhwala ophera tizilombo amaphatikizidwa ndi kupuma kochita kupanga pambuyo pa tracheotomy kuti athetse asphyxia, pamene maantibayotiki amayamba kugwira ntchito.