Paraparesis ndi mtundu wofatsa wa ziwalo zam'munsi zomwe zimachitika chifukwa cha ma virus kapena ma virus. Ululu ndi kukomoka kungathetsedwe ndi mankhwala, ndipo chithandizo cholimbitsa thupi ndi kuchita masewera olimbitsa thupi kumathandizira kuyenda komanso kulimbitsa minofu.

Tanthauzo la paraparesis

Paraparesis ndi mawu azachipatala omwe amagwiritsidwa ntchito kusonyeza kufooka kwapang'onopang'ono komwe kumatsagana ndi kugunda kwa minofu (kufooka kwa spastic) m'munsi. Ndi mtundu wocheperako wa paraplegia (kufa ziwalo za m'munsi).

Spastic paraparesis ndi gulu la matenda omwe amayamba chifukwa cha kusokonezeka kwa msana.

Mitundu ya paraparesis

Spastic paraparesis imatha kubadwa kapena kuyambitsidwa ndi ma virus.

Kubadwa kwa spastic paraparesis

Amagawidwa kukhala ovuta (kapena oyera) komanso ovuta (kapena ovuta) pamene zizindikiro zapamwamba za kutsika kwa miyendo kumunsi zimatsagana ndi zizindikiro zina monga:

• Cerebellar atrophy: kuchepa kwa voliyumu kapena kukula kwa cerebellum
• corpus callosum (kulumikizana pakati pa ma hemispheres awiri a ubongo)
• Ataxia: Kusokonezeka kwa kayendedwe ka kayendedwe kake chifukwa cha kuwonongeka kwa cerebellum

Mwachibadwa, spastic paraparesis imatha kugawidwa malinga ndi momwe amapatsira:

• Wolamulira: ndizokwanira kuti kusakhazikika kumakhudza jini imodzi kuti matendawa athe.
• Recessive: Kusakhazikika kuyenera kukhudza makope onse a jini, aliyense wotengera kwa kholo limodzi, kuti matendawa athe kukula.
• Zolumikizana ndi X: Amuna, omwe ali ndi X chromosome imodzi yokha, amadwala matendawa ngati ali ndi vuto lamtundu umodzi wa jini.

Tropical spastic paraparesis

Zomwe zimatchedwanso HTLV-1 zogwirizana ndi myelopathy, ndi matenda omwe akukula pang'onopang'ono a msana chifukwa cha mtundu wa T-virus wamtundu woyamba wa lymphotrophic (HTLV-1).

Zifukwa za spastic paraparesis

Hereditary spastic paraparesis ikhoza kukhala chifukwa cha mitundu yambiri ya zolakwika za majini kapena zimatha kuchitika zokha. Pakalipano, mitundu 41 ya chibadwa cha spastic paraparesis imadziwika, koma 17 yokha yomwe jini yodalirika yadziwika.

Tropical spastic paraparesis amayamba ndi kachilombo ka HTLV-1.

matenda

Hereditary spastic paraparesis amaganiziridwa chifukwa chokhalapo kwa mbiri yabanja komanso chizindikiro chilichonse cha spastic paraparesis.

Matendawa amayamba chifukwa cha kusagwirizana ndi zifukwa zina:

• Adrenoleukodystrophy, matenda a neurodegenerative olumikizidwa ndi X
• angapo sclerosis
• Matenda okhudza upper motor neuron (primary lateral sclerosis kapena amyotrophic lateral sclerosis)
• HIV kapena HTLV-1 matenda
• Kuperewera kwa vitamini B12, vitamini E kapena mkuwa
• Spinocerebellar ataxia, matenda a neuromuscular omwe amakhudza cerebellum
• Kuwonongeka kwa msana kwa arteriovenous
• Chotupa cha m'mafupa
• Cervicoarthritis myelopathy, kuchepa kwa ngalande ya msana yomwe imakanikiza chingwe cha khomo lachiberekero.

Kuzindikira kwa hereditary spastic paresis nthawi zina kumachitika kudzera mu kuyezetsa majini.

Anthu okhudzidwa

Matenda obadwa nawo amakhudza amuna ndi akazi mosasamala ndipo amatha kuchitika pa msinkhu uliwonse. Zimakhudza anthu 3 mpaka 10 mwa 100.

Zowopsa

Chiwopsezo chokhala ndi matenda otengera choloŵa chimakhala chachikulu ngati pali mbiri yabanja. Pankhani ya tropical spastic paraparesis, chiopsezo chotenga matendawa chimagwirizana ndi chiopsezo chokhala ndi kachilombo ka HTLV-1, komwe kumafalikira kudzera mu kugonana, kugwiritsa ntchito mankhwala osokoneza bongo kudzera m'mitsempha kapena kudzera m'magazi. Angathenso kupatsirana kuchokera kwa mayi kupita kwa mwana kudzera mu kuyamwitsa.

Spasticity ya m'munsi miyendo

Spasticity imatanthauzidwa ndi kuwonjezeka kwa tonic stretch reflex, ndiko kunena kuti kuwonjezereka kwa minofu ya reflex. Zimayambitsa kamvekedwe ka minofu yokwera kwambiri, zomwe zingayambitse kupweteka ndi ma spasms, ndipo zimayambitsa kusagwira ntchito kwa miyendo.

Kuperewera kwagalimoto

Anthu odwala paraparesis nthawi zambiri amavutika kuyenda. Amatha kupunthwa chifukwa amakonda kuyenda ndi zala zawo, mapazi awo atatembenuzira mkati. Nsapatozo nthawi zambiri zimawonongeka chala chachikulu. Nthaŵi zambiri anthu amavutika kutsika masitepe kapena kutsetsereka, kukwera pampando kapena m’galimoto, kuvala, ndi kudzikongoletsa.

Asthenia

Asthenia ndi kutopa kwachilendo pamene kumapitirira ngakhale mutapuma. Zimayambitsa kumverera kuti simungathe kuchita ntchito za tsiku ndi tsiku.

Kusokonezeka kwa proprioceptive

Kulephera kuzindikira malo a mapazi ndi zala

Zizindikiro zina

Mu mawonekedwe osavuta, titha kuwonanso:

• Kusokoneza pang'ono kwa kumva kugwedezeka
• Zizindikiro za mkodzo (incontinence)
• Mapazi opanda pake

Mu mawonekedwe ovuta,

• Ataxia, kusokonezeka kwa kayendedwe ka kayendedwe ka mitsempha
• Amyotrophie
• Optic atrophy
• Retinopathy pigmentosa
• Kusokonezeka maganizo
• Zizindikiro za Extrapyramidal
• Dementia
• Kusamva
• Matenda a ubongo
• khunyu

Chithandizo ndi symptomatic, kuphatikizapo mankhwala ochepetsa spasticity.

• Chithandizo chamankhwala chokhazikika: baclofen, dantrolene, clonazepam, diazepam, tizanidine, benzodiazepines.
• Mankhwala a m'deralo: mankhwala oletsa ululu, poizoni wa botulinum (omwe akulowera), mowa, opaleshoni (selective neurotomy)

Thandizo lolimbitsa thupi ndi kuchita masewera olimbitsa thupi zingathandize kuti mayendedwe aziyenda bwino komanso kuti minofu ikhale yolimba, kuwongolera kuyenda ndi kupirira, kuchepetsa kutopa, komanso kupewa ma spasms.

Odwala ena amapindula ndi kugwiritsa ntchito zomangira, ndodo kapena ndodo.

Kwa tropical spastic paraparesias, mankhwala angapo atha kukhala othandiza polimbana ndi kachilomboka:

• Interferon alpha
• Immunoglobulin (mtsempha)
• Corticosteroids (monga oral methylprednisolone)

Pofuna kupewa kutenga kachilombo koyambitsa matenda a tropical spastic paraparesis, kukhudzana ndi kachilombo ka HTLV-1 kuyenera kuchepetsedwa. Amafalitsidwa ndi:

• Kugonana
• Kugwiritsa ntchito mankhwala osaloledwa m'mitsempha
• Kutuluka magazi

Angathe kupatsirana kuchokera kwa mayi kupita kwa mwana kudzera mu kuyamwitsa. Ndizofala kwambiri pakati pa mahule, ogwiritsa ntchito mankhwala osokoneza bongo, anthu omwe amagwiritsa ntchito hemodialysis ndi anthu m'madera ena kuphatikizapo pafupi ndi equator, kum'mwera kwa Japan ndi South America.