Matenda a Lambert-Eaton

Matenda a Lambert-Eaton (LES) ndimatenda achilendo pomwe kulumikizana molakwika pakati pa mitsempha ndi minofu kumabweretsa kufooka kwa minofu.

LES ndimatenda amthupi okha. Izi zikutanthauza kuti chitetezo chanu chamthupi chimalakwitsa molakwika maselo amthupi ndi minyewa mthupi. Ndi LES, ma antibodies opangidwa ndi chitetezo cha mthupi amateteza maselo amitsempha. Izi zimapangitsa maselo amitsempha kulephera kutulutsa mankhwala okwanira otchedwa acetylcholine. Mankhwalawa amatulutsa zikoka pakati pa mitsempha ndi minofu. Zotsatira zake ndikufooka kwa minofu.

LES ikhoza kuchitika ndi khansa monga khansa yaying'ono yamapapo yam'mapapo kapena zovuta zamagulu monga vitiligo, zomwe zimayambitsa kutayika kwa khungu.

LES imakhudza abambo nthawi zambiri kuposa akazi. Zaka wamba zakuchitika pafupifupi zaka 60. LES sapezeka kawirikawiri mwa ana.

Kufooka kapena kuchepa kwa mayendedwe komwe kumatha kukhala kovuta kwambiri, kuphatikiza:

• Zovuta kukwera masitepe, kuyenda, kapena kukweza zinthu
• Kupweteka kwa minofu
• Kutsikira pamutu
• Kufunika kogwiritsa ntchito manja kudzuka pamalo pomwe mwakhala kapena mwabodza
• Mavuto kuyankhula
• Mavuto kutafuna kapena kumeza, omwe atha kuphatikizira kukugogoda kapena kutsamwa
• Masomphenya amasintha, monga kusawona bwino, masomphenya awiri, komanso kuyang'anitsitsa zovuta

Kufooka kumakhala kofatsa ku LES. Minofu yamiyendo imakhudzidwa kwambiri. Kufooka kumatha kusintha pambuyo pochita masewera olimbitsa thupi, koma kuyesetsa kosalekeza kumayambitsa kutopa nthawi zina.

Zizindikiro zokhudzana ndi magawo ena amanjenje nthawi zambiri zimachitika, ndipo zimaphatikizapo:

• Kuthamanga kwa magazi kumasintha
• Chizungulire poyimirira
• Pakamwa pouma
• Kulephera kwa Erectile
• Maso owuma
• Kudzimbidwa
• Kuchepetsa thukuta

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro. Mayeso atha kuwonetsa:

• Kuchepetsa malingaliro
• Kutheka kotheka kwa minofu yaminyewa
• Kufooka kapena ziwalo zomwe zimakhala bwino pang'ono ndi zochitika

Mayeso othandizira kuzindikira ndi kutsimikizira LES atha kukhala:

• Kuyezetsa magazi kuti ayang'ane ma antibodies omwe amalimbana ndi mitsempha
• Electromyography (EMG) yoyesa thanzi la ulusi waminyewa
• Kuthamanga kwamitsempha kwamitsempha (NCV) kuyesa kuyesa kwa magwiridwe antchito amagetsi minyewa

CT scan ndi MRI ya pachifuwa ndi pamimba, yotsatiridwa ndi bronchoscopy ya omwe amasuta atha kuchitapo kanthu kupatula khansa. Kujambula kwa PET kumatha kuchitidwanso ngati mukukayikira chotupa cham'mapapo.

Zolinga zazikulu za chithandizo ndi:

• Dziwani ndi kuchiza zovuta zilizonse, monga khansa yam'mapapo
• Perekani chithandizo chothandizira kufooka

Kusinthana kwa plasma, kapena plasmapheresis, ndi mankhwala omwe amathandiza kuchotsa m'thupi zomanga thupi zilizonse zomwe zimasokoneza kugwira ntchito kwa mitsempha. Izi zimaphatikizapo kuchotsa m'magazi omwe mumakhala ma antibodies. Mapuloteni ena (monga albumin) kapena plasma yoperekedwa kenako amalowetsedwa mthupi.

Njira ina imaphatikizapo kugwiritsa ntchito ma immunoglobulin (IVIg) kudzera m'mitsempha yolumikizira ma antibodies ambiri othandiza mwachindunji m'magazi.

Mankhwala omwe amathanso kuyesedwa ndi awa:

• Mankhwala omwe amaletsa kuyankha kwa chitetezo chamthupi
• Mankhwala oletsa anticholinesterase kuti athandize kutulutsa minofu (ngakhale izi sizothandiza mukamapereka nokha)
• Mankhwala omwe amalimbikitsa kutulutsa kwa acetylcholine m'maselo amitsempha

Zizindikiro za LES zitha kusintha pochiza matendawa, kupondereza chitetezo cha mthupi, kapena kuchotsa ma antibodies. Komabe, paraneoplastic LES sangayankhenso mankhwala. (Zizindikiro za Paraneoplastic LES zimachitika chifukwa cha kusintha kwa chitetezo cha mthupi kutengera chotupa). Imfa imabwera chifukwa cha zilonda zoyipa.

Zovuta za LES zitha kuphatikiza:

• Kuvuta kupuma, kuphatikizapo kupuma (kulephera)
• Zovuta kumeza
• Matenda, monga chibayo
• Zovulala zakugwa ndi zovuta zogwirizana

Itanani omwe akukuthandizani ngati zizindikiro za LES zikukula.

Matenda a Myasthenic; Matenda a Eaton-Lambert; Matenda a Lambert-Eaton myasthenic; ZOKHUMUDWITSA; LES

• Minofu yakunja yakunja

Evoli A, Vincent A. Matenda a kufalikira kwa ma neuromuscular. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chaputala 394.

Zowona HE. Matenda a khungu ndi nkhope. Mu: Liu GT, Volpe NJ, Galetta SL, olemba. Liu, Volpe, ndi Neuro-Ophthalmology ya Galetta. Wachitatu ed. Philadelphia, PA: Elsevier; 2019: chaputala 14.

Sanders DB, Guptill JT. Kusokonezeka kwa kufalikira kwa neuromuscular. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 109.