Myasthenia gravis

Myasthenia gravis ndi vuto la neuromuscular. Matenda a Neuromuscular amakhudza minofu ndi mitsempha yomwe imawalamulira.

Myasthenia gravis amakhulupirira kuti ndi mtundu wa matenda amthupi okha. Matenda omwe amabwera chifukwa chodzitchinjiriza thupi amachitika pamene chitetezo chamthupi chimagwirira molakwika minofu yathanzi. Ma antibodies ndi mapuloteni omwe amapangidwa ndi chitetezo chamthupi akamazindikira zinthu zoyipa. Ma antibodies amatha kupangidwa pamene chitetezo cha mthupi chimawona molakwika minofu yathanzi ngati chinthu chowopsa, monga myasthenia gravis. Mwa anthu omwe ali ndi myasthenia gravis, thupi limapanga ma antibodies omwe amalepheretsa ma cell a minofu kuti asalandire mauthenga (ma neurotransmitters) ochokera m'mitsempha yamitsempha.

Nthawi zina, myasthenia gravis imalumikizidwa ndi zotupa za thymus (limba la chitetezo chamthupi).

Myasthenia gravis imatha kukhudza anthu azaka zilizonse. Amakonda kwambiri atsikana komanso amuna achikulire.

Myasthenia gravis imayambitsa kufooka kwa minofu yodzifunira. Awa ndi akatumba omwe mutha kuwongolera. Minofu yodziyimira pawokha yam'mimba ndi yam'mimba nthawi zambiri samakhudzidwa. Kufooka kwa minofu ya myasthenia gravis kumakulirakulira ndikuchita bwino komanso kupumula.

Kufooka kwa minofu kumeneku kumatha kubweretsa zizindikilo zosiyanasiyana, kuphatikiza:

• Kupuma movutikira chifukwa cha kufooka kwa minofu yapachifuwa
• Kutafuna kapena kumeza kuvuta, kumayambitsa kugogoda pakamwa pafupipafupi, kutsamwa, kapena kukodza
• Zovuta kukwera masitepe, kukweza zinthu, kapena kukwera pansi
• Zovuta kuyankhula
• Kutulutsa mutu ndi zikope
• Kuuma ziwalo kapena kufooka kwa minofu ya nkhope
• Kutopa
• Kuwopsya kapena kusintha mawu
• Masomphenya awiri
• Zovuta kukhalabe ndikuyang'anitsitsa

Wothandizira zaumoyo adzayesa. Izi zikuphatikiza kuwunika kwamanjenje kwamanjenje. Izi zitha kuwonetsa:

• Kufooka kwa minofu, ndi minofu yamaso nthawi zambiri imakhudzidwa
• Maganizo abwinobwino ndikumverera (kutengeka)

Mayeso omwe angachitike ndi awa:

• Ma acetylcholine receptor antibodies ogwirizana ndi matendawa
• CT kapena MRI scan pachifuwa kuti ayang'ane chotupa
• Kafukufuku wamitsempha kuti ayese momwe ma sign amagetsi amayendera kudzera mu mitsempha
• Electromyography (EMG) yoyesa thanzi la minofu ndi mitsempha yomwe imayang'anira minofu
• Ntchito yama pulmonary imayesa kuyeza kupuma komanso momwe mapapo amagwirira ntchito
• Kuyesa kwa Edrophonium kuti muwone ngati mankhwalawa amasintha zizindikiritsozo kwakanthawi kochepa

Palibe mankhwala odziwika a myasthenia gravis. Chithandizo chingakuthandizeni kuti mukhale ndi nthawi yopanda zisonyezo (kukhululukidwa).

Kusintha kwa moyo wanu kumatha kukuthandizani kuti mupitilize ntchito zanu za tsiku ndi tsiku. Izi zingalimbikitsidwe:

• Kupuma tsiku lonse
• Kugwiritsa ntchito chigamba cha diso ngati masomphenya awiri ndizovuta
• Kupewa kupsinjika ndi kutentha, komwe kumatha kukulitsa zizindikilo

Mankhwala omwe angaperekedwe ndi awa:

• Neostigmine kapena pyridostigmine kukonza kulumikizana pakati pa mitsempha ndi minofu
• Prednisone ndi mankhwala ena (monga azathioprine, cyclosporine, kapena mycophenolate mofetil) kupondereza chitetezo cha mthupi ngati muli ndi zizindikilo zoopsa ndipo mankhwala ena sagwira bwino ntchito.

Mavuto ndi ziwopsezo za kufooka kwa minofu yopuma. Kuukira kumeneku kumatha kuchitika popanda chenjezo pakamwa mankhwala ambiri kapena ochepa. Kuukira kumeneku sikumatha milungu ingapo. Mungafunike kulandilidwa kuchipatala, komwe mungafune kuthandizidwa kupuma ndi makina opumira.

Njira yotchedwa plasmapheresis itha kugwiritsidwanso ntchito kuthana ndi vutoli. Njirayi imaphatikizapo kuchotsa gawo loyera la magazi (plasma), lomwe limakhala ndi ma antibodies. Izi zimalowetsedwa ndi plasma yoperekedwa yomwe ilibe ma antibodies, kapena ndi madzi ena. Plasmapheresis ingathandizenso kuchepetsa zizindikilo za milungu 4 mpaka 6 ndipo imagwiritsidwa ntchito asanafike opaleshoni.

Mankhwala otchedwa intravenous immunoglobulin (IVIg) amathanso kugwiritsidwa ntchito

Kuchita opaleshoni yochotsa thymus (thymectomy) kumatha kubweretsa kukhululukidwa kosafunikira kapena kufunikira kochepa kwa mankhwala, makamaka ngati pali chotupa.

Ngati muli ndi vuto la diso, dokotala wanu atha kunena ma prism kuti apange masomphenya. Kuchita opaleshoni kungalimbikitsidwenso kuchiza minofu yanu yamaso.

Thandizo lakuthupi lingakuthandizeni kukhalabe olimba minofu. Izi ndizofunikira makamaka kwa minofu yomwe imathandizira kupuma.

Mankhwala ena amatha kukulitsa zizindikilo ndipo amafunika kupewa. Musanamwe mankhwala, funsani dokotala ngati zili bwino kuti mumwe.

Mutha kuchepetsa nkhawa zamatenda polowa mgulu lothandizira myasthenia gravis. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Palibe mankhwala, koma kukhululukidwa kwakanthawi ndikotheka. Muyenera kuletsa zochitika zina za tsiku ndi tsiku. Anthu omwe ali ndi zisonyezo zamaso zokha (ocular myasthenia gravis), amatha kukhala ndi myasthenia wamba pakapita nthawi.

Mayi yemwe ali ndi myasthenia gravis atha kutenga pakati, koma chisamaliro chobereka asanabadwe ndikofunikira. Mwana atha kukhala wofooka ndipo amafunikira mankhwala kwa milungu ingapo atabadwa, koma nthawi zambiri samakhala ndi vutoli.

Vutoli limatha kubweretsa mavuto owononga moyo. Izi zimatchedwa vuto la myasthenic.

Anthu omwe ali ndi myasthenia gravis ali pachiwopsezo chachikulu cha zovuta zina za autoimmune, monga thyrotoxicosis, nyamakazi ya nyamakazi, ndi systemic lupus erythematosus (lupus).

Itanani okhudzana ndiumoyo wanu mukakhala ndi zizindikilo za myasthenia gravis.

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati mukuvutika kupuma kapena kumeza mavuto.

Matenda a Neuromuscular - myasthenia gravis

• Minofu yakunja yakunja
• Ptosis - kutsikira kwa chikope
• Central dongosolo lamanjenje ndi zotumphukira zamanjenje

Chang CWJ. Myasthenia gravis ndi matenda a Guillain-Barré. Mu: Parrillo JE, Dellinger RP, olemba. Zovuta Zosamalira Mankhwala: Mfundo Zazidziwitso ndi Kuwongolera Kwa Akuluakulu. 5th ed. Philadelphia, PA: Elsevier; 2019: mutu 61.

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.

Sanders DB, Wolfe GI, Benatar M, ndi al. Malangizo apadziko lonse lapansi pakuwongolera myasthenia gravis: chidule chachikulu. Neurology. 2016; 87 (4): 419-425. PMID: 27358333 www.ncbi.nlm.nih.gov/pubmed/27358333.