Matenda a Osmotic demyelination

Matenda a Osmotic demyelination (ODS) ndikutayika kwa ma cell aubongo. Zimayambitsidwa ndi kuwonongeka kwa wosanjikiza (myelin sheath) wophimba maselo amitsempha pakati pa ma brainstem (pons).

Pamene mchimake wa myelin womwe umaphimba maselo amitsempha wawonongeka, zikwangwani kuchokera ku mitsempha imodzi kupita kwina sizitumizidwa bwino. Ngakhale ubongo umakhudzidwa kwambiri, madera ena aubongo amathanso kutengapo gawo.

Chifukwa chofala kwambiri cha ODS ndikusintha mwachangu magawo amthupi a sodium. Izi zimachitika nthawi zambiri munthu akamachiritsidwa magazi otsika kwambiri a sodium (hyponatremia) ndipo sodium imasinthidwa mwachangu kwambiri. Nthawi zina, zimachitika mulingo wokwanira wa sodium m'thupi (hypernatremia) ukakonzedwa mwachangu kwambiri.

ODS sizimachitika zokha. Nthawi zambiri, ndizovuta zamankhwala pamavuto ena, kapena kuchokera pamavuto enawo.

Zowopsa ndi izi:

• Kumwa mowa
• Matenda a chiwindi
• Kusowa zakudya m'thupi kuchokera ku matenda aakulu
• Chithandizo cha radiation cha ubongo
• Kusuta kwambiri ndikusanza nthawi yapakati

Zizindikiro zimatha kuphatikizira izi:

• Kusokonezeka, kusokonezeka, kuyerekezera zinthu m'maganizo
• Kusamala mavuto, kunjenjemera
• Vuto kumeza
• Kuchepetsa kuchepa, kugona kapena kugona, ulesi, mayankho osavomerezeka
• Mawu osalankhula
• Kufooka kumaso, mikono, kapena miyendo, nthawi zambiri kumakhudza mbali zonse ziwiri za thupi

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro.

Kujambula kwa MRI pamutu kumatha kuwonetsa vuto muubongo (ma pon) kapena mbali zina zaubongo. Uku ndiye kuyesa kwakukulu kwa matenda.

Mayesero ena atha kuphatikizira:

• Mulingo wama sodium ndi mayeso ena amwazi
• Kuyankha kwamachitidwe a Brainstem (BAER)

ODS ndi vuto ladzidzidzi lomwe limafunikira chithandizo kuchipatala ngakhale anthu ambiri omwe ali ndi vutoli ali kale mchipatala chifukwa cha vuto lina.

Palibe mankhwala odziwika a central pontine myelinolysis. Chithandizo chimayang'ana kuthetsa zizindikiro.

Thandizo lakuthupi lingathandize kukhalabe ndi mphamvu ya minofu, kuyenda, ndikugwira ntchito m'manja ndi miyendo yofooka.

Kuwonongeka kwa mitsempha komwe kumayambitsidwa ndi pontine myelinolysis nthawi zambiri kumakhala kwakanthawi. Matendawa amatha kupangitsa kuti akhale wolumala kwanthawi yayitali.

Zovuta zingaphatikizepo:

• Kuchepetsa kuthekera kocheza ndi ena
• Kuchepetsa kutha kugwira ntchito kapena kudzisamalira
• Kulephera kusuntha, kupatula kungophethira maso ("otsekedwa" syndrome)
• Kuwonongeka kwamanjenje kwamuyaya

Palibe chitsogozo chenicheni cha nthawi yoti mupite kuchipatala, chifukwa ODS ndiyosowa pagulu.

Kuchipatala, kuchepetsedwa, kuwongolera mankhwala a sodium otsika kumachepetsa chiopsezo cha kuwonongeka kwa mitsempha m'maponi.Kudziwa momwe mankhwala ena amasinthira mulingo wa sodium kungalepheretse kuchuluka kuti kusinthe mwachangu kwambiri.

ODS; Kuchotsa pakati pa pontine

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje

Weissenborn K, Lockwood AH. Encephalopathies owopsa komanso amadzimadzi. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 84.

Yaqoob MM, McCafferty K. Mulingo wamadzi, madzi ndi ma electrolyte. Mu: Nthenga A, Randall D, Waterhouse M, eds. Kumar ndi Clarke's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021: chaputala 9.