Neuralgia

Neuralgia ndikumva kuwawa kwakuthwa, kowopsa komwe kumatsata njira ya mitsempha ndipo kumachitika chifukwa chakukwiya kapena kuwonongeka kwa mitsempha.

Ma neuralgias wamba amaphatikizapo:

• Postherpetic neuralgia (ululu womwe umapitilira patatha ma shingles)
• Trigeminal neuralgia (kupweteka kapena kupweteka kwamagetsi ngati mbali zina za nkhope)
• Matenda osokoneza bongo
• Matenda a m'mitsempha

Zomwe zimayambitsa neuralgia ndizo:

• Kupsa mtima kwa mankhwala
• Matenda a impso
• Matenda a shuga
• Matenda, monga herpes zoster (ming'alu), HIV / AIDS, matenda a Lyme, ndi syphilis
• Mankhwala monga cisplatin, paclitaxel, kapena vincristine
• Porphyria (matenda amwazi)
• Kupanikizika kwa mitsempha ndi mafupa apafupi, mitsempha, mitsempha yamagazi, kapena zotupa
• Zoopsa (kuphatikizapo opaleshoni)

Nthaŵi zambiri, chifukwa chake sichidziwika.

Postherpetic neuralgia ndi trigeminal neuralgia ndi mitundu iwiri ya neuralgia. Neuralgia yofanana koma yodziwika bwino imakhudza mitsempha ya glossopharyngeal, yomwe imamveketsa kummero.

Neuralgia imakonda kwambiri anthu okalamba, koma imatha kuchitika msinkhu uliwonse.

Zizindikiro zimatha kuphatikizira izi:

• Kuchulukitsa chidwi cha khungu panjira yamitsempha yowonongeka, kuti kukhudza kulikonse kapena kukakamizidwa kumveke ngati kupweteka
• Ululu womwe uli panjira yamitsempha yomwe imakhala yakuthwa kapena yolasa, pamalo omwewo gawo lililonse, limabwera ndikupita (pakatikati) kapena limangokhala lotentha, ndipo limatha kuipiraipira dera likasunthidwa
• Kufooka kapena kufooka kwathunthu kwa minofu yoperekedwa ndi mitsempha yomweyo

Wothandizira zaumoyo adzayesa thupi, ndikufunsani za zizindikiro.

Mayeso atha kuwonetsa:

• Zovuta pakhungu
• Mavuto a reflex
• Kutayika kwa minofu
• Kusakhala thukuta (thukuta limayang'aniridwa ndi mitsempha)
• Chifundo pamodzi ndi mitsempha
• Zoyambitsa (malo omwe ngakhale kukhudza pang'ono kumayambitsa kupweteka)

Muyeneranso kukawona dokotala wa mano ngati ululuwo uli pankhope panu kapena nsagwada. Kuyezetsa mano kumatha kuthana ndi zovuta zamano zomwe zimatha kupweteketsa nkhope (monga chotupa cha mano).

Zizindikiro zina (monga kufiira kapena kutupa) zitha kuthandiza kuthana ndi matenda monga matenda, mafupa, kapena nyamakazi.

Palibe mayesero enieni a neuralgia. Koma, mayesero otsatirawa atha kuchitidwa kuti mupeze chomwe chimayambitsa kupweteka:

• Kuyezetsa magazi kuti muwone shuga wamagazi, ntchito ya impso, ndi zina zomwe zingayambitse neuralgia
• Kujambula kwa maginito (MRI)
• Kuphunzira kwamitsempha yamagetsi ndi electromyography
• Ultrasound
• Mpampu ya msana (kuponyera lumbar)

Chithandizo chimadalira chifukwa, malo, komanso kuuma kwa ululu.

Mankhwala ochepetsa ululu amatha kuphatikiza:

• Mankhwala opatsirana
• Mankhwala osokoneza bongo
• Mankhwala owerengera kapena owerengera
• Mankhwala opweteka monga zigamba za khungu kapena mafuta

Mankhwala ena atha kukhala:

• Kuwombera ndi mankhwala osokoneza bongo (anesthetic)
• Mitsempha yamitsempha
• Thandizo lanyama (kwamitundu ina ya neuralgia, makamaka postherpetic neuralgia)
• Ndondomeko zochepetsera kumverera kwa mitsempha (monga kuchotsa mitsempha pogwiritsa ntchito radiofrequency, kutentha, kupanikizika kwa baluni, kapena jekeseni wa mankhwala)
• Kuchita opaleshoni kuti muchotse mitsempha
• Njira zochiritsira zina, monga kutema mphini kapena biofeedback

Njira sizingasinthe zizindikilo ndipo zimatha kuyambitsa kutaya mtima kapena kumva zachilendo.

Mankhwala ena akalephera, madokotala amayesa kukopa mitsempha kapena msana. Nthawi zambiri, njira yotchedwa motor cortex stimulation (MCS) imayesedwa. Maelekitirodi amaikidwa pamwamba pamitsempha, msana, kapena ubongo ndipo amalumikizidwa ndi wopanga zida pansi pa khungu. Izi zimasintha momwe mitsempha yanu imathandizira ndipo imatha kuchepetsa kupweteka.

Ma neuralgias ambiri sawopseza moyo ndipo sizizindikiro zamavuto ena owopsa. Kuti mupeze zowawa zazikulu zomwe sizikukula, onani katswiri wazopweteka kuti athe kuwunika njira zonse zamankhwala.

Ma neuralgias ambiri amayankha kuchipatala. Kuukira kwa zowawa nthawi zambiri kumabwera ndikutha. Koma, ziwopsezo zimatha kupezeka pafupipafupi mwa anthu ena akamakalamba.

Nthawi zina, vutoli limatha kusintha lokha kapena kusowa ndi nthawi, ngakhale chifukwa chake sichikupezeka.

Zovuta zingaphatikizepo:

• Mavuto a opaleshoni
• Kulemala komwe kumayambitsidwa ndi ululu
• Zotsatira zoyipa za mankhwala omwe amagwiritsidwa ntchito poletsa kupweteka
• Njira zamano zomwe sizikufunika neuralgia isanapezeke

Lumikizanani ndi omwe amakupatsani ngati:

• Mumakhala ndi ziboda
• Muli ndi zizindikiro za neuralgia, makamaka ngati mankhwala opweteka omwe sagwirizana nawo samachepetsa ululu wanu
• Mukumva kuwawa kwambiri (onani katswiri wazopweteka)

Kulamulira mwamphamvu shuga kungateteze kuwonongeka kwa mitsempha mwa anthu omwe ali ndi matenda ashuga. Pankhani ya ma shingles, mankhwala osokoneza bongo komanso katemera wa herpes zoster virus amatha kupewa neuralgia.

Kupweteka kwamitsempha; Kupweteka kwa mitsempha; Kupweteka kwa m'mitsempha

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje

Katirji B. Kusokonezeka kwamitsempha yotumphukira. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: mutu 107.

Scadding JW, Koltzenburg M. Zowawa zotumphukira za m'mitsempha. Mu: McMahon SB, Koltzenburg M, Tracey I, Turk DC, olemba. Wall ndi Melzack's Textbook of Pain. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2013: chap 65.

Smith G, Manyazi INE. Ozungulira neuropathies. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: mutu 392.