Neurology Clinic
Ukusekela Emuva Kwe-Clinical Neurology. El Paso, TX. I-Chiropractor, uDkt Alexander Jimenez uxoxa i-clinical neurology . UDkt. Jimenez unikeza ukuqonda okuthuthukisiwe kophenyo oluhlelekile lwezikhalazo ezivamile neziyinkimbinkimbi zezinzwa ezihlanganisa ikhanda, isiyezi, ubuthakathaka, ukuphazamiseka, kanye ne-ataxia. Kuzogxilwa ku-pathophysiology, i-symptomatology, kanye nokuphathwa kobuhlungu maqondana nekhanda kanye nezinye izimo ze-neurologic, namandla okuhlukanisa okungathi sína ku-benign pain syndromes.
Ukugxila kwethu emtholampilo kanye nemigomo yomuntu siqu ukusiza umzimba wakho ululame ngokwemvelo ngendlela esheshayo nephumelelayo. Ngezinye izikhathi, kungase kubonakale kuyindlela ende; nokho, ngokuzibophezela kwethu kuwena, kuzoba uhambo olujabulisayo. Ukuzibophezela kuwe ngokwezempilo ukuthi, ungalokothi ulahlekelwe ukuxhumana kwethu okujulile nesiguli sethu ngasinye kulolu hambo.
Uma umzimba wakho unempilo ngempela, uzofika ezingeni lakho lokufaneleka eliphelele esimweni sokuqina komzimba esifanele. Sifuna ukukusiza uphile impilo entsha nethuthukisiwe. Emashumini eminyaka adlule we-2 ngenkathi sicwaninga futhi sihlola izindlela nezinkulungwane zeziguli siye safunda ukuthi yini esebenza ngokuphumelelayo ekunciphiseni ubuhlungu ngenkathi kwandisa amandla omuntu. Ukuze uthole izimpendulo zanoma imiphi imibuzo ongase ube nayo sicela ushayele uDkt. Jimenez kokuthi 915-850-0900.
by UDkt Alex Jimenez Neurology Clinic
El Paso, TX. Udokotela weChiropractor, uDkt Alexander Jimenez ubheka izindlela zokuwa, isithuthwane kanye nokwelashwa.ukuquleka kuchazwa ngokuthi, ukunyakaza okungavamile noma ukuziphatha okuvela emsebenzini kagesi ongavamile ebuchosheni. ukuquleka ziwuphawu lwesifo sokuwa kodwa akubona bonke abanesifo sokuwa. Njengoba kuneqembu lezifo ezihlobene ezibonakala ngokuquleka okuphindaphindiwe.�Isithuthwane yiqembu leziyaluyalu ezihlobene futhi ezibonakala ngokuquleka okuphindelelayo. Kunezinhlobo ezahlukene zesithuthwane kanye nokuquleka. Kunemithi yesifo sokuwa enqunyelwe ukulawula ukuquleka, futhi ukuhlinzwa akuvamile ukuba kudingeke uma imithi ingasebenzi.
Ukuquleka & Isithuthwane
Ukudlidliza kwenzeka lapho kunokuchitheka kwegazi okuzenzakalelayo kanye nokudubula okuvumelanisiwe kwamaqembu ama-neuron, ngokuvamile kusabela ku-trigger efana ne-metabolic compromise.
Noma iyiphi Ubuchopho ingaba nokuquleka uma izimo zilungile
I-Epilepsy noma i-seizure disorder, ukwanda kwamathuba omsebenzi wokuquleka okwenzeka kumuntu. Ubuchopho
Izigaba zokuthumba
Ukuquleka okujwayelekile/umhlaba jikelele
Generalized motor seizure (Grand mal)
I-Absence seizure (Petite mal)
Ukubanjwa kokuqala kokugxila
Ukubanjwa kancane kancane
I-Motor cortex (Jacksonian)
I-sensory cortex
I-Somatosensory
I-Auditory-vestibular
Visual
I-olfactory-gustatory (uncinate)
I-complex partial seizure (libmbic)
Ukuquleka okuqhubekayo/okuqhubekayo
Okujwayelekile (isimo se-epilepticus)
I-focal (epilepticus partialis continua)
Generalized Motor Seizure
I-depolarization kagesi yama-neurons kuyo yonke i-cerebral cortex kanyekanye
I-trigger kucatshangwa ukuthi ingaphandle kwe-cerebral cortex, njenge-thalamus noma i-brainstem
Iziqephu ziqala ngokulahlekelwa ukwazi okulandelwa ukufinyela kwe-tonic (isandiso)
Ukuphefumula kuyamiswa, futhi izinwele zikhishwa kudlule i-glottis evaliwe (�khala�)
Umfutho wegazi ophakeme, abafundi abanwetshiwe
Ukufinyela okungapheli nokuphumula (umsebenzi we-clonic)
Ngokuvamile kuthatha imizuzu embalwa, kodwa kwezinye iziguli kungathatha amahora noma ngisho izinsuku (isimo sokuwa)
Ngokuvamile iqala ebuntwaneni
I-Tonic Clonic Seizure
nanfoundation.org/neurologic-disorders/epilepsy/what-is-epilepsy
I-Tonic Clonic/Grand Mal Seizure yami
VIDEO
Izimbangela zokubanjwa
Ukungajwayelekile kwe-Ionic (Na, K, Ca, Mg, BUN, pH)
Ukuhoxiswa kwe-sedative emiluthweni (utshwala, i-barbiturates, i-benzodiazepines)
kungakhuphula izinga likashukela
I-Hypoxia
I-Hyperthermia (ikakhulukazi iziguli ezingaphansi kweminyaka engu-4 ubudala)
Ukukhishwa kwe-toxin
Ukuzwela okungavamile kofuzo kwama-neurons (akuvamile)
I-EEG Ye-Grand Mal Seizure
Isigaba se-Tonic Isigaba se-Clonic Isigaba seposi
Swenson, R. Epilepsy. 2010
Ukungabikho (Petit Mal) Ukudlikiza
Ngokuvamile kwenzeka ezinganeni
Isuka ku-brainstem ephezulu
Ngokuvamile kubukeka njengokulahlekelwa isitimela somcabango noma ukugqolozela emkhathini
Lezi zingane zingase ziqhubeke nokuba nokuquleka okugxilile kamuva ekuphileni
Ukukhululwa okuzenzakalelayo kungenzeka njengoba ama-neurons ekhula
Ukubamba Ukungabikho Kubanjwe Ngekhamera
VIDEO
I-EEG Ye-Petit Mal Seizure
3 amagagasi e-spike/isekhondi Ingabangelwa yi-hyperventilation I-spike = ukuvusa Igagasi = inhibition
Swenson, R. Epilepsy. 2010
Ukubanjwa Ukugxila Okulula/Ingxenye
Kungaba nge-generalization yesibili noma ngaphandle kwayo
Isiguli ngokuvamile sigcina ukwazi
Qala endaweni yokusebenza eyisisekelo ye-cortex
Izimpawu ezihlukene kanye nezigaba kuye ngokuthi umsebenzi wesithuthwane usuka kuphi ebuchosheni
Izindawo zezinzwa ngokuvamile zikhiqiza into enhle (ukubona ukukhanya, ukuhogela okuthile, njll, ngokumelene nokuntula ukuzwa)
Izindawo zezimoto zingase ziveze izimpawu ezinhle noma ezimbi
Umsebenzi wendawo yokubandakanyeka ungancishiswa phakathi nesigaba se-posttal
Uma i-primary motor cortex ibandakanyeka = “Todd ukukhubazeka "
Ngokwengxenye (I-Focal Seizure) Umfana Oneminyaka eyi-12
VIDEO
Ukubanjwa Kwengxenye Ku-Motor Cortex
Ingase iqale njengokunyakaziswa kwendawo eyodwa yomzimba, ohlangothini oluphambene nomsebenzi wesithuthwane, kodwa ingase isakaze emzimbeni ngephethini ye-homuncular (i-Jacksonian seizure/mashi)
www.maxplanckflorida.org/fitzpatricklab/homunculus/science/
Ukubanjwa Kwengxenye Ku-Somatosensory Cortex
Ikhiqiza i-paresthesia ohlangothini oluphambene nomsebenzi we-epileptiform futhi ingasakazeka ngephethini ye-homuncular (mashi) efana nohlobo lwemoto.
en.wikipedia.org/wiki/Cortical_homunculus
Ukubanjwa Kwengxenye Engxenyeni Yokulalela - Indawo ye-Vestibular
Ukubandakanyeka kwesifunda sesikhashana sangemuva
Ingase ikhiqize i-tinnitus kanye/noma i-vertigo
I-Audiometry izoba evamile
Ukubanjwa Kwengxenye Ku-Visual Cortex
Ingase ikhiqize ama-hallucinations emkhakheni wokubuka we-contralateral
I-Visual cortex (i-calcarine cortex) ikhiqize ukukhanya, amabala, kanye/noma ama-zig-zag okukhanya
I-Visual association cortex ikhiqiza imibono ephelele eyengeziwe njengamabhaluni antantayo, izinkanyezi, namapholygoni.
Ukubanjwa Kwengxenye E-Olfactory - Gustatory Cortex
Ingase ikhiqize ama-hallucinations anuka kamnandi
Indawo okungenzeka isabalele ekubanjweni okuvamile
Ukuquleka Okuyingxenye Eyinkimbinkimbi
Kubandakanya ama-cortices enhlangano ye-frontal, temporal noma i-parietal lobes
Kufana nokuquleka okuncane kodwa kungase kube nokudideka okwengeziwe/ukwazi okuncishisiwe
I-Limbic Cortex (i-hippocampus, i-parahippocampal temporal cortex, i-retro-splenial-cingulate-subcallosal cortex, i-orbito-frontal cortex, kanye ne-insula) iyona esengozini enkulu yokulimala kwe-metabolic.
Ngakho-ke lolu uhlobo oluvame kakhulu lwesithuthwane
Ingase iveze izimpawu ze-visceral kanye ne-affective (okungenzeka kakhulu), iphunga nokunambitha okungavamile nokungajabulisi, ukuzwa kwesisu okuyinqaba, ukwesaba, ukukhathazeka, ukucasuka okungavamile, kanye nesifiso sokudla ngokweqile socansi, izigigaba zokuziphatha ezinjengokuhogela, ukuhlafuna, ukushaya izindebe, ukuqhinqa amathe, ngokweqile. imisindo yamathumbu, ukubhodla, ukuqhanyelwa, ukuncelisa, noma ukugijima
Iziqeshana Zokuquleka Okuhlukene Enganeni Eyodwa
VIDEO
Ukuquleka Okuqhubekayo/Okuqhubekayo
Izinhlobo ze-2
Okujwayelekile (isimo se-epilepticus)
I-focal (epilepticus partialis continua)
Ukuquleka okuqhubekayo noma okuphindelelayo esikhathini esiyimizuzu engama-30 ngaphandle kokubuyela kokujwayelekile phakathi naleso sikhathi
Umsebenzi wokuquleka isikhathi eside noma ukuquleka okuningi okwenzeka eduze ngaphandle kokululama okugcwele phakathi
Okuvame ukubonwa njengomphumela wokuzwa okunamandla kwemithi elwa nokuquleka ngenxa ye-rebound hyperexcitability.
Ukweqisa ngokomzwelo, umkhuhlane, noma ezinye izimo ze-hypermetabolic, i-hypoglycemia, i-hypocalcemia, i-hypomagnesemia, i-hypoxemia, izimo ezinobuthi (isb., i-tetanus, i-uremia, ukuphuma ngaphandle, ama-excitatory agents afana ne-amphetamine, i-aminophyline, i-lidocaine, i-penicillin) kanye nokuhoxiswa kokudambisa kungase kubangele ukubanjwa okuqhubekayo.
Isimo Se-Epilepticus
I-grand mal seizure eqhubekayo iyisimo esiphuthumayo sezempilo ngoba singaholela ekulimaleni kobuchopho noma ukufa uma ukuquleka okuthatha isikhathi eside kungayekwa.
Izinga lokushisa eliphakanyisiwe ngenxa yokusebenza okuqhubekayo kwemisipha, i-hypoxia ngenxa yokungangeni komoya okwanele kanye ne-lactic acidosis enamandla ingalimaza izinzwa.
Ukufa kungabangelwa ukushaqeka kanye nokuthelwa ngokweqile kwe-cardiopulmonary
I-Epilepsia Partialis Continua
Impilo encane esongela impilo kunesimo se-epilepticus, kodwa umsebenzi wokudlikiza kufanele unqanyulwe njengoba ungase uthuthukele efomini lokuquleka elijwayelekile uma livunyelwa ukuqhubeka isikhathi eside.
Kungaba umphumela we-neoplasm, ischemia-infarction, ubuthi obuvuselelayo noma i-hyperglycemia.
Ukwelashwa Kokuquleka
Uma ukuquleka kuwumphumela wesimo esicashile, esifana nokutheleleka, ukuphazamiseka kwebhalansi ye-fluid ne-electrolyte, ubuthi obuvela ngaphandle noma obungapheli, noma ukwehluleka kwezinso, ukwelashwa kwesimo esiyisisekelo kufanele kuthuthukise umsebenzi wokubanjwa.
Imithi eminingi ye-antiepileptic yelapha izinhlobo eziningi zokuquleka � ayiphelele nokho
Ezinye zisebenza kancane kancane (i-phenytoin, i-carbamazepine, i-valproic acid ne-phenobarbital)
Kukhona lezo ezinemiphumela emibi embalwa (i-gabapentin, i-lamotrigine ne-topiramate)
Imithi ethile iphatha kuphela uhlobo olulodwa lokuquleka (njenge-ethosuximide yokungabikho kokuquleka)
Imithombo
U-Alexander G. Reeves, A. & Swenson, R. Ukuphazamiseka Kwesistimu Yezinzwa. Dartmouth, 2004.
by UDkt Alex Jimenez Izingane , Neurology Clinic , El Paso Chiropractic Izindaba
El Paso, TX. Udokotela weChiropractor, uDkt Alexander Jimenez ubheka ukuphazamiseka kwentuthuko yengane, kanye nezimpawu zabo, izimbangela kanye nokwelashwa.
I-Cerebral Palsy
Izinhlobo ze-4
I-Spastic Cerebral Palsy
~80% wezigameko ze-CP
I-Dyskinetic Cerebral Palsy (iphinde ihlanganise i-athetoid, i-choreoathetoid, ne-dystonic cerebral palsies)
I-Ataxic Cerebral Palsy
I-Mixed Cerebral Palsy
Autism Spectrum Disorders
I-Autistic Disorder
Isifo sika-Asperger
I-Pervasive Developmental Disorder Ayicacisiwe (PDD-NOS)
I-Childhood Disintegrative Disorder (CDD)
I-Autism Spectrum Disorder Red Flags
Ukuxhumana Komphakathi
Ukusetshenziswa okulinganiselwe kokuthinta
Inkulumo ebambezelekile noma ukungabi bible
Imisindo eyinqaba noma iphimbo lezwi elingajwayelekile
Ubunzima bokubuka amehlo, ukuthinta namagama ngesikhathi esisodwa
Ukulingisa abanye kancane
Abasawasebenzisi amagama ababewasebenzise
Usebenzisa isandla somunye umuntu njengethuluzi
Ukusebenzisana Komphakathi
Ubunzima bokubuka amehlo
Ukuntula inkulumo ejabulisayo
Ukushoda kokuphendula egameni
Ayizami ukukubonisa izinto anentshisekelo kuzo
Ukuziphatha Okuphindaphindayo Nezintshisekelo Ezikhawulelwe
Indlela engavamile yokuhambisa izandla zabo, iminwe noma umzimba
Uthuthukisa amasiko, njengokubeka izinto emgqeni noma ukuphindaphinda izinto
Igxile ezintweni ezingajwayelekile
Intshisekelo eyeqile entweni ethile noma emsebenzini othikameza ukuxhumana nomphakathi
Izithakazelo zezinzwa ezingajwayelekile
Ukusabela okungaphansi noma ngaphezulu kokokufaka kwezinzwa
I-ASD Diagnostic Criteria (DSM-5)
Ukushoda okuqhubekayo ekuxhumaneni komphakathi nokusebenzelana komphakathi kuzo zonke izimo eziningi, njengoba kuboniswa yilokhu okulandelayo, okwamanje noma umlando (izibonelo ziyimifanekiso, aziphelele; bona umbhalo):
Ukushoda ekuvumelaneni komphakathi-ngokomzwelo, okusukela, isibonelo, kusukela ekuziphatheni komphakathi okungavamile kanye nokwehluleka kwengxoxo evamile emuva naphambili; ekwabelaneni okuncishisiwe kwezithakazelo, imizwa, noma umthelela; ukwehluleka ukuqalisa noma ukuphendula ekuhlanganyeleni komphakathi.
Ukushoda ekuziphatheni kokukhulumisana okungenazwi okusetshenziselwa ukuxhumana nomphakathi, kusukela, isibonelo, ekuxhumaneni okungahlanganisiwe kahle ngamazwi nokungakhulumi; kokungajwayelekile ekubhekaneni kwamehlo nolimi lomzimba noma ukusilela ekuqondeni nasekusetshenzisweni komzimba; ekuntulekeni okuphelele kwesimo sobuso kanye nokuxhumana okungenamagama.
Okushodayo ekuthuthukiseni, ekulondolozeni, nasekuqondeni ubudlelwano, okusukela, isibonelo, kusukela ebunzimeni bokulungisa indlela yokuziphatha ukuze ivumelane nezimo ezihlukahlukene zomphakathi; ebunzimeni bokwabelana ngokudlala okucabangayo noma ekwenzeni abangani; ukungabi nantshisekelo kontanga.
I-ASD Diagnostic Criteria
Amaphethini akhawulelwe, aphindaphindayo okuziphatha, okuthakaselayo, noma imisebenzi, njengoba kuboniswa okungenani kokubili kokulandelayo, okwamanje noma umlando (izibonelo ziyimifanekiso, aziphelele; bona umbhalo):
Ukunyakaza kwezimoto okufana ne-stereotyped noma okuphindaphindwayo, ukusetshenziswa kwezinto, noma inkulumo (isb., imibono elula yemoto, ukubeka amathoyizi noma izinto eziphetshwayo, i-echolalia, imishwana engaqondakali).
Ukuphikelela kokufana, ukunamathela ngokungaguquguquki ezinkambisweni, noma amaphethini ayisiko okuziphatha okukhulunywayo noma okungakhulumi (isb., ukweqisa Ukucindezeleka ezinguqukweni ezincane, ubunzima bokuguquguquka, amaphethini okucabanga aqinile, amasiko okubingelela, kudingeka bathathe umzila ofanayo noma badle ukudla okufanayo nsuku zonke).
Izithakazelo ezikhawulelwe kakhulu, ezilungisiwe ezingajwayelekile ngokuqina noma okugxilwe kuzo (isb., ukunamathela ngokuqinile noma ukuba matasa ngezinto ezingajwayelekile, ezisokiwe kakhulu noma ophikelelayo izithakazelo).
I-Hyper - noma i-Hyporeactivity ekufakweni kwezinzwa noma intshisekelo engavamile ezicini zezinzwa zemvelo (isb. ukubonakala kokungabi nandaba nobuhlungu/izinga lokushisa, ukusabela kabi emisindweni ethile noma ukwakheka, ukuhogela ngokweqile noma ukuthinta izinto, ukuthakaseleka kokubukwa ngokukhanya noma ukunyakaza).
I-ASD Diagnostic Criteria
Izimpawu kufanele zibe khona ekuqaleni kwesikhathi sokukhula (kodwa zingase zingabonakali ngokugcwele kuze kube yilapho izimfuno zomphakathi zeqa amandla alinganiselwe, noma zingase zifihlwe ngamasu afundiwe ekuphileni kwakamuva).
Izimpawu zibangela ukonakala okubalulekile emtholampilo kwezenhlalo, emsebenzini, noma kwezinye izindawo ezibalulekile zokusebenza kwamanje.
Lezi ziphazamiso azichazwa kangcono ngokukhubazeka kwengqondo (i-intellectual developmental disorder) noma ukubambezeleka kwentuthuko yomhlaba wonke. Ukukhubazeka ngokomqondo kanye ne-autism spectrum disorder kuvame ukwenzeka ngokubambisana; ukwenza ukuxilongwa kwe-comorbid ye-autism spectrum disorder kanye nokukhubazeka kwengqondo, ukuxhumana komphakathi kufanele kube ngaphansi kwalokho okulindelekile ezingeni lokuthuthuka elijwayelekile.
I-ASD Diagnostic Criteria (ICD- 10)
A. Ukuthuthukiswa okungavamile noma okukhubazekile kubonakala ngaphambi kweminyaka yobudala engu-3 okungenani endaweni eyodwa kwezilandelayo:
Ulimi olwamukelekayo noma oluveza imizwa njengoba lusetshenziswa ekuxhumaneni nomphakathi;
Ukuthuthukiswa kokunamathiselwe komphakathi okukhethiwe noma ukuxhumana komphakathi okuphindaphindiwe;
Umdlalo osebenzayo noma ongokomfanekiso.
B. Isamba okungenani sezimpawu eziyisithupha ezivela ku-(1), (2) kanye no-(3) kufanele zibe khona, okungenani ezimbili zisuka ku-(1) futhi okungenani zibe yinye kokunye (2) kanye (3)
1. Ukonakala kwekhwalithi ekusebenzelaneni komphakathi kubonakala okungenani ezindaweni ezimbili kwezilandelayo:
a. ukwehluleka ngokwanele ukusebenzisa ukugqolozela iso ngeso, isimo sobuso, ukuma komzimba, nokuthinta ukuze ulawule ukuxhumana komphakathi;
b. ukwehluleka ukuthuthukisa (ngendlela efanele ubudala bengqondo, futhi naphezu kwamathuba amaningi) ubudlelwano bontanga obuhilela ukwabelana ngezithakazelo, imisebenzi kanye nemizwa;
c. ukuntula ukubuyisana kwezenhlalo-ngokomzwelo njengoba kuboniswa ukusabela okukhubazekile noma okuphambukile emizweni yabanye abantu; noma ukuntuleka kokuguquguquka kokuziphatha ngokusho
d. ukuntula ukufuna okuzenzakalelayo ukwabelana nabanye abantu ngentokozo, izithakazelo, noma impumelelo (isb. ukuntula ukukhombisa, ukuletha, noma ukukhomba abanye abantu izinto abazithandayo kumuntu).
2. Ukungajwayelekile kwekhwalithi ekuxhumaneni njengoba kubonakala okungenani endaweni eyodwa kwezilandelayo:
a. ukubambezeleka noma ukuntula ngokuphelele, ukuthuthukiswa kolimi olukhulunywayo okungaphelezelwa umzamo wokunxephezela ngokusebenzisa izitho zomzimba noma ukulingisa njengenye indlela yokuxhumana (ngokuvamile okwandulelwa ukushoda kokuxoxa);
b. ukwehluleka okulinganiselwe ukuqalisa noma ukuqhubekisela phambili ukuxoxisana (kunoma yiliphi izinga lekhono lolimi elikhona), lapho kukhona ukusabela okuhambisanayo ekuxhumaneni komunye umuntu;
c. ukusetshenziswa kolimi ngendlela efanayo nokuphindaphindayo noma ukusetshenziswa kwamagama noma imishwana ngendlela engaqondakali;
d. ukuntuleka komdlalo wokuzenzisa ohlukahlukene noma (lapho usemusha) umdlalo wokulingisa umphakathi
3. Amaphethini okuziphatha, izintshisekelo, kanye nemisebenzi ekhawulelwe, ephindaphindayo, kanye nengacatshangwa muntu iboniswa kokukodwa kokulandelayo:
a. Ukuba matasa okuhlanganisayo ngephethini eyodwa noma amaningi enkolelo-ze nekhawulelwe yentshisekelo engajwayelekile kokuqukethwe noma okugxilwe kuyo; noma okuthakaselayo okukodwa noma ngaphezulu okungajwayelekile ngokushuba kanye nemvelo esokiwe nakuba ingekho kokuqukethwe noma igxile kukho;
b. Ukubambelela ngokusobala okuyimpoqo ezinkambisweni ezithile, ezingasebenzi noma amasiko;
c. Izindlela zokuziphatha ezingokwengqondo neziphindaphindayo ezihilela ukubhakuzisa kwesandla noma umunwe noma ukusonteka noma ukunyakaza komzimba wonke okuyinkimbinkimbi;
d. Ukukhathazeka ngengxenye yezinto zezinto ezingezona ezisebenzayo zezinto zokudlala (ezifana ne-oder yazo, ukuzwa kwendawo yazo, noma umsindo noma ukudlidliza kwazo.
C. Isithombe somtholampilo asibangelwa ezinye izinhlobo zezinkinga zokukhula ezigcwele; ukuphazamiseka okuthile kokuthuthukiswa kolimi olwamukelayo (F80.2) ngezinkinga zesibili zenhlalo-ngokomzwelo, ukuphazamiseka okunamathiselwe okusebenzayo (F94.1) noma ukuphazamiseka kokunamathiselwe okuvinjelwe (F94.2); ukukhubazeka kwengqondo (F70-F72) nokuphazamiseka okuthile okuhlobene nemizwelo noma ukuziphatha; i-schizophrenia (F20.-) yokuqala ngokungavamile; kanye ne-Rett's Syndrome (F84.12).
I-Asperger's Syndrome Diagnostic Criteria (ICD-10)
A. Ukonakala kwekhwalithi ekusebenzelaneni komphakathi, njengoba kuboniswa okungenani okubili kwalokhu okulandelayo:
ukonakala okumakiwe ekusetshenzisweni kokuziphatha okungaphikiswa okufana nokubuka iso ngeso, isimo sobuso, ukuma komzimba, nokuthinta ukuze kuqondiswe ukuxhumana komphakathi.
ukwehluleka ukuthuthukisa ubudlelwano kontanga obufanele ezingeni lokuthuthuka.
ukuntuleka kokuzenzakalelayo kokufuna ukwabelana ngentokozo, izithakazelo, noma impumelelo nabanye abantu (isb. ngokungabonisi, ukuletha, noma ukukhomba izinto abazithakaselayo kwabanye abantu).
ukuntula ukuvumelana komphakathi noma ngokomzwelo.
B. Amaphethini akhawulelwe aphindaphindayo futhi anenkolelo evamile yokuziphatha, izintshisekelo, kanye nemisebenzi, njengoba kuboniswa okungenani okukodwa kwalokhu okulandelayo:
okuhlanganisa ukuba matasatasa ngephethini eyodwa noma amaningi enkolelo-ze nekhawulelwe yentshisekelo engajwayelekile noma ngokushuba noma ekugxilweni kwayo.
ukunamathela ngokusobala okungenakuguquguquka ezinkambisweni ezithile, ezingasebenzi noma amasiko.
Izindlela zokunyakazisa umzimba ezingajwayelekile neziphindaphindayo (isb., ukubhakuzisa izandla noma umunwe noma ukusonteka, noma ukunyakaza komzimba wonke okuyinkimbinkimbi).
ukuba matasa okuphikelelayo ngezingxenye zezinto.C. Ukuphazamiseka kubangela ukonakala okubalulekile ngokomtholampilo kwezenhlalo, emsebenzini, noma kwezinye izindawo ezibalulekile zokusebenza.
D. Akukho ukubambezeleka okujwayelekile okubalulekile ngokomtholampilo olimini (isb., amagama angawodwa asetshenziswa iminyaka engu-2 ubudala, imisho yokuxhumana esetshenziswa iminyaka engu-3 ubudala).
E. Akukho ukubambezeleka okubalulekile ngokomtholampilo ekukhuleni kwengqondo noma ekuthuthukisweni kwamakhono afanele iminyaka yokuzisiza, ukuziphatha okuvumelana nezimo (ngaphandle kokuxhumana nabantu), kanye nelukuluku lokwazi ngendawo ezungezile ebuntwaneni.
F. Imibandela ayifinyelelwanga kwenye i-Pervasive Developmental Disorder ethile noma i-Schizophrenia.
I-Attention-Deficit/Hyperactivity Disorder (ADHD)
Inattention - uphuma kalula emsebenziniUkungaqondakali - ibonakala ihamba njaloUkungaziphathi kahle - wenza izenzo ezisheshayo ezenzeka okwamanje ngaphandle kokucabanga ngazo kuqala
Izingozi Ze-ADHD
Ufuzo Ukubhema ugwayi, ukusebenzisa utshwala, noma ukusebenzisa izidakamizwa phakathi nokukhulelwa Ukuchayeka kubuthi bemvelo ngesikhathi sokukhulelwa Ukuchayeka kubuthi bemvelo, njengamazinga aphezulu omthofu, esemncane Isisindo sokuzalwa esiphansi Brain ukulimala
Ukuhlolwa Kwentuthuko
www.cdc.gov/ncbddd/autism/hcp-screening.html
I-Primitive Reflexes
UMoro Umgogodla we-Galant
I-Asymmetrical Tonic Neck Reflex
I-Symetrical Tonic Neck Reflex
I-Tonic Labrynthine Reflex
I-Palmomental Reflex
I-Snout Reflex
Ukwelashwa Kokubambezeleka Kwentuthuko
Lungisa noma yimaphi ama-reflexes agciniwe
Fundisa abazali ngokuhlinzeka ngendawo ehlelekile
Thuthukisa imisebenzi yokulinganisa ubuchopho
Bhekana nokuzwela kokudla futhi ususe ukudla okungenzeka kube yinkinga
Yelapha amathumbu esiguli � ama-probiotics, i-glutamine, njll.
I-Pediatric Acute-Onse Neuropsychiatric Syndrome
(AMAPHANSI)
Ukuqala okumangalisayo kwe-OCD noma ukudla okukhawulelwe kakhulu
Izimpawu azichazwa kangcono yi-neurologic eyaziwayo noma ukuphazamiseka kwezokwelapha
Futhi okungenani okubili kwalokhu okulandelayo:
ukukhathazeka
Ukufaneleka komzwelo kanye / noma ukucindezeleka
Ukucasuka, ulaka kanye/noma ukuziphatha okuphikisa kakhulu
Ukwehla kokuziphatha/kwentuthuko
Ukuwohloka kokusebenza kwesikole
Okungajwayelekile noma okungahambi kahle
Izimpawu ze-Somatic ezihlanganisa ukuphazamiseka kokulala, i-enuresis noma imvamisa yomchamo
*Ukuqala kwe-PANS kungase kuqale ngezinto ezithathelwanayo ngaphandle kwe-strep. Kuhlanganisa nokuqala okuvela ezintweni ezibangela imvelo noma ukungasebenzi kahle kwamasosha omzimba
Izifo Zezingane Ezizimele Ezihlotshaniswa Ne-Streptococcus
(AMAPANDA)
Ukuba khona kokuthatheka okukhulu, ukucindezelwa kanye/noma ama-tics
Ukuqala ngokushesha kwezimpawu noma inkambo ephindiselayo yokuqina kwezimpawu
Ukuqala kwangaphambi kokuthomba
Ukuhlangana nokutheleleka kwe-streptococcal
Ukuhlotshaniswa nezinye izimpawu ze-neuropsychiatric (kuhlanganise nanoma yiziphi izimpawu ze-PANS �ezihambisana�)
Ukuhlolwa kwe-PANS/PANDAS
Isiko le-Swab/Strep
Ukuhlolwa kwegazi kwe-strep
Shintshanisa amasheya ASO
I-Anti-DNase B Titer
I-streptozyme
Hlola ezinye izifo ezithathelwanayo
I-MRI iyakhethwa kodwa i-PET ingasetshenziswa uma kunesidingo
I-EEG
Okubi okungamanga
Akuzona zonke izingane ezine-strep ezinamalebhu aphakeme
kuphela 54% izingane ezine-strep zibonise ukwanda okukhulu kwe-ASO.
kuphela 45% ibonise ukwanda kwe-anti�DNase B.
kuphela 63% ibonise ukwenyuka kwe-ASO kanye/noma i-anti�DNase B.
Ukwelashwa Kwe-PANS/PANDAS
Nemithi Elwa Namagciwane
IVIG
I-Plasmaphoresis
Amaphrothokholi e-Anti-Inflammatory
Imithi ye-steroid
Omega-3's
I-NSAIDS
probiotics
Umtholampilo Wokulimala Kwezokwelapha: I-Chiropractor (Kunconyiwe)
VIDEO
Imithombo
I-Attention Deficit Hyperactivity Disorder. Isikhungo Sikazwelonke Sezempilo Yengqondo, Umnyango Wezempilo kanye Nezinsizakalo Zabantu wase-US, www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adHD/index.shtml.
I-Autism Navigator, www.autismnavigator.com/.
�Isingeniso se-Autism.� I-Interactive Autism Network, iancommunity.org/introduction-autism.
Shet, Anita, et al. �Impendulo Yamasosha omzimba Eqembu A I-Streptococcal C5a Peptidase Ezinganeni: Imithelela Ekuthuthukisweni Komgomo.� The Journal of Infectious Diseases, vol. 188, no. 6, 2003, amakhasi 809�817., doi:10.1086/377700.
�Iyini I-PANDAS?� IPANDAS Network, www.pandasnetwork.org/understanding-pandaspans/what-is-pandas/.
by UDkt Alex Jimenez Neurology Clinic
El Paso, TX. I-Chiropractor, uDkt Alexander Jimenez ugxile ukuwohloka kanye nezifo eziqeda amandla esimiso sezinzwa, izimpawu zazo, izimbangela kanye nokwelashwa.
Izifo Eziwohlozayo Nezokwehlisa Umoya
Izifo Ze-Neuron Izifo
Ubuthakathaka bemoto ngaphandle kwezinguquko zezinzwa I-Amyotrophic lateral sclerosis (ALS) Izinhlobo ze-ALS I-primaryal lateral sclerosis
Ukukhubazeka kwe-bulbar okuqhubekayo
Izimo ezizuzwe njengefa ezibangela ukonakala kwamaseli ophondo lwangaphambili Isifo sika-Werdnig-Hoffmann ezinganeni
Isifo se-Kugelberg-Welander ezinganeni nakubantu abadala
Yesifo sokuwohloka kwezinzwa nemisipha (ALS)
Kuthinta iziguli ezineminyaka engama-40-60 ubudala Umonakalo ku: Amaseli ophondo lwangaphambili
I-cranial nerve motor nuclei
Amapheshana e-Corticobulbar kanye ne-corticospinal
Okutholakele kwe-motor neuron ephansi (i-atrophy, i-fasciculations) KANYE nokutholwe kwe-motor neuron ephezulu (i-spasticity, i-hyperreflexia)
Ukusinda ~iminyaka emithathu
Ukufa kubangelwa ubuthakathaka be-bulbar kanye nemisipha yokuphefumula kanye nomphumela wokutheleleka okuphezulu
Izinhlobo ze-ALS
Ngokuvamile ekugcineni iguqukela kuphethini ye-ALS evamile I-Primary Lateral Sclerosis Izimpawu ze-upper motor neuron ziqala kuqala, kodwa iziguli ekugcineni ziba nezimpawu eziphansi ze-motor neuron
Ukusinda kungaba iminyaka eyishumi noma ngaphezulu
I-Progressive Bulbar Palsy Okukhethayo kuhilela imisipha yekhanda nentamo
I-Herited Motor Neuron Conditions
Isifo i-Alzheimer
Ibonakala ngama-neurofibrillary tangles (izilinganiso ze-hyperphosphorylated tau protein) nama-beta-amyloid plaques
Ngokuvamile kwenzeka ngemva kweminyaka engu-65
Izici zobungozi ezizimele Ukuguqulwa kofuzo lwe-beta amyloid
Inguqulo ye-Epsilon 4 ye-apolipoprotein
Sifo
Ukuxilongwa kwe-Pathological kuwukuphela kwendlela yokuxilonga lesi sifo
Ukuthwebula izithombe kungase kukwazi ukukhipha ezinye izimbangela zokuwohloka komqondo
Izifundo ze-imaging ezisebenzayo zingathuthukiswa ukuze zibe usizo lokuxilonga esikhathini esizayo
Izifundo ze-CSF ezihlolela amaprotheni e-tau ne-beta amyloid zingase zibe usizo njengokuhlolwa kokuxilonga ngokuzayo.
Ama-Amyloid Plaque & Neurofibrillary Tangles
sage.buckinstitute.org/wp-content/uploads/2015/01/plaque-tanglesRNO.jpg
Izindawo Zobuchopho Ezithintwe Isifo I-Alzheimer
Hippocampus
Ukulahlekelwa inkumbulo yakamuva
Indawo ye-posterior temporo-parietal association
I-anomia emaphakathi ne-apraxia yokwakha
I-Nucleus basalis yaseMeynert (ama-cholinergic neurons)
Izinguquko ekuboneni okubukwayo
inchubekelembili
Njengoba izindawo eziningi ze-cortical zihileleka, isiguli sizothuthukisa ukuntula kwengqondo okunzima kakhulu, kodwa i-paresis, ukulahlekelwa kwezinzwa, noma ukukhubazeka kwensimu ebonakalayo kuyizici.
Izinketho zokwelapha
Imithi evimbela isimiso sezinzwa esimaphakathi i-acetylcholinesterase
Donepezil I-Galantamine Rivastigmine
Ukuzivocavoca kwe-Aerobic, imizuzu engama-30 nsuku zonke
Ukunakekelwa kwe-PT/OT ukugcina imisebenzi yokuphila kwansuku zonke
Imithi ye-Antioxidant kanye ne-anti-inflammatory
Ezigabeni ezithuthukile, kungadinga isikhathi esigcwele, ekunakekelweni kwasekhaya
I-Vascular Dementia
I-cerebral arteriosclerosis eholela ekushayweni
Isiguli sizoba nomlando obhaliwe wokushaywa unhlangothi noma izimpawu zokushaywa unhlangothi kwangaphambilini (i-spasticity, i-paresis, i-pseudobulbar palsies, i-aphasia)
Ingase ihlotshaniswe nesifo i-Alzheimer uma kungenxa ye-amyloid angiopathy
I-Frontotemporal Dementia (Isifo sika-Pick)
Ujwayelekile
Ithinta amalobe angaphambili nawesikhashana
Kungase kubonakale ekuthwebuleni uma ukonakala okuthuthukile kulezi zindawo
Izimpawu
Ukunganakwa
Ukuziphatha okungalungile
Ukufutheka Ukuziphatha okungalungile emphakathini Ukungaziphathi kahle
Izinkinga zolimi
Ngokuvamile akukho nkumbulo noma ubunzima bendawo
I-Pathology yembula imizimba ye-Pick ngaphakathi kwama-neurons
Imiphumela ekufeni eminyakeni emi-2-10
Khetha Bodies/Cytoplasmic Inclusions
slideplayer.com/9467158/29/images/57/Pick+bodies+Silver+stain+Immunohistochemistry+for+Tau+protein.jpg
Ukwelashwa
antidepressant
I-Sertraline I-Citalopram
Yeka ukusebenzisa imithi engabangela ukukhubazeka kwenkumbulo noma ukudideka
Ukuzijabulisa Benzodiazepines
Ukuzivocavoca
Ukuguqulwa kwendlela yokuphila Ukwelashwa kokushintsha kokuziphatha
Isifo sikaParkinson
Ingenzeka kunoma iyiphi iminyaka yobudala, kodwa ayivamile ngaphambi kweminyaka engama-30, futhi ikhulisa ukusabalala kwabantu abadala
Ukuthambekela komndeni kodwa futhi kungaba ngaphandle komlando womndeni
Kungenziwa ngenxa yezinto ezithile zemvelo
I-Exposure 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)
Izinhlanganisela ezikhiqiza ama-radicals mahhala ngokweqile
Ithinta i-substantia nigra pars compacta
I-Dopaminergic neurons
Ku-pathology, ubukhona be-Lewy Bodies
Ukuqoqwa kwe-alpha-synuclein
Imizimba ye-Lewy
scienceofpd.files.wordpress.com/2017/05/9-lb2.jpg
Izimpawu ze-Parkinsonism
Ukuqina (zonke izindiza)
I-Passive ROM
Ukunyakaza okusebenzayo
Ingase ibe yimvelo ye-cogwheel ngenxa yezimpawu zokuthuthumela
I-Bradykinesia
Ukunensa kokunyakaza
Ukungakwazi ukuqalisa ukunyakaza
Ukuqhwayiza
Ukuzamazama kokuphumula (�iphilisi-rolling�)
Idalwe yi-oscillation yamaqembu emisipha aphikisanayo
Amaphutha e-Postural
Ukuma okugobile ngaphambili (okugobile).
Ukungakwazi ukunxephezela ukuphazamiseka, okuholela ekubuyiseleni emuva
Ubuso obufana nemaski
Ukuwohloka komqondo okumaphakathi kuya kokumaphakathi
Ngokuhamba kwesikhathi, ngenxa yokuqoqwa komzimba okungalungile
Pathology
Ukuntuleka kwe-dopamine ku-striatum (caudate ne-putamen) ye-basal ganglia
I-Dopamine ngokuvamile inomphumela wokuvuselela isifunda esiqondile nge-basal ganglia, kuyilapho ivimbela indlela engaqondile.
I-Carbidopa/Levodopa
Ukwelashwa okuvame kakhulu umuthi oyinhlanganisela
Levodopa
Isandulela se-dopamine esinqamula umgoqo wegazi nobuchopho
I-Carbidopa
I-Dopamine decarboxylase inhibitor engaweli i-BBB
Ama-amino acid azonciphisa ukusebenza kahle (ukuncintisana) ngakho-ke imithi kufanele isuswe kumaprotheni
Ukwelashwa Isikhathi Eside Nge-Carbidopa/Levodopa
Amandla esiguli okugcina i-dopamine ayehla ngokusetshenziswa kwemithi ngakho-ke ukuthuthukiswa kwemithi kuzohlala isikhathi esifushane nesifushane uma umuthi usetshenziswa isikhathi eside.
Ngokuhamba kwesikhathi kungaholela ekwandeni kwama-dopamine receptors
Umthamo omkhulu we-dyskinesia
Ukusetshenziswa isikhathi eside kubeka ingcindezi esibindini
Eminye imiphumela emibi ingabandakanya isicanucanu, hypotension kanye nokubona izinto ezingekho
Ezinye Izinketho Zokwelashwa
Imithi
Anticholinergics
Ama-dopamine agonists
I-Dopanime breakdown inhibitors (i-Monoamine oxidase noma i-catechol-O-methyl transferase inhibitors)
Umthamo omkhulu we-glutathione
Ukulinganisa ubuchopho ukuzilolonga okusebenzayo kwe-neuro-rehab
Vibration
Ukugqugquzelwa kwe-retropulsive
Ukukhuthazwa kwe-reflex okuphindaphindiwe
I-CMT/OMT ehlosiwe
I-Multiple System Atrophy
Izimpawu ze-Parkinson Disease ezibhangqwe nokukodwa noma ngaphezulu kwalokhu okulandelayo:
Izimpawu ze-Pyramidal (i-Striatonigral degeneration)
I-Autonomic Dysfunction (ShyDrager syndrome)
Ukuthola i-Cerebellar (Olivopontocerebellar atrophy)
Ngokuvamile ayiphenduli ekwelashweni okujwayelekile kwe-Parkinson Disease
I-Progressive Supranuclear Palsy
Ukonakala okuqhubekayo okusheshayo okubandakanya amaprotheni e-tau ezindaweni eziningi okuhlanganisa ne-rostral midbrain
Izimpawu ngokuvamile ziqala eminyakeni engama-50-60
Ubunzima bokuhamba
I-dysarthria ephawulekayo
Ubunzima bokuzibheka obuqondile bokuzithandela
I-Retrocollis (isandiso se-dystonic yentamo)
I-dysphagia enzima
Ukukhubazeka ngokomzwelo
Izinguquko zomuntu
Ubunzima bokuqonda
Ayiphenduli kahle ekwelashweni okujwayelekile kwe-PD
Sabalalisa Isifo Somzimba We-Lewy
Ukuwohloka komqondo okuqhubekayo
Ama-hallucinations anamandla kanye nokukhohlisa okungenzeka
Ukudideka
Izimpawu ze-Parkinsonian
Sclerosis multiple
Izilonda eziningi ezimhlophe (ama-plaque of demyelination) ku-CNS
Iyahlukahluka ngosayizi
Osokiwe kahle
Kubonakala ku-MRI
Izilonda ze-Optic nerve zivamile
Izinzwa ze-peripheral azibandakanyi
Akuvamile ezinganeni ezingaphansi kweminyaka engu-10, kodwa ngokuvamile kuvezwa ngaphambi kweminyaka yobudala engama-55
Ukutheleleka ngegciwane kungase kubangele impendulo engafanele yokuzivikela komzimba ngama-antibodies ku-virus evamile-myelin antigen
Izindlela ezithathelwanayo nezokuzivikela komzimba zifaka isandla
Izinhlobo ze-MS
I-Primary progressive MS (PPMS)
I-MS yesibili eqhubekayo (SPMS)
I-relapsing remitting multiple sclerosis (RRMS)
Uhlobo oluvame kakhulu
Ingathuthuka ngokushesha, ngokuzenzakalelayo ibonakale ixazulula futhi ibuye
Ekugcineni iba njenge-SPMS
Ukubandakanyeka kwe-Optic Nerve
Ezimweni ezingama-40% ze-MS
Ubuhlungu ngokunyakaza kwamehlo
Isici senkambu ebonakalayo (i-scotoma emaphakathi noma emaphakathi)
Ukuhlolwa kwe-Funduscopic
Ingase iveze i-papilledema uma i-plaque ihilela i-optic disk
Kungase kungabonakali kungavamile uma ama-plaque engemuva kwe-optic disk (retrobulbar neuritis)
Ukubandakanyeka kwe-Medical Longitudinal Fasciculus
Ukuwohloka kwe-MLF kuphumela ku-internuclear ophthalmoplegia
Lapho ubheka eceleni kukhona i-paresis ye-rectus ephakathi kanye ne-nystagmus yeso eliphambene.
Ukuhlangana kuhlala kujwayelekile
Ezinye Izimpawu Ze-MS Ezingenzeka
I-Myelopathy
I-Spastic hemiparesis
Izinzwa ezikhubazekile (DC-ML)
I-Paresthesias
Ukubandakanyeka kwe-Cerebellar
I-Ataxia
I-Dysarthria
Ukubandakanyeka kwesistimu ye-Vestibular
Ukungalingani
I-vertigo encane
I-Nystagmus
I-Tic douloureux (i-trigeminal neuralgia)
Isibonakaliso sikaLhermitte
Ukuzwa ukudubula noma ukushoshozela kubhekiselwa esiqwini nasezithweni ngesikhathi sokuguquguquka kwentamo
Ukukhathala
Ukugeza okushisayo kuvame ukwandisa izimpawu
Umehluko Okufanele Ucatshangelwe
I-emboli eminingi kanye ne-vasculitis
Ingase ibonakale njengomonakalo wento emhlophe ku-MRI
Isistimu yezinzwa ephakathi i-sarcoidosis
Ingakhiqiza i-optic neuritis ebuyiselekayo nezinye izimpawu ze-CNS
Isifo seWhipple
Izilonda ezivuthayo
Ukunyakaza kwamehlo okuvamile
Ukwehla kwe-Vitamin B12
I-Dementia
Spasticity
Ikholomu yomgogodla
I-Meningovascular syphilis
Ukulimala kwe-CNS ye-Multifocal
Isifo se-CNS Lyme
Isifo se-Multifocal
Ukuxilongwa Okuhlukile: Izifundo zokuxilonga
Ukuhlolwa kwegazi kungasiza ukuhlukanisa
Gcwalisa inani legazi Amasosha omzimba e-Anuclear (ANA) Ukuhlolwa kwe-Serum ye-syphilis (i-RPR, i-VDRL, njll.) Ukuhlolwa kwe-fluorescent treponemal antibody I-Lyme titer ESR I-angiotensin eguqula izinga le-enzyme (kuya ku-r/o sarcoidosis)
Izifundo zokuxilonga ze-MS
I-MRI enokuqhathanisa nangaphandle
I-90% yamacala we-MS anokutholwa kwe-MRI okutholakalayo
Okutholakele kwe-CSF
Ukuphakama kwamaseli egazi amhlophe e-mononuclear
Amabhendi e-Oligoclonal IgG
Ukwenyuka kwesilinganiso se-globulin kuya ku-albumin
Lokhu kubonakala futhi kuma-90% ezimo ze-MS
Ukwenyuka kwamazinga amaprotheni ayisisekelo e-myelin
Isibikezelo
Isilinganiso sokusinda ngemuva kokuxilongwa kungu-~ 15 kuya ku-20 iminyaka
Ngokuvamile ukufa kuvela ekuthelelekeni okungaphezu kwamandla futhi akubangelwa yimiphumela yesifo ngokwaso
Imithombo
U-Alexander G. Reeves, A. & Swenson, R. Ukuphazamiseka Kwesistimu Yezinzwa. Dartmouth, 2004.
by UDkt Alex Jimenez Neurology Clinic
Isifo se-Cerebrovascular yiqembu elikhethiwe lezimo ezingaholela kumcimbi/izenzakalo ze-cerebrovascular, okungukuthi unhlangothi . Lezi zenzakalo zithinta ukunikezwa kwegazi kanye nemikhumbi eya ebuchosheni. Nge�ukuvaleka, ukonakala, noma ukopha kwenzeka, lokhu kuvimbela amangqamuzana obuchopho ekutholeni umoya-mpilo owanele, ongabangela ukulimala kwengqondo. Izifo ze-Cerebrovascular zingakhula ngezindlela ezahlukene. Lokhu kuhlanganisa i-vein thrombosis ejulile (i-DVT) futhi atherosclerosis
Izinhlobo zezifo ze-cerebrovascular: Isihlungu, ukuhlaselwa kwe-ischemic yesikhashana , i-aneurysms, nokukhubazeka kwemithambo
E-US isifo se-cerebrovascular siyimbangela yesihlanu evame kakhulu yokufa.
Izifo ze-Cerebrovascular
The Brain
Yakha ~ 2% wesisindo somzimba
Ibalelwa ku-10% wokusetshenziswa komoyampilo womzimba
Ibalelwa ku-20% wokusetshenziswa kweglucose emzimbeni
Ithola ~ 20% okukhiphayo kwenhliziyo
Ngomzuzu, kudinga ~50-80cc wegazi nge-100g ngayinye yezicubu zobuchopho ezimpunga kanye ~17-40cc wegazi ngo-100g wento emhlophe
If igazi eliya ebuchosheni ingu-<15cc nge-100g yezicubu, ngomzuzu, ukungasebenzi kahle kwe-neurologic kwenzeka
Njengazo zonke izicubu, uma kune-ischemia isikhathi eside, maningi amathuba okuba kube nokufa kwamangqamuzana kanye ne-necrosis
Ubuchopho buncike ekunikezeni njalo, okungaphazamiseki komoyampilo kanye neglucose
Imizuzu engu-3-8 yokuboshwa kwenhliziyo ingaholela ekulimaleni kwengqondo okungenakulungiseka!
I-Autoregulation Ebuchosheni
I-systemic hypotension idala i-cerebral vasodilation esebenzayo ukuvumela ukugeleza kwegazi okwengeziwe ebuchosheni
Ubuchopho bungakhipha umoya-mpilo owanele ebuchosheni uma umfutho we-systolic ungama-50 mmHg
Ukuncipha kwe-atherosclerotic kungaveza i-vasodilation esebenzayo ukuzama ukwehlisa ingcindezi eyeqile
Ukwenyuka komfutho wegazi kungabangela i-vasoconstriction, ukunciphisa amathuba okuphuma kwegazi
Uma ingcindezi ye-systolic ifinyelela ku->150 mmHg isikhathi eside, lesi sinxephezelo singase sehluleke.
Ibizwa nge-hypertensive encephalopathy
Ukuhlinzeka Ngegazi Ekhanda
madeinkibera.com/lingual-arterie-anatomie
I-Collateral Circulation
Ngokukhula kancane kancane kwe-occlusion efana ne-atherosclerotic thrombosis, ukujikeleza okuhlangene kunesikhathi sokukhula.
Umbuthano we-Willis uxhuma amasistimu we-carotid ne-basilar
Imithambo yangaphambili nangemuva yokuxhumana ihlinzeka ngokuhlinzeka ngesibambiso
Ama-Anastomoses phakathi kwemithambo yobuchopho eyinhloko kanye ne-cerebellar kwabanye abantu
Uxhumano lwe-carotid artery yangaphakathi nangaphandle nge-ophthalmic & maxillary arteries
Umbuthano we-Willis
Ixhuma uhlelo lwe-vertebrobasilar nohlelo lwangaphakathi lwe-carotid
Ngenkathi ihlinzeka ngokujikeleza okuwusizo okuwusizo, futhi iyindawo esengozini kakhulu ye-Berry Aneurysms engaholela ekushayweni kwegazi.
en.wikipedia.org/wiki/Circle_of_Willis
Ukuhlinzeka Ngegazi Engqondweni
teachingmeanatomy.info/neuro/vessels/arterial-supply/
I-Maxillary & Ophthalmic aa.
Izifo ze-Cerebrovascular
Abantu abadala abangu-700,000 e-US bashaywa unhlangothi unyaka ngamunye
Isizathu sesithathu esivame kakhulu sokufa e-US ~ 2 million abantu abakhubazekile ngenxa yestroke
Ngokuvamile kuvame kakhulu kubantu asebekhulile I-Occlusive/Ischemic Disease I-80% yazo yonke imivimbo
Indawo evame kakhulu yokuvaleka kusemthanjeni wangaphakathi we-carotid ngenhla nje kokuphinyiselwa kwe-carotid evamile a.
I-Atherothrombotic
I-Embolic
Umkhumbi omncane
Isifo Sokopha
I-Occlusive/Ischemic Stroke
Kungaba ngenxa ye-artery NOMA ukuvaleka komthambo Ukuvaleka komthambo kuvame kakhulu
Ngenxa yokuntuleka kwegazi nomoya-mpilo ofinyelela endaweni ethile yobuchopho Ukuqala okungazelelwe kokushoda kwe-neurologic, okuhambisana nokusatshalaliswa komthambo othile Ukushoda kuzohluka kuya ngokuthi imuphi umthambo ophazanyiswe ukusabalaliswa kwawo
Ukuvalwa kwe-Venus
I-Hyperviscocity Ukuphelelwa amanzi emzimbeni
I-Thombocytosis
Amaseli egazi abomvu noma amhlophe aphakanyisiwe
I-Polycythemia
I-Hypercoagulability I-homocysteine ephezulu
Ukungakwazi ukuhamba isikhathi eside noma ukuhamba ngendiza
Izinkinga ze-Genetic clotting factor
ukukhulelwa
Cancer
Ukushintshwa kwama-hormone nokusebenzisa i-OCP
I-Atherothrombotic
Ukushoda kwe-Neurologic kungase kube okwesikhashana noma kuthuthuke kancane ngokuhamba kwesikhathi Izimbangela/izinhlobo ezingenzeka: Ukuhlukaniswa kwe-tunica intima ne-tunica adventitia
Kwenzeka ezigulini ezisencane ezinokuphazamiseka kwezicubu ezixhumeneyo
Idiphozi yezinto ezivuthayo futhi zakheke ezindongeni zomkhumbi
I-Oxidized LDLs ifakwa ezindongeni zemikhumbi
I-Embolic
Ukushoda kwe-Neurologic okungenzeka kuqale kungazelelwe
Izicubu ezisusiwe ekuhlakazweni kwe-tunica intima kanye ne-tunica adventitia
Noma iyiphi i-thrombus exoshiwe ingaba i-embolus evimbela / evala i-lumen yemikhumbi emincane
Umkhumbi Omncane
I-Lipohyalinosis I-Micro-trauma yodonga lwemikhumbi & ibhaluni
I-Amyloid Angiopathy Ukuqoqwa kwamaprotheni e-amyloid ezindongeni zemikhumbi
Okuvame kakhulu ezigulini ezingaphezu kweminyaka engama-65 ubudala
Ibangela ukuncipha (okuholela ku-ischemia) kodwa futhi ingabangela ukuqina komkhumbi (okuholela ekopheni kwegazi)
Kuhlotshaniswa nesifo i-Alzheimer's
Ukuvuvukala I-Spasmotic
Izinto Eziyingozi Ze-Occlusive Stroke
umfutho ophakeme wegazi Isifo sikashukela Ukungajwayelekile kwenhliziyo Ama-shunts angakwesokudla (i-Patent foramen ovale, i-VSD, i-tetralogy ye-fallot, njll)
I-fibrillation ye-Atrial
Isifo se-valve/amavalvu enhliziyo yokwenziwa
Ubudala obudala Ukukhuluphala Hyperlipidemia Ikakhulukazi i-LDL ephezulu kanye ne-HDL ephansi
Indlela yokuphila yama-sedentary Ugwayi/Ukubhema ugwayi Isimo se-oxidation esiphezulu I-homocysteine ephezulu Kunikelwe yi-folic acid ephansi, izimo ze-B6 & B12
Ihlangana ne-LDL cholesterol
I-Hyperviscocity ne-hypercoagulability ithi njengoba kukhonjisiwe kusilayidi esidlule
I-Transient Ischemic Attack (TIA)
Iziqephu ezihlehliswa ngokuphelele zokushoda kwe-neurologic ngenxa yokungasebenzi kahle kwemithambo ngokuvamile ehlala isikhathi esingaphezu kwemizuzu engama-30 ngesikhathi.
Kwesinye isikhathi kungathatha amahora angama-24 noma ngaphezulu
Ingxenye yeziguli ezihlushwa unhlangothi oluphelele lwe-occlusive ngaphambilini bezinokuhlasela kwesikhashana kwe-ischemic
I-20-40% yeziguli ezine-TIA ziyaqhubeka nokuba ne-stroke ephelele
Kubalulekile ukuhlonza iziguli ezinama-TIA ukuze zikwazi ukulawulwa ngendlela efanele futhi kuncishiswe izici zengozi eziguquguqukayo
Umlando Wokushoda Kwemizwa Yesikhashana Esigulini > 45 y/o
DDx
I-TIA cishe i-dx
migraine
Ukuquleka okugxile
I-BPPV
I-Meniere
Izifo ze-Demyelinating
I-arteritis yesikhashana
kungakhuphula izinga likashukela
I-Tumor
Ukukhubazeka kwe-Arteriovenous
I-Carotid Artery Disease
I-high pitched systolic bruit ezwakala phezu komthambo we-carotid ingase ibonise i-carotid stenosis
Idinga ukuhlolwa kwe-duplex ultrasound
Izilonda ezinciphisa i-lumen> 70% zingabangela i-ischemia
I-carotid occlusions eminingi ayibangeli i-ischemia ngenxa yokuthuthukiswa kancane okuvumela ukujikeleza kwe-collateral kuthuthukiswe futhi.
Ukuvala okwakhiwa ngokushesha noma i-emboli kungaveza izinkinga nge-<70% stenosis
Ukungenelela kokuhlinzwa kufanele kucatshangelwe ezigulini ezine->70% stenosis kanye nezimpawu ze-TIA
I-Occlusive Stroke
Uma kukhona ukuqala kokushoda okukhulu kwe-neurologic, isiguli kufanele sibe ne-CT ukuze sikhiphe ukopha. Uma ukopha kunqatshelwe, i-tissue plasminogen activator kufanele inikezwe kungakapheli amahora angama-4.5 okuqala. Akufanele inikezwe kamuva kunalokhu ngoba ingandisa ingozi yokopha ngesikhathi sokuphindaphinda kwezicubu zobuchopho
Ngemuva kwalesi sikhathi sokuqala, i-thrombolysis egxilile noma ukukhishwa kwemishini kwe-embolus
I-Intracranial Hemorrhage
Cishe u-20% wezigameko zokushaywa unhlangothi I-HA enkulu noma ukuhlanza kuphakamisa ukopha ngaphezu kokuvaleka Izinhlobo ezimbili Ukopha okuzenzakalelayo kwe-intracranial umfutho ophakeme wegazi
I-Aneurysms ye-Arterial
Ukukhubazeka kwe-Arteriovenous
Ukuphazamiseka kokuphuza
Imikhumbi iba buthaka ngenxa ye-amyloid angiopathy
Okudabukisayo
Izindawo ze-Aneurysm
I-intraparenchymal hemorrhage 50% - amagatsha e-Lenticulostriate emthambo wobuchopho ophakathi
Ithinta i-putamen ne-capsule yangaphandle 10% – Amagatsha angena emthanjeni ongasemuva wobuchopho
Kuthinta ithalamus I-10% - Amagatsha angenayo omthambo ophakeme we-cerebellar
Kuthinta i-cerebellum I-10% - amagatsha weParamedian we-basilar artery
Kuthinta amaponi e-basilar 20% - Imikhumbi ehlukahlukene ethinta izindawo ezimhlophe
I-Subarachnoid hemorrhage I-Berry aneurysms ekuxhumaneni kwe-artery junctions
Ukuphazamiseka kwezibilini
Thrombocytopenia
I-leukemia
Ukwelashwa kwe-anticoagulant ngokweqile
Izinto Eziyingozi Ze-Hemorrhagic Stroke
umfutho ophakeme wegazi
I-Aneurysms ye-Arterial
Ukukhubazeka kwe-Arteriovenous
Ukuphazamiseka kokuphuza
Imikhumbi iba buthaka ngenxa ye-amyloid angiopathy
Head ukuhlukumezeka
Izimpawu Zesifo Sohlangothi: Fundisa Iziguli UKUSHESHA
chrcsf.org/expert-tips-to-help-with-detecting-the-early-signs-of-stroke/
Izimpawu Ezivamile Ezidlulayo
Vertigo
Ukufiphala kwamazwe amabili noma ukulahlekelwa umbono
I-Ataxia
I-Diplopia
Ukushoda kwezinzwa kanye nemoto kwamazwe amabili noma amabili
syncope
Ubuthakathaka ekusabalaliseni kwenzwa ye-motor cranial ohlangothini olulodwa lwekhanda olune-contralateral hemiparesis (ukulimala kobuchopho obuphakathi)
Ukulimala kwe-sensory cranial nerve & Horner�s syndrome ohlangothini olulodwa lwekhanda kanye nokulahlekelwa kwe-contralateral ubuhlungu kanye nomuzwa wokushisa emzimbeni (ukulimala kwe-brain stem)
Izimpawu Zesikhathi Eside Zincike Endaweni Ethintekile
Ukufiphala okubonakalayo kwe-monocular (amaurosis fugax) okubangelwa yi-ischemia ye-retina
I-contralateral hemiparesis
Ukushoda kwe-Hemisensory
Ukushoda kwenkambu ebonakalayo
Dysphasia
I-aphasia eyamukelekayo (i-Wernicke's area lesion)
I-Expressive aphasia (izilonda zezindawo ze-Broca)
Ukunganakwa kwe-Contralateral (isilonda se-parietal lobe esinamandla)
Inkinga yokushintshwa kokunyakaza (Isilonda se-Supplementarymotorcortex)
Ubunzima bokubheka ngokuzithandela ohlangothini lwe-contralateral (Izilonda zenkundla yamehlo yangaphambili)
Ukushoda kwenkumbulo yesikhashana (i-medial temporal lobes lesioned)
I-Brain-Stem Syndromes
roho.4senses.co/stroke- syndromes/common-stroke-syndromes-chapter-9-textbook-of-stroke-medicine.html
Ukubuyiselwa Kwesifo Sohlangothi
Izidingo zokuvuselela kabusha zincike endaweni yezicubu zobuchopho ezithintwe yi-stroke Ukwelashwa kwenkulumo
Ukuvinjelwa kokusebenza kwemilenze
Balance and gait exercise
Ikhuthaza ukuhlelwa kabusha kwe-neuroplastic Izimpawu zingase zibe ngcono phakathi nezinsuku ezingu-5 zokuqala ngenxa yokuncipha kwe-edema I-edema ingabangela ukubola nge-foramen magnum engabangela ukucindezelwa kobuchopho nokufa � iziguli ezinale nkinga zingadinga i-craniectomy. (ithemba lokugcina)
Imithombo
U-Alexander G. Reeves, A. & Swenson, R. Ukuphazamiseka Kwesistimu Yezinzwa. Dartmouth, 2004.
by UDkt Alex Jimenez Ubuhlungu obungapheliyo , Neurology Clinic , Mental Health , Inhlekelele Yokulimala , I-neuropathy
Ngemva kokuhlolwa kwezinzwa, ukuhlolwa ngokomzimba, umlando wesiguli, ama-x-reyi nanoma yiziphi izivivinyo zokuhlola zangaphambilini, udokotela angase ayale ukuhlola okukodwa noma ngaphezulu kwalokhu okulandelayo ukuze anqume umsuka wenkinga yemizwa okungenzeka/okusolisayo noma ukulimala. Lezi zindlela zokuxilonga ngokuvamile zibandakanya neuroradiology , esebenzisa amanani amancane ezinto ezikhipha imisebe ukutadisha ukusebenza kwesitho nokwakheka kanye isithombe sokuxilonga , ezisebenzisa omazibuthe namashaji kagesi ukutadisha ukusebenza kwesitho.
Izifundo Zezinzwa
I-Neuroradiology
I-MRI
I-MRA
MRS
fMRI
CT scan
I-Myelograms
Ukuhlola kwe-PET
Abanye abaningi
Magnetic resonance imaging (MRI)
Ibonisa izitho noma izicubu ezithambile kahle
Ayikho imisebe ye-ionizing
Izinguquko ku-MRI
I-Magnetic resonance angiography (MRA)
Hlola ukugeleza kwegazi emithanjeni
Thola ama-aneurysms e-intracranial kanye nokukhubazeka kwemithambo
I-Magnetic resonance spectroscopy (MRS)
Hlola ukungahambi kahle kwamakhemikhali ku-HIV, unhlangothi, ukulimala ekhanda, ikhoma, isifo se-Alzheimer, izimila, kanye ne-multiple sclerosis
Ukufaniswa kwe-resonance magnetic imaging (fMRI)
Nquma indawo ethile yobuchopho lapho kwenzeka khona umsebenzi
I-Computed Tomography (CT noma i-CAT Scan)
Isebenzisa inhlanganisela yama-X-ray nobuchwepheshe bekhompyutha ukukhiqiza izithombe ezivundlile, noma ezi-axial
Ibonisa amathambo kahle kakhulu
Kusetshenziswa lapho ukuhlolwa kobuchopho kudingekile ngokushesha njengokungathi ukopha okusolekayo nokuphuka
I-Myelogram
Udayi wokuqhathanisa ohlanganiswe ne-CT noma i-Xray
Okuwusizo kakhulu ekuhloleni intambo yomgogodla
Stenosis
Izicubu
Ukulimala kwezimpande zemizwa
I-Positron Emission Tomography (PET Scan)
I-Radiotracer isetshenziselwa ukuhlola umzimba wezicubu ukuze kutholwe izinguquko ze-biochemical ngaphambi kwesikhathi kunezinye izinhlobo zocwaningo
Isetshenziselwa ukuhlola
Isifo i-Alzheimer
Isifo sikaParkinson
Isifo sikaHuntington
Isithuthwane
Ingozi ye-cerebrovascular
Izifundo ze-Electrodiagnostic
I-Electromyography (EMG)
Izifundo ze-Nerve Conduction Velocity (NCV).
Ivuse Izifundo Ezingenzeka
I-Electromyography (EMG)
Ukutholwa kwamasiginali avela ekususweni kwe-depolarization kwemisipha yamathambo
Ingalinganiswa ngokusebenzisa:
Ama-electrode angaphezulu kwesikhumba
Ayisetshenziselwa izinjongo zokuxilonga, okuningi kwe-rehab ne-biofeedback
Izinaliti ezibekwe ngqo ngaphakathi kwemisipha
Okujwayelekile kwe-EMG yomtholampilo/yokuxilongwa
I-depolarizations erekhodiwe ingaba:
Ngokungajwayelekile
Umsebenzi wokufaka
Umphumela wokugoqeka kwemisipha ngokuzithandela
Imisipha kufanele ithule ngogesi lapho iphumula, ngaphandle kwasepuletini lemoto
Umsebenzisi kumele agweme ukufakwa epuletini lenjini
Okungenani amaphuzu angu-10 ahlukene emsipha akalwa ukuze achazwe kahle
Inqubo
Inaliti ifakwa emsipha
Umsebenzi wokufaka urekhodiwe
Ukuthula kukagesi kurekhodiwe
Ukufinyela kwemisipha ngokuzithandela kurekhodiwe
Ukuthula kukagesi kurekhodiwe
Umzamo omkhulu wokufinyeza urekhodiwe
Amasampula Aqoqiwe
imisipha
Ingenelwe yi-nerve efanayo kodwa izimpande zezinzwa ezihlukene
Ingenelwe yimpande yemizwa efanayo kodwa imizwa ehlukene
Izindawo ezahlukene ngesikhathi sezinzwa
Isiza ukuhlukanisa izinga lesilonda
I-Motor Unit Potential (MUP)
Ukulinganisa
Ukuminyana kwemicu yemisipha exhunywe kuleyo motor neuron eyodwa
Ukuba seduze kwe-MUP
Iphethini yokuqasha nayo ingahlolwa
Ukuqashwa okubambezelekile kungabonisa ukulahlekelwa kwamayunithi emoto ngaphakathi kwemisipha
Ukuqashwa kusenesikhathi kubonakala ku-myopathy, lapho ama-MUP evame ukuba nesikhathi esifushane se-amplitude ephansi.
Ukwenyuka kwe-amplitude kanye nobude besikhathi kungaba umphumela wokubuyiselwa kabusha ngemuva kokuncipha okungapheli
Ukususwa kwe-myelination kwezingxenye eziningi ngokulandelana kungaholela ekuvinjweni okuphelele kwe-nerve conduction ngakho-ke akukho mphumela wokufundwa kwe-MUP, nokho-ke ngokuvamile izinguquko kuma-MUP zibonakala kuphela ngokulimala kwama-axon, hhayi i-myelin.
Ukulimala kwesimiso sezinzwa esimaphakathi ngaphezu kwezinga le-motor neuron (njengokuhlukumezeka komgogodla wesibeletho noma ukushaywa unhlangothi) kungaholela ekukhubazekeni okuphelele okuncane kokungajwayelekile kwenaliti ye-EMG.
I-Denervated Muscle Fibers
Kutholwe njengamasignali kagesi angavamile
Umsebenzi wokufaka owengeziwe uzofundwa emasontweni ambalwa okuqala, njengoba kuba nokucasuka kakhulu
Njengoba imicu yemisipha izwela kakhulu kumakhemikhali izoqala ukukhiqiza umsebenzi wokudambisa okuzenzakalelayo
Amandla E-Fibrillation
UNGAZE kwenzeke emicu yemisipha evamile
Ama-fibrillation awakwazi ukubonakala ngeso lenyama kodwa ayabonakala ku-EMG
Ngokuvamile okubangelwa isifo sezinzwa, kodwa kungakhiqizwa izifo ezinzima zemisipha uma kunomonakalo kuma-axon emoto
UNGABI emicu esebenza ngokujwayelekile
I-depolarization ezenzakalelayo ngenxa yokwanda kwamandla olwelwesi lokuphumula
Okutholwe kwama-fibrillations namagagasi abukhali amahle kuyinkomba enokwethenjelwa kakhulu yokulimala kwama-axon e-motor emsipha ngemuva kwesonto elilodwa kuya ezinyangeni eziyi-12 ngemuva kokulimala.
Ngokuvamile ibizwa ngokuthi �acute� emibikweni, naphezu kokuthi kungenzeka ibonakale ezinyangeni ngemva kokuqala
Izonyamalala uma kukhona ukuwohloka okuphelele noma ukuncipha kwemicu yezinzwa
Izifundo ze-Nerve Conduction Velocity (NCV).
motor
Ilinganisa amandla esenzo semisipha (CMAP)
Izinzwa
Ikala amandla esenzo sezinzwa (SNAP)
Izifundo Zokuqhuba Izinzwa
Isivinini (Isivinini)
Ukubambezeleka kwetheminali
Ukulinganisa
Amathebula okuvamile, alungiselwe ubudala, ubude nezinye izici ayatholakala ukuze odokotela baqhathanise.
Ukubambezeleka kwetheminali
Isikhathi phakathi kwesikhuthazo kanye nokubukeka kwempendulo
I-Distal entrapment neuropathies
Ukwenyuka kokubambezeleka kwetheminali kumzila wemizwa ethile
Velocity
Kubalwa ngokususelwe ekubenimbezeleka nokuguquguqukayo njengebanga
Kuncike kububanzi be-axon
Futhi kuncike ekugqineni kwe-myelin sheath
I-focal neuropathies i-myelin sheaths emincane, ijubane lokuhamba kancane
Izimo ezifana neCharcot Marie Tooth Disease noma i-Guillian Barre Syndrome zilimaza i-myelin ngobubanzi obukhulu, imicu eqhuba ngokushesha.
Ukulinganisa
Impilo ye-axonal
I-neuropathy enobuthi
I-CMAP ne-SNAP amplitude zithintekile
Diabetic-peripheral
I-Distal, i-symmetric
I-Demyelination kanye nokulimala kwe-axonal ngakho-ke isivinini kanye ne-amplitude yokuqhuba kuthinteka kokubili
Ivuse Izifundo Ezingenzeka
Amandla e-Somatosensory evoked (SSEPs)
Isetshenziselwa ukuhlola imizwa yezinzwa ezithweni
I-Visual evoked potentials (VEPs)
Isetshenziselwa ukuhlola izinzwa zezinzwa zesistimu yokubuka
I-Brainstem auditory evoked potentials (AEPs)
Isetshenziselwa ukuhlola izinzwa zezinzwa zesistimu yokuzwa
Amandla arekhodwa ngama-electrode angaphezulu ane-impedance ephansi
Ukurekhodwa kwesilinganiso ngemuva kokuchayeka kaningi kusisusa sezinzwa
Isusa ingemuva umsindo
Icwenga imiphumela njengoba amandla mancane futhi kunzima ukuwabona ngaphandle komsebenzi ojwayelekile
Ngokusho kukaDkt. Swenson, endabeni yama-SSEPs, okungenani izisusa ze-256 zivame ukudingeka ukuze kutholwe izimpendulo ezithembekile, eziphindaphindekayo.
Amandla E-Somatosensory Evoked (SSEPs)
Ukuzwa okuvela emisipha
Thinta nokucindezela ama-receptors esikhumbeni nasezicutshini ezijulile
Kuncane uma kukhona ubuhlungu Umnikelo
Imikhawulo yekhono lokusebenzisa ukuhlolwa kwezinkinga zobuhlungu
Isivinini kanye/noma izinguquko ze-amplitude zingabonisa i-pathology
Izinguquko ezinkulu kuphela ezibalulekile njengoba ama-SSEP evamise ukuhluka kakhulu
Iwusizo ekuqaphelweni kwangaphakathi kokuhlinzwa kanye nokuhlola ukubikezelwa kweziguli ezilimale kanzima ebuchosheni be-anoxic
Akusizi ekuhloleni i-radiculopathy njengoba izimpande zezinzwa zomuntu ngamunye azikwazi ukubonakala kalula
Amandla Asephuzile
Kwenzeka ngaphezu kwama-millisecond angu-10-20 ngemva kokukhuthazwa kwemizwa yemoto
Izinhlobo ezimbili
I-H-Reflex
Iqanjwe ngoDkt. Hoffman
Waqala ukuchaza lokhu kucabanga ngo-1918
Ukubonakaliswa kwe-Electrodiagnostic ye-myotatic stretch reflex
Ukusabela kwemoto okurekhodwa ngemva kokukhuthazwa kokwelula kagesi noma ngokomzimba komsipha ohlobene
Kuwusizo kuphela emtholampilo ekuhloleni i-radiculopathy ye-S1, njengoba i-reflex esuka ku-tibial nerve kuya ku-triceps surae ingahlolwa ngesivinini kanye nobukhulu.
Kuyalinganiseka kakhulu ukuthi ukuhlolwa kwe-Achilles reflex
Yehluleka ukubuya nayo ngemva kokulimala ngakho-ke ayisebenziseki ngokomtholampilo ezimeni eziphindaphindayo ze-radiculopathy
F-Impendulo
Iqanjwe kanjalo ngoba yaqala ukuqoshwa onyaweni
Kuvela 25 -55 millisecond ngemva kwesisusa sokuqala
Ngenxa ye-antidromic depolarization ye-motor nerve, okuholela esignali kagesi ye-orthodromic
Akuyona i-reflex yeqiniso
Imiphumela yokufinyela kwemisipha encane
I-amplitude ingahluka kakhulu, ngakho-ke ayibalulekile njengesivinini
Isivinini esincishisiwe sibonisa ukuhamba kancane
Iwusizo ekuhloleni i-proximal nerve pathology
I-Radiculopathy
I-Guillian Barre Syndrome
I-Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP)
Iwusizo ekuhloleni i-demyelinative peripheral neuropathies
Imithombo
U-Alexander G. Reeves, A. & Swenson, R. Ukuphazamiseka Kwesistimu Yezinzwa. Dartmouth, 2004.
Usuku, Jo Ann. �I-Neuroradiology | Johns Hopkins Radiology.� Johns Hopkins Medicine Health Library, 13 Oct. 2016, www.hopkinsmedicine.org/radiology/specialties/ne uroradiology/index.html.
Swenson, Rand. I-Electrodiagnosis.
Yabelana nge-Ebook
by UDkt Alex Jimenez Ubuhlungu obungapheliyo , Neurology Clinic , Izimo zenziwe , Ukuphathwa yikhanda nokwelashwa , Ukunakekelwa kokulimala , Mental Health , Ukulimala Kwezemidlalo , Ukwelashwa , Whiplash
Ukungqubuzana kuwukulimala kobuchopho okulimazayo okuthinta ukusebenza kobuchopho. Imiphumela yalokhu kulimala imvamisa ingeyesikhashana kodwa ingabandakanya izinhlungu zekhanda , izinkinga zokugxilisa ingqondo, inkumbulo, ibhalansi nokuxhumana. Ukungqubuzana kuvame ukubangelwa ukushaywa ekhanda noma ukunikina ikhanda nomzimba ongaphezulu ngobudlova. Okunye ukungqubuzana kubangela ukulahlekelwa ukwazi, kodwa iningi alikwenzi. Futhi kungenzeka ukuthi ube ne-concussion futhi ungaqapheli. Izingxabano zivamile emidlalweni yokuxhumana, njengebhola lezinyawo. Kodwa-ke, abantu abaningi bathola ukululama okuphelele ngemuva kokungqubuzana.
Izimpikiswano
I-Traumatic Brain Injuries (TBI)
Ngokuvamile umphumela wekhanda ukuhlukunyezwa
Kungenzeka futhi ngenxa yokunikina ikhanda ngokweqile noma ukusheshisa/ukuncipha
Ukulimala okuncane (mTBI/concussions) wuhlobo oluvame kakhulu lokulimala kobuchopho
I-Glasgow Coma Scale
Izimbangela Ezivamile Zokungqubuzana
Ukushayisana kwezimoto Falls Ukulimala kwezemidlalo Assault Ukukhipha izikhali ngengozi noma ngamabomu Umthelela ngezinto
Prevention
Ukuvimbela ukulimala kwekhanda kungaba okubaluleke kakhulu
Khuthaza Iziguli Ukuba Zigqoke Izigqoko Zokuzivikela
Ukuncintisana Ezemidlalo , ikakhulukazi isibhakela, i-hokey, ibhola lezinyawo ne-baseball
Ukugibela emhlane we hhashi
Ukugibela amabhayisikili, izithuthuthu, ama-ATV, njll.
Ukuphakama okuphezulu kuyasebenza njengokukhuphuka kwamatshe, umugqa we-zip
Ukushushuluza, i-snowboarding
Khuthaza Iziguli Ukuba Zifake Amabhande
Xoxa ngokubaluleka kokubopha amabhande ngaso sonke isikhathi ezimotweni nazo zonke iziguli zakho
Futhi khuthaza ukusetshenziswa kwe-booster efanele noma izihlalo zemoto zezingane ukuze kuqinisekiswe ukulingana okwanele nokusebenza kwamabhande ezihlalo.
Ukushayela Ngokuphepha
Iziguli akufanele neze zishayele ziphuze izidakamizwa, okuhlanganisa imithi ethile noma utshwala
Ungalokothi uthumele umbhalo bese ushayela
Yenza Izikhala Ziphephe Ezinganeni
Faka amasango ezingane kanye nezinsimbi zamafasitela ekhaya
Kwangathi ezindaweni ezinempahla ebamba ukushaqeka, njenge-hardwood mulch noma isihlabathi
Gada izingane ngokucophelela, ikakhulukazi uma ziseduze namanzi
Vimbela Ukuwa
Ukususa izingozi ezikhubekayo njengamaragi axegayo, iphansi elingalingani noma i-walkway clutter
Ukusebenzisa amacansi angashibiliki kubhavu nakuma-shower floors, nokufaka izinsimbi zokudonsa eduze kwendlu yangasese, ubhavu kanye neshawa
Qinisekisa izicathulo ezifanele
Ukufaka ama-handrails ezinhlangothini zombili zezitebhisi
Ukuthuthukisa ukukhanya kulo lonke ikhaya
Balance ukuqeqeshwa umzimba
Ibhalansi Ukuqeqeshwa
Ibhalansi yomlenze owodwa
Ukuqeqeshwa kwebhola le-Bosu
Ukuqinisa ingqikithi
Izivivinyo zokulinganisa ubuchopho
I-Concussion Verbiage
I-Concussion vs. mTBI (ukulimala kobuchopho okubuhlungu okuncane)
I-mTBI igama elisetshenziswa kakhulu ezilungiselelweni zezokwelapha, kodwa ukungqubuzana yitemu eyaziwa kakhulu emphakathini ngabaqeqeshi bezemidlalo, njll.
La magama womabili achaza into efanayo eyisisekelo, i-mTBI yitemu elingcono ongalisebenzisa eshadini lakho
Ukuhlola Ukungqubuzana
Khumbula ukuthi akudingekile ukuba njalo kube nokulahlekelwa ukwazi ukuze kube khona ukungqubuzana
I-Post-Concussion Syndrome ingenzeka ngaphandle kwe-LOC nayo
Izimpawu zokungqubuzana zingase zingasheshi futhi zingathatha izinsuku ukuvela
Gada ukulimala kwekhanda okuthunyelwe okungama-48 ubheke amafulegi abomvu
Sebenzisa Ifomu lokuhlola i-acute concussion evaluation (ACE). ukuqoqa ulwazi
Oda i-imaging (CT/MRI) njengoba kudingeka uma amafulege abomvu okungqubuzana ekhona
Amafulegi Abomvu
Idinga imaging (CT/MRI)
Ikhanda elibuhlungu liya liba limbi
Isiguli sibonakala sisozela noma asikwazi ukuvuswa
Unobunzima bokubona abantu noma izindawo
ubuhlungu Neck
Umsebenzi wokubamba
Ukuhlanza okuphindaphindiwe
Ukwandisa ukudideka noma ukucasuka
Ukushintsha kokuziphatha okungajwayelekile
Izimpawu ze-neurologic ezigxile
Inkulumo emisiwe
Ubuthakathaka noma ukuba ndikindiki emaphethelweni
Ushintsho esimweni ukuqonda
Izimpawu Ezivamile Zokungqubuzana
Ikhanda elibuhlungu noma umuzwa wokucindezela ekhanda
Ukulahlekelwa noma ukushintshwa kokwazi
Ukungaboni kahle kwamehlo noma ezinye izinkinga zokubona, njengokunwebeka noma ukungalingani kwabafundi
Ukudideka
isiyezi
Ukukhala ezindlebeni
Ukudabuka noma ukuhlanza
Inkulumo emisiwe
Ibambezelekile ukuphendula imibuzo
Ukulahlekelwa kwememori
Ukukhathala
Inkinga igxila
Ukulahleka kwenkumbulo okuqhubekayo noma okuqhubekayo
Ukucasuka kanye nezinye izinguquko zobuntu
Ukuzwela ukukhanya nomsindo
Izinkinga zokulala
Ukushintshashintsha kwemizwa, ukucindezeleka, ukukhathazeka noma ukucindezeleka
Ukuphazamiseka kokunambitha nokuhogela
Izinguquko Zengqondo/Zokuziphatha
Ukuqhuma ngamazwi
Ukuqhuma ngokomzimba
Ukwahlulela okubi
Ukuziphatha ngokungacabangi
Ukungabi nalutho
Ukungabekezelelani
Ukunganakwa
I-Egocentricity
Ukuqina nokungaguquguquki
Ukuziphatha okuyingozi
Ukungabi nozwela
Ukungabi nogqozi noma ukuzisukumela
Ukucindezeleka noma ukukhathazeka
Izimpawu Ezinganeni
Izingxoxo zingavela ngendlela ehlukile ezinganeni
Ukukhala kakhulu
Ukulahlekelwa kwesifiso
Ukulahlekelwa intshisekelo kumathoyizi ayintandokazi noma imisebenzi
Izinkinga zokulala
Ukuvota
Ukuthukuthela
Ukungaqini lapho umile
Amnesia
Ukulahlekelwa inkumbulo nokwehluleka ukwakha izinkumbulo ezintsha
Buyisela kabusha i-Amnesia
Ukungakwazi ukukhumbula izinto ezenzeka ngaphambi kokulimala
Ngenxa yokwehluleka ukukhumbula
I-Anterograde Amnesia
Ukungakwazi ukukhumbula izinto ezenzeka ngemva kokulimala
Ngenxa yokwehluleka ukwenza izinkumbulo ezintsha
Ngisho nokulahlekelwa inkumbulo emfushane kungase kubikezele umphumela
I-Amnesia ingase ibikezele izikhathi ezi-4-10 ngaphezulu kwezimpawu kanye nokushoda kwengqondo kulandela ukungqubuzana kune-LOC (ngaphansi komzuzu ongu-1)
Buyela Ekuthuthukeni kokudlala
Isisekelo: Azikho Izimpawu
Njengesinyathelo sokuqala Sokubuyela Ekuthuthukeni kwe-Play, umsubathi udinga ukuthi aqede ukuphumula ngokomzimba nangokomqondo futhi angabi nezimpawu zokuquleka okungenani amahora angama-48. Khumbula, lapho umsubathi esemncane, indlela yokwelapha ilondoloza kakhulu.
Isinyathelo 1: Umsebenzi Olula we-Aerobic
Umgomo: Kuphela ukukhulisa izinga lokushaya kwenhliziyo komsubathi.
Isikhathi: Imizuzu emi-5 ukuya kweyi-10.
Imisebenzi: Ibhayisikili lokuzivocavoca, ukuhamba ngezinyawo, noma ukugijima okulula.
Akukho nhlobo ukuphakamisa izinsimbi, ukugxuma noma ukugijima kanzima.
Isinyathelo sesi-2: Umsebenzi ophakathi nendawo
Umgomo: Ukunyakaza komzimba nekhanda okulinganiselwe.
Isikhathi: Sehlisiwe kusukela esimisweni esijwayelekile.
Imisebenzi: Ukugijima okulingene, ukugijima isikhashana, ukuhamba ngebhayisikili okugxilile okumaphakathi, nokuphakamisa izinsimbi
Isinyathelo sesi-3: Umsebenzi osindayo, ongaxhumene naye
Umgomo: Kushube kakhulu kodwa akuxhumani naye
Isikhathi: Iseduze nesimiso esivamile
Imisebenzi: Ukugijima, ukuhamba ngebhayisikili okunamandla aphezulu, inqubo evamile yomdlali yokuphakamisa izinsimbi, kanye nezivivinyo eziqondene nezemidlalo ezingaxhumene nazo. Lesi sigaba singase sengeze ingxenye ethile yengqondo ukuze uzijwayeze ngaphezu kwezingxenye ze-aerobic kanye nokunyakaza ezethulwe kuzinyathelo 1 no-2.
Isinyathelo sesi-4: Zijwayeze futhi uxhumane ngokugcwele
Umgomo: Hlanganyela kabusha ekusebenzeni okugcwele kokuxhumana.
Isinyathelo sesi-5: Ukuncintisana
Umgomo: Buyela emqhudelwaneni.
I-Microglial Priming
Ngemuva kokuhlukumezeka kwekhanda amaseli e-microglial ayaqalwa futhi angasebenza kakhulu
Ukuze ugweme lokhu, kufanele uxazulule i-cascade yokuvuvukala
Vimbela ukuhlukumezeka kwekhanda okuphindaphindiwe
Ngenxa yokukhishwa kwamangqamuzana egwebu, ukusabela ekulandeleni ukuhlukumezeka kungase kube kubi kakhulu futhi kulimaze.
Iyini I-Post-Concussion Syndrome (PCS)?
Izimpawu ezilandela ukuhlukumezeka kwekhanda noma ukulimala okuncane kobuchopho, okungahlala amasonto, izinyanga noma iminyaka ngemva kokulimala
Izimpawu ziqhubeka isikhathi eside kunalokho obekulindelwe ngemuva kokungqubuzana kokuqala
Okuvame kakhulu kwabesifazane nakubantu asebekhulile abahlukumezeka ekhanda
Ubukhulu be-PCS ngokuvamile abuhambelani nobukhulu bokulimala ekhanda
PCS Izimpawu
Ukuphathwa yikhanda
isiyezi
Ukukhathala
Ukuthukuthela
ukukhathazeka
Insomnia
Ukulahlekelwa ukugxilisa ingqondo nenkumbulo
Ukukhala ezindlebeni
Umbono ogqamile
Umsindo nokuzwela ukukhanya
Akuvamile, kunciphisa ukunambitheka kanye nephunga
I-Concussion Associated Risk Factors
Izimpawu zakuqala zekhanda ngemuva kokulimala
Izinguquko zengqondo ezifana ne-amnesia noma inkungu
Ukukhathala
Umlando wangaphambili wekhanda elibuhlungu
Ukuhlolwa Kwe-PCS
I-PCS iwukuxilongwa kokukhishwa
Uma isiguli sibonisa izimpawu ngemva kokulimala kwekhanda, nezinye izimbangela ezingenzeka ziye zakhishwa => I-PCS
Sebenzisa izifundo ezifanele zokuhlola nezithombe ukuze ukhiphe ezinye izimbangela zezimpawu
Ubuhlungu bekhanda Ku-PCS
Ngokuvamile �ukungezwani� uhlobo lwekhanda elibuhlungu
Phatha ngendlela obungenza ngayo ngekhanda elibuhlungu
Ncipha ukucindezeleka
Thuthukisa amakhono okubhekana nokucindezeleka
Ukwelashwa kwe-MSK kwezifunda zomlomo wesibeletho kanye ne-thoracic
I-hydrotherapy yomthethosisekelo
Amakhambi asekela i-Adrenal/adaptogenic
Kungaba i-migraine, ikakhulukazi kubantu ababenezimo ze-migraine ezivele zikhona ngaphambi kokulimala
Yehlisa umthwalo wokuvuvukala
Cabangela ukuphathwa ngezithasiselo kanye noma imithi
Nciphisa ukukhanya nomsindo uma kukhona ukuzwela
Isiyezi Ku-PCS
Ngemuva kokulimala kwekhanda, hlala uhlola i-BPPV, njengoba lolu uhlobo oluvame kakhulu lwe-vertigo ngemva kokuhlukumezeka.
Ukuqondisa kuka-Dix-Hallpike ukuxilonga
I-Epley's maneuver yokwelashwa
Ukuzwela Okukhanyayo Nomsindo
Ukuzwela okukhulu ekukhanyeni nomsindo kuvamile ku-PCS futhi ngokuvamile kwandisa ezinye izimpawu ezifana nekhanda elibuhlungu nokukhathazeka
Ukulawulwa kokugqugquzelwa kwe-mesencephalon ngokweqile kubalulekile ezimweni ezinjalo
Izibuko
Ezinye izibuko ezivimba ukukhanya
Earplugs
Ukotini ezindlebeni
Ukwelashwa Kwe-PCS
Phatha uphawu ngalunye ngendlela obungenza ngayo
Lawula ukuvuvukala kwe-CNS
Curcumin
Boswelia
Amafutha ezinhlanzi/i-Omega-3s � (***ngemuva kokopha kwe-r/o)
Ukwelashwa kokuziphatha kwengqondo
Ukuqeqeshwa kwengqondo nokuphumula
I-acupuncture
Ukuvivinya umzimba kokulinganisa ubuchopho
Bheka ukuhlolwa/ukwelashwa kwengqondo
Bheka kuchwepheshe we-mTBI
mTBI Ochwepheshe
I-mTBI inzima ukuyelapha futhi iwumsebenzi okhethekile kokubili ku-allopathic kanye nemithi ehambisanayo
Inhloso eyinhloko ukuqaphela nokudlulisela ukunakekelwa okufanele
Phishekela ukuqeqeshwa ku-mTBI noma uhlele ukubhekisa kochwepheshe be-TBI
Imithombo
�Inhloko Yekusasa.� DVBIC, 4 Apr. 2017, dvbic.dcoe.mil/aheadforthefuture.
U-Alexander G. Reeves, A. & Swenson, R. Ukuphazamiseka Kwesistimu Yezinzwa. Dartmouth, 2004.
�Iya Kwabahlinzeki Bezempilo.� Izikhungo Zokulawula Nokuvimbela Izifo, Izikhungo Zokulawula Nokuvimbela Izifo, 16 Feb. 2015, www.cdc.gov/headsup/providers/.
�I-Post-Concussion Syndrome.� I-Mayo Clinic, i-Mayo Foundation for Medical Education and Research, 28 July 2017, www.mayoclinic.org/diseases-conditions/post- concussion-syndrome/symptoms-causes/syc-20353352.
by UDkt Alex Jimenez Ubuhlungu obungapheliyo , Neurology Clinic , Ukuphathwa yikhanda nokwelashwa , migraine , I-Migraines , Ukwelashwa
Umsuka: Isizathu esivame kakhulu sika�imigraines/ikhanda elibuhlungu imbangela yamakhanda . Iningi lalolu hlobo lwekhanda elibuhlungu lenzeka ngenxa yokuqina phakathi kwamahlombe, okubangela ukuthi imisipha engaphezulu kwamahlombe iphinde iqinise futhi ikhiphe ubuhlungu ekhanda.
Umsuka Wobuhlungu Bekhanda
Kuvela ezakhiweni ezizwelayo ekhanda
Imicu emincane yobubanzi (ubuhlungu/izinga lokushisa) ayinavani
Ukukhuluma
Imithambo yegazi
Izakhiwo ze-Extracranial
TMJ
Amehlo
Izono
Imisipha yentamo kanye nemigqa
Izakhiwo zamazinyo
Ingqondo ayinazo izinzwa zobuhlungu
Umgogodla we-Trigeminal Nucleus
I-Trigeminal nerve
Inzwa yobuso
I-Glossopharyngeal nerve
I-nerg yegagasi
I-C2 nerve (Inzwa enkulu ye-occipital)
Izinzwa ze-Occipital
dailymedfact.com/neck-anatomy-the-suboccipital-triangle/
Ukuzwela kwamaNociceptors
Imiphumela ku-allodynia kanye ne-hyperalgesia
slideplayer.com/9003592/27/images/4/Izindlela+ezihlotshaniswa+ne-peripheral+sensitization+ to+pain.jpg
Izinhlobo Ezibuhlungu Bekhanda
Ububi:
Ukucasuka kwe-Meningeal I-Intracranial izilonda mass Izinhlungu zemithambo yegazi Ukuphuka komlomo wesibeletho noma ukonakala I-Metabolic I-glaucoma
I-Benign:
migraine Izinhloko zekhanda I-Neuralgia Ukukhanda ikhanda Ikhanda lesibili I-post-traumatic/post-concussion “I-analgesic rebound” yekhanda elibuhlungu� Psychiatric
I-HA Ngenxa Yokulimala Kwama-Extracranial
Sinuses (ukutheleleka, isimila) Isifo somgogodla wesibeletho Izinkinga zamazinyo Ukuhlanganiswa kwe-Temporomandibular Ukutheleleka kwezindlebe, njll. Iso (i-glaucoma, uveitis) Imithambo ye-Extracranial Izilonda zemizwa
HA Amafulegi Abomvu
Isikrini samafulegi abomvu futhi ucabangele izinhlobo ze-HA eziyingozi uma zikhona
Izimpawu zesistimu:
Ukwehla kwesisindo
Ubuhlungu bubavusa ebuthongweni
Fever
Izimpawu ze-Neurologic noma izimpawu ezingavamile:
Ukuqala ngokuzumayo noma ngokuqhuma
Uhlobo lwe-HA olusha noma olubambi kakhulu ikakhulukazi ezigulini esezikhulile
I-HA ubuhlungu obuhlala busendaweni efanayo
Umlando wangaphambili wekhanda elibuhlungu
Ingabe lena i-HA yokuqala owake waba nayo?
Izici zobungozi zesibili:
Umlando womdlavuza, i-immunocompromised, njll.
Ikhanda Eliyingozi/elibi
Ukucasuka kwe-Meningeal
I-Subarachnoid hemorrhage
I-Meningitis kanye ne-meningoencephalitis
Izilonda ze-Intracranial mass
Ama-Neoplasms
I-Intracerebral hemorrhage
I-subdural noma i-epidural hemorrhage
Abscess
I-hydrocephalus eyingozi
Izinhlungu zemithambo yegazi
I-arteritis yesikhashana
I-hypertension encephalopathy (ngokwesibonelo, i-hypertension eyingozi, i-pheochromocytoma)
Ukukhubazeka kwe-Arteriovenous kanye nokwandisa ama-aneurysms
I-Lupus cerebritis
I-venous sinus thrombosis
Ukuphuka komlomo wesibeletho noma ukonakala
Ukuphuka noma ukuhlukaniswa
I-occipital neuralgia
Ukuhlukaniswa komthambo we-vertebral
Chiari malformation
I-Metabolic
kungakhuphula izinga likashukela
I-Hypercapnea
I-carbon monoxide
I-Anoxia
I-anemia
Ubuthi be-Vitamin A
I-glaucoma
Ukubhujiswa kwe-Subarachnoid
Ngokuvamile ngenxa yokuqhuma kwe-aneurysm Ukuqala ngokuzumayo kobuhlungu obunzima Ngokuvamile ukuhlanza Isiguli sibonakala sigula Ngokuvamile i-nuchal rigidity Bheka i-CT kanye nokubhoboza i-lumbar
I-meningitis
Isiguli sibonakala sigula Fever I-Nuchal rigidity (ngaphandle kwabadala nabantwana abancane) Bheka ukubhoboza i-lumbar - ukuxilonga
Ama-Neoplasms
Imbangela engenakwenzeka ye-HA esilinganisweni sabantu besiguli
Ubuhlungu bekhanda obuncane futhi obungacacisiwe
Okubi kakhulu ekuseni
Ingase ivuswe ukunikina ikhanda ngamandla
Uma izimpawu ezigxile, ukuquleka, izimpawu ze-neurologic ezigxile, noma ubufakazi bokwanda kwengcindezi ye-intracranial bukhona bulawula i-neoplasm yethu.
I-Subdural noma i-Epidural Hemorrhage
Ngenxa yomfutho wegazi ophakeme, ukuhlukumezeka noma amaphutha e-coagulation
Ngokuvamile kwenzeka esimweni sokuhlukumezeka kwekhanda okubuhlungu
Ukuqala kwezimpawu kungase kube amasonto noma izinyanga ngemva kokulimala
Hlukanisa nekhanda elivamile langemva kokuquleka
I-post-Concussive HA ingase iqhubeke amasonto noma izinyanga ngemva kokulimala futhi ihambisane nesiyezi noma i-vertigo kanye nezinguquko ezincane zengqondo, ezizodamba zonke.
Khulisa I-Intracranial Pressure
I-Papilledema Ingabangela izinguquko ezibonakalayo
openi.nlm.nih.gov/detailedresult.php?img=2859586_AIAN-13-37- g001&query=papilledema&it=xg&req=4&npos=2
I-Arteritis Yesikhashana (I-Giant-Cell).
> Iminyaka engu-50 ubudala I-polymyalgia rheumatic Malaise Izinhlungu eziseduze I-Myalgia Ubuhlungu bekhanda obungaqondile Ubumnene obukhulu kanye/noma ukuvuvukala phezu kwemithambo yesikhashana noma ye-occipital Ubufakazi bokungaphumeleli kwe-arterial ekusabalaliseni amagatsha emikhumbi ye-cranial Inani eliphakeme kakhulu lama-ESR
Isifunda somlomo wesibeletho HA
Ukuhlukumezeka kwentamo noma ngezimpawu noma izimpawu zempande yomlomo wesibeletho noma ukucindezelwa kwentambo Oda ukucindezelwa kwentambo ye-MR noma ye-CT ngenxa yokuphuka noma ukugudluka Ukungaqini komlomo wesibeletho Oda i-x-ray yomgogodla womlomo wesibeletho ukuguquguquka kwezinhlangothi nokubukwa kwesandiso
Ukukhipha I-HA Eyingozi
Lawula umlando wethu wokulimala okubi kwekhanda noma intamo, ukuquleka noma izimpawu ezigxile ku-neurologic, kanye nezifo ezingase zibeke phambili i-meningitis noma ithumba lobuchopho. Hlola imfiva Linganisa umfutho wegazi (i-diastolic>120) Ukuhlolwa kwe-Ophthalmoscopic Hlola intamo ukuze uqine I-Auscultate ye-cranial bruits. Qedela ukuhlolwa kwe-neurologic Uma kudingeka oda inani eliphelele lamaseli egazi, i-ESR, i-cranial noma i-cervical imaging
Episodic Noma Ezingamahlalakhona?
<15 izinsuku ngenyanga = Episodic
> Izinsuku eziyi-15 ngenyanga = Ezingamahlalakhona
I-Migraine HA
Ngokuvamile ngenxa yokwenyuka noma ukunwebeka kwemithambo yobuchopho
I-Serotonin ku-Migraine
I-AKA 5-hydroxytryptamine (5-HT) I-Serotonin iyancipha eziqephu ze-migraine I-IV 5-HT ingamisa noma yehlise ukuqina
I-Migraine nge-Aura
Umlando wokuhlaselwa okungenani okungu-2 okufeza le mibandela elandelayo
Enye yalezi zimpawu ezilandelayo ze-aura ezibuyiseleka kahle emuva:
Visual
Izinzwa zeSomatic
Ubunzima bokukhuluma noma ulimi
motor
I-Brain stem
Izici ezi-2 kwezingu-4 ezilandelayo:
Uphawu olu-1 lwe-aura lusabalala kancane kancane ngaphezu kwamaminithi angu-?5, kanye/noma izimpawu ezi-2 zenzeka ngokulandelana
Uphawu ngalunye lwe-aura luthatha imizuzu engu-5-60
Uphawu olu-1 lwe-aura luhlangothi olulodwa
I-Aura ihambisane noma ilandelwe ku-<60 min ngekhanda elibuhlungu
Akubalwa kangcono ngokunye ukuxilongwa kwe-ICHD-3, futhi i-TIA ikhishiwe
I-Migraine Ngaphandle kwe-Aura
Umlando wokuhlaselwa okungenani okungu-5 ogcwalisa le mibandela elandelayo:
Ukuhlasela kwekhanda okuthatha amahora angu-4-72 (akulashwanga noma kungalashwanga ngempumelelo)
Ubuhlungu obuhlangene
Ikhwalithi yokudonsa/ukushaya ngamandla
Ukuqina kobuhlungu obumaphakathi kuya kobunzima
Ukuhlukumeza noma ukubangela ukugwema umsebenzi ojwayelekile womzimba
Ngesikhathi sekhanda isicanucanu kanye/noma ukuzwela ukukhanya nomsindo
Akubalwa kangcono ngokunye ukuxilongwa kwe-ICHD-3
Ikhanda elibuhlungu Cluster
Ubuhlungu obukhulu be-unilateral orbital, supraorbital kanye/noma besikhashana
�Njengeqhwa elingigwaza esweni�
Ubuhlungu buhlala imizuzu engu-15-180
Okungenani okukodwa kokulandelayo ohlangothini lwekhanda elibuhlungu:
Umjovo we-conjunctival
Ukujuluka kobuso
I-Lacrimation
Miosis
Ukungqubuzana kwe-nasal
I-Ptosis
I-Rhinorrhea
I-edema yejwabu leso
Umlando wekhanda elifanayo esikhathini esidlule
Amaphaphu Ikhanda elibuhlungu
Ubuhlungu bekhanda obuhambisana nokubili kwalokhu okulandelayo:
Ikhwalithi yokucindezela/ukuqinisa (okungaphuhli).
�Ngizizwa njengebhande ekhanda lami�
Indawo yamazwe amabili
Akwenziwa kubi umsebenzi womzimba ojwayelekile
Ikhanda elibuhlungu kufanele lingabikho:
Ukudabuka noma ukuhlanza
I-Photophobia kanye ne-phonophobia (enye noma enye ingaba khona)
Umlando wekhanda elifanayo esikhathini esidlule
Phinda Ubuhlungu bekhanda
Ikhanda elibuhlungu elivela ?izinsuku eziyi-15 ngenyanga esigulini esinenkinga yekhanda eyayivele ikhona
Ukusetshenziswa ngokweqile okujwayelekile kwezinyanga ezi-3 zomuthi owodwa noma ngaphezulu ongathathelwa ukwelashwa okubuhlungu kanye/noma okuyizimpawu zekhanda
Ngenxa yokusebenzisa ngokweqile/ukuhoxa imithi
Akubalwa kangcono ngokunye ukuxilongwa kwe-ICHD-3
Imithombo
U-Alexander G. Reeves, A. & Swenson, R. Ukuphazamiseka Kwesistimu Yezinzwa. Dartmouth, 2004.
Yabelana nge-Ebook Yamahhala
nanfoundation.org/neurologic-disorders/epilepsy/what-is-epilepsy
en.wikipedia.org/wiki/Cortical_homunculus
Church, Archibald. Izifo Zemizwa Nengqondo. I-WB Saunders Co., ngo-1923.
Inalithi Yokuxilongwa EMG
I-MUPS ye-Polyphasic
Gcwalisa Amabhulokhi Angenzeka
Amagagasi Abukhali Alungile
Imiphumela engavamile
