ʻO ka Opisthotonus kahi ʻokoʻa maʻamau o nā ʻiʻo hope o ke kino, e koi ana i ke kino e pio ikaika, kiola ke poʻo i hope a me nā lālā i hyperextension. Loaʻa kēia ʻano pathological i nā maʻi e pili ana i ka ʻōnaehana nerve. 

Hiki ke hoʻohālikelike ʻia nā opisthotonos me ke kūlana i loko o kahi pōʻai i lawe ʻia, ma nā kiʻi pena kahiko, e nā poʻe i loaʻa i ka diabolo. 

ʻO nā ʻiʻo hope o ke kino, ʻo ia hoʻi ke kua a me ka ʻāʻī, ua hoʻopaʻa ʻia a hoʻonui ke kino iā ia iho, e kau ana ma luna o kona papa ma nā kuʻekuʻe wāwae a me ke poʻo. ʻO nā lima a me nā wāwae he lōʻihi a paʻa. ʻAʻole mālama ʻia kēia ʻano pathological, ʻeha e ka mea maʻi.

Loaʻa nā Opisthotonos i nā pathologies e pili ana i ka ʻōnaehana nerve, ʻo ia hoʻi:

• tetanus: ma hope o ka ʻeha, nā spores o ka bacteria ʻO Clostridium tetani komo i loko o ke kino a hoʻokuʻu i kahi neurotoxin, i loko o kekahi mau lā e hoʻoulu ai i ka tetany holomua o nā ʻiʻo o ke kino. ʻO ka wikiwiki, hoʻopiʻi ka mea maʻi no ka paʻakikī i ka haʻi ʻana, ua paʻa kona mau ʻāʻī. A laila ʻoʻoleʻa kona ʻāʻī, a laila ʻaelike ke kino holoʻokoʻa. Inā ʻaʻole mālama ʻia ka maʻi i ka manawa, ʻaʻole hiki i ke kanaka ke hanu a make. ʻO ka mea pōmaikaʻi, mahalo i ka hoʻopaʻa ʻia ʻana o nā pēpē e kūʻē i ka tetanus, i hoʻokomo ʻia i ka makahiki 1952, ua aneane nalowale ka maʻi ma Farani. Akā, pili nō naʻe ia i kekahi poʻe i kēlā me kēia makahiki ka poʻe ʻaʻole i hoʻopaʻa ʻia a ʻaʻole hoʻi i ʻike i kā lākou mau hoʻomanaʻo;
• nā pilikia psychogenic nā maʻi epileptic ʻole (CPNE) : hiki iā lākou ke hana iā ʻoe e noʻonoʻo i ka epileptic seizures, akā ʻaʻole pili lākou i nā mea like ʻole o ka lolo. He paʻakikī ko lākou kumu, me nā ʻāpana neurobiological (predisposition o ka lolo e pane i kēia ala) akā psychopathological kekahi. I nā manawa he nui, aia kahi moʻolelo o ka trauma poʻo a i ʻole ka maʻi post-traumatic stress;
• hoʻokaʻawale ʻia epileptic seizures, ma muli o ka ʻeha poʻo a i ʻole ka lāʻau neuroleptic, hiki ke hōʻike e like me ia;
• rabies, i kakaikahi;
• hypocalcaemia koʻikoʻi a koʻikoʻi : ʻo kahi haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa o ka calcium i loko o ke koko e pili pinepine ana i kahi pilikia me ka parathyroid glands, kuleana no ka hoʻoponopono ʻana i ka loaʻa ʻana o kēia mineral i loko o ke kino;
• ʻeha lolo : ʻaʻa i hana ʻia e kekahi maningitis, luku ʻia ka ʻiʻo o ka lolo e ka encephalopathy, a i ʻole ke komo ʻana o nā tonsils i loko o ka pahu cranial, hiki ke hopena i nā opisthotonos.

Ka hihia kūikawā o nā opisthotonos i nā pēpē

I ka hānau ʻana, nānā mau nā palekeiki i ke kani o ka ʻiʻo o ke keiki. Ma o nā ʻano hana like ʻole, hiki iā lākou ke ʻike i ka ʻoki nui ʻana o nā ʻiʻo ma hope o ke kino. Inā ʻaʻole lākou e hōʻike i kahi anomali, ua maikaʻi nā mea a pau.

Inā ʻaʻole i hoʻopaʻa ʻia ka makuahine i ka maʻi tetanus, a ʻike koke ʻia ka opisthotonus ma hope o ka hānau ʻana, pili me ka hiki ʻole o ka hānai ʻana a me kahi ʻano smirk o ka maka, pono ke kānalua ʻia ka tetanus neonatal. ʻOi aku ka nui o ke kūlana ma nā ʻāina kahi i loaʻa ʻole ai ka lāʻau lapaʻau e pili ana i kēia maʻi, a ʻaʻole i sterile nā ​​kūlana o ka hānau ʻana.

Ma hope, hana pinepine ka pēpē i kahi kūlana opisthotonos e hōʻike i ka huhū hikiʻole ke hoʻopaʻa ʻia: ala ʻo ia i luna a piʻi i hope ma ke ʻano kupaianaha, no kona maʻalahi. Inā he wā pōkole a inā e paʻa kona mau lālā, ʻaʻole ia he pathological. Ma ka ʻaoʻao ʻē aʻe, hiki iā ʻoe ke kamaʻilio me ka pediatrician e pili ana iā ia: hiki i kēia ʻano ke hōʻike i kahi ʻeha ikaika, e pili ana i kahi laʻana i kahi reflux gastroesophageal nui a me ka waikawa.

Inā hoʻomau a hoʻomau hou ʻia ka hoʻouka ʻana o ka tetanus, me ka ʻoʻoleʻa o ke kino a aneane hiki ke paʻa i ke poʻo a me nā wāwae wale nō, a me nā lālā hyperextended, he pilikia olakino ia, pili i ka ʻeha o ke kino. lolo. Hiki iā mākou ke alo me:

• maningitis keiki ;
• ka umauma'ōpiopio ;
• hypocalcemia neonatal ;
• maʻi maʻi miko ʻaʻala : keia ma'i ma'i ma'i ma'amau (ma lalo o 10 mau hihia no ka 1 miliona o ka hānau 'ana) he po'o maika'i 'ole ke mālama 'ia i ka manawa. Hōʻike ʻia ia e ka ʻala o ka maple syrup i loko o ka earwax a laila ka mimi, nā pilikia hānai, lethargy a me nā spasms. Inā haʻalele ʻole ʻia, ukali ʻia e ka encephalopathy holomua a me ka hāʻule ʻole o ka hanu waena. Hoʻomaʻamaʻa ʻia i ka manawa, hiki ke ola akā pono ka ʻai koʻikoʻi no ke ola;
• kekahi mau ʻano o ka maʻi Gaucher : ʻO ke ʻano 2 o kēia maʻi ʻano kakaʻikahi e hōʻike ʻia iā ia iho i nā mahina mua o ke keiki pēpē, i ka hoʻomaka ʻana ma ka pae oculomotor paralysis a i ʻole ka strabismus paʻa paʻa. Hoʻololi koke ia i ka encephalopathy holomua, me nā pilikia hanu a me ka ʻai ʻana, a me nā hōʻeha opisthotonos. ʻO kēia pathology kahi prognosis maikaʻi loa.

ʻO ka opisthotonus, ʻoiai ʻo ia, pono e alakaʻi i kahi kūkākūkā. E like me ka mea i ʻike ʻia ma luna, hiki iā ia ke hōʻike i kahi maʻi koʻikoʻi, a hiki i ka make, ʻo ka pathology o ka ʻōnaehana nerve.

ʻO kēia spasm maʻamau, no ka mea e hāʻule koke ai ka mea maʻi, hiki ke hōʻeha i ke kino: hiki iā ia ke hōʻeha iā ia iho ma ka papahele a i ʻole i kahi ʻāpana i ka wā e hāʻule ai. Eia kekahi, ʻo ka hoʻopaʻa ʻana o nā ʻiʻo hope i kekahi manawa e hiki ai iā lākou ke hoʻoulu i ka spinal compression.

ʻO ka mālama ʻana i ka pilikia tetanus e pili ana i nā sedatives ikaika, ʻo ia hoʻi nā curariants (nā lāʻau lapaʻau i loaʻa i nā waiwai lolo o curare), e hakakā i ka contracture. 

Inā hiki, mālama ʻia ka maʻi i nīnau ʻia. Ua mālama pū ʻia kāna mau hōʻailona ʻē aʻe. No laila, i ka hihia o ka tetanus, ua hui pū ʻia nā mea hoʻomaha me ka hanu ʻana ma hope o ka tracheotomy e hakakā ai i ka asphyxia, ʻoiai ke hoʻohana ʻia nā lāʻau antibiotic.