ʻO Paraparesis kahi ʻano akahai o ka paralysis o ka ʻaoʻao i lalo i kūlohelohe a i kumu ʻia e kahi maʻi. Hiki ke hōʻoluʻolu i ka ʻeha a me nā spasms me ka lāʻau, a hiki i ka hoʻoikaika kino a me ka hoʻoikaika kino ke mālama i ka neʻe a me ka ikaika o ka mākala.

Ka wehewehe ʻana o ka paraparesis

ʻO Paraparesis kahi manawa olakino i hoʻohana ʻia e hōʻike i ka nāwaliwali o ka holomua me ka huikau muscle (nāwaliwali spastic) ma nā ʻaoʻao haʻahaʻa. ʻO ia kahi ʻano palupalu o ka paraplegia (paralysis o nā lālā lalo).

ʻO Spastic paraparesis kahi hui o nā maʻi i hoʻokumu ʻia e nā maʻi o ke kuamoʻo.

Nā ʻano o ka paraparesis

Hiki i nā spares paraparesis ke hoʻoilina a i kumu ʻia e kahi maʻi.

Heredity spastic paraparesis

Hoʻokaʻawale ʻia lākou i mea maʻalahi (a i ʻole maʻemaʻe) a paʻakikī (a paʻakikī paha) i ka hihia kahi e hele pū ai nā hōʻailona kahiko o ka spasticity ma lalo me nā ʻōuli ʻē aʻe e like me:

• Cerebellar atrophy: kahi hoʻemi i ka nui a i ʻole ka nui o ka cerebellum
• ʻO kahi corpus callosum lahilahi (ka hui ma waena o nā hemispheres ʻelua o ka lolo)
• Ataxia: ka hoʻoneʻe ʻana o ka neʻe ma muli o ka hōʻino ʻana i ka cerebellum

Genetically, hiki ke hoʻokaʻawale ʻia nā spares paraparesis e like me kā lākou ʻano o ka lawe ʻana.

• Dominant: ua lawa ka hopena ma luna o kahi kope hoʻokahi o ka ʻaoʻao no ka maʻi e ulu.
• Recessive: pono kahi anomaly e hoʻopili i nā kope ʻelua o ka moʻokūʻauhau, kēlā me kēia hoʻoilina mai kekahi o nā mākua, no ka maʻi e ulu.
• Hoʻohui ʻia me X: ʻO nā kāne, hoʻokahi wale nō X chromosome, loaʻa i ka maʻi inā lawe lākou i kahi mea maʻamau ʻole i kā lākou kope hoʻokahi o ka ʻāpana.

Nā lāʻau spastic tropikika

Ua kapa ʻia ʻo HTLV-1 pili myelopathy, he maʻi ulu lohi ia o ka iwi kuamoʻo i hoʻokumu ʻia e ka maʻi maʻi lymphotrophic T type 1 (HTLV-1).

Nā kumu o nā spares paraparesis

Hiki i ka hereditary spastic paraparesis ke hopena o nā ʻano he nui o nā ʻano ʻē aʻe a i ʻole hiki ke hoʻomohala iā lākou iho. I kēia manawa, ʻike ʻia nā ʻano 41 o nā spares paraparesis hoʻoilina, akā ʻo 17 wale nō kahi i ʻike ʻia ai ke ʻano kuleana.

Hoʻokumu ʻia nā lāʻau spastic tropic e ka maʻi HTLV-1.

PalekanaEND_LINK

Manaʻo ʻia ʻo heredered spastic paraparesis ma muli o ka loaʻa ʻana o ka mōʻaukala ʻohana a me nā hōʻailona o nā spares paraparesis.

Hoʻokumu mua ʻia ke kuhi ma ka haʻalele ʻana o nā kumu kūpono ʻē aʻe:

• Adrenoleukodystrophy, kahi maʻi neurodegenerative X-pili
• ʻO ka moʻo'ōlelo nui
• ʻO kahi maʻi e pili ana i ka neuron kaʻa luna (sclerosis mua mua a i ʻole amyotrophic lateral sclerosis)
• ʻO ka maʻi HIV a HTLV-1 paha
• ʻO kahi hemahema i ka wikamina B12, wikamina E a keleawe paha
• ʻO Spinocerebellar ataxia, kahi maʻi neuromuscular e hoʻopili i ka cerebellum
• ʻO kahi malformation ākea arteriovenous
• He ʻōiwi ʻōiwi iwi
• Cervicoarthritis myelopathy, kahi hoʻopili ʻana o ke aʻa kuamoʻo e kaomi i ke kaula o ka ʻeha

ʻO ka hōʻailona o ka paresis spastic hereditary i kekahi manawa i hana ʻia ma o ka hoʻāʻo ʻana.

Pili ka poʻe

Hoʻopili ka paramaresis hoʻoilina i nā kāne āpau me ka makaʻala ʻole a hiki ke hana i kēlā me kēia makahiki. Hoʻopili ia i 3 a 10 mau kānaka i 100.

Nā mea pilikino

ʻOi aku ka makaʻu o ka hoʻomohala ʻana i nā paraparesis hoʻoilina inā aia kekahi moʻolelo ʻohana. I ka hihia o nā spares tropical spastic, pili ka makaʻu o ka ʻaelike ʻana i ka maʻi me ka makaʻu o ke kū ʻana i ka maʻi ʻo HTLV-1, i lawe ʻia ma o ka pili moekolohe ʻana, hoʻohana lāʻau lapaʻau hoʻomāinoino ʻia a i ʻole kū i ke koko. Hiki ke hoʻoili ʻia mai ka makuahine a ke keiki ma o ka hānai ʻana i ka waiū.

Spasticity o nā lālā lalo

Hoʻomaopopo ʻia ka spasticity e ka hoʻonui ʻia ʻana o ka reflex tonic, ʻo ia hoʻi kahi exaggerated reflex muscle contraction. Kuhi ia i ke kani kiʻekiʻe o nā mākala i hiki ke lilo i kumu o ka ʻeha a me nā spasms, a kumu i ka impotence o nā lālā.

Defisit kaʻa

ʻO ka poʻe me ka paraparesis paʻakikī i ka hele wāwae. Hiki iā lākou ke huakaʻi no ka mea hele lākou i ko lākou manamana wāwae, me ka huli ʻana o ko lākou mau wāwae i loko. Hoʻino pinepine nā kāmaʻa i ka manamana nui. Pilikia pinepine ka poʻe i ka iho ʻana i lalo i ke alapiʻi a i ʻole nā ​​pali, ke komo ʻana i kahi noho a i kahi kaʻa, ke kāhiko ʻana, a me ke kāhiko ʻana.

Asthenia

ʻO ka luhi maʻamau ʻo Asthenia ke hoʻomau ia ʻoiai ma hope o ka hoʻomaha. Kuhi ia i ka manaʻo o ka hiki ʻole ke hoʻokō i nā hana o kēlā me kēia lā.

Nā maʻi Proprioceptive

Ka nalowale o ke kūlana o nā wāwae a me nā manamana wāwae

ʻO nā hōʻailona ʻē aʻe

I nā ʻano huikau ʻole, hiki iā mākou ke ʻike:

• Nā haunaele haʻahaʻa o ka ʻike vibratory
• Urinary hōʻailona (incontinence)
• Wāwae puha

I nā ʻano paʻakikī,

• Ataxia, maʻi o ka hoʻohui ʻana o nā neʻe o ke kumu neurological
• ʻO Amyotrophie
• Hoʻoiho optic
• ʻO Retinopathy pigmentosa
• Hoʻoiho noʻonoʻo
• Nā hōʻailona Extrapyramidal
• Dementia
• Pono maoli
• ʻO ke kino neuropathy
• Epilepsy

Hoʻomaʻamaʻa ka mālama ʻana, me nā lāʻau e hōʻoluʻolu ai i ka spasticity.

• Ka mālama lāʻau ʻōnaehana: baclofen, dantrolene, clonazepam, diazepam, tizanidine, benzodiazepines
• Nā mālama kūloko: palaka anesthetic, botulinum toxin (intromuscular i hoʻokumu ʻia), ʻalekoke, ʻoki kino (neurotomy wae)

Hiki i ke olakino kino a me ka hoʻoikaika kino ke kōkua i ka neʻe a me ka ikaika o ka mākala, hoʻomaikaʻi i ke kaʻina o ka neʻe a me ke ahonui, hoʻemi i ka luhi, a pale i nā spasms.

Hoʻomaikaʻi ʻia kekahi mau mea maʻi mai ka hoʻohana ʻana i nā splints, kahi kō a i ʻole nā ​​koʻokoʻo.

No nā parastasia spastic tropical, hiki ke hoʻohana ʻia kekahi mau ʻano lapaʻau e kaua aku i ka maʻi.

• Interferon alpha
• Immunoglobulin (i loko o ke koko)
• Corticosteroids (e like me methylprednisolone waha)

I mea e hōʻalo ai i ka hana ʻana i nā paraparesis spastic tropical, pono e hoʻēmi ʻia ka pilina me ka maʻi HTLV-1. Hoʻouna ʻia e:

• Pili pili kolohe
• Hoʻohana lāʻau lāʻau pono ʻole i loko
• Hōʻike koko

Hiki ke hoʻoili ʻia mai ka makuahine a ke keiki ma o ka hānai ʻana i ka waiū. ʻOi aku ka maʻamau i waena o nā wahine hoʻokamakama, hoʻokomo i nā mea hoʻohana lāʻau, nā poʻe ma hemodialysis a me nā lehulehu i kekahi mau wahi e pili kokoke ana i ka equator, hema o Iapana a me ʻAmelika Hema.