ʻO ka paralysis kau manawa Thyrotoxic

ʻO kahi maʻi palaka ʻo Thyrotoxic kahi kūlana kahi i loaʻa ai nā ʻāpana o ka nāwaliwali o nā mākala koʻikoʻi. Hana ʻia ia i ka poʻe i loaʻa nā kiʻekiʻe o ka thyroid hormone i loko o kā lākou koko (hyperthyroidism, thyrotoxicosis).

He kūlana laha ʻole kēia e kū wale i ka poʻe me nā kiʻekiʻe o ka nui o ka thyroid (thyrotoxicosis). Hoʻopili pinepine ʻia nā kāne o nā kūpuna ʻAsia a Hispanic paha. ʻO ka hapa nui o ka poʻe e hoʻomohala i nā kiʻekiʻe o ka hormone thyroid ʻaʻole makaʻu i ka palapū manawa.

Aia kekahi maʻi like, i kapa ʻia ʻo hypokalemic, a i ʻole familial, paralysis wā. He kūlana hoʻoilina ia a ʻaʻole pili i nā kiʻekiʻe thyroid kiʻekiʻe, akā loaʻa nā ʻōuli like.

ʻO nā kumu pilikia e pili ana i ka moʻolelo ʻohana o ka maʻi lōlō a me ka hyperthyroidism.

Hoʻopili nā ʻōuli i ka hōʻeha ʻana i ka nāwaliwali o ka nāhelehele a i ʻole ka palapū. Hoʻololi nā hoʻouka me nā wā o ka hana maʻa mau. Hoʻomaka pinepine ka hoʻouka kaua ʻana ma hope o ka hoʻomohala ʻia o nā ʻōuli o hyperthyroidism. Hiki paha i nā hōʻailona Hyperthyroid ke maʻalea.

ʻOkoʻa ka pinepine o nā hoʻouka ʻana mai kēlā me kēia makahiki a i kēlā me kēia makahiki. E mau paha nā ʻāpana o ka nāwaliwali i nā mākala no kekahi mau hola a mau mau lā paha.

ʻO ka nāwaliwali a i ʻole ka maʻi lōlō:

• Hele mai a hele
• Hiki ke hala mai kekahi mau hola a i kekahi mau lā (kākaʻikahi)
• ʻOi aku ka maʻamau i nā wāwae ma mua o nā lima
• ʻO ka mea maʻamau i nā poʻohiwi a me nā pūhaka
• Hoʻoulu ʻia e nā mea kaumaha, kiʻekiʻe-carbohydrate, nā paʻakai paʻakai kiʻekiʻe
• Hoʻomaka ʻia i ka wā hoʻomaha ma hope o ka hoʻoikaika kino

Hiki i nā ʻōuli ʻē aʻe ke komo i kekahi o kēia mau mea:

• Hanu paʻakikī
• Pilikia haʻi ʻōlelo
• Pahu i ka paʻakikī
• Hoʻololi ka hihiʻo

Makaʻala ka poʻe i ka wā hoʻouka a hiki ke pane i nā nīnau. Hoʻi ka ikaika maʻamau ma waena o nā hoʻouka. E ulu paha ka nāwaliwali o ka ʻiʻo ma ka manawa me ka hoʻouka pinepine ʻana.

ʻO nā ʻōuli o hyperthyroidism me:

• Nui ka hou ʻana i ka hou
• Ka helu puʻuwai wikiwiki
• Ka luhi
• ʻEha poʻo
• Ka hoʻomanawanui wela
• Hoʻonui i ka makemake
• ʻO Insomnia
• ʻO ka neʻe pinepine ʻana o ka ʻōpū
• ʻO ka manaʻo o ka puʻuwai ikaika (palpitations)
• Nā haʻalulu o ka lima
• Mahana mehana, ʻili ʻili
• Kaumaha emi

E kānalua paha ka mea mālama ola i kāu maʻi palau ma loko o ka thyrotoxic ma muli o:

• Nā pae hormonone thyroid maʻamau
• He moʻolelo ʻohana o ka maʻi
• ʻO ka pae potassium haʻahaʻa i ka wā hoʻouka
• Nā hōʻailona e hele mai a hele i nā ʻāpana

Hoʻopili ka diagnostics i ka hoʻoholo ʻana i nā maʻi e pili ana i ka potassium haʻahaʻa.

Hiki paha i ka mea hāʻawi ke hoʻāʻo i kahi hoʻouka kaua ma ka hāʻawi ʻana iā ʻoe i ka insulin a me ke kō (glucose, kahi e hoʻēmi ai i ka pae potassium) a i ʻole ka thyroid hormone.

E ʻike ʻia paha nā ʻōuli i ka hoʻouka kaua.

• Hoʻoemi a ʻaʻohe reflexes
• Nā arrhythmia puʻuwai
• ʻO ka potassium haʻahaʻa i ke kahe o ke koko (he maʻamau nā pae potassium ma waena o nā hoʻouka ʻana)

Ma waena o nā hoʻouka, he maʻamau ka hoʻokolokolo. A i ʻole, aia paha he mau hōʻailona o hyperthyroidism, e like me ka hoʻonui ʻana o ka thyroid i nā maka, haʻalulu, lauoho a me nā loli kui.

Hoʻohana ʻia nā hōʻike aʻe e kuhikuhi ai i ka hyperthyroidism:

• Nā pae hormone thyroid kiʻekiʻe (T3 a i ʻole T4)
• Low serum TSH (thyroid stimulate hormone) pae
• Lawe ʻia ka thyroid a scan

Nā hopena hōʻike ʻē aʻe:

• ʻO electrocardiogram maʻamau (ECG) i ka wā o ka hoʻouka kaua
• ʻO electromyogram maʻamau (EMG) i ka wā o ka hoʻouka kaua
• ʻO ka potassium haʻahaʻa haʻahaʻa i ka wā o ka hoʻouka ʻana, akā maʻamau ma waena o nā hoʻouka

Lawe ʻia kahi biopsy muso i kekahi manawa.

Pono e hāʻawi ʻia i ka potassium i ka wā o ka hoʻouka kaua, pinepine ma ka waha. Inā koʻikoʻi ka nāwaliwali, pono paha ʻoe e kiʻi i ka pāhare potassium ma o kahi aa koko (IV). Kahakaha: Pono ʻoe e loaʻa i ka IV inā maʻamau kāu hana kidney a nānā ʻia ʻoe i ka haukapila.

ʻO ka nāwaliwali e pili ana i nā mākala i hoʻohana ʻia no ka hanu ʻana a me ka ale ʻana paha he pilikia. Pono e lawe i ka poʻe i ka haukapila. Hiki paha ke kūleʻa koʻikoʻi o ka puʻuwai i ka wā o ka hoʻouka.

Koi aku paha kāu mea hāʻawi i kahi papaʻai i haʻahaʻa i nā haʻuki a me ka paʻakai e pale ai i ka hōʻeha. ʻO nā lāʻau i kapa ʻia ʻo beta-blockers e hōʻemi paha i ka helu a me ke koʻikoʻi o ka hoʻouka ʻana ke mālama ʻia kāu hyperthyroidism.

Maikaʻi ka Acetazolamide i ka pale ʻana i nā hōʻeha i ka poʻe me ka maʻi palapū ʻohana. ʻAʻole maikaʻi ia no ka paralysis kauā thyrotoxic.

Inā mālama ʻole ʻia kahi hoʻouka a hoʻopili ʻia nā mākala hanu, hiki i ka make ke hiki.

Hiki i nā hōʻeha kūlohelohe i ka manawa ke alakaʻi i ka nāwaliwali o nā mākala. Hiki ke hoʻomau i kēia nāwaliwali ma waena o nā hoʻouka inā ʻaʻole mālama ʻia ka thyrotoxicosis.

ʻO ka lōlō manawa Thyrotoxic e pane maikaʻi i ka lāʻau. ʻO ka mālama ʻana i ka hyperthyroidism e pale aku i nā hoʻouka kaua. Hiki paha iā ia ke hoʻohuli i ka nāwaliwali o nā mākala.

Hiki ke alakaʻi ʻia ka paralysis thyrotoxic periodic i:

• Ka hanu paʻakikī ʻana, ʻōlelo ʻana, a me ka ale ʻana i ka wā hoʻouka (kakaʻikahi)
• ʻO nā arrhythmia puʻuwai i ka wā o ka hoʻouka ʻana
• Ka nāwaliwali o ka ʻiʻo e ʻoi aku ana ka maikaʻi ma mua o ka manawa

Kāhea i ka helu kūloko kūloko (e like me 911) a i ʻole e hele i ke keʻena pilikia inā he mau wā nāwaliwali kou nāʻiʻo. He mea nui loa kēia inā loaʻa iā ʻoe kahi moʻolelo ʻohana o ka maʻi lōlō wā a me nā maʻi thyroid.

ʻO nā hōʻailona kūpilikiʻi me:

• Ka paʻakikī i ka hanu ʻana, ʻōlelo ʻana, a me ka ale ʻana paha
• Hāʻule ma muli o ka nāwaliwali o nā mākala

Kūkā ʻia paha ka ʻōlelo aʻoaʻo genetic. ʻO ka mālama ʻana i ka maʻi thyroid e pale ai i ka hōʻeha ʻana o ka nāwaliwali.

Paralysis kau - thyrotoxic; Hyperthyroidism - paralysis kau manawa

• Kelepaʻi thyroid

ʻO Hollenberg A, Wiersinga WM. Nā maʻi Hyperthyroid. I: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 12.

Kerchner GA, Ptacek LJ. Channelopathies: nā maʻi episodic a me nā uila o ka ʻōnaehana hopohopo. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 99.

Selcen D. Nā maʻi maʻi. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 393.