ʻO Guillain-Barré Syndrome

ʻO Guillain-Barré Syndrome (GBS) kahi pilikia olakino koʻikoʻi e kū i ka pale ʻana o ke kino (immune) ʻōnaehana kuhi hewa i kahi ʻāpana o ka ʻōnaehana nūhou. ʻO kēia ke alakaʻi i ka mumū nerve e kumu ai i ka nāwaliwali o nā mākala a i ʻole ka maʻi lōlō a me nā ʻōuli ʻē aʻe.

ʻAʻole ʻike ʻia ke kumu kikoʻī o GBS. Manaʻo ʻia ʻo GBS kahi maʻi autoimmune. Me kahi maʻi autoimmune, hoʻouka hewa ke kino ʻōnaehana o ke kino iā ia iho. Hiki i GBS ke hana i kēlā me kēia makahiki. ʻO ka mea maʻamau i nā poʻe ma waena o nā makahiki 30 a 50.

Kūleʻa paha ʻo GBS me nā maʻi mai nā virus a i ʻole nā ​​bacteria, e like me:

• Influenza
• ʻO kekahi mau maʻi gastrointestinal
• Mycoplasma pneumonia
• HIV, ka mea hoʻomaʻi nāna i hoʻokumu i ka maʻi HIV / AIDS (kakaikahi loa)
• ʻO Herpes simplex
• Mononucleosis

Hiki paha i GBS me nā ʻano olakino ʻē aʻe, e like me:

• ʻO ka lupus erythematosus ʻōnaehana
• Maʻi ʻo Hodgkin
• Ma hope o ke kaha ʻana

Hoʻopilikia ʻo GBS i nā ʻāʻī o nā aʻalolo. Hoʻopilikia kēia ʻino i ke aʻalolo, nāwaliwali o nā mākala, nalo ʻana o ke kaulike, a me ka paralysis. Hoʻopili pinepine ʻo GBS i ka uhi o ke aʻalolo (myelin sheath). Kapa ʻia kēia pōʻino he demyelination. Kuhi ia i nā neʻe neʻe e neʻe mālie. Hiki ke hōʻino i nā ʻāpana ʻē aʻe o ke aʻalolo i ka hana a ke aʻalolo.

Hiki i nā ʻōuli o GBS ke lilo i mea ʻoi aku ka hewa. He mau hola wale paha e ʻike ʻia ai nā ʻōuli koʻikoʻi loa. Akā ʻo ka nāwaliwali e hoʻonui ana i nā lā he mea maʻamau pū kekahi.

ʻO ka nāwaliwali o ka mākala a i ʻole ka nalo ʻana o ka hana muscle (palalysis) e pili ana i nā ʻaoʻao ʻelua o ke kino. I ka hapanui o nā hihia, hoʻomaka ka nāwaliwali o nā mākala i nā wāwae a pālahalaha i nā lima. Kāhea ʻia kēia e piʻi aʻe ka maʻi lōlō.

Inā pili ka mumū i nā ʻāʻī o ka umauma a me ka diaphragm (ka mākala nui ma lalo o kou mau māmā e kōkua ai iā ʻoe e hanu) a nāwaliwali kēlā mau mākala, pono ʻoe i ke kōkua hanu.

ʻO nā hōʻailona ʻē aʻe a me nā ʻōuli o GBS me:

• Loaʻa ka reflexes tendon i nā lima a me nā wāwae
• Tingling a numbness paha (nalowale o ke ʻano o ka naʻau)
• Ka palupalu o ka puʻupuʻu a i ʻole ʻeha (hiki paha i kahi ʻeha like me ka cramp)
• ʻO ka neʻe ʻana ʻole (ʻaʻole hiki ke hele me ke kōkua ʻole)
• Ke kahe haʻahaʻa a i ʻole ke kaohi kahe o ke koko
• Kuhi naʻau maʻamau

Hiki i nā ʻōuli ʻē aʻe ke:

• ʻIke makapō a me ka hihiʻo pālua
• Clumsiness a hāʻule
• Ka paʻakikī e neʻe ana i nā mākala
• Pākuʻi mākala
• Manaʻo ka puʻuwai puʻuwai (palpitations)

Nā ʻōuli pilikia (e ʻimi koke i ke kōkua lapaʻau):

• Kū iki ka hanu ʻana
• ʻAʻole hiki ke hanu hohonu
• Hanu paʻakikī
• Pilikia i ka ale ʻana
• Drooling
• Mauleʻa
• Hele ka māmā i ka wā e kū ana

ʻO kahi mōʻaukala o ka hoʻonui ʻana i ka nāwaliwali o nā mākala a me ka paralysis he hōʻailona paha ia o GBS, keu hoʻi inā he maʻi i hala iho nei.

Hōʻike kahi hōʻike lāʻau lapaʻau i ka nāwaliwali o nā mākala. Aia paha kekahi mau pilikia me ke kaomi koko a me ka helu o ka puʻuwai. ʻO kēia nā hana e kāohi aunoa ʻia e ka ʻōnaehana makaʻu. Hōʻike paha ka hōʻike i nā reflexes e like me ka kuʻekuʻe wāwae a i ʻole ke kuli e hoʻemi ʻia a nalowale paha.

Aia paha he hōʻailona o ka hōʻemi ʻana i ka hanu ʻana ma muli o ka paralysis o nā mākia hanu.

E hana ʻia paha kēia mau hoʻāʻo:

• Cerebrospinal fluid sample (spinal tap)
• ECG e nānā i ka hana uila i ka puʻuwai
• Electromyography (EMG) e hoʻāʻo i ka hana uila i nā mākala
• E hoʻāʻo i ka wikiwiki wikiwiki e hoʻāʻo i ka neʻe ʻana o nā hōʻailona uila ma waena o kahi aʻalolo
• Nā hoʻāʻo ʻana o ka hana pulmonary e ana i ka hanu ʻana a me ka maikaʻi o ka hana ʻana o nā māmā

ʻAʻohe mea ola no GBS. Hoʻolālā ʻia ka mālama ʻana i ka hoʻēmi ʻana i nā ʻōuli, ka mālama ʻana i nā pilikia, a me ka wikiwiki e ola hou.

I nā wā mua o ka maʻi, hiki ke hāʻawi ʻia kahi lāʻau i kapa ʻia apheresis a i ʻole plasmapheresis. Hoʻopili ia i ka wehe a pale ʻana paha i nā protein, i kapa ʻia he antibodies, e hoʻouka nei i nā hunaola nerve. Kekahi lapaʻau mea intravenous immunoglobulin (IVIg). ʻO nā kuʻina ʻelua e alakaʻi i ka hoʻomaikaʻi wikiwiki, a like ka hopena o ka hopena. Akā ʻaʻohe mea maikaʻi i ka hoʻohana ʻana i nā mālama ʻelua i ka manawa like. Kōkua nā mālama ʻē aʻe i ka hoʻohaʻahaʻa ʻana i ka lī

Ke kaumaha nā ʻōuli, pono ka lapaʻau ma ka haukapila. E hāʻawi ʻia paha ke kākoʻo hanu.

ʻO nā lāʻau lapaʻau ʻē aʻe i ka haukapila e nānā i ka pale ʻana i nā pilikia. Pākuʻi ʻia kēia mau mea:

• ʻO nā mea lahilahi o ke koko e pale aku i nā kahe o ke koko
• Kākoʻo hanu a i ʻole ka paipu hanu a me ka ea, inā nāwaliwali ka diaphragm
• Nā lāʻau ʻeha a i ʻole nā ​​lāʻau ʻē aʻe e mālama ai i ka ʻeha
• ʻO ke kau ʻana i ke kino kūpono a i ʻole kahi paipu hānai e pale ai i ke kolo i ka wā o ka hānai ʻana, inā nāwaliwali nā mākala i hoʻohana ʻia no ka ale ʻana
• Hoʻoikaika kino e kōkua i ke olakino a me nā mākala

Hāʻawi paha kēia mau kumuwaiwai i ka ʻike hou aku e pili ana i GBS:

• ʻO Guillain-Barré Syndrome Foundation International - www.gbs-cidp.org
• National Organization for Rare Disorder - rarediseases.org/rare-diseases/guillain-barre-syndrome

Hiki i ka ho'ōla hou ke hala i mau hebedoma, mau mahina, a mau makahiki paha. Ola ka hapanui o nā kānaka a ola hou. I kekahi poʻe, hoʻomau mau paha ka nāwaliwali. E maikaʻi paha ka hopena ke hele aku nā ʻōuli ma waena o 3 mau pule ma hope o ko lākou hoʻomaka mua.

ʻO nā pilikia kūpono o GBS me:

• Hanu pilikia (hanu hoʻokō 'ole)
• Ka hoʻopōkole ʻana o nā pūnaewele i nā hono (ʻaelike) a i ʻole nā ​​deformities ʻē aʻe
• ʻO ke kōkō ʻana o ke koko (thrombosis vein deep) i hana ke hana ʻole ke kanaka me GBS a noho paha i kahi moe
• Hoʻonui i ka pilikia o nā maʻi
• Kaomi haʻahaʻa a paʻa ʻole paha
• Paralysis paʻa mau
• Pulumonia
• ʻIno poino (ulcer)
• Ka hanu ʻana i ka meaʻai a i ʻole nā ​​wai i loko o nā akemāmā

E ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi o kēia mau ʻōuli.

• Hoʻopilikia i ka hanu hohonu ʻana
• Manaʻo hoʻohaʻahaʻa (sensation)
• Hanu paʻakikī
• Pilikia i ka ale ʻana
• Mauleʻa
• Ka nalowale o ka ikaika i nā wāwae e hele a hewa i ka hala ʻana o ka manawa

GBS; Landry-Guillain-Barré maʻi pale; Huʻi idiopathic polyneuritis; ʻO ka maʻi polyneuritis maʻi; Huʻi polyneuropathy huʻi; Huʻi ākea demyelinating polyradiculoneuropathy; Piʻi piʻi lōlō

• Nā mākala mua ma mua
• Lako ke kōkua i ka pelvis
• ʻŌnaehana lolo a me ka pūnao

Chang CWJ. Myasthenia gravis a me Guillain-Barré syndrome. I: Parrillo JE, Dellinger RP, eds. Lapaʻau mālama koʻikoʻi: nā loina o ka ʻike a me ka hoʻokele i ka makua. 5th lā. Piladelapia, PA: Elsevier; 2019: chap 61.

Katirji B. Nā maʻi o nā aʻa ākea. 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 107.