ʻO Neuropathy ka lua i nā lāʻau

He ʻeha ʻo Neuropathy i nā aʻalolo āpau. ʻO kēia nā aʻalolo ʻaʻole i ka lolo a i ʻole nā ​​kaula iwi. ʻO Neuropathy ka lua i nā lāʻau lapaʻau he nalowale o ka sensation a neʻe paha i kahi ʻāpana o ke kino ma muli o ka ʻino nerve mai ka lawe ʻana i kekahi lāʻau a i ʻole ka hui pū ʻana o nā lāʻau.

Hoʻokumu ʻia ka pōʻino e ka hopena ʻino o kekahi mau lāʻau i nā aʻa peripheral. Hiki paha ke hōʻino i ka ʻākona axon o ke aʻalolo nerve, nāna e hoʻopilikia i nā hōʻailona nerve. A i ʻole, pili paha ka poino i ka wahī myelin, ka mea e insulate ai i nā axon a hoʻonui i ka wikiwiki o ka lawe ʻana o nā hōʻailona ma o ka axon.

ʻO ka maʻamau, pili nā aʻa he nui (polyneuropathy). Hoʻokumu pinepine kēia i nā loli sensation e hoʻomaka i nā ʻaoʻao i waho o ke kino (distal) a neʻe i ke kikowaena o ke kino (proximal). Hiki paha i nā hoʻololi i ka neʻe, e like me ka nāwaliwali. E ʻeha pū paha ka ʻeha.

Hiki i nā lāʻau a me nā lāʻau ke alakaʻi i ke kūkulu ʻana o neuropathy. Aia nā laʻana i lalo.

Nā lāʻau naʻau a i ʻole ke kaomi koko:

• Amiodarone
• Hydralazine
• Perhexiline

Hoʻohana nā lāʻau i hakakā i ka maʻi ʻaʻai:

• ʻO Cisplatin
• ʻO Docetaxel
• Paclitaxel
• ʻO Suramin
• ʻO Vincristine

Hoʻohana nā lāʻau i ke kaua i nā maʻi:

• Chloroquine
• ʻO Dapsone
• Isoniazid (INH), hoʻohana kūʻē iā tuberculosis
• Metronidazole (Flagyl)
• Nitrofurantoin
• Thalidomide (hoʻohana e hakakā i ka maʻi lepera)

Nā lāʻau i hoʻohana ʻia e mālama i ka maʻi autoimmune:

• Etanercept (Enbrel)
• Infliximab (Remicade)
• Leflunomide (Arava)

Nā lāʻau i hoʻohana e mālama i ka hopu ʻana:

• ʻO Carbamazepine
• ʻO Phenytoin
• Phenobarbital

Nā lāʻau ʻona anti-ʻona:

• ʻO Disulfiram

Nā lāʻau e hakakā ai i ka maʻi HIV / AIDS:

• Didanosine (Videx)
• Emtricitabine (Emtriva)
  
• Stavudine (Zerit)
• Tenofovir a me emtricitabine (Truvada)

ʻO nā lāʻau ʻē aʻe a me nā mea e hoʻonāukiuki paha i ka neuropathy:

• Colchisin (hoʻohana ʻia e mālama i ka gout)
• Disulfiram (hoʻohana e mālama i ka hoʻohana ʻana i ka waiʻona)
• ʻAikena
• Gula

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• Numbness, nalo o ke ʻano
• Tingling, nā manaʻo ʻē
• Nawaliwali
• ʻEha ʻaʻā

Hoʻomaka ka loli ʻana o ka manaʻo i nā wāwae a i ʻole nā ​​lima a neʻe i loko.

E nānā ʻia kahi lolo a me ka ʻōnaehana ʻōnaehana.

ʻO nā hōʻike ʻē aʻe kekahi:

• ʻO nā hoʻokolohua koko e nānā i nā pae o ka lāʻau (ʻo nā pae koko maʻamau o kekahi mau lāʻau lapaʻau he mea ʻawaʻawa ia i nā mākua a i ʻole kekahi mau kānaka ʻē aʻe)
• EMG (electromyography) a me nā hoʻāʻo conduction nerve o ka hana uila o nā aʻa a me nā mākala

Hoʻokumu ʻia ka lapaʻau ʻana ma nā ʻōuli a me ke ʻano o ko lākou koʻikoʻi. ʻO ka lāʻau e hana ai i ka neuropathy e kū paha, hoʻemi ʻia i ka lāʻau, a i ʻole hoʻololi ʻia i kahi lāʻau ʻē aʻe. (Mai hoʻololi i kekahi lāʻau i ke kamaʻilio mua ʻole ʻana i kāu kauka.)

E ʻōlelo paha kāu mea hāʻawi i nā lāʻau aʻe e kōkua i ka mālama ʻana i ka ʻeha.

• Hiki ke kōkua i nā mea hōʻemi ʻeha ʻoi loa no ka ʻeha haʻahaʻa (neuralgia).
• ʻO Phenytoin, carbamazepine, gabapentin, pregabalin, duloxetine, a i ʻole nā ​​antidepressants tricyclic e like me nortriptyline e hōʻemi i ka ʻeha ʻana i nā ʻeha a kekahi poʻe i ka ʻike.
• ʻO nā mea hōʻemi ʻeha opiate, e like me morphine a i ʻole fentanyl, pono paha e kāohi i ka ʻehaʻeha.

ʻAʻohe lāʻau i kēia manawa e hiki ke hoʻohuli i ka nalo ʻana o ka naʻau. Inā ua nalowale kou manaʻo, pono ʻoe e hana i nā hana palekana e pale ai i ka hōʻeha.

E noi i kāu mea hāʻawi inā loaʻa nā hana e hiki ke kōkua i ka hōʻoluʻolu i kāu mau ʻōuli.

Hiki i nā kānaka he hapa a i ʻole hoʻi piha i kā lākou hana maʻamau. ʻAʻole kumu ka maʻi i nā pilikia hoʻoweliweli i ke ola, akā hiki ke hōʻoluʻolu a hoʻopau ʻole paha.

Komo pū nā pilikia:

• ʻAʻole hiki ke hana ma ka hana a home paha no ka nalowale mau ʻana o ka naʻau
• ʻEha me ke kaniʻuhū ma kahi o ka ʻeha o ke aʻalolo
• Ka nalowale paʻa ʻana o ka naʻau (a i ʻole kākaʻikahi, neʻe) i kahi ʻāpana

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe ka nalo o ka naʻau a i ʻole ka neʻe ʻana o kēlā me kēia wahi o ke kino ʻoiai ʻoe e lawe nei i nā lāʻau.

E nānā pono kāu mea lawelawe i kāu lāʻau me nā lāʻau e hiki ai ke kumu i ka neuropathy. ʻO ka pahuhopu ka mālama ʻana i ke kiʻekiʻe o ke koko e pono ai e kaohi i ka maʻi a me kāna mau ʻōuli ke pale nei i ka lāʻau mai ka pae ʻana i nā pae ʻona.

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

Jones MR, Urits I, Wolf J, et al. ʻO ka neuropathy ākea i hoʻokomo ʻia i lāʻau lāʻau, kahi loiloi moʻolelo. ʻO Curr Clinic Pharmacol. Ianuali 2019. PMID: 30666914 www.ncbi.nlm.nih.gov/pubmed/30666914.

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.

O'Connor KDJ, Mastaglia FL. Nā maʻi hōʻeuʻeu i hoʻokomo ʻia i ka ʻōnaehana. I: Aminoff MJ, Josephson SA, eds. ʻO Aminoff's Neurology a me General Medicine. 5th lā. Waltham, MA: Elsevier Academic Press; 2014: chap 32.