Atrophy ʻōnaehana lehulehu - ʻano parkinsonian

ʻO kahi ʻōnaehana atrophy- parkinsonian type (MSA-P) kahi ʻano maʻamau i kumu ʻia nā ʻōuli e like me ka maʻi Parkinson. Eia nō naʻe, ʻoi aku ka nui o ka hōʻino o ka poʻe me MSA-P i ka ʻāpana o ka ʻōnaehana hopohopo e kaohi ana i nā hana nui e like me ka helu o ka puʻuwai, ke kahe o ke koko, a me ka hou.

ʻO ka subtype ʻē aʻe o MSA ʻo MSA-cerebellar. Hoʻopili nui ia i nā wahi hohonu o ka lolo, ma luna pono o ka iwi kuamoʻo.

ʻAʻole ʻike ʻia ke kumu o MSA-P. Hoʻopili nā wahi i hoʻopili ʻia o ka lolo me nā wahi i hoʻopilikia ʻia e ka maʻi Parkinson, me nā ʻōuli like. No kēia kumu, ua kapa ʻia kēia subtype o MSA parkinsonian.

Hoʻomaopopo pinepine ʻia ʻo MSA-P i nā kāne ma mua o 60.

Hoʻopōʻino MSA i ka ʻōnaehana hopohopo Holomua ka maʻi i ka holomua me ka wikiwiki. Ma kahi o ka hapalua o ka poʻe me MSA-P i lilo ka hapa nui o ko lākou mākau kaʻa i loko o 5 mau makahiki o ka hoʻomaka ʻana o ka maʻi.

Pākuʻi ʻia paha nā ʻōuli:

• Nā haʻalulu
• ʻO nā pilikia neʻe, e like me ka lohi, nalo o ke kaulike, shuffling ke hele wāwae
• Hāʻule pinepine
• ʻEha nā ʻeha a me nā ʻeha (myalgia), a me ka ʻoʻoleʻa
• Hoʻololi nā helehelena, e like me ka helehelena masklike i ka maka a me ka haka pono
• Paʻa i ka nau ʻana a i ʻole ka ale ʻana (i kekahi mau manawa), ʻaʻole hiki ke pani i ka waha
• Hoʻolālā nā hiʻohiʻona hiamoe (pinepine i ka neʻe ʻana o ka maka wikiwiki [REM] hiamoe i ka pō.
• Pōpō a maule paha i ke kū ʻana a i ʻole ma hope o ke kū mālie
• Nā pilikia kūkulu
• Ka nalowale o ka kaohi ma luna o ka ʻōpū a i ʻole kīwī
• Nā pilikia me ka hana e koi ai i nā neʻe liʻiliʻi (nalo ʻana o nā mākau kaʻa maikaʻi), e like me ke kākau ʻana he liʻiliʻi a paʻakikī e heluhelu
• Lilo o ka hou i kekahi ʻāpana o ke kino
• E hōʻole i ka hana noʻonoʻo
• Nausea a me nā pilikia me ka digestion
• Nā pilikia kū, e like me ke kūpaʻa ʻole, kūlou, a hāʻule paha i luna
• Hoʻololi ka hihiʻo, hoʻoliʻiliʻi a i ʻole ʻike hihi
• Hoʻololi ka leo a me ka walaʻau

Nā ʻōuli ʻē aʻe i hiki ke loaʻa me kēia maʻi.

• Huikau
• Dementia
• Kaumaha
• Nā pilikia hanu e pili ana i ka hiamoe, e like me ka apnea hiamoe a i ʻole ke kahakaha ʻana i ke ala ʻea e hiki ai i kahi kani haʻalulu koʻikoʻi

E nānā ana kāu mea mālama ola iā ʻoe, a nānā i kou mau maka, nā ʻalolo, a me nā mākala.

Lawe ʻia kou kaomi koko ke moe ʻoe i lalo a kū i luna.

ʻAʻohe hoʻokolohua kikoʻī e hōʻoia i kēia maʻi. ʻO ke kauka i loea i ka ʻōnaehana hopohopo (neurologist) hiki ke hana i ka hōʻailona ma muli o:

• Mōʻaukala o nā ʻōuli
• Nā hopena hōʻike kino
• Hoʻopau i nā kumu ʻē aʻe o nā ʻōuli

ʻO ka hoʻāʻo ʻana e kōkua e hoʻokūpaʻa i ke kuhi manaʻo:

• MRI o ke poʻo
• Nā pae norepinephrine Plasma
• ʻImi i ka mimi no nā huahana breakdown norepinephrine (mimi catecholamines)

ʻAʻohe lāʻau lapaʻau no MSA-P. ʻAʻohe ala i ʻike ʻia e pale aku ai i ka maʻi e hele a maikaʻi ʻole. ʻO ka pahuhopu o ka mālama ʻana e kaohi i nā ʻōuli.

Hiki ke hoʻohana ʻia nā lāʻau Dopaminergic, e like me levodopa a me carbidopa, e hōʻemi i ka haʻalulu mua a i ʻole ka haʻalulu.

Akā, no ka poʻe he nui me MSA-P, ʻaʻole holo pono kēia mau lāʻau.

Hiki ke hoʻohana ʻia nā lāʻau e mālama ai i ke koko haʻahaʻa.

ʻO kahi mea hana pacemaker i hoʻolālā ʻia e hoʻonāukiuki i ka puʻuwai e paʻi i ka wikiwiki (ʻoi aku ka wikiwiki ma mua o 100 mau kī i kēlā me kēia minuke) hiki ke hoʻonui i ke kahe o ke koko no kekahi poʻe.

Hiki ke mālama ʻia i ka paʻa paʻa ʻana me ka papaʻai fiber kiʻekiʻe a me nā laxatives. Loaʻa nā lāʻau e mālama ai i nā pilikia kūkulu.

Hiki ke ʻike hou aku i ka ʻike a me ke kākoʻo no ka poʻe me MSA-P a me ko lākou mau ʻohana ma:

• National Organization for Rare Disorder - rarediseases.org/rare-diseases/multiple-system-atrophy
• ʻO ka Coalition MSA - www.multceptsystematrophy.org/msa-resource/

ʻO ka hopena no ka MSA ʻilihune. ʻO ka nalowale o ka hana noʻonoʻo a me ke kino e hele mālie. ʻO ka make mua paha. Noho mau ka poʻe ma kahi o 7 a 9 mau makahiki ma hope o ka ʻike ʻana.

Kāhea i kāu mea hāʻawi inā hoʻomohala ʻoe i nā ʻōuli o kēia maʻi.

Kāhea i kāu mea hāʻawi inā ua loiloi ʻia ʻoe me MSA a hoʻi a hōʻeha paha kāu mau ʻōuli. Kāhea pū kekahi inā ʻike ʻia nā ʻōuli hou, me nā hopena o nā lāʻau lapaʻau, e like me:

• Hoʻololi i ka makaʻala / hana / ʻano
• Hana hoʻopunipuni
• Puʻupuʻu
• Nā Haleluʻa
• Nā neʻe manawaleʻa
• Loaʻa o ka hana noʻonoʻo
• Nausea a i ʻole ka luaʻi
• Huikau nui a disorientation paha

Inā loaʻa iā ʻoe kekahi lālā ʻohana me MSA a hōʻole ko lākou kūlana a hiki i kahi e hiki ʻole ai iā ʻoe ke mālama i ke kanaka ma ka home, e ʻimi i nā ʻōlelo aʻo mai ka mea hāʻawi a kou ʻohana.

ʻO Shy-Drager Syndrome; ʻO ke Neurologic orthostatic hypotension; ʻO Shy-McGee-Drager Syndrome; Parkinson me ka maʻi maʻi maʻi; MSA-P; MSA-C

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

ʻO Fanciulli A, ʻO Wenning GK. Hoʻopiʻi ʻōnaehana lehulehu. N Engl J Med. 2015; 372 (3): 249-263. PMID: 25587949 pubmed.ncbi.nlm.nih.gov/25587949/.

ʻO Jankovic J. Parkinson maʻi a me nā ʻano neʻe ʻē aʻe. 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 96.

Romero-Ortuno R, Wilson KJ, Hampton JL. Nā maʻi o ka ʻōnaehana autonomic. I: Fillit HM, Rockwood K, Young J, eds. ʻO Brocklehurst's Textbook of Geriatric Medicine a me Gerontology. 8th ed. Piladelapia, PA: Elsevier; 2017: chap 63.