ʻO ka maʻi demyelination Osmotic

ʻO Osmotic demyelination Syndrome (ODS) ka hana ʻole o ka lolo. Hoʻokumu ʻia ia e ka luku ʻia o ka papa (myelin sheath) e uhi ana i nā hunaola nerve i waenakonu o ka lolo (pons).

Ke hoʻopau ʻia ka uhi myelin e uhi ana i nā hunaola nerve, ʻaʻole e lawe pono ʻia nā hōʻailona mai kekahi aʻa a i kekahi. ʻOiai pili ka lolo i ka lolo, hiki i nā wahi ʻē aʻe o ka lolo ke hoʻopili pū ʻia.

ʻO ke kumu maʻamau o ODS kahi hoʻololi wikiwiki i nā pae sodium o ke kino. Kū pinepine kēia i ka manawa e mālama ʻia ai kekahi no ka sodium haʻahaʻa (hyponatremia) a ua wikiwiki ʻia ka paʻakai. I kekahi manawa, puka ia ke hoʻoponopono ʻia me ke kiʻekiʻe o ka sodium i ke kino (hypernatremia) me ka wikiwiki.

ʻAʻole hana maʻamau ʻo ODS iā ia iho. ʻO ka pinepine, he pilikia ia no ka mālama ʻana i nā pilikia ʻē aʻe, a mai nā pilikia ʻē aʻe iā lākou iho.

Nā pilikia me:

• Hoʻohana rama
• Maʻi maʻi ate
• Kaʻai pono ʻole mai nā maʻi koʻikoʻi
• Ka mālama ʻana i ka lolo i ka lolo
• ʻO ka nausea nui a me ka luaʻi i ka wā hāpai

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

• Huikau, delirium, hallucination
• Nā pilikia kaulike, haʻalulu
• Pilikia i ka ale ʻana
• Hoʻoemi i ka makaʻala, hiamoe a hiamoe paha, lethargy, pane maikaʻi ʻole
• ʻLelo lohi
• ʻO ka nāwaliwali i ka maka, nā lima, a me nā wāwae, e maʻa mau i nā ʻaoʻao ʻelua o ke kino

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i nā ʻōuli.

Hōʻike paha kahi scan MRI poʻo i kahi pilikia i ka ʻōnaehana lolo (pons) a i ʻole nā ​​ʻāpana ʻē aʻe o ka lolo. ʻO kēia ka hōʻoia diagnostical nui.

Hiki i nā hoʻokolohua ʻē aʻe ke:

• ʻO ke kiʻekiʻe sodium sodium a me nā hoʻokolohua koko ʻē aʻe
• Hoʻokū ka auditory Brainstem i ka pane (BAER)

ʻO ODS kahi maʻi pōpilikia e pono e mālama ʻia i ka haukapila ʻoiai ʻo ka hapanui o ka poʻe me kēia ʻano i loko o ka haukapila no kahi pilikia ʻē aʻe.

ʻAʻohe lāʻau i ʻike ʻia no ka myelinolysis pontine waena. Mālama ʻia ka mālama ʻana i ka hoʻomaha ʻana i nā ʻōuli.

Hiki i ke olakino hoʻoikaika kino ke mālama i ka ikaika o ka mākala, ka hoʻoneʻe, a me ka hana i nā lima a nāwaliwali nāwaliwali.

ʻO ka hōʻino nā nerve i hoʻokumu ʻia e ka pontine myelinolysis ʻoi loa ka lōʻihi. Hiki i ka maʻi ke hōʻeha i ke kīnā lōʻihi.

Komo pū nā pilikia:

• Hoʻemi i ka hiki ke launa pū me nā poʻe ʻē aʻe
• Hoʻemi i ka hiki ke hana a mālama paha iā ʻoe iho
• ʻAʻole hiki ke neʻe, ʻē aʻe o ka maka o nā maka ("laka ʻia"
• Poino pūnaewele paʻa paʻa

ʻAʻohe kumu alakaʻi maoli i ka wā e ʻimi ai i ka lāʻau lapaʻau, no ka mea laha ʻole ʻo ODS i ke kaiāulu nui.

I ka haukapila, lohi, mālama ʻia ka mālama ʻana i kahi pae sodium haʻahaʻa e hōʻemi paha i ka makaʻu no ka hōʻino nā nerve i nā pons.Ke hoʻomaopopo nei pehea e hiki ai i kekahi mau lāʻau ke hoʻololi i nā pae sodium ke pale i ka pae mai ka loli wikiwiki ʻana.

ODS; Demyelination pontine waena

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

ʻO Weissenborn K, Lockwood AH. Nā encephalopathies hoʻowalewale a me nā metabolic. 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 84.

Yaqoob MM, McCafferty K. Koena wai, nā wai a me nā electrolytes. I: Feather A, Randall D, Waterhouse M, eds. ʻO Kauka Lapaʻau ʻo Kumar lāua ʻo Clarke. 10 o ka lā. Piladelapia, PA: Elsevier; 2021: chap 9.