ʻO ka polyneuropathy demyelinating hoʻoʻino

ʻO ka polyneuropathy hōʻemi demyelinating maʻi (CIDP) kahi maʻi e pili ana i ka pehu nerve a me ka huhū (mumū) e alakaʻi i ka nalo ʻana o ka ikaika a i ʻole sensation.

ʻO CIDP kahi kumu o ka hōʻino ʻana i nā aʻalolo ma waho o ka lolo a i ʻole ka iwi ʻula (neuropathy āpau). ʻO ka manaʻo o Polyneuropathy he mau aʻa ʻē aʻe i pili. Hoʻopili pinepine ʻo CIDP i nā ʻaoʻao ʻelua o ke kino.

Hoʻokumu ʻia ʻo CIDP e kahi pane pale pale ʻole. Hana ʻo CIDP ke hoʻouka ka ʻōnaehana pale i ka uhi myelin o nā ʻalolo. No kēia kumu, manaʻo ʻia ʻo CIDP kahi maʻi autoimmune.

Manaʻo pū nā mea mālama ola iā CIDP ma ke ʻano he ʻano mau o Guillain-Barré Syndrome.

ʻOkoʻa nā pānaʻi kikoʻī o CIDP. I nā manawa he nui, ʻaʻole hiki ke ʻike ʻia ke kumu.

Kū paha ʻo CIDP me nā kūlana ʻē aʻe, e like me:

• Hepatitis maʻi
• Diabetes
• ʻO ka maʻi me ka maʻi bacteria Campylobacter jejuni
  
• HIV / AIDS
• Nā maʻi ʻōnaehana pale ʻole ma muli o ke kanesa
• Maʻi maʻi ʻōpū
• ʻO ka lupus erythematosus ʻōnaehana
• Ka maʻi ʻaʻai o ka ʻōnaehana lymph
• ʻOhana thyroid
• Nā hopena o nā lāʻau e mālama ai i ka maʻi ʻaʻai a i ʻole HIV

Pākuʻi ʻia nā ʻōuli i kekahi o kēia mau mea:

• ʻO nā pilikia e hele ana ma muli o ka nāwaliwali a i ʻole nele o ka manaʻo i nā wāwae
• Ka pilikia i ka hoʻohana ʻana i nā lima a me nā lima a i ʻole nā ​​wāwae a me nā wāwae ma muli o ka nāwaliwali
• Hoʻololi ka manaʻo, e like me ka helu a i ʻole ka hōʻemi ʻana o ka naʻau, ʻeha, puhi ʻana, ʻoniʻoni ʻana, a i ʻole nā ​​ʻano ʻē aʻe ʻē aʻe (hana pinepine i nā wāwae ma mua, a laila nā lima a me nā lima)

ʻO nā ʻōuli ʻē aʻe i hiki ke hana ʻia me CIDP me:

• ʻO ka neʻe maʻamau a i ʻole ka hoʻoneʻe ʻana
• Pilikia i ka hanu ʻana
• Ka luhi
• Hoʻonani a hoʻololi paha i ka leo a i ʻole ka ʻōlelo slurred

E hana ka mea hāʻawi i kahi hoʻokolohua kino a nīnau e pili ana i nā ʻōuli, e kia ana i ka ʻōnaehana a me nā mākala.

ʻO nā hoʻokolohua i kauoha ʻia e komo pū:

• Electromyography (EMG) e nānā i nā mākala a me nā aʻalolo e kaohi i nā mākala
• Nā ho'āʻo conduction nerve e nānā i ka wikiwiki o nā neʻe uila e neʻe ma waena o kahi aʻalolo
• ʻO ke biopsy nerve e wehe i kahi ʻāpana liʻiliʻi o ke aʻalolo no ka hoʻokolokolo ʻana
• Spinal tap (lumbar puncture) e nānā i ka wai e hoʻopuni i ka lolo a me ka iwi kuamoʻo
• Hiki ke hana i nā hoʻokolohua koko e nānā i nā protein ponoʻī e hoʻonāukiuki i nā aʻalolo
• Nā hoʻāʻo ʻana o ka hana lung e nānā inā pilikia ka hanu

Kaukaʻi ʻia i ke kumu i manaʻo ʻia o CIDP, nā hoʻokolohua ʻē aʻe, e like me nā kukuna x, nā kiʻi kiʻi, a me nā hoʻāʻo ʻana i ke koko.

ʻO ka pahuhopu o ka mālama ʻana e hoʻohuli i ka hoʻouka kaua ma nā ʻalolo. I kekahi mau hihia, hiki i nā nerves ke hoʻōla a hiki ke hoʻihoʻi ʻia kā lākou hana. I nā hihia ʻē aʻe, ʻinoʻino nā aʻa a ʻaʻole hiki ke hoʻōla, no laila mālama ʻia ka mālama ʻana i ka pale ʻana i ka maʻi mai ka ʻino.

Hāʻawi ʻia kahi lāʻau i ka nui o nā ʻōuli, a me nā mea ʻē aʻe. Hāʻawi wale ʻia ka lapaʻau hoʻomāinoino loa inā paʻakikī ʻoe i ka hele wāwae, ka hanu ʻana, a i ʻole inā ʻaʻole e ʻae nā hōʻailona iā ʻoe e mālama iā ʻoe iho a hana paha.

Hiki i nā mālama ke hoʻopili:

• ʻO Corticosteroids e kōkua i ka hoʻohaʻahaʻa ʻana i ka palaho a me ka hoʻomaha ʻana i nā ʻōuli
• Nā lāʻau ʻē aʻe e kaomi i ka ʻōnaehana pale (no kekahi mau hihia koʻikoʻi)
• Hoʻololi ʻo Plasmapheresis a i ʻole plasma e lawe i nā mea ʻino mai ke koko
• Intravenous immune globulin (IVIg), e pili ana i ka hoʻohui ʻana i nā helu he nui o nā mea ʻino i ka plasma koko e hōʻemi ai i ka hopena o nā mea ʻino e hoʻomaka nei i ka pilikia

Hoʻololi ka hopena. Hiki ke hoʻomau i ka maʻi lōʻihi lōʻihi, a i ʻole he mau manawa hou kāu o nā ʻōuli. Hiki ke hoʻōla piha, akā ʻaʻole maʻamau ka nalo mau ʻana o ka hana nerve.

Nā pilikia o CIDP me:

• ʻEha
• Hoʻemi mau a nalowale paha o ka sensation i nā wahi o ke kino
• Ka nāwaliwali paʻa a i ʻole ka maʻi lōlō ma nā wahi o ke kino
• ʻO ka hōʻeha hou a ʻike ʻole ʻia paha i kahi ʻāpana o ke kino
• Nā hopena o nā lāʻau i hoʻohana ʻia e mālama i ka maʻi

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe ka nalowale o ka neʻe a i ʻole sensation i kēlā me kēia wahi o ke kino, keu hoʻi inā ʻoi aku ka maikaʻi o kāu mau ʻōuli.

Maʻi hoʻohaʻahaʻa demyelinating polyradiculoneuropathy; Polyneuropathy - hōʻeha mau loa; CIDP; Polyneuropathy maʻi kūpilikiʻi; ʻO Guillain-Barré - CIDP

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

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.

Smith G, Shy ME. Nā neuropathy ākea. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 392.