Miller-Fisher chirwere: zviratidzo, kurapwa, upenyu anotarisirwa

Imwe mhando zvisingawanzoitiki Guillain-Pazvibato zvechizarira urwere, inova bazi kubva Kunyatsoona mumuviri varwere munhu pezvakaitwa ndiye Miller-Fisher syndrome. Zvinonzi dzinoratidzwa vanamwari vatatu vatatu zviratidzo kuti anozviratidza zvakafanana Varwere zvose.

tsananguro

Guillain-Pazvibato zvechizarira chirwere haiwanzowaniki kutanga. In okurapa, nhamba dzake dziri vanhu 1-2 paminiti zviuru zana kwevanhu. Rinooneka kakawanda nevanhu uye ane nenhongonya mbiri kwayakaita:

• mudiki - makore 20-24;
• kare - makore 70-74.

Zvinonyatsozivikanwa neurologists uye ane vanoverengeka yakasiyana features, chokuendesa inoongorora confirmative cerebrospinal mvura. Kunze venguva aibuda chirwere, inowanikwa Miller Fisher urwere, akatsanangura ichi wetsinga American shure muna 1956 gore.

zviratidzo

The chirwere apo neapo uye rinoreva kusachengeteka kukuru anogumbura autoimmune chirwere kunokanganisa myelin etsinga mumuhara. Pakutanga uye pakuzadzisa Miller-Fisher chirwere nguva dzose kuoneka zvakafanana uye chinosanganisira zvinotevera munhevedzano mamirire zviratidzo iye

• arefleksiya - kuina chimbichimbi kutsakatika, uye pakupedzisira kusavapo Mbabvu hunenge zvakakwana;
• ataxia - cerebellar zvirwere unhu;
• ophthalmoplegia - kuoma ziso tsandanyama, kazhinji zvokunze, uye kunzwisisa nyaya uye mudzimba;
• tarapez uye kuoma kufema tsandanyama - kuva huru, yepamusoro zviitiko.

With kwakakodzera kutsunga zviratidzo uye nenguva mharuro kurapwa, chirwere chacho benign, hazvina kukonzera matambudziko uye kazhinji rinopera vaingoerekana kupora.

zvikonzero

With nenguva kurapwa nachiremba kwemavhiki mashoma kana mwedzi, unogona kurapa Miller-Fisher syndrome. Kusvikira vangani kurarama nechirwere chakadaro, hazvisi afunga kuti kwete yakajeka uye zvinokonzera ayo. Asi vanhu vakawanda vane ichi chirwere nyanzvi anovimbisei kupfuura zvakanaka Zvaifungidzirwa. Full kupora mitambo zvose mumuviri munyika yakarurama uye zvakakodzera kurapwa, zvinotora vaifanira vhiki gumi. Uye vashoma varwere yepamusoro zviitiko zvinoda zvinoverengeka dzokuwedzera utano matanho.

Part wevashandi vezvokurapa akati kuti kazhinji chinokonzera chirwere ichi kuri kuva nevakawanda kubaya. Mune zvimwe zviitiko, zvakanzi dzakaonekwa pashure nesimba Kutamiswa nemavhairasi zvirwere, zviratidzo dzimwe nguva airatidzwa pashure kwenguva refu kurapwa anoverengeka kunzwisisa chirwere. Dzinozivikanwa nhoroondo mhuri chirwere, zvichireva nemagene kubatwa nechirwere ichi muviri.

zvekuchipatara hwakawanda

Mukusarudza kunyunyuta yakapa murwere, achinyanya kwakunoitwa zvinotevera zvinoumba:

• simba, kurasikirwa simba, kushaya simba, dzungu;
• achinetseka kutsenga, uye gare gare, kutaura;
• kuomerwa kufamba, uye kuzvidzora basa;
• Kakawanda chiveve maoko nemakumbo, chinozunguzirwa kufanana marwadzo ari maoko nemakumbo.

Kuti rigone mitezo - kutyora ziso racho, uye zvimwe nezvimwe migumo (kunzwa kuvapo magiravhusi mumaoko) anoratidzwa kuti Miller-Fisher syndrome. Zviratidzo zviri chaizvo akafanana Gane-Pazvibato zvechizarira urwere, asi kwakadai zvokurwara iri dzakaona kuoma zvichikwira hunhu - apasi kusvikira rokumusoro chikamu muviri.

Mukuwedzera nekuneta ziso tsandanyama, vakadhakwa Kufambisa uye kurasikirwa hunenge rakakwana, murwere anogona ringazivikanwa uye zvinoverengeka yechipiri zviratidzo, kuita kuti zvakarurama kuongorora chirwere.

• The tembiricha aikanganiswa ganda dererei zvikuru.
• The murwere kushanda kwete nehanya nokurwadziwa.
• Pakuparadza mate anova zvakaoma.
• Hazvina discontinuous, mashoko unpronounceable.
• Gag dzepanguva vasipo.
• Zvichemo pamusoro dundira nematambudziko.

Part zviratidzo zvakadai tsandanyama simba uye kutaura matambudziko anogona zvaitika. Rinoratidza zvakajeka kwakakomba kuomesa zvinhu uye zvinoda nokukurumidza nyanzvi zano.

Diagnostics

To zvakarurama kuziva Miller-Fisher urwere, zvinodikanwa vaite zvinoverengeka zvakakodzera tsvakurudzo.

1. Fanira rwendo kuna wetsinga, uyo anoongorora uye rinozivisa zvose zvinogoneka chetsinga zvirwere.
2. Unoratidza lumbar ponji. Kazhinji, rinozivisa yakakwirira mapuroteni zviratidzi yakananga kuti chirwere.
3. PCR Analysis - anobvumira kuziva zvinoita exciter. Izvi zvingava herpes utachiona, Epstein-Barr utachiona, cytomegalovirus nezvimwe.
4. Kazhinji nyanzvi anowedzera ibasa imwe CT scan kubatsira kuziva zvichibvira comorbidities chetsinga.
5. For kwairayirwa bvunzo ropa kuratidza kuvapo Anti-ganglioside antibodies. Iyi inoratidza pachena pamberi kuzvimba, zvakanaka mugumisiro ongororo iyi ndiko kupupurira yakarurama nechirwere.

Miller-Fisher chirwere yakaoma uye kunoda rakarurama kupfuura Diagnostics, vakashandisa elektroneyromirografiya, differential pachisara kuenzanisa zviratidzo ane nhamba zvirwere zvakafanana.

kurapa

Kurapa chirwere ichi kunosanganisira matanho akaoma kudzvinyirira zvirwere siyana uye ropa Clearance yacho antibody. Nokuraramisa kwakakodzera uye symptomatic kurapa kunoita kwenguva pfupi nguva kubvisa zvachose Miller-Fisher syndrome. Treatment achitungamirirwa ane ruzivo nyanzvi kunotungamirira yakanaka chaizvo zvabuda, uye kupora zvizere. Mune zvisingawanzoitiki chaizvo Muzviitiko (chete muzana matatu nhamba) zvazvo, zvichireva wokuwedzera nzira kunzwisisa mishonga.

1. An Maonero ari kufema ezvinhu, mune zviitiko apo murwere zvakaoma kufamba voga, chipatara iri basa nokusingaperi zvokurapa achitarisirwa.
2. Mumazuva mashanu okutanga (hapana paya pane mavhiki maviri pashure yokutanga zviratidzo kutanga) akagadzwa plasmapheresis uye immunoglobulin.
3. Nokuti kudzivirira munhu zvichibvira venous thrombosis vachishandisa anticoagulants.
4. Zvinoda kuramba kudzora BP, sezvo ayo unopinza kusiyana kungaita kuti dzakakomba matambudziko.
5. Uyezve, makirasi chiremba wechikadzi achindidzidzisa kutaura.