I-Neurology Clinic
INkxaso yokuNgeniswa kweKlinikhi yeNeurology. El Paso, TX. I-Chiropractor, uDkt. Alexander Jimenez uxoxa neurology . UDkt. Jimenez unikeza ukuqonda okuphambili kophando oluchanekileyo lwezikhalazo eziqhelekileyo neziyinkimbinkimbi ezinjengeentloko, utywala, ubuthathaka, ugugu, kunye ne-ataxia. Ugxininiso luya kuba kwi-pathophysiology, i-symptomatology, kunye nokuphathwa kwentlungu ngokuphathelele intloko kunye nezinye iimeko ze-neurologic, enekhono lokuhlukanisa ubunzulu obuvela kwiintlungu zesifo sengqondo.
Ujoliso lwethu lweklinikhi kunye neenjongo zethu zobuqu kukunceda umzimba wakho uziphilise ngokwendalo ngokukhawuleza nangendlela esebenzayo. Maxa wambi, kusenokubonakala ngathi yindlela ende; nangona kunjalo, ngokuzibophelela kwethu kuwe, ngokuqinisekileyo iya kuba luhambo olunika umdla. Ukuzinikela kuwe empilweni kukuba, ungaze uphulukane nonxibelelwano lwethu olunzulu kwisigulana ngasinye kolu hambo.
Xa umzimba wakho usempilweni ngokwenene, uya kufika kwinqanaba lokufaneleka elilelona lifanelekileyo lobume bomzimba. Sifuna ukukunceda uphile ubomi obutsha nobuphucukileyo. Kwiminyaka eyi-2 edlulileyo ngelixa uphando kunye neendlela zokuvavanya kunye namawaka ezigulane siye safunda oko kusebenza ngokufanelekileyo ekunciphiseni intlungu ngelixa kwandisa amandla omntu. Ukuze ufumane iimpendulo kuyo nayiphi na imibuzo onokuba nayo nceda ufowunele uDkt Jimenez kwi-915-850-0900.
by UGqr Alex Jimenez I-Neurology Clinic
El Paso, TX. I-Chiropractor, uDkt. Alexander Jimenez ukhangeleka ekuthinjeni, ukuhluthwa nokunyanga.Ukuxhamla zichazwa njenge, iintshukumo ezingaqhelekanga okanye ukuziphatha okuvela kwimisebenzi yombane engaqhelekanga engqondweni. Ukuxhamla luphawu lokuxhuzula kodwa asingabo bonke abaxhuzulayo abanesifo sokuwa. Njengoko kukho iqela lezigulo eziyeleleneyo eziphawulwa kukuxhuzula okuphindaphindiweyo.�sokuwa liqela leengxaki ezidibeneyo kwaye zibonakaliswe ngokukhawuleza. Kukho iintlobo ezahlukeneyo zokuhluthwa kunye nokuthintela. Kukho imishanguzo yokwehliswa okumiselweyo ukulawula ukugonywa, kwaye ukuhlinzwa akufuneki ukuba kufuneka ukuba unyango lungasebenzi.
Ukuxhuzula nokuwa sisifo sokuwa
Ukuqubukana kwenzeka xa kukho ukutshatyalaliswa ngokuzenzekelayo kunye nokuqhutyelwa kweqela lama-neurons, ngokuphindaphindiweyo ekuphenduleni i-trigger njenge-compromise
nayiphina ngengqondo unokubanjwa xa iimeko zichanekile
Ukuxhuzula okanye ukuphazamiseka kokuxhuzula, kukonyuka ngokwengqondo kwamathuba okuxhuzula okwenzeka emntwini. ngengqondo
Iimpawu zoLungiso
Jikelele / i-Global iyakhula
Ukubanjwa kwemoto ngokuqhelekileyo (i-Grand mal)
Ukungabikho kokuthatha (Petite mal)
Ukujoliswa kokugxilwa
Ukuhlutha okulula
I-cortex ye-Motor (i-Jacksonian)
Cortex
Somatosensory
I-Auditory-vestibular
Visual
I-Olfactory-yogustatory (uncinate)
Ukunciphisa ngokukhawuleza kwinqanaba (libmbic)
Ukuqhubeka okuqhubekayo / okuqhubekayo
Jikelele (isimo se-epilepticus)
I-Focal (epilepticus partialis continua)
I-Motoralized Seizure
Ukutshatyalaliswa kombane kwee-neurons kwi-cortex yonke ye-cerebral kanyekanye
I-Trigger ithathwa ukuba ingaphandle kwe-cortex ye-cerebral, njenge-thalamus okanye i-brainstem
Iziqalo ziqala ngokulahlekelwa kwengqondo zilandelwa ukutyunjwa kwetoni (ukongezwa)
Ukuphefumla kuyanqunyanyiswa, kwaye iinwele ziyakhutshwa ngaphaya kwegloti elivaliweyo (�lila�)
Ukuphakanyiswa kwengcinezelo yegazi, abafundi abahlaziyiweyo
Ukuqhekeka okungapheli kunye nokuphumula (umsebenzi we-clonic)
Ngokuqhelekileyo ihlala imizuzu embalwa, kodwa ezinye izigulana zikwazi ukuhlala iiyure okanye iintsuku (isimo se-epilepticus)
Ukuqala ngokubanzi ebuntwaneni
I-Tonic Clonic Seizure
nanfoundation.org/neurologic-disorders/epilepsy/what-is-epilepsy
Yam Tonic Clonic / Grand Mal Malice
VIDEO
Iimpawu zokuQala
Ionic engaqhelekanga (Na, K, Ca, Mg, BUN, pH)
Ukurhoxiswa ngokwemali kwizidakamizwa (utywala, iibharbiturates, benzodiazepines)
Hypoglycemia
Hypoxia
I-Hyperthermia (ingakumbi izigulana phantsi kwe-4 iminyaka ubudala)
Ukuxhoma kweTyxin
I-Genetic ubuzwe obungavamile be-neurons (ngokungafanekiyo)
I-EEG ye-Grand Mal Seizure
Isigaba se Tonic Isigaba seClonic Isigaba sokungena
I-Swenson, R. I-Epilepsy. 2010
Ukungabikho (i-Petit Mal) Ukuxhatshazwa
Ngokuqhelekileyo kubakho abantwana
Uvela kwi-brainstem ephezulu
Ngokuqhelekileyo kubonakala ngathi ulahlekelwa ngumzila wesicatshulwa okanye ukhankanya kwindawo
Aba bantwana bangaqhubeka nokuhlakulela ingxaki ekugqibeleni kamva ebomini
Ukuxolelwa ngokukhawuleza okunokwenzeka njengoko i-neurons ekhulile
Ukungabikho kobuNtu obunjiweyo kwiKhamera
VIDEO
I-EEG ye-Petit Mal Seizure
I-3-waves-spase-waves / yesibini Unokucetyiswa ngu-hyperventilation I-Spike = ukuzonwabisa I-Wave = inhibition
I-Swenson, R. I-Epilepsy. 2010
I-Focal Focal / Iingxaki zokuzikhethela
Mhlawumbi mayibe kunye okanye ungenakho ukuzaliswa kwesekondari
Isigulane sigcina sigxina
Qalisa kwindawo engundoqo yokusebenza ye-cortex
Izimpawu ezahlukileyo kunye nokuhlula ngokuxhomekeke kwindawo apho kwingqondo isenzo se-epileptiform sivela khona
Iindawo ezibonakalayo zivame ukuvelisa into efanelekileyo (ukubona izibane, ukuphosa into ethile, njl, ngokuchasene nokungabi noluvo)
Iindawo zeenqwelo-moya zingenza iimpawu ezilungileyo okanye ezimbi
Umsebenzi wendawo yokubandakanyeka ungancitshiswa ngexesha lesithuba
Ukuba i-motor motor cortex ibandakanyekile = "Ukukhubazeka kukaTold "
Icandelo elithile (i-Focal Seizure) 12 Yr Old Boy
VIDEO
Ukutyunjwa okuKhethekileyo kwi-Motor Cortex
Ingaqala njengento yokukrokra komzimba omnye, kwicala elibhekiselele kumsebenzi we-epileptiform, kodwa isenokusasazeka ngomzimba kwipatheni yomzimba (i-Jacksonian seizure / march)
www.maxplanckflorida.org/fitzpatricklab/homunculus/science/
Ukutyunjwa okuKhethekileyo Kwi-Somatosensory Cortex
Uvelisa i-paresthesia kwicala eliphambili kwi-epilform activity kwaye linokusasazeka kwipateni yomzimba (umkhonto) ofana nohlobo lwesithuthi
xh.wikipedia.org/wiki/Cortical_homunculus
Ubuncwane boBucala kwi-Auditory-Vestibular Area
Ukubandakanywa kommandla wexeshana
Unokuvelisa i-tinnitus kunye / okanye i-vertigo
I-Audiometry iya kuba yinto eqhelekileyo
Ukutyunjwa okuKhethekileyo kwi-Visual Cortex
Unakho ukuvelisa i-hallucinations kwintsimi ebonakalayo
I-cortex ebonakalayo (i-calcarine cortex) ivelise ukukhanya, amabala, kunye / okanye i-zig-zags zokukhanya
I-cortex yobudlelwane bobuboniso ivelisa i-hallucinations epheleleyo njengamabhaloni athafayo, iinkwenkwezi kunye nama-polygoni
Ubuncwane obuKhethekileyo kwi-Olfactory-Gustatory Cortex
Unakho ukuvelisa iilucucactory hallucinations
Mhlawumbi indawo yokusabalalisa ekubanjweni kwamanye amazwe
Iingqungquthela eziKhethekileyo
Ibandakanya i-cortices yombutho we-frontal, temporal or parietal lobes
Ifana neendlela ezilula zokukhetha kodwa kukho ukudideka / ukuncipha
I-Limbic Cortex (i-hippocampus, i-parahippocampal temporal cortex, i-retro-splenial-cingulate--calcallosal cortex, i-cortex e-orbito-frontal, kunye ne-insula).
Ngako-ke olu luhlobo oluqhelekileyo lokuthwala
Unokuvelisa iimpawu ezibonakalayo kunye neempembelelo (ubuninzi), ubunqabileyo obubi kunye neentlobo ezingenakonwabisayo kunye nezinto ezithandekayo, iimvakalelo ezinqamlekileyo zesisu, ukwesaba, ukuxhalaba, ukungabi nxamnye nobudlova, nokuxhalaba ngokwesondo ngokugqithiseleyo, ukunyanga, ukuhlafuna, ukubetheka komlomo, ukunyusa izandi, ukubetha, ukulungiswa kweepenile, ukutya, okanye ukuqhuba
Iziqeshana Zokuhlukana Kwezihlobo Ngomntwana Ofanayo
VIDEO
Ukuqhubela phambili / okuqhubekayo
Iintlobo ze-2
Jikelele (isimo se-epilepticus)
I-Focal (epilepticus partialis continua)
Ukuqhuma okuqhubekayo okanye okuphindaphindiweyo kwixesha elingu-30 ngaphandle kokubuyela kwisigqirha ngaphezu kwexesha
Umsebenzi wokubamba ixesha elide okanye ukuthatha amanxeba amaninzi kufutshane ngaphandle kokuhlaziywa ngokupheleleyo phakathi
Eyona nto ibonakala ibonakala njengesiphumo esininzi semithi ye-anticonvulsive ngenxa yokunyuka kwe-hyperexcitability
Ukugqithisa ngokomzwelo, umkhuhlane, okanye ezinye i-hypermetabolic states, i-hypoglycemia, i-hypocalcemia, i-hypomagnesemia, i-hypoxemia, iindawo ezinobuthi (isib. I-tetanus, uremia, exogenous, i-tanus, i-uremia, i-aminophyline, i-lidocaine, i-penicillin) kunye nokuhoxisa
Isimo Epilepticus
Ukutshatyalaliswa kokubandezeleka kokuqhubekayo kuyingozi yonyango ngenxa yokuba kunokubangela ukulimala kwengqondo okanye ukufa xa ukuxhatshazwa kwexesha elide kungekhona
Ubushushu obuphakamileyo ngenxa yomsebenzi osisigxina, u-hypoxia ngenxa yokungena ngokwaneleyo kunye ne-lactic acidosis enokungonakalisa i-neurons
Ukufa kunokubangelwa kukutshatyalaliswa nokugqithiswa kwe-cardiopulmonary
Epilepsia Partialis Continua
Ubuncipheko obuncinane bokuphila ngaphandle kwesimo se-epilepticus, kodwa umsebenzi wokubanjwa kufuneka ugqitywe njengoko unokuthi uqhubele phambili kwifomu yokubanjwa ngokubanzi xa uvumelekile ukuba uqhubeke ixesha elide.
Ingaba ngumphumo we-neoplasm, ischemia-infarction, inetyxic stimulant okanye hyperglycemia
Unyango lweNkunkuma
Ukuba ukutshatyalaliswa kungumphumo wesimo esisisigxina, njengokusuleleka, ukuphazamiseka kwemilinganiselo yamanzi kunye ne-electrolyte, ukuxhatshazwa okungaqhelekanga kunye nokuphelelwa yintsholongwane, ukunyangwa kweemeko kufuneka kulungise umsebenzi wokubamba
Uninzi lwamayeza e-antiepileptic anyanga iintlobo ezininzi zokuxhuzula � akagqibelelanga nangona kunjalo
Ezinye zisebenza ngakumbi (phytotoin, carbamazepine, valproic acid kunye ne phenobarbital)
Kukho abo baneempembelelo ezimbalwa (i-gabapentin, i-lamotrigine kunye ne-topiramate)
Amanye amayeza aphatha uhlobo oluthile lokuthumba (njenge-ethosuximide yokungabikho kokuthinteka)
imithombo
UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
by UGqr Alex Jimenez abantwana , I-Neurology Clinic , I-El Paso Chiropractic News
El Paso, TX. I-Chiropractor, uDkt. Alexander Jimenez ukhangelelana neengxaki zokuphuhliswa kwabantwana, kunye neempawu zabo, izizathu kunye nonyango.
Umvakalelo yokitazo
Iintlobo ze-4
Ukukhubazeka kweCerebral Palsy
~ 80% yamacala e-CP
I-Dyskinetic Cerebral Palsy (ikwaquka i-athetoid, i-choreoathetoid, ne-dystonic cerebral palsies)
I-Ataxic Cerebral Palsy
Ukuxhamla kweCerebral Palsy
I-Autism Spectrum Disorder
Disistic Disorder
Isifo sika-Asperger
Ingxaki yoPhuhliso eNgqongileyo�Ayichazwanga ngenye indlela (PDD-NOS)
I-Disability Disturbance Child (CDD)
I-Autism Spectrum Disorder Iiflagi ezibomvu
ULuntu lweNtlalo
Ukusetyenziswa okuthe ngqo kwempawu
Intetho echelekileyo okanye ukungabikho kwamathambo
Izandi ezingaqhelekanga okanye ilizwi elingaqhelekanga lelizwi
Ubunzima bokuthintana kwamehlo, imiqondiso kunye namazwi ngexesha elifanayo
Ukuxelisa abanye
Akasasebenzisi amagama asetyenziswayo
Usebenzisa isandla somnye umntu njengesixhobo
Intsebenziswano yeNtlalo
Unzima ukujonga iso
Ukungabi ncokola
Ukungabi nokuphendula kwigama
Ayizami ukukubonisa izinto abanomdla kuzo
Ukuphindaphinda izinto ezinomdla kunye nomdla othintelweyo
Indlela engavamile yokuhambisa izandla, iminwe okanye umzimba
Ukuphuhlisa izithethe, ezifana nokucwangcisa izinto okanye ukuphinda izinto
Ugxila kwizinto ezingavamile
Inomdla ogqithiseleyo kwinto ethile okanye umsebenzi ophazamisa intsebenziswano yoluntu
Iminqweno engavamile
Ngaphantsi okanye ngaphaya kwempendulo ekungeneni kweengcinga
I-ASD Diagnostic Criteria (DSM-5)
Ukungapheli kokuqhubekayo ekunxibelelweni kwezentlalo kunye nentsebenziswano yentlalo kwiimeko ezininzi, njengoko kubonakaliswe ngolu hlobo lulandelayo, ngoku okanye ngembali (imizekelo ibonisa, ayikho iphelele; funda itekisi):
Ukulahlekelwa kwintlalo-ntlalontle, ekuhambeni, ngokukodwa, ukususela kwintlalo engaqhelekanga kunye nokungaphumeleli kwintetho eqhelekileyo yangaphambili kunye nentetho; ukunciphisa ukwabelana kweminqweno, iimvakalelo, okanye ukuthintela; ukuhluleka ukuqala okanye ukuphendula ekusebenzisaneni kwezentlalo.
Iingxaki kwiindlela zokuthetha ezingabonakaliyo ezisetyenziselwa ukusebenzisana kwentlalo, kubandakanyeka, umzekelo, ukususela ekunxibelelaneni kakubi kunye nokuthetha okungabonakaliyo; ukungaqhelekanga ekuthintweni kwamehlo kunye nolwimi lomzimba okanye ukulahleka ekuqondeni nasekusebenziseni impawu; ukungabikho kobukho obusweni kunye nokuthetha okungabonakali.
Ukulahleka ekuphuculeni, ukugcina, nokuqonda ubudlelwane, kubandakanya, ukususela ekubunzima ukuguqula ukuziphatha ukuhambelana nemimiselo yeentlalo ezahlukeneyo; ubunzima ekukwabeleni umdlalo ocingayo okanye ekwenzeni abahlobo; ukungabikho komdla kwiontanga.
I-ASD Diagnostic Criteria
Ukukhawulelwa, ukuphindaphinda iipatheni zokuziphatha, iminqweno okanye imisebenzi, njengoko kubonakaliswe ubuncinane kwezi zilandelayo zilandelayo, okwangoku okanye kwimbali (imizekelo ibonisa, ayikho iphelele; funda itekisi):
Ukutshintsha okanye ukuphindaphinda, ukusetyenziswa kwezinto, okanye intetho (umz., Izithuthi ezilula, ukucwangcisa amathoyizi okanye izinto zokuphamba, i-echolalia, iindidi ze-idiosyncratic).
Ukunyanzelisa ngokufanayo, ukunyanzeliswa ngokungagqibekanga kwiindlela eziqhelekileyo, okanye iindlela eziqhelekileyo zokuziphatha okanye izithandabuzo (umz. Ndezelo utshintsho oluncinci, ubunzima bokuguquka, iipateni zokucinga eziqinileyo, izithethe zokubingelelana, kufuneka ukuba uthathe indlela efanayo okanye udle ukutya okufanayo imihla ngemihla).
Iminqweno ephakamileyo kakhulu, yokulungiswa okungekho ngokweqile kwintsebenzo okanye ingqwalasela (umzekelo, isinamathiselo esinamandla okanye ukukhathalela ngezinto ezingavamile, ngokugqithiseleyo okanye ukunyamezela umdla).
I-Hyper - okanye i-Hyporeactivity kwi-input input okanye inzala engaqhelekanga kwimimandla yendalo (umz. Ukubonakala ukungathandekiyo kwintlungu / ubushushu, impendulo engalungileyo kwizandi ezithile okanye iimpawu, ukuvumba okweqile okanye ukuthintela izinto, ukukhangela izibane okanye ukuhamba).
I-ASD Diagnostic Criteria
Iimpawu kufuneka zibe khona kwixesha lokuqala lokuphuhliswa (kodwa lingaze libonakaliswe ngokupheleleyo kuze kube yilapho iimfuno zentlalo zidlula ubunzima obuncinane, okanye zingagxinwa ngamasu okufunda kwimpilo kamva).
Iimpawu zibangelwa ukonakaliswa okubalulekileyo kwintlalo, emsebenzini, okanye kwezinye izinto ezibalulekileyo zokusebenza kwangoku.
Ezi ziphazamiso azichazi kakuhle ngokukhubazeka kwengqondo (ingxaki yokuphuhliswa kwengqondo) okanye ukulibaziseka kwehlabathi jikelele. Ukukhubazeka kwengqondo kunye ne-autism disorder disorder often happens; ukwenza ukuxilongwa kwe-autism ye-autism kunye nokukhubazeka kwengqondo, uxhulumaniso loluntu kufuneka lube ngaphantsi kwekulindeleke kwinqanaba lokuphuhlisa jikelele.
ASD Diagnostic Criteria (ICD- 10)
A. Ukuphuhliswa kokungaqhelekanga okanye ukungaphumeleli kubonakala ngaphambi kweminyaka yobudala be-3 ubuncinane kwimiba elandelayo:
Ulwimi olwamkelekileyo okanye oluthethayo njengoko lusetshenziselwa ukunxibelelana kwezentlalo;
Ukuphuhliswa kokunxibelelwaniswa kweentlalo ezikhethiweyo okanye ukusebenzisana kwezentlalo;
Umdlalo osebenzayo okanye ongumqondiso.
Bonke ubuncinane ubuncinane beempawu ezi-6 (1), (2) kunye (3) kufuneka zibe khona, ubuncinane ezimbini ukusuka (1) kwaye ubuncinane omnye kwi-2 nganye kunye (3)
1. Ukukhubazeka okufanelekileyo ekusebenzisaneni kwentlalo kubonakala ubuncinane kwezi zilandelayo zilandelayo:
a. ukuhluleka ngokwaneleyo ukusebenzisa iso lokubheka amehlo, ukubonakalisa ubuso, ukunyameka komzimba, kunye nokuthintela ukulawula ukusebenzisana kwentlalo;
b. ukuhluleka ukuhlakulela (ngendlela efanelekileyo yengqondo, kwaye nangona kunamathuba amaninzi) ubudlelwane bontanga obubandakanya ukwabelana ngokubambisana kwezenzo, imisebenzi kunye neemvakalelo;
c. ukunqongophala kokubuyelana ngokwentlalo novakalelo njengoko kuboniswa yimpendulo engalunganga okanye etenxileyo kwiimvakalelo zabanye abantu; okanye ukunqongophala kokumodareyitha kokuziphatha ngokwe
d. ukungabikho kokufuna ngokuzenzekelayo ukwabelana ngokuzonwabisa, umdla, okanye ukuphumelela nabanye abantu (umz. ukungabonakali, ukuzisa, okanye ukukhomba abanye abantu izinto ezinomdla kumntu ngamnye).
2. Ukungafaneki ngokufanelekileyo kokunxibelelana njengobonakaliso ubuncinane kwimiba elandelayo:
a. ukulibaziseka okanye ukungabi nako, ukuphuhliswa kolwimi oluthethiweyo olungahambi kunye nokuzama ukuhlawula ngokusetyenziswa kwempawu okanye imimiselo njengendlela yokunxibelelana enye (edlalwa ngaphambili ngokungabikho kolwazi lokuthetha);
b. Ukungaphumeleli okwethutyana ukuqalisa okanye ukugcina intsebenziswano yokuxoxa (nakwinqanaba lezakhono zolwimi likhoyo), apho kukho ukuphendula ngokuthe ngqo kwintetho yomnye umntu;
c. ukusetyenziswa ngokuphindaphindiweyo nokusetyenziswa kweelwimi okanye ukusebenzisa idiosyncratic yamagama okanye amabinzana;
d. ukungabikho kwemidlalo eyahlukeneyo yokuzikhethela okanye (xa ulutsha) umdlalo wokulinganisa uluntu
3. Imilinganiselo yokuziphatha, ukuphindaphinda, kunye neendlela eziphathekayo zokuziphatha, iimfuno kunye nemisebenzi ibonakaliswe ubuncinane kwezi zinto zilandelayo:
a. Ukukhathazeka ngokubanzi kunye neepesenti ezithintekayo kunye nezithintelo ezinomdla ezingaqhelekanga kumxholo okanye kugxininiso; okanye enye okanye eminye iminqweno engaqhelekanga ekusebenziseni kwayo kunye neemeko ezingqongileyo nangona kungengomxholo wabo okanye kugxininiso;
b. Kubonakala ngokunyanzela ukunyanzela kwimimiselo ethile, engeyiyo yokubambisana okanye imicimbi;
c. Indlela ehamba ngayo kunye nokuphindaphinda imoto ebandakanya isandla okanye umlenze wokutshintshisa okanye ukuguqula okanye ukuhambela komzimba wonke;
d. Ukuxhalabisa ngezinto ezithile zezinto ezingezizo zokusebenza zemidlalo yokudlala (njengokwenza kwazo, ukuvakalelwa kwendawo yabo, okanye ingxolo okanye ukunyakaza
C. Umfanekiso weklinikhi awubalelwanga kwezinye iindidi zeengxaki zophuhliso ezixhaphakileyo; ukuphazamiseka okuthile kophuhliso lolwimi olwamkelayo (F80.2) kunye neengxaki zesibini zentlalo-ngokomzwelo, ukuphazamiseka kwe-attachment esebenzayo (F94.1) okanye i-disinhibited attachment disorder (F94.2); ukukhubazeka kwengqondo (F70-F72) kunye nokuphazamiseka kwengqondo okanye ukuziphatha okuhambelanayo; i-schizophrenia (F20.-) ekuqaleni ngokungaqhelekanga; kunye neRett's Syndrome (F84.12).
Iikhrayitheriya zokuxilongwa kwe-Asperger's Syndrome (ICD-10)
A. Ukukhubazeka okufanelekileyo ekusebenzisaneni kwezentlalo, njengoko kubonakaliswe ubuncinane kwezi zilandelayo zilandelayo:
ukuphazamiseka okuphawulekayo ekusebenziseni iimpawu ezininzi ezingabonakaliyo ezifana nokujonga amehlo, amehlo, ukunyameka komzimba kunye nokuthintela ukulawula ukusebenzisana kwentlalo.
ukuhluleka ukuhlakulela ubudlelwane beentanga ezifanelekileyo kwinqanaba lokuphuhlisa.
ukungabikho kokufuna ngokuzenzekelayo ukwabelana ngokuzonwabisa, umdla, okanye ukuphumelela nabanye abantu (umz. ngokungabikho kokubonisa, ukuzisa okanye ukubonisa izinto ezinomdla kwabanye abantu).
ukungabikho koxanduva loluntu okanye lwengqondo.
B. Iipatheni eziphindaphindiweyo kunye nezikhokelo zokuziphatha, iimfuno kunye nemisebenzi, njengoko kubonakaliswe ubuncinane kwezi zinto zilandelayo:
kubandakanyeka kunye nomnye okanye ngaphezulu kweepatheni zentsingiselo ezingaqhelekanga okanye ngokugxininisa okanye kugxininiso.
Ukubonakala ngokungahambisani nokuthethelela kwimimiselo ethile, engeyiyo yokusebenza okanye imicimbi.
indlela ehamba ngayo kunye nokuphindaphinda imoto (umz., ukutsalwa kwesandla okanye umunwe okanye ukujikeleza, okanye ukuhambela komzimba wonke).
ukukhathalela okuqhubekayo kunye neengxenye zezinto.C. Ukuphazamiseka kubangela ukukhubazeka okwenyathelo olusisiseko kwizentlalo, emsebenzini, okanye kwezinye izinto ezibalulekileyo zokusebenza
D. Akukho ukulibaziseka ngokuqhelekileyo kwilwimi (umzekelo, amagama angatshatanga asetyenziswa iminyaka yobudala be-2, amabinzana okuthetha asetyenziswa iminyaka yobudala be-3).
E. Akukho ukulibaziseka kliniki ekuphuculweni kwengqondo okanye ekuphuhliseni izakhono zokuzinceda ngokwaneleyo ubudala, ukuziphatha okuguquguqukayo (ngaphandle kwentsebenziswano yentlalontle), kunye nolwazi malunga nendalo ebuntwaneni.
F. Iingqinisiso azihlanganyelwanga kwenye iNgxaki yokuThuthukiswa okuPhezulu okanye iSchizophrenia.
Ingqwalasela-Ukulahleka / Ukuxhatshazwa kwengxaki (ADHD)
Inattention - uvala umsebenzi lulaUkungasebenzi - ibonakala ihamba rhoqoImpulsivity - yenza izenzo ezikhawulezayo ezenzeka ngethuba ngaphandle kokucinga okokuqala
Izinto zeengozi ze-ADHD
Genetics Ukubhema i-cigarette, ukusetyenziswa kotywala, okanye ukusebenzisa iziyobisi ngexesha lokukhulelwa Ukubonakaliswa kwiibhoksi zendalo ngexesha lokukhulelwa Ukubonakaliswa kweengxube zendalo, njengamazinga aphezulu okukhokela, esemncinci Isisindo sokuzalwa esincinane ingqondo nzakala
UkuCoca
www.cdc.gov/ncbddd/autism/hcp-screening.html
Reflexes Primitive
Moro Spinal Galant
I-Tonic Neck Reflex ye-Asymmetrique
I-Tonic Neck Reflex
I-Tonic Labrynthine Reflex
Palmomental Reflex
Reflex Snout
Ukunyangwa kweeNtlupheko zoPhuhliso
Ukulungiselela nayiphi na ingcamango egcinwe
Fundisa abazali ngokubonelela ngokusingqongileyo
Ukukhuthaza imisebenzi yokulinganisela ingqondo
Ukujongana nokukhathazeka kokutya kunye nokususa ukutya okunengxaki
Nyanga amathumbu wesigulana � probiotics, glutamine, njl.
Iintsholongwane ze-Neuropsychiatric Syndrome
(PANS)
Ukuqala ngokugqithisileyo kwe-OCD okanye ukukhawuleza ukutya okunciphise
Iimpawu azichazekanga ngokuchazwa kwintsholongwane yegazi okanye yezokwelapha
Kwakhona ubuncinane ezimbini kwezi zinto zilandelayo:
Ukuxhalabisa
Ukunyamekela ngokomzwelo kunye / okanye ukudandatheka
Ukutshatyalaliswa, ugonyamelo kunye / okanye iimpawu ezichasileyo
Ukuziphatha / ukuphuhliswa koPhuhliso
Ukutshatyalaliswa kokusebenza kwesikolo
Iimpawu eziqhelekileyo okanye ezihamba ngeemoto
Izimpawu zeSomatic ziquka ukuphazamiseka kokulala, i-enuresis okanye i-urinary frequency
* Ukuqalisa kwe-PANS kungaqala ngama-agent angeneleleki ngaphandle kwe-strep. Kwakhona kubandakanya ukuvela kwizinto ezikhuselekileyo zendalo okanye ukukhubazeka kwamagciwane
Izifo eziMzimbeni eziMzimbeni eziManyeneyo ezihlanganiswe neStreptococcus
(PANDAS)
Ubuninzi bezinto ezibalulekileyo, ukunyanzeliswa kunye / okanye i-tics
Ukuqala ngokukhawuleza kweempawu okanye inkqubo yokubuyiselwa kwakhona ye-symptom
Ukuqala kokushicilelwa kokuqala
Umbutho kunye nosulelo lwe-streptococcal
Unxulumano nezinye iimpawu ze-neuropsychiatric (kubandakanywa nayiphi na i-PANS �ekhaphayo� iimpawu)
I-PANS / PANDAS Iimvavanyo
I-Swab / iStrep culture
Ukuhlolwa kwegazi nge-strep
Strep ASO
Anti-DNase B Titer
Streptozyme
Uvavanyo lwabanye abachaphazelekayo
I-MRI ikhethwa kodwa i-PET inokusetyenziswa xa kuyimfuneko
EEG
Amanqaku Amanga
Akunabo bonke abantwana abanesitrafti abaphakanyisile iilabhu
kuphela 54% lwabantwana abane-strep kubonise ukwanda okwenziwe kwi-ASO.
kuphela 45% ibonise ukwanda kwe-anti-DNase B.
kuphela 63% ibonise ukonyuka kwe-ASO kunye/okanye i-anti�DNase B.
Unyango lwe-PANS / PANDAS
Antibiotics
IVIG
Plasmaphoresis
Iiprotokholi ezichasayo
Imithi ye Steroid
Omega-3
NSAIDS
Probiotics
I-Clinic yezoNyango: I-Chiropractors (Kunconywe)
VIDEO
imithombo
�I-Attention Deficit Hyperactivity Disorder.� Iziko leSizwe leMpilo yeNgqondo, iSebe lezeMpilo lase-US kunye neeNkonzo zoLuntu, www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adHD/index.shtml.
Autism Navigator, www.autismnavigator.com/.
�Intshayelelo nge-Autism
Shet, Anita, et al. �IiMpendulo zoKhuseleko kwiQela A iStreptococcal C5a Peptidase ebantwaneni: Iimpembelelo kuPhuhliso lwesitofu.� Ijenali yeZifo ezosulelayo, vol. 188, no. 6, 2003, iphepha 809�817., doi:10.1086/377700.
�Yintoni iPANDAS?� IPANDAS Network, www.pandasnetwork.org/understanding-pandaspans/what-is-pandas/.
by UGqr Alex Jimenez I-Neurology Clinic
El Paso, TX. I-Chiropractor, uDkt. Alexander Jimenez ugxile kulo ukuguga kunye nokutshatyalaliswa kwezifo zesimiso senzwa, iimpawu zabo, izizathu kunye nokonyango.
Izifo eziDala iziQinisekiso kunye neDemyelinating
Neuron Izifo
Ubuthathaka obuthathaka ngaphandle kweenguqulelo I-Amyotrophic lateral sclerosis (ALS) ALS Primary sclerosis
Inkqubela yokuqhuma
Iimeko ezizuzelelweyo ezibangelwa ukuhlaliswa kwecilongo yangaphondo Isifo sikaM Werdnig-Hoffmann kwiintsana
Isifo se-Kugelberg-Welander kubantwana kunye nabantu abadala
I-Amyotrophic Lateral Sclerosis (ALS)
Ichaphazela izigulane ze-40-60 ubudala ubudala Umonakalo: Iipilisi zophondo zangaphambili
I-cranial motor ner nuclei
I-Corticobulbar kunye namaphecana eprostospin
Iziphumo zokufumana i-neuron (infrostity, hyperreflexia)
Ukusinda ~ iminyaka emithathu
Ukufa kubangelwa kukungabikho kobuthathaka kunye nomzimba wokuphefumula kunye nokusuleleka kwintsholongwane
ALS
Ngokuqhelekileyo ekugqibeleni iguqukela kumzekelo we-ALS oqhelekileyo I-Primary Lateral Sclerosis Iimpawu ze-neuron ezisemgangathweni ziqala kuqala, kodwa izigulane zigcina zineempawu ezisezantsi ze-neuron
Ukusinda kungaba yiminyaka elishumi okanye ngaphezulu
Ukuguqulwa kweBarbar Palsy Ukhetho luquka intloko nentamo yentambo
Izimo zeMoto zeNoron
Izifo zeAlzheimer
Echazwe zii-tangles ze-neurofibrillary (i-aggregates ye-protein ye-hyperphosphorylated tau) kunye ne-beta-amyloid plaques
Ngokuqhelekileyo kwenzeka emva kweminyaka yobudala 65
Imiba yobungozi Ukuguqulwa kwegazi kwi-beta amyloid gene
Uhlobo lwe-Epsilon 4 lwe-apolipoprotein
Ukuqondwa
Ukuxilongwa kwe-Pathologic yindlela ephela yokufumanisa ngokucacileyo imeko
Ukucingwa kunokukwazi ukulawula ezinye izizathu zengqondo
Izifundo zengcamango zokusebenza ziyakwazi ukuphuhliswa ukuze zifumaneke luncedo kwixesha elizayo
Ucwaningo lwe-CSF ukuhlola iiprotheni ze-tau kunye ne-beta amyloid zinokuba luncedo njengeemvavanyo zokuxilonga kwixesha elizayo
Iiplaque zeAmyloid kunye neeTangles zeNeurofibrillary
sage.buckinstitute.org/wp-content/uploads/2015/01/plaque-tanglesRNO.jpg
IiNdawo zeBongo ezichaphazelekayo yi-Alzheimer's disease
Hippocampus
Ukulahleka kwememori yakutshanje
Ummandla we-posterior temporo-parietal
Ukungahambi kakuhle kunye nokwakhiwa kweapraxia
I-Nucleus basalis yaseMeynert (i-neurons e-cholinergic)
Utshintsho kwiimbono ezibonakalayo
Inkqubela
Njengoko ezinye iinkalo zee-cortical zibandakanyeka, isigulane siza kuba neengxaki ezingenangqondo ezingqondweni, nangona kunjalo i-paresis, ukulahleka kwintliziyo, okanye iimpembelelo zentsimi ebonakalayo ziyimpawu.
Izinyango Zonyango
Amachiza avimbela inkqubo ye-nervous acetylcholinesterase
Donepezil Galantamine Rivastigmine
I-Aerobic Exercise, imizuzu ye-30 imihla ngemihla
I-PT / OT ilondoloze imisebenzi yokuphila kwansuku zonke
Iipilisi ze-Antioxidant kunye ne-anti-inflammatory
Kwizigaba eziphambili, kunokufuna ixesha elipheleleyo, ekunakekelwa ekhaya
IVascular Dementia
I-cerebral arteriosclerosis ekhokelela ekubetheni
Umonde uya kuba nembali yesiganeko sombhalo okanye iimpawu zesifo sokuqala (ukuxhamla, i-paresis, i-pseudobulbar palsies, aphasia)
Inokuthi idibana ne-Alzheimer's disease ukuba ngenxa ye-angiopathy ye-amyloid
I-Frontotemporal Dementia (Isifo Sokukhetha)
Uhlobo
Ichaphazela i-lobes yangaphambili neyesikhashana
Ngangabonwa kwi-imaging ukuba ukuguqulwa okuphambili kule mimandla
iimpawu
Ukunganakwa
Ukuziphatha kakubi
Ukutshitshiswa Ukuziphatha okungalunganga komphakathi Impulsivity
Ubunzima beelwimi
Ngokuqhelekileyo akukho memori okanye ubunzima bendawo
I-Pathology ibonisa imizimba ye-Pick ngaphakathi kwe-neurons
Iziphumo ekufeni kwi-2-10 iminyaka
Pick Bodies / Cytoplasmic Inclusions
slideplayer.com/9467158/29/images/57/Pick+bodies+Silver+stain+Immunohistochemistry+for+Tau+protein.jpg
impatho
Ukuxhatshazwa
Sertraline Citalopram
Yeka imithi enokubangela ukukhubazeka kwememori okanye ukudideka
Uhlobo Benzodiazepines
Lolonga
Indlela yokuphila yokuguqula Inkqubo yokuguqulwa kwamathambo
Izifo zePasinson
Unokuthi lenzeke nangaliphi na iminyaka, kodwa inqabile ngaphambi kwe-30 yobudala, kwaye ukwandisa ukukhula kwandala kubantu abadala
Ukutyekela kobuhlobo kodwa kungabikho kwimbali yosapho
Unokubakhokelwa yizinto ezithile zendalo
I-1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)
Iimveliso ezivelisa i-radicals ekhululekile
Ichaphazela i-substantia nigra pars compacta
Neoponergic neurons
Kwi-pathology, ubukho be-Lewy Bodies
Ukuhlanganiswa kwe-alpha-synuclein
Amabhunga aseLeyyy
scienceofpd.files.wordpress.com/2017/05/9-lb2.jpg
Iimpawu zePasinsinism
Ubungqina (zonke iindiza)
ROM
Ukunyakaza okusebenzayo
Kwangathi ingaba yendalo ye-cogwheel ngenxa yeempawu zentshukumo
I Bradykinesia
Ukunyuka kokuhamba
Ukungakwazi ukuqala ukuhamba
Ukukhupha
Ukungcangcazela kokuphumla (�ipilisi-iqengqeleka�)
Yadalwa ngokutshatyalaliswa kwamaqela omzimba aphikisayo
I ziphene
Ukuguquka kwangaphambili (kugxininiswe)
Ukungakwazi ukuhlawulela ukuphazamiseka, okubangelwa ukuphindaphinda
Iimpawu ezinjengeMask
Ukunyuka kwengqondo ngokuthe ngqo
Kamva ekuqhubekeni, ngenxa yokuqokelela umzimba
KuPathology
Ukusilela kwe-dopamine kwi-striatum (i-caudate ne-putamen) ye-basal ganglia
I-Dopamine ivame ukuba nefuthe lokukhupha isiphaluka esithe ngqo kwi-basal ganglia, ngelixa livimbela indlela engathanga ngqo
Carbidopa / Levodopa
Unyango oluqhelekileyo unyango luyinkampani
Levodopa
Umtshintshisi we-dopamine owela umqobo wegazi
ICarbidopa
I-Dopamine decarboxylase inhibitor engadluli iBBB
Ama-amino acids aya kunciphisa ukusebenza (ukhuphiswano) kwaye ngoko amayeza kufuneka asuswe kwiiprotheni
Utyando olude kunye neCarbidopa / iLevodopa
Umthamo wesigulana wokugcina i-dopamine uyehla ngokusetyenziswa kwamayeza kwaye ke uphuculo lwamayeza luya kuhlala ixesha elifutshane nelifutshane ukuba iyeza lisetyenziswa ixesha elide.
Ngokuhamba kwexesha kunokubangela ukwanda kwee-receptors ze-dopamine
I-dose-dyskinesia
Ukusetyenziswa kwexesha elide kugxininisa kwisibindi
Ezinye iziphumo ezichaphazelekayo zingabandakanywa izibilini, i-hypotension kunye ne-hallucinations
Ezinye iindlela zokonyango
Mayeza
Anticholinergics
Dopamine agonists
I-Dopanime breakdown inhibitors (i-Monoamine oxidase okanye i-catechol-O-methyl transfase inhibitors)
I-glutathione ephezulu
Ukulinganisa ubuchopho bokusebenza ngokusebenza kwe-neuro-rehab umzimba
wentshukumo
Ukuvuselela ngokutsha
Ukuphindaphinda ukuvuselela
I-CMT / OMT ejoliswe kuyo
Multirogram System Atrophy
Izibonakaliso zePasinson Izifo zibambene kunye okanye ngaphezulu kwezi zilandelayo:
Iimpawu zePyramidal (ukubola kwe-Striatonigral)
Ukukhubazeka kwe-Autonomic (ShyDrager syndrome)
Ukufumana iCerebellar (i-Olivopontocerebellar atrophy)
Ngokuqhelekileyo ayiphenduli kwiinkqubo eziqhelekileyo zonyango lwe-Parkinson
Inkqubela yokuPhuphuma kweSunyukliya
Ukuqhubeka ngokukhawuleza okuqhubekayo okubandakanya amaprotheni kwiindawo ezininzi kuquka ne-rostral midbrain
Iimpawu zivame ukuqala malunga nobudala be-50-60
Ukufumana ubunzima
Dysarthria ebalulekileyo
Inkathazo yokujonga ngokuzithandela
I-Retrocollis (ukongezwa kwe-dystonic entanyeni)
Dysphagia
Ukunyamekela ngokomzwelo
Utshintsho lwabantu
Inkathazo engqondweni
Ayiphenduli kakuhle kwiinkqubo eziphambili zePD
Ukusasaza i-Lewy Body's Disease
Ukugula kwengqondo
Iingcamango ezinzulu kunye nokukhohlisa okusemandleni
Ukudideka
Izimpawu zeParkinsonian
Isifo sokugubhuka
Izilonda zamanqaku ezimhlophe amaninzi (iipliti zokutshatyalaliswa kwemimoya) kwi-CNS
Utshintshi ngobukhulu
I-circumscribed kakuhle
Ibonakala kwiMRI
Iilonda ze-Optic ziqhelekile
Iimbulunga zomhlaba azibandakanyeki
Ngokuqhelekileyo kubantwana abangaphantsi kwe10, kodwa ngokuqhelekileyo banikela phambi kwe-55 yobudala
Ukusuleleka ngentsholongwane ka-Virus kungabangela ukuphendula okungalunganga kwamagciwane kunye neengqungquthela kwi-antiel virus-myelin antigen
Izisombululo zokusasazeka kunye nokuzivikela
Iintlobo ze-MS
I-MS eqhubekayo ephambili (PPMS)
MS eqhubekayo yeSMS (SPMS)
Ukubuyiselwa kwakhona kwi-multiple sclerasis (i-RRMS)
Uhlobo oluqhelekileyo
Unokukhula ngokukhawuleza, ngokukhawuleza kubonakala ukucombulula nokubuyela
Ekugqibeleni iba njenge-SPMS
Ukubandakanywa kweNgulo yamaNyo
Kwi-40% yeemeko ze-MS
Ubuhlungu kunye nokuhamba kwamehlo
Isalathisi sensimu yokubonakalayo (ephakathi okanye epacentral scotoma)
Uviwo lweFunduscopic
Ingabonakalisa i-papilledema ukuba i-plaque ibandakanya i-optic disk
Kwangathi kungabonakali into engaqhelekanga ukuba iiplathi zingemva kwe-optic disk (retrobulbar neuritis)
I-Longitudinal Fasciculus Inxaxheba
Ukuxhatshazwa kweMLF kudala kwi-ophthalmoplegia ye-nyukliya
Ngethuba lombono wecala kukho i-paresis yecala eliphakathi kunye ne-nystagmus yeso linye
Ukuguquka kuhlala kuqhelekileyo
Ezinye iindlela ezinokwenzeka ze-MS
Myelopathy
I-hemiparesis ye-Spastic
Amaphecana anomzimba ongekho amandla (DC-ML)
Pherehesias
Ukubandakanyeka kweCerebellar
Ataxia
Dysarthria
Ukubandakanya inkqubo yeVestibular
Ukungalingani
Vertigo
Nystagmus
I-tic douloureux (i-trigeminal neuralgia)
Uphawu lukaLhermitte
Ukutshitshiswa okanye ukutshitshiswa kwintsimbi ebhekiswe kwisiqu kunye neenyawo ngexesha le-neckxion
Ukukhathala
Ukuhlamba okufudumele kudla ngokugqithiseleyo iimpawu
Ezahlukeneyo Ukuqwalasela
Iimboli ezininzi kunye ne-vasculitis
Inokuthi ibonakale njengommandla omhlophe umonakalo eMRI
Inkqubo yesantya ephakathi kwe-sarcoidosis
Unokuvelisa i-optic neuritis kunye nezinye iimpawu ze-CNS
Isifo esinesifo
Izilonda ezivuthayo
Ukunyuka kwamehlo
Ukunqongophala kweVitamin B12
Dementia
Ukunyaniseka
Ikholam yeDorsal
Isifo se-meningovascular syphilis
Umonakalo we-CNS we-Multifocal
Isifo seCSS Lyme
Isifo se-Multifocal
Ukuxilongwa okungafaniyo: Izifundo zokuxilonga
Ukuhlolwa kwegazi kunokunceda ukuhlukanisa
Gcwalisa inani legazi I-anti-nuclear antibodies (ANA) Uvavanyo lweSerum ye-syphilis (RPR, VDRL, njl.) Vavanyo lwe-treponemal antibody Isiqu seLyme ESR I-Angiotensin iguqula i-enzyme level (ukuya kwi-r / o sarcoidosis)
Izifundo zoxilongo ze-MS
MRI kunye kwaye ngaphandle kokungafani
I-90% yamatyala e-MS afunyenwe iziphumo ze-MRI
Ziphumo ze CSF
Ukuphakanyiswa kweeseli zamhlophe zegazi zamononuclear
Iinqwelo ze-Oligoclonal IgG
Ukwandisa i-globulin kwi-albumin ratio
Oku kubonakala nakwi-90% yeemeko ze-MS
Ukwandisa izinga lamaprotheni e-myelin
Prognosis
Umlinganiselo wokuphila emva kokuxilongwa ngu ~ 15 kunyaka we-20
Ukufa kudla ngokusuleleka kwintsholongwane ephezulu kwaye kungekhona ngenxa yeziphumo zesifo ngokwazo
imithombo
UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
by UGqr Alex Jimenez I-Neurology Clinic
Izifo ze-Cerebrovascular liqela elikhethiweyo lemiqathango engakhokelela kwisiganeko / i-cerebrovascular / s, oko kukuthi ukubetha . Ezi ziganeko zichaphazela ukunikezelwa kwegazi kunye nemithwalo yengqondo. Nge�ukukhutshwa, ukungasebenzi, okanye ukubola �kuyenzeka, oku kuthintela iiseli zobuchopho ekubeni zifumane ioksijini eyaneleyo, nto leyo enokubangela ukonakala kwengqondo. Izifo ze-Cerebrovascular zingakhula ngeendlela ezahlukeneyo. Ezi ziquka i-vein thrombosis (DVT) kwaye i-atherosclerosis
Iintlobo zesifo se-cerebrovascular: Stroke, ukuhlaselwa kwe-ischemic , aneurysms, kunye neentsholongwane ze-vascular
Esi sifo se-US cerebrovascular disease sisona sihlandlo esiqhelekileyo sokufa.
Iingxaki zeCerebrovascular Disorders
Ubungqina
Yenza ~ 2% yesisindo somzimba
Ibalelwa kwi-10% yokusetyenziswa kweoksijini emzimbeni
Iiakhawunti malunga ne-20% yokusetyenziswa kweglucose emzimbeni
Ufumene ~ 20% yemveliso yenhliziyo
Ngomzuzu, kufuna i-50-80x yegazi nge-100g yezinto eziyimfutho yengqondo yengqondo kunye ~ 17-40x yegazi nge-100g yento emhlophe
If ukunikezelwa kwegazi kwingqondo yi <15cc nge-100g yeethishu, ngomzuzu, ukungasebenzi kakuhle kwe-neurologic
Njengazo zonke izicubu, ixesha elide likhona i-ischemia, kunokwenzeka ukuba kukho ukufa kweseli kunye ne-necrosis
Ingqondo ixhomekeke kwi-constant oxygen, ne-glucose
Imizuzu ye-3-8 yokubanjwa kwentliziyo ingabangela ukulimala kwengqondo engapheliyo!
Ukugunyazwa Kwebhanki
I-hypotension ye-Systemic yenza i-cerebral vasodilation esebenzayo ukuvumela ukuphuma kwegazi ngaphezulu kwengqondo
Ingqondo ingakwazi ukukhipha oksijini okwaneleyo ukusuka kwingqondo xa uxinzelelo lwe-systolic yi-50 mmHg
Ukunciphisa i-Atherosclerotic kunokuvelisa i-vasodilation esebenzayo ukuzama ukunciphisa uxinzelelo olungaphezulu
Ukunyuswa kwengcinezelo yegazi kunokubangela ukuba i-vasoconstriction, ukunciphisa ubuncipheko bokuqhwaba
Ukuba umndilili woxinzelelo lwe-systolic> 150 mmHg ixesha elide, le mbuyekezo inokungaphumeleli
Ikhefu lexinzelelo lexinzelelo
Ukunikezelwa ngegazi kwiNtloko
madeinkibera.com/lingual-arterie-anatomie
Utshatyalalwano lokuBambisana
Kwi-occlusion ngokukhawuleza efana ne-atherosclerotic thrombosis, ukujikelezwa kwezinto zokubambisa kunexesha lokuphuhlisa
Isangqa se-Willis sidibanisa iinkqubo ze-carotid kunye ne-basilar
Iingqungquthela zokuxhumana zangaphambili nezangaphandle zibonelela ngokubonelela
I-Anastomoses phakathi kwezinto eziphambili ze-cerebral kunye ne-cerebellar kwabanye abantu
Uxhumano lwangaphakathi kunye nolwangaphandle lwe-carotid ye-artery ngokusebenzisa i-ophthalmic & maxillary arteries
Isangqa sikaDowis
Udibanisa inkqubo ye-vertebrobasilar kunye ne-internal carotid system
Ngethuba ekunikezeni ukujikelezwa kokubambisa okunceda, yindawo enokuyithintela kakhulu kwi-Berry Aneurysms engakhokelela kwisifo esibuhlungu
xh.wikipedia.org/wiki/Circle_of_Willis
Ukunikezela ngegazi kwiBongo
teachingmeanatomy.info/neuro/vessels/arterial-supply/
UMaxillary kunye neOphthalmic aa.
Iingxaki zeCerebrovascular Disorders
Abantu abadala base-700,000 e-US banomdlavuza ngamnye ngonyaka
Isizathu sesithathu esibangela ukufa e-US ~ Abantu abayi-2 abakhubazekile ngenxa yokubetha
Ngokuqhelekileyo kakhulu kubantu abakhulileyo Izifo eziMnyama / iziShekemic 80% yazo zonke izibetho
Indawo eqhelekileyo ye-occlusion i-artery carotid yangaphakathi ngaphaya kwe-bifurcation ye-carotid ejwayelekile.
Atherothrombotic
Embolic
Inqanawa encinane
Izifo eziHlumayo
I-Occlusive / Ischemic Stroke
Kungenziwa ngenxa yombane okanye OKUYIMPILO Ubume bombuso buninzi kakhulu
Ngenxa yokunqongophala kwegazi kunye neoksijini yokufikelela kwindawo ethile yengqondo Ukuqala ngokukhawuleza kweephene ze-neurologic, ezihambelanayo nokusasazwa komthi othile Iintsilelo ziya kwahluka kuxhomekeka ekubeni yeyiphi na i-artery ethe yaphazamiseka
Occlusion Occlusion
Hyperviscocity emzimbeni
Thombocytosis
Iiseli zegazi ezibomvu okanye ezimhlophe zibala
Polycythemia
Hypercoagulability I-homocysteine ephakamileyo
Ukuhamba okungapheliyo okanye ukuhamba kwendiza
Iziphazamiso ze-Genetic clotting factor
Ukukhulelwa
Cancer
Ukufakwa endaweni kweHormone kunye nokusetyenziswa kwe-OCP
Atherothrombotic
Iingxaki ze-neurologic zingaphantsi kwexesha okanye ziphucule ngokukhawuleza emva kwexesha Izizathu ezinokwenzeka / iintlobo: Ukuchithwa kwe-tunica intima kunye ne-tunica adventitia
Kungenzeka kwizigulane ezincinci ezineengxaki zenyama
Izixhobo zokuvuvukala zibeka kwaye zakha kwiindonga zeenqanawa
I-LDL i-Oxidized deposit in walls
Embolic
Iingxaki ze-neurologic zenzeka ukuba zenzeke ngokukhawuleza
Izicubu ezixoshiwe kwi-dissection ye-tunica intima kunye ne-tunica adventitia
Naliphi na i-thrombus ekhutshweyo ingaba yindawo yokuvala / ukuvala i-lumen yeenqanawa ezincinci
Isitya esincinci
Lipoyalinosis Udonga lomkhumbi olonzakeleyo kunye neebhaluni
Angiopathy Ukuhlanganiswa kwamaprotheni e-amyloid kwiindonga zetyana
Eyona nto ixhaphakileyo kwizigulana> iminyaka engama-65 ubudala
Ubangela ukunciphisa (okukhokelela kwi-ischemia) kodwa kunokubangela ukuba iinqanawa zitshatyalaliswe (ezikhokelela ekusikeni kwegazi)
Iyahambelana nesifo i-Alzheimer's
Ukuvutha Spasmotic
Izinto ezinobungozi kwi-Stroke ebonakalayo
U xinzelelo Isifo sikashukela Ukukhubazeka kweenhliziyo Ukushiya ngakwesobunxele (i-Patent foramen ovale, iVSD, i-tetralogy of fallot, njl)
I-fibrillation ye-Atrial
Isifo seValve / iigraves zenhliziyo
Ubudala ukutyeba Hyperlipidemia I-LDL ephezulu kunye ne-HDL ephantsi
Indlela yokuphila Ugwayi / utshaya ugwayi Isimo se-oxidation esiphezulu I-homocysteine ephakamileyo Igalelo le-folic acid esezantsi, i-B6 kunye neB12
Idibana ne-LDL cholesterol
I-Hyperviscocity kunye ne-hypercoagulability ichaza njengoko kuboniswe kwisilayidi sangaphambili
Ukuhlaselwa kwe-Ischemic encinci (TIA)
Iziganeko eziguquguqukayo ezipheleleyo ze-neurologic deficient ngenxa yokungafihli kwemisipha engapheli ngaphezu kwemizuzu ye-30 ngexesha
Ngamanye amaxesha unokugcina iiyure ze-24 okanye ngaphezulu
Isiqingatha sezigulane ezithwaxwa yi-stroke epheleleyo ngaphambili,
I-20-40% yezigulane ezine-TIA ziya kuqhubeka zihlaselwa ngokupheleleyo
Kubalulekile ukuchonga izigulane nge-TIAs ukuba zikwazi ukulawulwa ngokufanelekileyo kunye nezinto ezinobungozi ezinokuthi zinciphise
Imbali yentsilelo yeThutyana yeNeurologic kwisigulana> 45 y / o
DDx
I-TIA inokwenzeka kakhulu
Migraine
Ukugxininisa
BPPV
Meniere
Ukutyhila izifo
I-arteritis yesikhashana
Hypoglycemia
Ukuxhamla
Iimpembelelo eziphambeneyo
I-Carotid Artery Disease
Isicaka se-systolic esiphezulu esifakwe kwi-artery carotid singabonisa i-carotid stenosis
Kudinga ukuhlolwa kwe-ultrasound ye-duplex
Izilonda ezinciphisa ukukhanya> i-70% inokubangela ischemia
Iziganeko ezininzi ze-carotid azibangeli i-ischemia ngenxa yokuphuculwa kwephuhliso okuvumela ukuba kubekho ukuqhutyelwa kwemigudu yokuqhutyelwa kwintsebenziswano kunye nokuphuhliswa
Ukwenza izinto ngokukhawuleza okanye ukubumba kunokuvelisa iingxaki nge <70% stenosis
Ungenelelo ngoncedo kufuneka luqwalaselwe kwizigulana ezine-> 70% stenosis kunye neempawu ze-TIA
Stroke ebonakalayo
Ukuba kukho ukuqala kokusilela kwe-neurologic ecacileyo, isigulane kufuneka sibe ne-CT ukulawula isisu Ukuba i-hemorrhage igqityiwe ngaphandle, i-activminogen i-activator i-activator kufanele inikwe kwiiyure zokuqala ze-4.5 Akufanele kunikwe emva kwexesha ngenxa yokuba kunokunyusa umngcipheko wokuphuma kwegazi ngexesha lokupheliswa kwesisu seengqondo
Emva kweli xesha lokuqala, i-thrombolysis egxininisekisiweyo okanye ukukhutshwa komatshini we-embolus
Intracranial Hemorrhage
I-20% yamatyala enxeba U-HA okhulu okanye ukuhlanza kubonisa ukuphazamiseka kokugqithisa Ezimbini iindidi Ukuqhekeza ngokungaqhelekanga U xinzelelo
Aneerysms zeArterial
Iimpembelelo eziphambeneyo
Ukuphazamiseka kwegazi
Umkhumbi uyancipha ngenxa ye-angiopathy yama-amyloid
Ezibuhlungu
Aneurysm Sites
Intraparenchymal isisu I-50% - Amasebe aseLenticulostriate e-central artery cerebral
Ichaphazela i-putamen kunye ne-capsule yangaphandle I-10% - Amasebe atshabalalayo e-posterior cerebral artery
Ichaphazela i-thalamus I-10% - Amasebe atshabalalayo amacandelo e-cerebellar ephezulu
Ichaphazela i-cerebellum I-10% - Amasebe eParamediya we-basilar artery
Ichaphazela i-basilar pons I-20% - Iinqanawa ezahlukeneyo ezichaphazela imimandla emhlophe
Ukutshatyalaliswa kwesisu I-Berry aneurysms ekunxibelelaneni iibhendi zamatri
Ukuphazamiseka kwezibilini
Thrombocytopenia
Leukemia
Iimpawu zonyango ezingaphezulu kwama-antiticoagulant
Izinto ezinobungozi kwiStyroke eHemorrhagic
U xinzelelo
Aneerysms zeArterial
Iimpembelelo eziphambeneyo
Ukuphazamiseka kwegazi
Umkhumbi uyancipha ngenxa ye-angiopathy yama-amyloid
Intlungu yentlekele
Izibonakaliso zesisu: Fundisa izigulane
chrcsf.org/expert-tips-to-help-with-detecting-the-early-signs-of-stroke/
Iimpawu eziqhelekileyo eziqhelekileyo
Vertigo
Ukutshatyalaliswa okanye ukulahleka kombono
Ataxia
Diplopia
Ukubambisana okanye ukungahambisani nendawo kunye nokuphungulwa kwemoto
Syncope
Ubuthathaka ekuhanjisweni kwentsholongwane ye-cranial nerve kwicala enye yentloko kunye ne-hemiparesis yenkalo (umonakalo we-brainstem)
Umonakalo kwi-sensory cranial nerve kunye ne-Horner's syndrome kwelinye icala lentloko kunye nokulahleka kwe-contralateral intlungu kunye nemvakalelo yobushushu emzimbeni (umonakalo wengqondo esecaleni)
Iimpawu zexesha elide zixhomekeke kwiNgingqi echaphazelekayo
I-Monocular obscuration ebonakalayo (i-amaurosis fugax) emele i-retinal ischemia
Hemiparesis
Ulwaphulo lwentando
Iintsilelo ezibonakalayo kwintsimi
Dysphasia
I-aphasia eyamkelekileyo (isilonda sendawo ye-Wernicke)
Expressive aphasia
Ukungahoywa komthetho (i-logeal lobe lesion)
Iingxaki zokuxhaswa (i-Supplementarymotorcortex lesion)
Ubunzima ngokubheka ngokuzithandela kwinqanaba eliphambili (Iimpawu zesilwanyana zangaphambili)
Ukulahleka kweememori zesikhashana (i-lobes temporal period).
Ama-Syndromes eStem
roho.4senses.co/stroke- syndromes / common-stroke- syndromes-chapter-9-textbook-of- stroke-medicine.html
Ukubuyiswa kwesisu
I-Rehab idinga kuxhomekeke kwingingqi yeengcambu zengqondo ezithintekile ngengozi Unyango lo kuthetha
Ukulungiswa kwemilenze yokusebenza
Ukuzilinganisa kunye nokuzibandakanya
Ikhuthaza ukulungiswa kwe-neuroplastic Iimpawu zingaphucula kwiintsuku zokuqala ze-5 ngenxa yokunciphisa i-edema I-Edema inokubangela ukukhutshwa kwe-foramen magnum enokubangela uxinzelelo lwengqondo kunye nokufa � abaguli abanale ngxaki banokufuna i-craniectomy. (ukuncamela Okokugqibela)
imithombo
UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
by UGqr Alex Jimenez Ubuhlungu obungapheliyo , I-Neurology Clinic , Impilo Yengqondo , Injury , Neuropathy
Emva kokuvavanywa kwengqondo, ukuhlolwa ngokomzimba, imbali yesigulane, i-ray-ray kunye nayo nayiphina imvavanyo yokuhlola, udokotela unokuyalela omnye okanye ngaphezulu kwezi zilandelayo zivavanyo zokuhlola ukufumana ingcambu yesifo okanye ukulimala okunokwenzeka. Ezi zifo ziquka ngokubanzi neuroradiology , esebenzisa ubuncinci bezinto ezichithwa ngama-radioactive ukufunda umsebenzi wesigqeba kunye nesakhiwo kunye ukucinga ngomntu , esebenzisa amatshini kunye neendleko zombane ukuze afunde umsebenzi wequmrhu.
Studies Neurological Studies
Neuroradiology
MRI
MRA
NKS
fMRI
CT scans
IMyelograms
PET ihlola
Abanye abaninzi
Ukujonga umfanekiso weMagnetic Resonance (MRI)
Ibonisa iziko okanye izicubu ezincinci kakuhle
Ayikho imisebe ye-ionizing
Utshintsho kwiMRI
I-magnetic resonance angiography (MRA)
Ukuphonononga ukuphuma kwegazi kwimithambo
Fumana i-aneurysms ne-malformations
I-spectroscopy ye-magnetic resonance (MRS)
Hlola ukungaqhelekanga kweekhemikhali kwi-HIV, ukubetha, ukulimala kwentloko, i-coma, isifo se-Alzheimer, i-tumor, kunye ne-multiple sclerosis
Ukucatshulwa kwemifanekiso emaganetic (fMRI)
Misela indawo ethile yengqondo apho kwenzeka khona umsebenzi
I-Tomography eComputer (CT okanye i-CAT Scan)
Usebenzisa umxube we-X-ray kunye nobuchwepheshe bekhompyutha ukuvelisa imifanekiso engqambileyo, okanye i-axial
Ubonisa amathambo ngokukhethekileyo
Isetyenziswe xa uvavanyo lwengqondo lufuneka ngokukhawuleza njengokuba kukhankanywa ukuphuma kwegazi kunye neentambo
IMyelogram
Idayi yokungafani kunye ne-CT okanye i-Xray
Uninzi luncedo ekuhloleni intambo yomthambo
Stenosis
Izidumbu
Ukulimala kwengcambu
I-Positron Ukuchithwa kwe-Tomography (i-PET Scan)
I-Radiotracer isetyenziselwa ukuvavanya i-metabolism of tissue ukufumana utshintsho lwezinto eziphilayo ngaphaya kwezinye iintlobo zezifundo
Ukusetyenziswa ukuhlola
Isifo se-Alzheimer
Isifo sikaParkinson
Isifo sikaHuntington
sokuwa
Ingozi yeCerebrovascular
Studiodagnostic Studies
I-Electromyography (EMG)
Iingcali zokuPhathwa kweMigudu yeVelocity (NCV)
Ukukhutshwa kwezifundo
I-Electromyography (EMG)
Ukufumanisa izibonakaliso ezibangelwa ukugqithiswa kwemisipha yomzimba
Inokulinganiswa nge:
I-electrodes ebusweni
Ayisetyenziselwa iinjongo zokuxilonga, ngaphezulu kwe-rehab ne-biofeedback
Iinaliti ezibekwe ngqo kwi-muscle
Eqhelekileyo kwi-EMG yekliniki / yokuxilonga
Ukugqithiswa kokurekhodwa kuku:
Ngokukhawuleza
Umsebenzi wokufaka
Isiphumo sokuqhawula ngokuzithandela kwemisipha
Imisipha kufuneka ibe yombane ngokuphumla, ngaphandle kwesiphelo semoto
Umsebenzi kufuneka agweme ukufakwa kwisitya sokugqibela
Ubuncinane ubunzima be-10 kwiimisipha zilinganiswa ngokuchazwa kakuhle
Procedure
Inaliti ifakwe kwisisipha
Umsebenzi obhalisiweyo oqoshiwe
Ukuthuliswa kombane kubhalwe
Ukuqhekeka kwemizimba ngokuzithandela kubhalwe
Ukuthuliswa kombane kubhalwe
Umgudu wokuqhawula umphezulu oqoshiwe
Iisampula eziqokelelwayo
izihlunu
Iyalondolozwa ngentshontsho efanayo kodwa iingcambu zentliziyo ezahlukileyo
Iyalondolozwa yinkomo yesondlo efanayo kodwa imiqobo eyahlukileyo
Iindawo ezahlukeneyo kunye neentambo
Unceda ukuhlukanisa izinga lesilonda
I-Motor Unit Ingenzeka (MUP)
Amplitude
Ubuninzi beemfayili zomsila ezixhomekeke kuloo moto we-neuron
Ukukhawulelwa kweMUP
Iprotration yokubambisa ingahlolwa kwakhona
Ukuqeshiswa kwexesha elichanekileyo kunokubonisa ukulahlekelwa kweenjini eziphakathi kweesistim
Ukuqashwa kwangaphambili kubonakala kwi-myopathy, apho ii-MUPs zihlala ziphantsi kwexesha elifutshane
Ukwandiswa kwe-amplitude kunye nobude bungaba ngumphumo we-reinnervation emva kokuchaswa okungapheliyo
Ukuxutywa kwemimoya yamacandelo amaninzi ngokulandelelana kunokubangela ibhloko epheleleyo yokuqhutyelwa kwentsholongwane kwaye ngoko akukho miphumo efundwayo ye-MUP, nangona kunjalo iinguqu eziguqukayo kwi-MUPs zibonwa nje ngengozi kwi-axon, kungekhona i-myelin
Ukulimala kwinkqubo yomnatha ephakathi kwinqanaba le-neuron yemoto (njengentlungu yomlomo wesibeletho okanye isisu) kungabangela ukukhubazeka okupheleleyo okungaqhelekanga kwi-needle EMG
I-Denervated Muscle Fibers
Kufunyenwe njengempawu zombane ezingavamile
Ukwandiswa komsebenzi wokunyusa kuya kufundwa kwiiveki zokuqala zeveki, njengoko kuqhutyiswa kancinci
Njengoko iimbumba ze-muscle ziba neengqondo ezininzi ziza kuqaliswa ukuvelisa umsebenzi wokuphoxeka ngokukhawuleza
Iifabrillation Potentials
NGAKHO kwenzeke kwiimpawu zomzimba eziqhelekileyo
Izibhakabhaka azikwazi ukubonwa ngelihlo kodwa zibonakala kwi-EMG
Ngokuqhelekileyo kubangelwa zizifo zesibindi, kodwa kunokuveliswa zizifo ezinzima zomzimba xa kukho umonakalo kwiinqwelo zeemoto
AWAKHO kwenzeke kwiifayili eziqhelekileyo zokusebenza
Ukugqithiswa ngokukhawuleza ngenxa yokunyuka kweembrane
Ukufunyanwa kweefayili kunye namaza abukhali angumqondiso onokuthenjelwa kwimonakalo yemoto ukuya kwisisipha emva kweveki enye ukuya kwiinyanga ze-12 emva komonakalo
Rhoqo ibizwa ngokuba yi- acute kwiingxelo, ngaphandle kokuba zibonakala kwiinyanga emva kokuqala
Kuya kutshabalala ukuba kukho ukuguqulwa okupheleleyo okanye ukuchithwa kwemibhobho yesibindi
Iingcali zokuPhathwa kweMigudu yeVelocity (NCV)
imoto
Iimilinganiselo zibandakanya izakhono zamathambo (CMAP)
Efanelekileyo
Imilinganiselo yezinyathelo zentshukumo yezinzwa zesifo (SNAP)
Izifundo zokuPhathwa kweMigudu
Velocity (Speed)
Ukuphela kwekota
Amplitude
Iifayili eziqhelekileyo, ezilungelelaniswa ubudala, ubude kunye nezinye izinto zifumaneke kwiingcali ukuba zenzele uqhathaniso
Terminal Latency
Ixesha phakathi kwe-stimulus nokubonakala kwempendulo
Ukungena kwendawo neuropathies
Ukwandisa i-latency yesigxina kwindlela ethile yomgca
Velocity
Ukubalwa ngokusekelwe kwi-latency kunye neziguquko ezifana nomgama
Ixhomekeke kumgama we-axon
Kwakhona kuxhomekeke ekubunjeni kwe-myelin sheath
I-neuropathies egxile kwi-myelin sheaths, iyanciphisa ukuqhubela phambili
Imiqathango efana neCharcot Marie Tooth Disease okanye i-Guillian Barre Syndrome yonakalisa i-myelin ngobubanzi obukhulu, iimbombo ezihamba ngokukhawuleza
Amplitude
Impilo yeAxonal
Nexicopathies ezinobuthi
I-CMAP kunye ne-SNAP amplitude ethintekile
I-Diabetes Neuropathy
Ukwahlula, umlinganiso
Ukutshatyalaliswa kwemimoya kunye nomonakalo we-axonal ngoko ke ukukhawuleza kunye nokuphakama kwe-conduction zichaphazelekayo
Ukukhutshwa kwezifundo
I-Somatosensory evoked potentials (SSEPs)
Kusetshenziselwa ukuvavanya imisipha yamalungu
Iimpawu ezikhutshwayo ezibonakalayo (VEPs)
Kusetshenziselwa ukuvavanya imisipha ye-visual system
I-Brainstem yokuphicothwa kwezinto ezinokukhupha iziphumo (AEPs)
Isetshenziselwa ukuvavanya imizwa yengqondo yenkqubo yokuhlola
Amandla afakwe kwi-electrodes ephezulu ye-impedance
Ukurekhoda ngokulinganayo emva kokuphindaphindiweyo kokuvakala kwintliziyo
Isusa imvelaphi
Ihlaziya iziphumo kuba izakhono zincinci kwaye kunzima ukuzibona ngaphandle komsebenzi oqhelekileyo
Ngokutsho kukaDkt. Swenson, kwimeko ye-SSEP, ubuncinane i-256 stimuli zidla ngokufunekayo ukwenzela ukufumana iimpendulo ezinokwethenjelwa, ezizalisekayo
I-Somatosensory Evoked Potentials (SSEPs)
Ukuvalelwa kwiimisipha
Ukuthintela kunye neengxaki zokufumana uxinzelelo kwesikhumba kunye nezicubu ezinzulu
Incinci ukuba ikho intlungu Negalelo
Amandla okunciphisa ukusebenzisa uvavanyo lweengxaki zentlungu
I-Velocity kunye / okanye iinguqulelo ze-amplitude zingabonisa ukugula
Kukho utshintsho olukhulu oluphawulekayo kuba i-SSEP ziqheleke kakhulu
Ukunceda ukubeka iliso kwi-intraoperative kunye nokuvavanya ukugxekwa kwezigulane ezinobungozi obunobungozi obuchotshozayo
Akukho luncedo ekuhloleni i-radiculopathy njengengcambu yesondlo somntu ngamnye ayikwazi ukufumaneka lula
Iimpawu ezizayo
Zenzeke ngaphezu kwe-10-20 millisecond emva kokuvuselelwa kweemoto
Ezimbini iindidi
H-Reflex
Ebizwa ngokuba nguDkt. Hoffman
Okokuqala ichaza le ngcamango kwi-1918
Ukubonakalisa i-Electrodiagnostic ye-reflex stretch stretch
Impendulo yeemoto ezirekhodwa emva kokuvuselelwa kombane okanye ukunyusa ngokomzimba we-muscle edibeneyo
Kuphela kuphela luncedo ekliniki ekuhloleni i-radioxpathy ye-S1, njengoko i-reflex evela kwi-nervous nerve to triceps surae inokuhlolwa ngokukhawuleza kunye ne-amplitude
Uninzi olunokuthi uvavanyo lwe-Achilles reflex
Ihluleka ukubuyela kunye nomonakalo kwaye ngoko kungengokuthi luncedo olusesikliniki kwiimeko zengxubevange ze-radiculopathy
F-Response
Ngaloo nto ibizwa ngokuba ibhalwe kuqala ngenyawo
Ivela kwi-25 -55 i-millisecond emva kokuvuselelwa kokuqala
Ngenxa yokugqithiswa kwe-antidromic depolarization ye-nerve ye-motor, okubangele uphawu lwombane lwama-orthodromic
Ayikho ingqiqo yeqiniso
Iziphumo kwintambo encinci yemisipha
Ubungakanani buyahlukahluka kakhulu, ngoko kungabalulekanga nje ngexabiso
Ukunciphisa ukunyuka kwembonakalo kubonisa ukuqhuba okucothayo
Uncedo ekuhloleni i-nerve pathology
Radiculopathy
Guillian Barre Syndrome
I-Polyidculophyphism Demyelinating Polyradiculopathy (Chronicle Inflammatory Demyelinating Polyradiculopathy)
Uncedo ekuhloleni i-demyelinative peripheral neuropathies
imithombo
UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
Usuku, Jo Ann. EI-Neuroradiology | Johns Hopkins Radiology. Johns Hopkins Medicine Health Library, 13 Okt. 2016, www.hopkinsmedicine.org/radiology/specialties/ne uroradiology / index.html.
Swenson, iRandi. Electrodiagnosis.
Yabelana ngeEbook
by UGqr Alex Jimenez Ubuhlungu obungapheliyo , I-Neurology Clinic , Iimeko eziPhathwayo , Intloko kunye nonyango , Ukunyamekela , Impilo Yengqondo , Ukulimala kwezemidlalo , Unyango , Whiplash
Iingqungquthela kukulimala kwengqondo echaphazela ingqondo. Iimpembelelo ezi zinto zixakeka ngexeshana kodwa zingabandakanya intloko , iingxaki zoxinzelelo, imemori, ukulinganisela kunye nokulungelelaniswa. Iingqungquthela zivame ukubangelwa ukuvuthela intloko okanye ukugubhazela kwintlanzi nentloko ephezulu. Ezinye iingqungquthela zibangela ukulahlekelwa kwengqondo, kodwa ininzi ayinayo. Kwaye kunokwenzeka ukuba ube nomngcipheko kwaye ungayiqondi. Iingqungquthela ziqhelekileyo kwimidlalo yokuthintana, njengebhola. Nangona kunjalo, abaninzi abantu bafumana ukufumana ngokupheleleyo emva kwengqungquthela.
Iingxoxo
Ukulimala kweBrainatic Brain (TBI)
Ngokuqhelekileyo isiphumo sekhanda ngxakini
Kananjalo kwenzeka nangenxa yokugungqiswa kancinci kwentloko okanye ukukhawuleza / ukunciphisa
Ukulimala kanobuhlungu (mTBI / iingcamango) yindlela eqhelekileyo yokulimala kwengqondo
Glasgow Coma Scale
Izizathu Eziqhelekileyo Zengqungquthela
Iinqwelo zithuthi Falls Ukulimala kwezemidlalo uhlaselo Ukukhutshwa ngengozi okanye ukukhutshwa ngamabomu kwezixhobo Impembelelo ngezinto
uthintelo
Ukuthintela ukulimala ngokukhawuleza kunokubaluleka
Khuthaza izigulana zokugqoka iiklasi
Khu phiswano zemidlalo , ngakumbi ibhokisi, hokey, ibhola lebhola
Ukukhwela ngemva ehashini
Ukukhwela iibhayisikili, izithuthuthu, ii-ATVs, njl.
Ukuphakama okuphezulu kusebenza njengokwenyuka kwamatye, i-zip lining
Ukushushuluza, ukuhamba ngekhephu
Khuthaza izigulana ukugqoka ii-Seatbelts
Xoxa ukubaluleka kokugqoka iibhande zokubamba ngamaxesha onke kwizithuthi kunye nezigulane zakho zonke
Khuthaza nokusetyenziswa kwe-booster ezifanelekileyo okanye izihlalo zeemoto kubantwana ukuqinisekisa ukufaneleka okufanelekileyo kunye nomsebenzi weebhanti zokuhlala.
Ukuqhuba Ngokuphepha
Izigulane akufanele ziqhube ngexa ziphantsi kwefuthe lamachiza, kuquka amachiza athile okanye utywala
Ungalokothi uthumele umyalezo kwaye uqhube
Yenza iZithuba zikhuselekileyo kubantwana
Faka ifowuni yamasango kunye neefestile ezisekhaya
Ngamana kwiindawo ezinokubangela ukukrakra, ezifana ne-mulch hardwood okanye isanti
Gcina abantwana ngononophelo, ngakumbi xa bekufuphi namanzi
Ukuthintela
Ukucima izingozi ezinjengeemigqomo ehlambulukileyo, i-unven flooring okanye i-clutter
Ukusebenzisa amatshini angenasiphelo kwibhayibhile kunye nasesibhedini sokuhambisa, kwaye ufaka imivalo yokubamba ngasese kwindlu yangasese, ibhagi nesitya
Qinisekisa izihlangu ezifanelekileyo
Ukufaka ii-handrails kumacala amabini
Ukuphucula ukukhanya kulo lonke ikhaya
Uqeqesho lokulinganisela
UkuQeqesha
Ukulingana komlenze omnye
Ukuqeqeshwa kwebhola yeBosu
Ukuqiniswa okukhulu
Ukuqhelanisa ubuchopho
Ingqungquthela
Ingqungquthela ngokubhekiselele kwi-mTBI (ukulimala kwengqondo ebuhlungu)
I-MTTI igama lisetyenziselwa ngokuqhelekileyo kwisethingi zonyango, kodwa ingqungquthela yimizuzu eyaziwayo ngokubanzi ebantwini ngabaqeqeshi bezemidlalo, njl njl.
Amagama amabini achaza into efanayo, i-mTBI iyonaxesha elifanelekileyo lokusebenzisa ekutshintsheni kwakho
Ukuphonononga Ingqungquthela
Khumbula ukuba akusoloko kukho ukulahlekelwa yintliziyo ngenxa yokuba kukho ingxubusho
I-Post-Concussion Syndrome ingenzeka ngaphandle kwe-LOC
Iimpawu zesigxina asinakukhawuleza kwaye zingathatha iintsuku ukuphuhlisa
Jonga kwi-48 yokulimala kwentloko ukujonga iiflegi ezibomvu
ukusebenzisa Uhlobo lokuhlalutya oluchanekileyo (ACE) ukuqokelela ulwazi
I-order imaging (CT / MRI) njengoko kuyimfuneko ukuba iiflegi ezibomvu zincinci zikhoyo
Iiflegi ezibomvu
Kudinga ukucinga (CT / MRI)
Intloko ziba nzima
Umonde ubonakala esozela okanye engakwazi ukuvuswa
Ngaba kunzima ukuqonda abantu okanye indawo
intlungu entanyeni
Umsebenzi wokuSebenza
Ukuhlanza okuphindaphindiweyo
Ukwandisa ukudideka okanye ukucaphuka
Ukuguquka kokuziphatha okungavamile
Iimpawu ze-neurologic
Intetho edibeneyo
Ubuthathaka okanye ukuphazamiseka kwimida
Tshintsha kwimeko ukuqonda
Iimpawu eziqhelekileyo zeNgqungquthela
Intloko okanye uvakalelo lwexinzelelo entloko
Ukulahlekelwa okanye ukuguqulwa kwengqondo
Amehlo athatywayo okanye ezinye iingxaki zombono, ezifana nabafundi abahlanjululwe okanye abangenalo
Ukudideka
Utywala
Ukubetha ezindlebeni
Isihlunu okanye ukuhlanza
Intetho edibeneyo
Impendulo ekhawulezileyo kwimibandela
Ukulahleka kwememori
Ukukhathala
Ingxaki ijolise
Ukulahleka kwememori eqhubekayo okanye eqhubekayo
Ukutshatyalaliswa kunye nolunye utshintsho lomntu
Ukuqonda ukukhanya nokuvakala
Iingxaki zokulala
Umoya uguquka, uxinzelelo, uxhalabe okanye uxinzelelo
Ukuphazamiseka kwengongoma kunye nevumba
Iinguqu zeengqondo / zokuziphatha
Ukugqithwa kwamagama
Ukuqhuma komzimba
I sigwebo
Indlela yokuziphatha
Ukungahambi kakuhle
Ukungathobeli
Ukunganakwa
Egocentricity
Ubungqina kunye nokungaziphathi kakuhle
Ukuziphatha okungengozi
Ukungabi novelwano
Ukungabi nasishukumisayo okanye iqhinga
Ukuxinezeleka okanye uxhalabe
Izimpawu Kubantwana
Iingqungquthela zingabonisa ngokuhlukileyo kubantwana
Ukukhala ngokweqile
Ukuphelelwa kwesidlo
Ukulahlekelwa ngumdla kwimidlalo yamatye okanye imisebenzi
Imiba yokulala
Ukuvutha
Ukutshatyalaliswa
Ukungaqiniseki ngethuba
kunesifo
Ukulahleka kweememori kunye nokungaphumeleli ukwenza imibulelo emitsha
Ukuhlaziya i-Amnesia
Ukungakwazi ukukhumbula izinto ezenzeka ngaphambi kokulimala
Ngenxa yokuhluleka kokukhumbula
Anterograde Amnesia
Ukungakwazi ukukhumbula izinto ezenzeka emva kokulimala
Ngenxa yokungaphumeleli ukwenza izinto ezintsha
Nokuba ukulahlekelwa kweememori ezimfutshane kungabikho kwangaphambili kwesiphumo
I-Amnesia ingaba yimizuzu ye-4-10 ngaphezulu kweempawu kunye nokulahlekelwa kwengqondo emva kokuxubusha kunokuba yi-LOC (ngaphantsi kwe-1 iminithi)
Buyisela Ukudlala Inkqubela
Isiseko: Akukho zibonakaliso
Njengoko isinyathelo esisezantsi sokubuyela kuPhuculo lokuPhumela, umdlali kufuneka azalise ukuphumla komzimba kunye nokuqonda kwaye angabikho iimpawu zokuxubusha ubuncinane beeyure ze-48. Gcinani engqondweni, omncinci umdlali, okhuselekileyo unyango.
Inyathelo 1: Umsebenzi wokukhanya we-Aerobic
Injongo: Kukunyusa nje ukubetha kwentliziyo yembaleki.
Ixesha: 5 kumzuzu we-10.
Imisebenzi: Ukuqhuba ibhayisikili, ukuhamba, okanye ukuhamba ukukhanya.
Ngokuqinisekileyo akukho ukuphakama kwesisindo, ukuxuma okanye ukuqhuba kanzima.
Inyathelo 2: Umsebenzi omiselweyo
Injongo: Umzimba ongekho phantsi kunye nentloko.
Ixesha: Iyancipha kwixesha eliqhelekileyo.
ImiSebenzi: Ukuhamba ngokukhawuleza, ukuhamba okufutshane, ukuhamba ngokukhawuleza ukuhamba ngebhayisikili, kunye nokunyaniseka kokulinganisela
Isinyathelo 3: Umsebenzi omninzi, ongathintana naye
Iinjongo: Uninzi olungakumbi kodwa ungathintana
Ixesha: Vala kwixesha eliqhelekileyo
Izinto ezenziwayo: Ukubaleka, ukuhamba ngamandla ngebhayisikile, indlela yomdlali yokuphakamisa ubunzima rhoqo, kunye nokungaziqhagamsheli kwezemidlalo. Eli nqanaba linokongeza icandelo elithile lokuziqhelanisa nokuzilolonga ukongeza kwizinto ze-aerobic kunye neentshukumo eziziswe kwiNyathelo 1 kunye nelesi-2.
Inyathelo 4: Ziqhelise kwaye uqhagamshelane ngokupheleleyo
Injongo: Phinda uvuselele ngokuqhagamshelana ngokupheleleyo.
Inyathelo 5: Ukhuphiswano
Injongo: Buyela kukhuphiswano.
Ukumnandi kweMicrolial
Emva kweentloko ze-microglial cells ezithintekayo kwaye ziyakwazi ukusebenza
Ukulwa nale nto, kufuneka uxolelane ne-inflammation cascade
Ukuthintela intlungu ephindwe rhoqo
Ngenxa yokuthotywa kweeseli ze-foam, impendulo ekutshatyalaliswa kwintlungu ingaba nzima kakhulu kwaye ibonakalise
Yintoni i-Post-Concussion Syndrome (i-PCS)?
Iimpawu ezilandela ukukhathazeka kwentloko okanye ukulimala kanobuhlungu obunzima, obuya kuthatha iiveki, iinyanga okanye iminyaka emva kokulimala
Iimpawu ziqhubeka ixesha elide kunokuba zilindelwe emva kwengqungquthela yokuqala
Okuqhelekileyo kubasetyhini kunye nabantu abaneminyaka yobudala abahluphekileyo
Ubunzima be-PCS kaninzi aluhambelani nobunzima bokulimala kwentloko
Iimpawu zePSS
Intloko
Utywala
Ukukhathala
Ukutshatyalaliswa
Ukuxhalabisa
ugwayi
Ukulahlekelwa kwengqalelo kunye nokukhumbula
Ukubetha ezindlebeni
Umbono ogqabileyo
Umsindo kunye nobuthakathaka bokukhanya
Ngokuqhelekileyo, kuncipha kwintleko kunye novumba
Iingxubusho ezinxulumene nobungozi
Impawu zokuqala zentloko emva kokulimala
Iinguqu zengqondo ezinjenge-amnesia okanye i-fogginess
Ukukhathala
Ngaphambili imbali yeentloko
Uvavanyo lwe-PCS
I-PCS isifo sokuxilongwa
Ukuba isigulana sibonisa iimpawu emva kokonzakala kwentloko, kunye nezinye izinto ezinokubangela ukuba zikhutshwe => PCS
Sebenzisa iimvavanyo ezifanelekileyo zokuphonononga kunye nokucinga ukulawula ezinye izizathu zeempawu
Intloko e-PCS
Rhoqo tension yintloko yentloko
Yiphatha njengoko unokuyenza ngenxa yentloko yesifo
Ukunciphisa uxinzelelo
Ukuphucula izakhono zokujamelana nokuxinezeleka
I-MSK unyango lweengingqi zomlomo wesibeleko
I-hydrotherapy
I-adrenal support / adaptogenic herbs
Unokufudumala, ingakumbi kubantu ababenemibandela ye-migraine ngaphambi kokulimala
Ukunciphisa umthwalo ovuthayo
Cinga ngolawulo kunye neyeza kunye neyeza
Ukunciphisa ukukhanya nokukhanya okucacileyo ukuba kukho uvakalelo
Utywala e PCS
Emva kwexinzelelo lwentloko, hlalutya rhoqo kwi-BPPV, njengolu luhlobo oluqhelekileyo lwe-vertigo emva kwexinzelelo
I-Dix-Hallpike isebenze ukuxilonga
Uhambo luka-Epleyys kunyango
UkuKhanya kunye noVavanyo lweSandi
Ukunyanzelisa ukukhanya kunye nokuvakala kuqhelekileyo kwi-PCS kwaye ngokugqithiseleyo kuqhuba ezinye iimpawu ezifana nentloko kunye nokuxhalabisa
Ukulawulwa kokunyuka kwama-mesencephalon kubaluleke kakhulu kwiimeko
iindondo
Ezinye iziglasi zokuvala izibane
Iiplebe
Ikhokotle ezindlebeni
Unyango lwe-PCS
Ukulawula uphawu ngalunye njengoko uthanda
Ukulawula ukuvuvukala kwe-CNS
Curcumin
Boswelia
Ioyile yentlanzi / i-Omega-3s (*** emva kokuba r / o wophile)
Ulwaphulo lokuziphatha
Ingqondo kunye noqeqesho lokuphumla
Ukwenza i-Acupuncture
Ukulinganisa ubuchopho obunzima bokuzilolonga umzimba
Khangela ukuhlolwa kwengqondo / unyango
Khangela kwi-mTBI ingcali
Iingcali zeMTBI
I-MTBI kunzima ukuyiphatha kwaye iyodwa ekhethekileyo kwi-allopathic kunye neyeza ezongezelelweyo
Injongo ephambili kukuba kuqaphele kwaye ibhekiselele kunyango olufanelekileyo
Phishekela uqeqesho kwi-MTBI okanye icebo lokubhekisela kwiingcali ze-TBI
imithombo
Intloko yexesha elizayo Future I-DVBIC, 4 ku-Epreli 2017, dvbic.dcoe.mil/aheadforthefuture.
UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
�Nxibelela kubaBoneleli bezeMpilo.� Amaziko oLawulo noThintelo lweZifo, amaZiko oLawulo lweSifo noThintelo, ngomhla we-16 kuFebhruwari wama-2015, www.cdc.gov/headsup/providers/.
�I-Post-Concussion Syndrome.� Ikliniki yaseMayo, iSiseko seMayo seMfundo yezoNyango kunye noPhando, nge-28 kaJulayi 2017, www.mayoclinic.org/diseases-conditions/post-concussion-syndrome/symptoms-causes/syc-20353352.
by UGqr Alex Jimenez Ubuhlungu obungapheliyo , I-Neurology Clinic , Intloko kunye nonyango , Migraine , Migraines , Unyango
imvelaphi: Oyena nobangela uxhaphakileyo we�migraines / intloko kubangela intloko . Uninzi lwalo hlobo lweentloko luya kwenzeka ngenxa yobunzima phakathi kwamagxa ehlombe, okubangela ukuba izihlunu zibe phezulu kumahlombe ukuze zomeze kwaye zenze intlungu ibe yintloko.
Umvelaphi weNtlungu
Ivela kwiintlungu ezinobulunga entloko
Ubuncinane obukhulu bomthamo (iintlungu / i-temp) ezingenanto
Meninges
Ivazi yegazi
Izakhiwo ze-Extracranial
TMJ
Amehlo
Sinuses
Imisipha yamathambo kunye nemigqa
Izakhiwo zamazinyo
Ingqondo ayinayo i-receptors yeentlungu
I-Spinal Trigeminal Nucleus
Iimbindi zeTrigeminal
Ubuso bentsholongwane
Glossopharyngeal nerve
Iigulane
I-C2 nervous (Greater occipital nererve)
Amagxobhozo
dailymedfact.com/neck-anatomy-the-suboccipital-triangle/
Ukwazisa ngeeNociceptors
Iziphumo kwi-allodynia kunye ne-hyperalgesia
slideplayer.com/9003592/27/images/4/Mechanisms+eyanyaniswa+ne+peripheral+sensitization+ to+pain.jpg
Iintlobo zeentloko
Umbi:
Ukunxiliswa kwabantu Intracranial izilonda Iintloko ze-Vascular Ukuphulwa komlomo wesibeleko okanye ingxaki nguqulo Glaucoma
Benign:
Migraine Intloko yeentloko Neuralgias Intloko yesifo Intloko yesibini I-post-traumatic / post-concussion “I-analgesic rebound” intloko ebuhlungu� Psychiatric
HA Ngenxa yezilonda ze-extracranial
Iisines (intsholongwane, isisu) Izifo zentambo yomlomo wesibeleko Iingxaki zamazinyo Ngokubambisana kweTemoromandibular Izifo zentloko, njl Iliso (glaucoma, uveitis) I-extracranial arteries Izilonda zesisu
HA Iiflegi ezibomvu
Isikrini seeflegi ezibomvu kwaye uqwalasela iintlobo ze-HA ezinobungozi ukuba zikhona
Iimpawu eziqhelekileyo:
Ukuhla ukusinda
Ubuhlungu bubavusela ebuthongweni
Fever
Izimpawu ze-neurologic okanye iimpawu ezingavumelekanga:
Ukuqala ngokukhawuleza okanye ukuqhuma
Uhlobo olutsha okanye oluvuthayo lwe-HA ngokukhethekileyo kwizigulane ezisebekhulile
HA ubuhlungu obuhlala kwindawo efanayo
Imbali yomlomo wangaphambili
Ngaba le yeHA yokuqala owakhe waba nayo?
Iziphumo zengozi:
Imbali yomhlaza, i-immunocompromised, njl.
Ingozi / Isifo seentloko
Ukunxiliswa kwabantu
Ukutshatyalaliswa kwesisu
I-Meningitis kunye ne-meningoencephalitis
Izilonda zesisu
Neoplasms
Intracerebral hemorrhage
Izidumbu zengxowankulu okanye i-epidural hemorrhage
Abscess
Hydrocephalus
Iintloko ze-Vascular
I-arteritis yesikhashana
Ukuxhamla komzimba (umz., Uxinzelelo olubi kakhulu, i-pheochromocytoma)
Iimpazamo zeArteriovenous kunye nokwandisa ii-aneurysms
Lupus cerebritis
I-sinous thrombosis
Ukuphulwa komlomo wesibeleko okanye ingxaki
Ukwaphuka okanye ukutshatyalaliswa
I-Occipital neuralgia
Umthambo we-vertebral dissection
Chiari malformation
nguqulo
Hypoglycemia
Hypercapnea
I-carbon monoxide
Anoxia
IAnemia
I-Vitamin A
Glaucoma
Imihla yokumisa imitha
Ngokuqhelekileyo ngenxa ye-Aneurysm Ngokukhawuleza iqala intlungu Ngokuvuthiweyo ukuhlanza Umonde ubonakala egula Ngokuqhelekileyo i-nuchal rigidity Jonga i-CT kwaye mhlawumbi ukugqitywa kwe-lumbar
Meningitis
Umonde ubonakala egula Fever Ukunyaniseka kwe-Nuchal (ngaphandle kwabadala kunye nabantwana abancinci) Khangela ukutshitshiswa kwe-lumbar - ukuxilonga
Neoplasms
Akunakwenzeka isizathu se-HA kumlinganiselo wesigulane
Iintlungu zentloko engenabuhlungu kunye nentlungu
Okubi kakhulu kusasa
Mhlawumbi unokufunwa ngumoya onamandla
Ukuba iimpawu ezigxininisiweyo, iimpawu zokubamba, iziganeko ze-neurologic, okanye ubungqina bokunyuswa kwengcinezelo engaphezu kwezinto ezikhoyo zikhona umthetho wethu wesifo se-neoplasm
Iimpawu zemiSebenzi yeeNkcazo
Ngenxa yengozi yempembelelo, ukuxhwaleka okanye iimpazamo kwi-coagulation
Ngokuqhelekileyo kubakho kwimiba yentlekele enkulu yentloko
Ukusetyenziswa kweempawu zingaphi iiveki okanye iinyanga emva kokulimala
Ukwahlukana ukusuka kwintloko yesigxina
I-post-Concussive HA ingaphikelela kwiiveki okanye kwiinyanga emva kokulimala kwaye ihambisane noxinzelelo okanye i-vertigo kunye nezinguqu zengqondo ezinzulu, eziya kuphelisa
Ukwandisa i-Intracranial Pressure
Papilledema Kungenza ukuba utshintsho olubonakalayo
openi.nlm.nih.gov/detailedresult.php?img=2859586_AIAN-13-37- g001&query=papilledema&it=xg&req=4&npos=2
Ixesha lexeshana (iGiant-Cell) Arteritis
> Iminyaka eyi-50 ubudala Polymyalgia rheumatic Malaise Iintlungu ezihlanganyelweyo Myalgia Iintloko ezingapheliyo Ububele obukhulu kunye / okanye ukuvuvukala kwimibhobho yexesha le-occipital Ububungqina bokungapheli komyinge ekuhanjisweni kwamasebe eenqwelo ESR ephezulu
Ummandla wesibeleko HA
Ukuxhwaxeka kwekhanda okanye kunye neempawu okanye iimpawu zengcambu yomlomo okanye intambo yoxinzelelo Umyalelo woMyalelo weNkundla okanye iC CT ngenxa yokuphulwa okanye ukuchithwa Ukungazinzi komlomo Umyalelo we-colervical spine x-ray kunye nokujonga kwandiso
Ukulawula iH HA eyingozi
Imithetho yethu yexinzelelo enzima okanye entanyeni, ukuxhatshazwa okanye iimpawu zeengxaki ze-neurologic, kunye nezifo ezingadluliselwa kwi-meningitis okanye kwi-abscess brain Hlola umkhuhlane Linganisa uxinzelelo lwegazi (inkxalabo ukuba yi-diastolic> 120) Uvavanyo lwe-Ophthalmoscopic Hlola intamo ngokunyaniseka Ukuqulunqa iziqhamo ze-cranial. Gcwalisa uviwo lwe-neurologic Ukuba kufuneka i-oda izalise inani le-cell cell, i-ESR, i-cranial okanye i-imaging yomlomo wesibeleko
Isifo okanye Isifo?
<Iintsuku ezili-15 ngenyanga = Episodic
> Iintsuku ezili-15 ngenyanga = ezingapheliyo
Migraine HA
Ngokuqhelekileyo ngenxa yokuhlutha okanye ukuhanjiswa kwe-vasculature ye-cerebral
I-Serotonin Kwi-Migraine
I-AKA 5-hydroxytryptamine (i-5-HT) I-Serotonin iya kugqitywa kwi-epraode IV 5-HT inokumisa okanye ukunciphisa ubunzima
Migraine ngeAura
Imbali ubuncinane bokuhlaselwa kwe-2 ezalisekisa imigaqo elandelayo
Enye yezi zilandelayo zibonakaliso ezipheleleyo:
Visual
I-Somatic sensory
Intetho okanye ubunzima beelwimi
imoto
Isiqu seBrain
I-2 yeempawu ezilandelayo ze-4:
1 uphawu lwe-aura lusasazeka ngokuthe ngcembe ngaphezulu kwe-5 min, kunye / okanye 2 iimpawu zenzeka ngokulandelelana
Isibonakaliso ngasinye se-aura sigcina i-5-60 min
I-1 uphawu lwe-aura ayihambelani
I-Aura ihamba kunye okanye ilandelwe kwi <60 min ngentloko
Akukho bhetele kubhalwe ngenye i-ICHD-3 ukuxilongwa, kunye ne-TIA ingabandakanywa
Migraine ngaphandle kweAura
Imbali ubuncinane be-5 ukuhlaselwa kwezi zilandelayo:
Uhlaselo lweentloko luhlala ku-4-72 h (ungakhange ulashwe okanye ungaphathwa ngempumelelo)
Unilateral intlungu
Ikhwalithi yokukhangela / ukukhwela
Ukuxinwa kweentlungu ezinzulu
Ukugqithiswa okanye ngokubangela ukuphepha ekusebenzeni rhoqo ngokomzimba
Ngethuba leentloko zentlungu kunye / okanye uvakalelo ukukhanya kunye nesandi
Akukho bhetele kubhalwe ngenye i-ICHD-3 ukuxilongwa
Intloko yeCluster
Unobateral unbateral orbital, u-supraorbital kunye / okanye intlungu yesikhashana
�Njengomkhenkce endihlaba esweni�
Ubuhlungu bugcina imizuzu ye-15-180
Ubuncinane enye yezinto ezilandelayo kwicala lentloko:
Ijoyi yokudibanisa
Ukukhupha ubuso
Ulwabiwo
Miosis
Ukudibanisa kwamanzi
Ptosis
Rhinorrhea
Idipidi edema
Imbali yeentloko ezifanayo ngexesha elidlulileyo
Ukuxhatshazwa kwentloko
Intlungu yentloko ihamba kunye nezi zilandelayo:
Ukucindezela / ukuqinisa (umgangatho ongeyena)
�Ndiziva ngathi ndinebhanti ejikeleze intloko yam�
Indawo ehlala kuyo
Akunakunyanyiswa ngumsebenzi oqhelekileyo
Intloko kufuneka ilahleke:
Isihlunu okanye ukuhlanza
Ifotophobia kunye nefonophobia (enye okanye enye ikhona)
Imbali yeentloko ezifanayo ngexesha elidlulileyo
Intloko yeNtloko
Intloko ebakho ngeentsuku ezili-15 ngenyanga kwisigulana esinesifo esivele sikhona
Ukusetyenziswa gwenxa rhoqo kwe-> iinyanga ezintathu zelinye okanye amachiza amaninzi anokuthathwa ngenjongo yokunyanga iintlungu ezibuhlungu kunye / okanye iimpawu zentloko
Ngenxa yokusetyenziswa kakubi ngamachiza / ukurhoxiswa
Akukho bhetele kubhalwe ngenye i-ICHD-3 ukuxilongwa
imithombo
UAlexander G. Reeves, A. kunye noSwenson, R. Ukuphazamiseka kwenkqubo yeNervous. UDartmouth, 2004.
Yabelana nge-Ebook yamahhala
nanfoundation.org/neurologic-disorders/epilepsy/what-is-epilepsy
xh.wikipedia.org/wiki/Cortical_homunculus
Icawa, u-Archibald. Izifo Neengqondo. WB Saunders Co., 1923.
ISigineshana seNgcaciso EMG
Polyphasic MUPS
Gcwalisa i ziBloko
Iimpawu eziPhezulu eziPhambili
Iziphumo ezingavumelekanga
