Steroid-Kuponesa Encephalopathy Yakabatana w / Autoimmune Thyroiditis
Chirwere chinonzi " Hashimoto's Encephalopathy " chakatanga kurondedzerwa chete muna 1966. Mushure mekunge nguva iyoyo, vanachiremba vakatanga kuunganidza nyaya dzenyaya, uye "Hashimoto's Encephalopathy" yakave zita rakagamuchirwa nokuda kwekushaya chirwere chinokonzerwa neHashimoto's thyroiditis.
Sezvo varwere vakawanda vane Hashimoto's Encephalopathy vachivandudza steroids kana kuti immunosuppressant kurapwa, dzimwe nyanzvi zvino dzinotaura nezvechiitiko se "steroid-responsive encephalopathy inobatanidza ne autoimmune thyroiditis" (SREAT).
Mune zvimwe zviitiko, chirwere chacho chinogonawo kunzi "nonvasculitic autoimmune meningoencephalitis" (NAIM), iyo inogona kusanganisira kwete zvinongoraramisa matambudziko ehutori asiwo mamwe matambudziko anokonzerwa nemasikirwo akadai saSjögren syndrome uye systemic lupus erythematosus-inosanganiswa na meningoencephalitis. Izvo zvinowanikwa pakati pemamiriro ose aya ndezvokuti vanoita steroid kurapwa.
Izwi rokuti "encephalopathy" rinoreva chirwere cheuropi chinoshandura huropi hunoita basa kana sarudzo. Chimwe chinhu chinokosha chepfungwa chero ipi zvayo inogadziriswa inoshandurwa mupfungwa. Nepo zviratidzo zvichienderana nerudzi rwekushaya nepfungwa uye kuti yakakomba sei, dzimwe zviratidzo zvinowanzobatanidza:
- kurasikirwa mupfungwa
- kuoma kuisa pfungwa
- kurasikirwa kweruzivo rwekuziva uye basa
- unhu hunoshanduka
- kunetseka uye kuneta
- kurasikirwa kwekuziva
- myoclonus (inobvumirana nekunyanyisa kwemisungo)
- nystagmus (kukurumidza, kusazviona kwemaziso)
- kudengenyeka
- kupera simba kwemasumbu
- dementia
- kugumburwa, kunetseka
- kuoma kunomedza
- kunetseka kutaura
Zvimwe zviratidzo zvinogona kuonekwa zvinosanganisira:
- kuvhiringidzika, kuora mwoyo
- psychosis
- headaches
- right sided hemiparesis - kurudyi sided partial paralysis
- Matambudziko akanaka ekufambisa motokari - matambudziko nekubatana kwemaoko, maoko, neminwe
Nemhaka yokuti Hashimoto's Encephalopathy / SREAT haina kunyatsonzwisiswa, mune imwe nyanzvi yakarondedzerwa munaFebruary 2006 Archives of Neurology , nyanzvi dzakagadzirirwa kuti dziratidze zvirwere zvakasiyana-siyana, laboratory, uye radiologic zvakawanikwa zvechiitiko chacho.
Chinangwa chavo ndechekubatsira kuvandudza kukwanisa kwechiremba kubvuma uye kuongorora mamiriro aya.
Chidzidzo chacho chakatarisa varwere makumi maviri (14 vakadzi, varume vatanhatu) vakaonekwa kuti pakati pe 1995 na2003. Nguva yavo yepakati pakurwara yakatanga makore makumi mashanu nemashanu (84, makore makumi manomwe nemakumi mapfumbamwe nemakumi mana nemashanu).
Inonyanya kuonekwa makiriniki anoonekwa / zviratidzo zvaive:
- Kuvhunduka - 80%
- Nguva iri pasi apa - 80% (Aphasia inonetsa nerurimi, inokonzera kukwanisa kutaura, kuverenga kana kunyora)
- Myoclonus - 65% (kamwe-kamwe, kusanganisa kusingabatsiri kwemuviri kana kuti boka remisungo)
- Gawa ataxia - 65% (uncoordinated kana kufamba zvakaoma, zvakaoma kufamba)
- Kukanganiswa - 60%
- Kurara kusakanganiswa - 55%
Misdiagnosis Ndedze
Chinonyanya kukosha ndechekuti nyanzvi dzakawana kuti VANHU VOSE VANHU VAKANGA vanga vasati vatariswa. Semuyenzaniso:
- Viral encephalitis - 25%,
- Degenerative dementia - 20%
- Creutzfeldt-Jakob chirwere - 15% (Creutzfeldt-Jakob chirwere chisingawanzoitiki, chinopera simba, chinowanzokonzera chirwere chepfungwa chinokonzera, dzimwe nguva zvisiri izvo chinonzi "Mad Cow Disease" kuvanhu)
Bhizinesi uye Muedzo Usakanganiswa muHashimoto's Encephalopathy / SREAT
Chimwe chiitiko chekuedza kusina kunaka kwakaonekwa, kusanganisira:
- Kuwedzera kwechiropa enzyme - 55%
- Kuwedzera kwetroroid-stimulating hormone (TSH) mizinga - 55%
- Kuwedzera erythrocyte sedimentation rate ("sed sed") - 25%
- Mvura yakasvibiswa isingakanganisi inoratidza kupisa - 25%
- Magnetic resonance imaging kusagadzikana kwakaenderana nekudzivirira kwepfungwa - 26%
Mhedziso
Vatsvakurudzi vakagumisa kuti pane zvakasiyana-siyana zvinowanikwa zvinogona kuwirirana neHashimoto's Encephalopathy / SREAT, uye kuti kusaziva mafungiro kwakajairika.
Vatsvakurudzi vanokurudzira kuti Hashimoto's Encephalopathy / SREAT inofanira kufungwa kunyange kana TSH ne "sed rate" yakajairika, cerebrospinal fluid haina kuratidza uchapupu hwokuputika uye MRI inowanzoitika.
Kuti Uwane Mamwe Mashoko
Hashimoto's Encephalopathy Information Page
> Sources
> Castillo, Pablo MD; et. al. "Steroid-Kuponesa Encephalopathy Yakabatana neA autoimmune Thyroiditis." Arch Neurol . 2006; 63: 197-202. (Vol. 63 Nha. 2, February 2006)
> National Institute of Neurological Disorders uye Stroke