Kuongorora zvirwere zve multiple sclerosis (MS) zvakaoma uye zvinonetsa, kunyanya nokuti zviratidzo zveMMS zvakasiyana kune mumwe nomumwe, uye vanogona kutevedzera zvimwe zvezvirwere zvakawanda. Mukuwedzera, hakusi kuongororwa ropa rimwechete, kuongorora kwemuviri kuwana, kana kuongorora kwekufungidzira kwekuongororwa kwe MS.
Mazuva ano, maurogiologist anoshandisa McDonald Criteria kuti aongorore MS. Iyi nheyo yemitungamiri yakadzokororwa muna 2010 kuti iise maMRIs muhutano hwehutano.
Mashoko akanaka pamusoro peizvi ndeokuti vanhu vane MS vava kutoonekwa kare-izvi zvinoreva kuti vanhu vanogona kutanga kurapwa kare uye vanogona kuderedza chirwere chavo pasi.
Zvinonzi McDonald Criteria for Kuona MS
Zvinonzi McDonald Criteria zvinotarisana nekuvapo kwe MS zvakare, zvakare anozivikanwa sekurwiswa, mahara, kuwedzera, kana kuti kusangana.
SMS inodzokera zvakare inoreva chirwere chetachiona-chakataurwa chisingaoneki kana chimiro chisingaoneki chinowanikwa pakuongorora kwepanyama. Izvo zvisina kufanana neurological inofanirwa kunge inofananidzira yeSMS lesion mukatikati yenheyo, iyo inonzi uropi, mutsara wesimbi, uye magetsi emagetsi. Ichi chinhu chinonzi neurologist yako ichaziva.
Maererano nemitemo yeMcDonald, kuitira kuti iongororwa neMS, panofanira kunge kune uchapupu hwehuwandu hweSMS hwakaitika mune dzimwe nzvimbo mbiri dzakasiyana dzenheyo yenheyo. Mukuwedzera, idzi idzi dze MS dzinofanira kuparadzaniswa nemwedzi wemwedzi.
Kuongororwa kweSMS kunogona kuitwa kliniki, zvinoreva kuburikidza nemararamiro emunhu, kunyange kana kudzoka kwavo kuchiitika munguva yakapfuura-kunyange izvi zvingangova zvekudzoka zvakare, imwe inofanira kuva ikozvino. Uyezve, chimwe chezvekudzoka kwavo chinofanira kusimbiswa kana nehuongorori hwemapfungwa, hunoonekwa hunokwanisa, kana MRI.
Zvimwe, kuongororwa kunogona kuitwa kuburikidza nekubatanidzwa kwekliniki kuwanikwa uye uchapupu hweS MS lesion pane MRI. Kunyange kana munhu akasangana nemitemo yeMcDonald, nyanzvi dzezvehutano dzinowanzoita zvimwe zviedzo zvakadai sekushanda kweropa, kuvharwa kwemazimbe, uye kuonekwa kunovhiringidza kunogona kusimbisa kuongororwa uye kutonga kunze kwezvirwere zvinogona kutevedzera MS .
Mune mamwe mazwi, nyanzvi yezvehutano inoda kuva nechokwadi kuti ari kugadzira chirwere chakarurama uye kuti hakuna imwe yatsanangudzo-inonzwisisika, yakarurama? Chinhu chekupedzisira chaunoda ndechokuti uonekwe neMS kana iwe usina chaicho. Saka nyanzvi yezveuropi inoda kuva nechokwadi, uye isu tinofara nokuda kweizvozvo, kunyange kana zvinoreva zvizhinji zvekuedzwa.
Zviitiko Zvinofungidzirwa uye Nzira Dzakashandiswa Kuongorora Diki MS
Heino kutarisa zvakanyanya pane zvishandiso chiremba wako achashandisa zvose zvinorapwa MS uye kutonga kunze kwekuongororwa:
History Medical
Chiremba achabvunza mibvunzo yakawanda pamusoro pezviratidzo zvauri kuona iye zvino uye chero zvawakaona munguva yakapfuura. Ndiyo pfungwa yakanaka yekuita "zviratidzo zvehutano" usati waona chiremba, uchitarisa chero rudzi rwechiratidzo chawakave nacho munguva yakapfuura, yakareba kwenguva yakadini, uye mamwe mashoko pamusoro payo. Iva nechokwadi chekunyorera zviratidzo zvose, kunyange kana marechi apfuura akakuudza kuti hapana chakaipa.
Mukuwedzera, tora humwe humwe hutano hwehutano pamwe chete, kusanganisira ipi yemishonga yemishonga iwe uripo, uye chero mimwe miedzo yekurapa yaunogona kunge yaive nayo munguva yakapfuura.
Iwewo uchabvunzwa mibvunzo yakawanda pamusoro pehutano hwehutano hwehama, zvinodhaka uye doro kushandiswa, pamwe chete nedzimwe nyaya dzehutano husati dzavapo. Zvose izvi ruzivo ruchatibatsira chikwata chezveuropiti pamwe chete mufananidzo kuti ubatsire kana MS inogona kuonekwa.
Neurological Exam
Chiremba achave achiedza izvo zvinotevera:
- Kushanda kwemitsipa yakaoma (izvi zvinodzora manzwiro, pamwe chete nekutaura kwako uye kumedza)
- Kurongeka
- Strength
- Reflexes
- Kunzwa
Achaita izvi nekuita kuti iwe uite mabasa (sekubata nemhino yako, uye munwe wake mukutsvaga), kukubata iwe nemitauro yakasiyana-siyana (uye iwe uchitaura kushungurudzika kana kutsvaga mhinduro pachako) uye kuongorora maziso ako. Iva nechokwadi chokuti iyi miedzo haikuvadzi. Muedzo wose unogona kupedza maminitsi 45 asi unogona kupedza chero maawa maviri.
Magnetic Resonance Imaging (MRI) Scan
MRIs anoshandisa magnetic mazai kubudisa mifananidzo yeuropi nemutsipa wepelinha. Kana MS ichifungidzirwa, injini yakasiyana-siyana (gadolinium) injection inowanikwa panguva yekutsvaga, sezvo inopindira kune nzvimbo dzekuvhiringidza uye "ichapenya" kana chironda chiri kushanda. Izvi zvinoratidza kuti kuregererwa kunoitika ikozvino kana mukati memavhiki akawanda apfuura.
MRI haina kukuvadza, asi inogona kuva chiitiko chinoshamisa. Inobatsira kana iwe uchiziva zvaunotarisira panguva iyi. Panewo zvimwe zvinhu zvaunogona kuita kuti chiitiko chako chive nani .
Sezvakataurwa, izvi zvinonzi ndiyo mutsara wakanaka wekuongororwa kweSMS, sezvo zvipembenene zvisingawanzoitiki zvinowanikwa paMMIs inopfuura 95 muzana yevanhu vane MS. Zvisinei, 5 muzana yevanhu vane MS havakwanise kuonekwa paMRI (inobereka nhema dzisina kururama), uye zvimwe zvinokonzerwa nemakore kana mamwe mamiriro ezvinhu, zvakadai semagraine kana kuora mwoyo, zvinotarisa semasipiresi MS (kubudisa nhema positive).
Lumbar Puncture
Izvo zvinonziwo ruvara rwepelinha , ichi chiyero chinoda kuti chiduku chiduku chechirebrospinal fluid (CSF) chibviswe kubva mumugwagwa wako wepaupena kuburikidza netsanga inowanikwa pakati pe vertebrae yako. Chiremba achatumira mvura inoshandiswa kuti iongorore, ichitsvaga kuvepo kweogogoclonal bands (inowedzera nhamba yemamwe maitiro epamusoro) - chiratidzo chekuwedzera maitiro echirwere mumusana wepenjini.
Uyu muedzo wakanaka muna 90 kubva muzana yevanhu vane MS asi asiri pachena kune MS, saka chiitiko chakanaka chinogona kuratidza chimwe chirwere kana chirwere. Zvichienderana nemigumisiro inobva kuMRI, kuongorora kwepfungwa, uye zviratidzo zvenhoroondo, zvinogona kuti iwe usatombofanira kuwana mvumo yekugashira kugamuchira tsanangudzo yekujekesa yaMS (ini handina). Kunyange zvakadaro, zvigaro zvinogadziriswa zvigaro zvingava zvinobatsira kutonga kunze kwezvinhu zvimwe kana kuchine mubvunzo pamusoro pekuongororwa.
Kuonekwa kwakasvibiswa Kunogona Kuedzwa
Mhando mitatu mikuru yezvidzidzo zvekugadzirisa zvinoshandiswa inoshandiswa mukuongororwa kweMS. Chimwe nechimwe chezviedzo chinodikanwa kuti magetsi anosanganiswa neecalp yako uye akabatanidzwa kune electroencephalograph (EEG) kuti inyore mauropiyo ekupikisa zvakasiyana siyana. Miedzo yakasiyana ndeyekuti:
- Brainstem Auditory Evoked Potentials (BAEP): Rutsva rwekucheka kunowedzerwa munzeve imwe neimwe kuburikidza ne headphones.
- Kuonekwa Kunokonzerwa Nayo Mikana (VEP): Mutsara wema checkerboard maitiro anoratidzwa pahwindo.
- Sensory Evoked Potentials (SEP): Kushorwa kwemagetsi kushandiswa kune ruoko kana gumbo.
Chiremba ari kutarisa zvose zvakasvibirira mhinduro uye kukurumidza iyo uropi inogamuchira mureza. Weaker kana zviratidzo zvishoma zvinogona kuratidza kuti kuregererwa kwakaitika uye kuti MS inogona. Zvisinei, iyi muedzo haisiwo yakananga kune MS, zvinoreva kusakanganiswa kunogona kuratidza imwe dambudziko. Mutsara wezviedzo zvitatu zvinogona kutora maawa maviri kuti apedzise.
Dambudziko reRopa
Iko parizvino hapana kuongororwa kweropa kwaMS. Kunyange zvakadaro, kuongororwa kwezvikwata kuchashandiswa paropa rako kutonga kunze kwezvimwe zvinhu, zvakadai sechirwere cheLyme , HIV, zvimwe zvisingawanzoitiki zvirwere zvegeneti, neboka rezvirwere rinozivikanwa sezvirgoni-mavhinga, semapus.
Shoko Rinobva
MS inogona kuva chirwere chinonyangadza kuti chigadziriswe, uye iyo inowanzoda kutsungirira. Nezvo, zvakakosha kuwana nyanzvi yehutano iwe unonzwa wakasununguka uye uine chivimbo mukati o kushanda paunofungidzirwa. Mushure mezvose, kana iwe une MS, munhu uyu angangove ari wako muhutano kwenguva yakareba.
Sources
National MS Society. Kuongorora MS.
Polman, CH, uye al. (2011). Chirwere chekuongorora zvirwere zve multiple multiple sclerosis: 2010 kuongororwa kweMcDonald zvirongwa. Annals of Neurology , Feb; 69 (2): 292-302.