Myasthenia Gravis, Lambert-Eaton, uye Botulism
Paunofunga nezvechikonzero chekushaya simba, zvinobatsira zvikuru kufungidzira magetsi ekudururwa kwemashoko kubva ku-cortex yeuropi kusvika kune musimba unopinda. Pakati penzira, iyo inomhanya inofamba nomumutsipa wepelinha ichienda kune runyanga rwekare , kunze kweperminal nerve midzi, pasi pemitsipa yeropa , uye pakupedzisira kuyanana kweyeuromuscular.
Kupindirana kweyeuromuscular ndiko kwokuti chiratidzo chegetsi chinokonzera maurotransmitter kuti abudiswe kubva kuma vesicles pamagumo emagetsi (iyo terminal).
Ivourotransmitters inopfuura chikamu chiduku pakati pechirwere chendangara (the synapse ) uye nepamusoro pemisungo (the endplate). Kumirira kwekutumira kune rumwe rutivi rwepakati ndezvimwe zvinogamuchirwa zvinokodzera mutumidzi sekivha kune kiyi. Kana pane zvakakosha, kuputika kweononi kunotungamirira kumusungo wepfungwa.
Iyo yeurotransmitter inoshandiswa kuratidza pakati pemazimbe uye musimba ndeye acetylcholine. Pane nzira dzakasiyana-siyana kuti kupfuura uku kweacetylcholine neurotransmitter pakati pemishu uye muscle cTan kunoparadzaniswa. Zvitatu zvemienzaniso yakanakisisa ndeyangu myasthenia gravis , chirwere cheMambert -Eaton, uye botulinum toxicity.
Myasthenia Gravis
Nekuwandisa pakati pevanhu 150 kusvika ku200 pamamiriyoni ega, myasthenia gravis ndiyo inowanzosiyana neyeuromuscular disorders, uye imwe yezvinonyanya kunzwisiswa zvezvirwere zvose zvehutano. Chirwere ichi chinokonzera musimba utera nekuda kwekuvharwa neurotransmitter receptors pamusana.
Zvirwere zvinowanzorehwa kurwisa zvirwere zvinoputika zvinokanganisa acetylcholine receptors ye pathogen uye kurwisa. Kudzidzira kunowanzoita kuti utera uwedzere. Pakati pe60 kusvika ku70 muzana yevanhu vane myasthenia gravis vane dambudziko ne thymus , uye 10 kusvika ku 12 muzana vane thymoma. Zvimwe zvirongwa zvakasiyana-siyana zviripo.
Lambert-Eaton Myasthenic Syndrome (LEMS)
Lambert-Eaton kazhinji inonzi chirwere cheparaneoplastic syndrome , zvinoreva kuti zvirwere zvinokonzerwa nekenza zviri kurwisawo chikamu chegadziriro yenzwa. Kusiyana ne myasthenia gravis, umo maitiro akaroverwa ari pamusana, dambudziko mu LEMS rine magumo emudhudhudhu. Calcium chiteshi inowanzozarura uye inofananidzira kusunungurwa kwevanhu vane chirwere chemaurotransmitter, asi haigoni kuita kudaro muE LEMS nokuti masimba anokonzera chirevo. Somugumisiro, hapana neurotransmitter inosunungurwa, uye murwere anonzwa asina simba nokuti musuru haugoni kugamuchira chiratidzo kune contract. Nekudzidzira muviri nguva dzose, kukanganisa kunogona kukundwa; saka mune LEMS, zviratidzo dzimwe nguva zvinowedzera zvishoma nekuedza zvakawedzerwa.
Botulism
Botulinum toxin dzimwe nguva inoshandiswa nechinangwa navanachiremba kumanikidzira mishonga kuti izorore mumamiriro ezvinhu eDystonia . Mune iyo nontherapeutic form, iyo inopinhwa inokonzerwa nemaabhakitiriya uye inogona kukonzera chirwere chepfungwa chinotanga nemisungo yechiso nehuro uye ichidzika pamusoro pemumwe muviri wose. Kufanana nemamwe matambudziko emukwata we-neuromuscular, izvi zvinogona kunge zvirikurumidzira mune zvehutano izvo zvinoda kubvunzwa . Izvozvo zvinokonzera mapuroteni anobvumira vheicles izere neurotransmitter mukati me-pre-synaptic neuron kuti igare pamagumo emhangura musati yatanga kupinda munzvimbo pakati pehutano nemasumbu.
Mishonga inorwisa mushonga we botulinum, iyo inofanira kupiwa nokukurumidza sezvinobvira.
Zvimwe Neuromuscular Junction Matambudziko
Zvimwe zvinodhaka, zvakadai sepenicillamine nedzimwe nhengo, hazvigoni kuita kuti autoimmune reaction iyo mimics myathenia gravis. Mamwe mishonga yakawanda inogona kukuvadza kana kuunza dambudziko mumunhu anenge atova myasthenia gravis.
Kuedzwa kwezvirwere zveNeuromuscular Junction
Kunze kwekuongororwa kwemuviri, danho rokutanga pakutsvaga chirwere chekugadzirisa neuromuscular is electromyogram uye nerve conduction study. Izvi hazvibatsiri chete kusiyanisa pakati pe myasthenia gravis, botulinum toxicity, uye Lambert-Eaton asiwo inogona kubatsira kubvisa zvimwe zvirwere zvakadai semotokari neuron, kusanganisira amyotrophic lateral sclerosis.
Kushungurudzika kwegadziriro ye-neuromuscular kunogona kuva yakakomba zvikuru, inoda kubvumirana uye kuputika kwemhepo kubatsira kubatsira kufema kana utera hukava hwakaoma zvakakwana. Nzira dzematambudziko acho dzakasiyana kwazvo, dzinoda kurapa kwakasiyana. Kuongororwa kwakakodzera ndiyo danho rokutanga rekuwana zvakare simba uye kuchengeteka.
Sources:
Ropper AH, Samuels MA. Adams naVictor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
Hal Blumenfeld, Neuroanatomy kuburikidza neCliniki Cases. Sunderland: Sinauer Associates Publishers 2002.