Chirwere cheLambert-Eaton

Lambert-Eaton syndrome (LES) chirwere chisingawanzoitika umo kutaurirana kwakashata pakati pemitsipa nemhasuru kunotungamira mukusasimba kwemhasuru.

LES chirwere chemuviri. Izvi zvinoreva kuti immune system yako inokanganisa kuisa maseru ane hutano uye zvinyama mumuviri. Iine LES, antibodies inogadzirwa ne immune immune inorwisa maseru etsinga. Izvi zvinoita kuti tsinga dzemasero dzitadze kuburitsa yakakwana kemikari inonzi acetylcholine. Ichi chemakemikari chinotamisa mafungiro pakati pemitsipa nemhasuru. Mhedzisiro yacho kushomeka kwemhasuru.

LES inogona kuitika nekenza senge diki kenza yemapapu kenza kana autoimmune kusagadzikana senge vitiligo, iyo inotungamira mukurasikirwa kweganda pigment.

LES inobata varume kazhinji kupfuura vakadzi. Zera rakajairika rezviitiko rakatenderedza makore makumi matanhatu. LES ishoma muvana.

Kuneta kana kurasikirwa kwekufamba kunogona kuve kwakanyanya kana kushoma, kusanganisira:

• Zvakaoma kukwira masitepisi, kufamba, kana kusimudza zvinhu
• Kutambudzika kwemhasuru
• Kudonha kwemusoro
• Iko kudiwa kwekushandisa maoko kusimuka kubva pakagara kana pakunyepa chinzvimbo
• Matambudziko kutaura
• Zvinetso zvekutsenga kana kumedza, izvo zvinogona kusanganisira kusanganisa kana kudzipwa
• Chiono chinoshanduka, senge chiono chisina kujeka, kuona zvakapetwa, uye dambudziko rekutarisa rakadzikama

Kushaya simba kunowanzo nyoro muLES. Tsandanyama dzemakumbo dzinonyanya kukanganiswa. Kuneta kunogona kuvandudzika mushure mekurovedza muviri, asi kushingirira kunoenderera kunokonzera kuneta mune zvimwe zviitiko.

Zviratidzo zvine chekuita nezvimwe zvikamu zvehurongwa hwemitsipa zvinowanzoitika, uye zvinosanganisira:

• Ropa reropa rinochinja
• Dzungu pakamira
• Muromo wakaoma
• Erectile kusagadzikana
• Maziso akaoma
• Kuzvimbirwa
• Kuderedza kudikitira

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezvezviratidzo. Bvunzo dzinogona kuratidza:

• Kupera kwekufungisisa
• Zvinogona kurasikirwa nemhasuru yemhasuru
• Kushaya simba kana kupora mitezo inova nani zvishoma nebasa

Miedzo yekubatsira kuongorora uye kusimbisa LES inogona kusanganisira:

• Kuongororwa kweropa kutsvaga masoja ekudzivirira chirwere anorwisa tsinga
• Electromyography (EMG) kuyedza hutano hwemhasuru fibers
• Nerve conduction velocity (NCV) kuyedza kumhanya kwechiitiko chemagetsi pamwe nemitsipa

CT scan neMRI yechipfuva uye mudumbu, inoteverwa nebronchoscopy yevasvuti inogona kuitwa kusabvisa cancer. PET scan inogona zvakare kuitwa kana bundu remapapu riri kufungidzirwa.

Zvinangwa zvakakosha zvekurapa ndezvekuti:

• Ziva uye ubate chero chinetso chiri kukonzera, senge kenza yemapapu
• Ipa kurapwa kubatsira neutera

Plasma kuchinjana, kana plasmapheresis, kurapwa kunobatsira kubvisa kubva mumuviri chero mapuroteni anokuvadza (antibodies) ayo ari kukanganisa nehutano hwebasa. Izvi zvinosanganisira kubvisa plasma yeropa iro rine ma antibodies. Mamwe mapuroteni (senge albumin) kana plasma yakapihwa inoiswa mumuviri.

Imwe nzira inosanganisira kushandisa intravenous immunoglobulin (IVIg) yekumisikidza huwandu hwakawanda hweanobatsira masoja muropa.

Mishonga inogona kuyedzwa inosanganisira:

• Zvinodhaka zvinodzvinyirira mhinduro yemusununguko
• Anticholinesterase zvinodhaka kuvandudza mhasuru toni (kunyange izvi zvisina kunyatsoita kana zvipihwa wega)
• Mishonga inowedzera kuburitswa kweacetylcholine kubva kumasero etsinga

Zviratidzo zveLES zvinogona kuvandudza nekurapa chirwere chiri pasi, kudzvinyirira immune system, kana kubvisa masoja ekudzivirira. Zvisinei, paraneoplastic LES inogona kusapindura pamwe chete nekurapa. (Paraneoplastic LES zviratidzo zvinokonzerwa nekushandurwa kwema immune system kune bundu). Rufu runokonzerwa nekukanganisa kwakaipa.

Zvinetso zveLES zvinogona kusanganisira:

• Kunetseka kufema, kusanganisira kutadza kufema (kushoma)
• Zvakaoma kumedza
• Zvirwere, zvakadai semabayo
• Kukuvara kubva pakuwa uye matambudziko nekubatana

Fonera waunopa kana zviratidzo zveLES zvichikura.

Chirwere cheMyasthenic; Eaton-Lambert chirwere; Lambert-Eaton myasthenic chirwere; LEMS; LES

• Mashura epamberi epamusoro

Evoli A, Vincent A. Kushungurudzika kwekutapurika kwemitsipa. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 394.

Moss HE. Eyelid uye kumeso kwehutano hwemitsipa. Mune: Liu GT, Volpe NJ, Galetta SL, eds. Liu, Volpe, uye Galetta's Neuro-Ophthalmology. 3rd ed. Philadelphia, PA: Elsevier; 2019: chitsiko 14.

Sanders DB, Guptill JT. Kukanganisa kweiyo neuromuscular transmission. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits. 109.