Osmotic demyelination chirwere

Osmotic demyelination syndrome (ODS) uropi hwesero kusagadzikana. Izvo zvinokonzerwa nekuparadzwa kweiyo dura (myelin sheath) inovhara maseru etsinga mukati meiyo brainstem (pons).

Kana iyo myelin sheath inovhara maseru etsinga yaparadzwa, zviratidzo kubva kune imwe tsinga kuenda kune imwe hazvifambidzwe nemazvo. Kunyangwe iyo brainstem ichinyanya kukanganiswa, dzimwe nzvimbo dzehuropi dzinogona zvakare kuverengerwa.

Chikonzero chinowanzoitika cheODD ndiko kuchinjika kuchimbidzika mumatanho emuviri esodium. Izvi zvinowanzoitika kana mumwe munhu achirapwa low low sodium sodium (hyponatremia) uye iyo sodium inotsiviwa nekukurumidza. Dzimwe nguva, zvinoitika kana mwero wakakwira wesodium mumuviri (hypernatremia) ukagadziriswa nekukurumidza.

ODS haiwanzo kuitika yega. Kazhinji kazhinji, iko kunetseka kwekurapwa kwemamwe matambudziko, kana kubva kune mamwe matambudziko ivo pachavo.

Ngozi dzinosanganisira:

• Doro shandisa
• Chiropa chirwere
• Kusadya zvinovaka muviri kubva kuzvirwere zvakakomba
• Radiation kurapwa kwehuropi
• Kushungurudzika kwakanyanya uye kurutsa panguva yekuzvitakura

Zviratidzo zvinogona kusanganisira chero zvinotevera:

• Kuvhiringidzika, kukanganisika, kuona zvisipo
• Matanho emari, kudedera
• Dambudziko kumedza
• Kuderedzwa kusvinura, kukotsira kana kurara, kuneta, mhinduro dzakaipa
• Kutaura kwakadzikira
• Kushaya simba kumeso, maoko, kana makumbo, kazhinji zvinokanganisa mativi ese emuviri

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezvezviratidzo.

Musoro weMRI scan unogona kuburitsa dambudziko mu brainstem (pons) kana zvimwe zvikamu zvehuropi. Iyi ndiyo huru yekuongorora bvunzo.

Mimwe bvunzo inogona kusanganisira:

• Ropa sodium level uye kumwe kuongororwa kweropa
• Brainstem auditory yakadzora mhinduro (BAER)

ODS idambudziko rekukurumidzira rinoda kurapwa muchipatara kunyangwe vanhu vazhinji vane chirwere ichi vatove muchipatara kune rimwe dambudziko.

Iko hakuna kurapwa kunozivikanwa kwepakati pontine myelinolysis. Kurapa kunoitirwa kurerutsa zviratidzo.

Kurapa kwepanyama kunogona kubatsira kuchengetedza simba remhasuru, kufamba, uye kushanda mune isina simba maoko nemakumbo.

Iko kukuvara kwetsinga kunokonzerwa nepakati pontine myelinolysis inowanzo gara kwenguva refu. Dambudziko racho rinogona kukonzera kuremara kwenguva refu (kusingaperi) kuremara.

Zvinetso zvinogona kusanganisira:

• Yakadzikira kugona kuyanana nevamwe
• Kuderedza kugona kushanda kana kuzvitarisira
• Kusakwanisa kufamba, kunze kwekubwaira maziso ("rakakiiwa" syndrome)
• Permanent nervous system kukuvara

Iko hakuna chairo nhungamiro pane nguva yekutsvaga kurapwa, nekuti ODS isingawanzoitika munharaunda yakajairika.

Muchipatara, kunonoka, kudzora kurapwa kweiyo yakaderera sodium mwero kunogona kudzora njodzi yekukuvara kwetsinga mumaponi.Kuziva mashandisiro anoita mimwe mishonga masodium kunogona kudzivirira danho kubva pakuchinja nekukurumidza.

ODS; Central pontine kuderedzwa

• Central nervous system uye yekumusoro tsinga system

Weissenborn K, Lockwood AH. Inoturu uye metabolic encephalopathies. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits 84.

Yaqoob MM, McCafferty K. Chiyero chemvura, mvura nemvura. Mune: Nhenga A, Randall D, Waterhouse M, eds. Kumar uye Clarke's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021: chits. 9.