I-Dysmetabolic polyneuropathy ingukugula okungaqhamuka ngemuva kwesisekelo sokuba khona kwezinkinga ze-somatic ezinqunyelwe ukuphazamiseka kwe-metabolic:
- isifo sikashukela mellitus;
- izifo zezinso, isibindi;
- izinkinga zokugaya ukudla.
Lezi zifo ziba yisidingo sokuswela i-thiamine namanye amavithamini. Ngaphezu kwalokho, izilonda ezivame kakhulu zokuphelela kwezinzwa zangaphakathi ziyabonakala.
I-Diabetesic polyneuropathy iba nesifo sikashukela emaphesenti angama-90. Isibalo esiqondile sezinkinga ezinjalo sizoncika ngqo esikhathini sokuqhubeka kwesifo sikashukela, noma kunjalo, akuncike ekuthini sengozi saso.
Izimpawu ze-polyneuropathy zingaba futhi izidakamizwa zesifo.
Isici esibalulekile ekuthuthukiseni i-neuropathy kungaba yi-hypoxia enezinguquko. Ngenxa yalokhu, ukusetshenziswa koshukela ngezinzwa ezizungezile kuzokhubazeka.
Njengokwehluleka kwenqubo ye-glycolysis, kuzoqongelela i-lactic acid ne-pyruvic acid ngokweqile. Amacala wezinguquko enqubweni ye-thiamine phosphorylation ayaqapheleka.
Hhayi indima encane ezodlalwa ukwephulwa kwezinye izinhlobo zokudla okukhona ngokulwa nesizinda se-mellitus yesifo sikashukela:
- i-electrolyte yamanzi;
- lipid;
- amaprotheni.
Isithombe somtholampilo sesi sifo
Kuzo zombili izikhathi, inkambo ye-dysmetabolic polyneuropathy ingahluka. Uma lesi sifo sikhula ekuseni ngokwanele futhi sikhonjiswa ngokuncipha okukhulu kokuzwela kokudlidliza, khona-ke ukulahleka kwamadolo kanye ne-Achilles Reflexes kungabonakala.
Leli cala elingafani ne-polyneuropathy alibangeli zinhlungu, kepha liba minyaka eminingana ngokulandelana.
Isifo sikashukela se-polyneuropathy singabonakala ngokuthuthuka kwe-subacute noma i-acute. Kulokhu, kulimala izingxenye ezithile zeziqu zezinzwa. Njengomthetho, ukulimala kwezinzwa kwenzeka:
- kwezesayensi;
- umlamuleli;
- ulnar;
- okwabesifazane.
Lezi zinkinga zingahambisana nama-paresis weqembu elihambisanayo lemisipha, izinhlungu nokuzwela kokuzwa. Uma izinzwa zabesifazane zithintekile, khona-ke ukulahleka kokuqina kwamadolo kuyabonakala.
Ngaphezu kwalokho, kuye kwaphawulwa ngomonakalo emithanjeni ye-cranial (ukuthunjwa, i-trigeminal, oculomotor).
Kunohlobo lwesithathu lwezifundo zesifo sikashukela se-polyneuropathy. Kubonakala ngomonakalo kwezinye izinzwa zezinto eziphelele kanye nokuthuthukiswa kokuphazamiseka kwemizwa nezimoto (ikakhulukazi imikhawulo ephansi).
Ama-Tendon reflexes anganyamalala ngokuphelele, futhi kubuhlungu be-palpation bezinzwa zemithambo buyezwakala.
Nge-polyneuropathy, ukuphazamiseka kwemifino kanye nethropiki akuyona into engjwayelekile. Kuvela izinkinga zokuchama kanye ne-postural hypotension.
Ukwelashwa kanjani?
Okokuqala, kufanele wenze ushintsho kuma-carbohydrate metabolism usebenzisa imijovo ye-insulin nokudla okukhethekile okulinganiselayo. Udokotela angancoma:
- ama-painkiller;
- Amavithamini e-B;
- i-Finlepsin;
- ganglion blockers (gangleron);
- i-espa lipon (i-Berlition).
Isheduli yezinyathelo ezisetshenziselwa ukuqeda i-neuropathy izokhonjiswa.
I-Polyneuropathy enezifo ezihlelekile
Uma isiguli sine-lupus erythematosus ethinta isikhumba, izinso kanye nokuhlangana, khona-ke i-polyneuropathy ibonakala ngokuthuthukiswa kokuqina komzimba noma i-paresis yemisipha ye-proximal, ukulahleka kokunye kwe-tendon reflexes. Ukwehla okukhulu kokuthambekela kobuhlungu kusenokwenzeka.
Kwezinye izimo, izimpawu ze-polyneuropathy zingaba yizibonakaliso zokuqala zokuthuthuka kwezifo ezingaphansi. Ezokwelapha ziyazazi izinhlobo ezinomonakalo omkhulu ezinhlotsheni ezahlukahlukene zezingalo nasemilenzeni.
Kulokhu, sizokhuluma nge-mononeuropathy. Esikhathini samathambo anamandla, i-polyneuropathy iyabonakala futhi. Kuqala, iziveza njengokuphazamiseka okubucayi, bese kunalokho i-sensorimotor neuropathy enamandla.
Uma i-periarteritis nodosa ikhona, i-neuropathy elandelanayo yama-cranial kanye nezinzwa zomgogodla iba. Ukwephulwa okufanayo kuzohlotshaniswa nokuphazamiseka okukhulu:
- imifino;
- motor;
- ozwelayo.
Uhlobo olubhekwayo lwe-neuropathy luvame ukuhambisana nezimpawu ze-angiopathy zokuvuvukala kwezinye izitho nezinhlelo.
I-Hereditary polyneuropathy
Okokuqala, yi-polyneuropathy, ekhula ngokukhubazeka kwe-porphyria (ukuphazamiseka kwezakhi zofuzo). Izimpawu eziphambili zalesi sifo sofuzo yilezi:
- Ubuhlungu emgodini wesisu;
- ukwanda kwengcindezi yegazi;
- ukulimala kwesistimu yezinzwa ephakathi;
- ukukhiqizwa komchamo okunombala omnyama ohlukile.
I-Porphyric polyneuropathy izoboniswa ngenxa yenkimbinkimbi ye-neurological yezimpawu. Kulokhu, kubuhlungu, ubuthakathaka bemisipha, i-paresthesia (imikhawulo ephezulu nephansi). Ukubonakaliswa kwezimoto kungakhula kancane kancane, kuze kufinyelele ekukhubazekeni kwe-distal noma paresis.
Ngalesi sifo, isiguli sizozwa:
- usizi lweziqu zemithambo;
- ukulahleka kwazo zonke izinhlobo zokuzwela.
Ukwenza ukuxilongwa okwanele, udokotela uzocabanga ngazo zonke izimpawu zokuphazamiseka kwe-porphyrin metabolism. Ukuqeda lesi sifo, udokotela uncoma ukuphathwa kwe-glucose okufakwa emzimbeni nasekwakheni umthamo ofinyelela kuma-400 mg (ukwelashwa okufanayo kukhonjisiwe kwezinye izindlela ze-polyneuropathy).
Amyloid polyneuropathy
Uhlobo lwe-amyloid lwe-polyneuropathy lwenzeka kulezi ziguli ezinomlando we-amyloidosis yelifa. Izimpawu zayo eziphambili zomtholampilo yilezi:
- ukuphazamiseka kwesitulo (ukuqunjelwa kanye nohudo);
- ubuhlungu emgodini wokugaya ukudla;
- ukwehluleka kwenhliziyo;
- i-macroglossia (ukukhuphuka kosayizi bolimi).
Ngalesi ukugula, ukuphazamiseka kwemizwelo kusengaphambili, ngokwesibonelo, usizi lwamaphethelo, ukulahleka kobuhlungu nokuzwela kokushisa. Emazingeni akamuva, i-paresis ibuye ijoyine ukuphazamiseka.
Ngokuqondene nokwelashwa okwanele, okwamanje akukho.
I-distal sensory-motor polyneuropathy
Ngesifo sikashukela, imicu emide yezinzwa ihlala ithinteka kakhulu. I-Diabetesic polyneuropathy ibonwa kuma-40% abantu abanesifo sikashukela. Lolu hlobo lokugula lubonakala ngokungabi naluzwa kwengcindezi, izinguquko kumazinga okushisa, izinhlungu, ukudlidliza nendawo okuhlobene nezinye izinto.
I-Sensory polyneuropathy iyingozi ngoba umuntu onesifo sikashukela akabuzwa ubuhlungu noma amazinga okushisa aphezulu.
Izilonda zenzeka emaphethelweni aphansi, amanxeba kule festiyini yomlenze. Ukulimazeka okubucayi okuhlanganayo nokuqhekeka akukhishwa.
I-Sensomotor polyneuropathy ingabonakaliswa yizimpawu ezisebenzayo, ngokwesibonelo, izinhlungu eziqinile ngokwanele emilenzeni, okuyinto embi kakhulu ebusuku.
Lapho lesi sifo sikhula, ukuphazamiseka ekusebenzeni kohlelo lwe-musculoskeletal kuzobhekwa. Lapho lokhu kwenzeka:
- ukuguqulwa kwamathambo;
- dystrophy yemisipha;
- ukoma ngokweqile kwesikhumba;
- ukubonakala kwamabala obudala;
- ithoni yesikhumba ebomvu;
- ukujuluka kokujuluka.
Izimpawu ezibaluleke kakhulu ze-distal polyneuropathy kwisifo sikashukela kuzoba yizilonda ezenzeka phakathi kwezinzwane nakwezinyawo zezinyawo. Izilonda azikwazi ukudala usizi ngenxa yokungabikho kobuhlungu. Ezimweni ezisezingeni eliphakeme, sizokhuluma ngokunqunywa kwezingalo.
I-Autonomous polyneuropathy kushukela
Lapho kukhona izilonda zohlelo lwezinzwa ezizimele ngokumelene nesizinda sesifundo sikashukela, isiguli siyozwa:
- mnyama emehlweni;
- ukufiphala lapho iqondile;
- isiyezi.
Le ndlela ye-polyneuropathy izohambisana nokungasebenzi kahle ekusebenzeni okujwayelekile komgudu wokugaya ukudla, obonakaliswa ukwehla kokudla kokudla. Ngenxa yalokhu, akunakwenzeka ukuqina kokuqina kweglucose egazini likashukela.
Imbangela yokufa kungazelele kungaba ukwephula isigqi senhliziyo ku-polyneuropathy yesifo sikashukela.
Labo bantu abahlushwa yilokhu kugula bayozwa izinkinga ezivela ohlelweni lwezitho zofuzo - ukuqubuka komchamo kwenzeka. I-bladder izolahlekelwa amandla ayo okungenalutho ngokuphelele, okuba yinto yokuqala yokuthuthukiswa kwezifo ezithathelanayo. I-erectile dysfunction in autonomic polyneuropathy izophawulwa emadodeni, kanye ne-dyspareunia kwabesifazane (ukungakwazi ukufeza i-orgasm).
