I-Ophthalmoplegia yangaphakathi

-Delile

• Ukubuka konke
• Yiziphi izinhlobo ezahlukahlukene?
• Ziyini izimpawu?
• Ziyini izimbangela?
• Kutholakala kanjani?
• Izinketho zokwelashwa
• Uyini umbono?

Ukubuka konke

I-Internuclear ophthalmoplegia (INO) ukungakwazi ukuhambisa amehlo akho womabili lapho ubheke eceleni. Kungathinta iso elilodwa kuphela, noma womabili amehlo.

Lapho ubheka ngakwesobunxele, iso lakho langakwesokudla ngeke liphendukele lapho kufanele lifinyelele khona. Noma uma ubheka ngakwesokudla, iso lakho lesobunxele ngeke liphenduke ngokuphelele. Lesi simo sihlukile kwamehlo awele (strabismus), okwenzeka uma ubheke phambili ngqo noma eceleni.

Nge-INO, ungaba nombono ophindwe kabili (diplopia) nokunyakaza okusheshayo okungazibandakanyi (nystagmus) esweni elithintekile.

I-INO idalwa ukulimala kwe-medial longitudinal fasciculus, iqembu lamaseli ezinzwa aholela ebuchosheni. Kuvamile kubantu abadala nasebekhulile. I-INO isezinganeni.

Yiziphi izinhlobo ezahlukahlukene?

I-INO ihlukaniswe ngezinhlobo ezintathu eziyinhloko:

• Unilateral. Lesi simo sithinta iso elilodwa kuphela.
• Okubili. Lesi simo sithinta amehlo womabili
• Amazwe amabili abhekene nodonga (WEBINO). Leli fomu elibi, elihlangene le-INO livela lapho amehlo womabili ephumela ngaphandle.

Ngokomlando, ongoti baphinde bahlukanisa i-INO ezinhlotsheni zangaphambili (ngaphambili) nasemuva (emuva). Kwakucatshangwa ukuthi izimpawu ezithile zingakhombisa ukuthi ebuchosheni ukulimala kwemizwa kwakukuphi. Kepha lolu hlelo selujwayeleka kakhulu. Ukuhlolwa kwe-MRI kukhombisile ukuthi ukuhlukaniswa akuthembekile.

Ziyini izimpawu?

Uphawu oluyinhloko lwe-INO ukungakwazi ukuhambisa iso lakho elithintekile liye ekhaleni lakho lapho ufuna ukubheka kolunye uhlangothi.

Igama lezokwelapha lokunyakazisa iso libheke ekhaleni lithi “ukuthwalwa.” Ungase futhi uzwe uchwepheshe ethi unokuphazamiseka kokunyakaza kweso elixakayo.

Uphawu lwesibili oluyinhloko lwe-INO ukuthi elinye iso lakho, elibizwa ngokuthi “iso lokuthumba,” lizoba nokunyakaza okungazibandakanyi emuva naphambili. Lokhu kubizwa nge- “nystagmus.” Lokhu kunyakaza kuhlala ukushaya okumbalwa, kepha kungaba nzima kakhulu. INystagmus ivela kumaphesenti angama-90 abantu abane-INO.

Yize amehlo akho angahambi ndawonye, ​​usengakwazi ukugxila kuwo womabili amehlo entweni oyibukayo.

Ezinye izimpawu ze-INO kungenzeka zifaka:

• ukungaboni kahle
• ukubona kabili (idiplopia)
• isiyezi
• ukubona izithombe ezimbili, esinye ngaphezulu kwesinye (i-diplopia emile)

Esimweni esimnene, ungazizwa izimpawu zesikhashana nje. Lapho iso elixoshayo lifinyelela ngelinye iso, umbono wakho uba ojwayelekile.

Cishe uhhafu wabantu abane-INO bazohlangabezana nalezi zimpawu ezimnene kuphela.

Ezimweni ezinzima kakhulu, iso lokuxhuma lizokwazi kuphela ukuguqula ingxenye yendlela iye ekhaleni.

Ezimweni ezimbi kakhulu, iso elithintekile lingafinyelela kuphela phakathi nendawo. Lokho kusho ukuthi iso lakho elithintekile lizovela libheke ngqo phambili, lapho uzama ukubheka ngokuphelele ohlangothini.

Ziyini izimbangela?

I-INO ingumphumela wokulimala kwe-medial longitudinal fasciculus. Le fibre yezinzwa eholela ebuchosheni.

Umonakalo kungenzeka ngenxa yezimbangela eziningi.

Mayelana namacala angumphumela wokushaywa unhlangothi nezinye izimo ezivimbela ukunikezelwa kwegazi ebuchosheni.

I-stroke ingabizwa ngokuthi i-ischemia, noma i-ischemic attack. Ukushaywa unhlangothi kuthinta abantu abadala, futhi kuthinta iso elilodwa kuphela. Kepha isifo sohlangothi esithinta uhlangothi lobuchopho kwesinye isikhathi singadala i-INO emehlweni womabili.

Cishe elinye lamacala libangelwa i-multiple sclerosis (MS). Ku-MS, i-INO ivame ukuthinta womabili amehlo. I-INO ebangelwe yi-MS isentsheni nasebancane.

Gcina ukhumbula ukuthi i-MS incazelo yesimo, hhayi imbangela. Kulesi simo, amasosha omzimba ahlasela i-myelin sheath ezungeze futhi ivikele imicu yezinzwa. Lokhu kungadala ukulimala emgodleni nasezintanjeni zezinzwa ezizungezile.

Nge-INO, akwaziwa njalo ukuthi yini edala umonakalo emgodleni we-myelin, obizwa nge- "demyelination." Ukutheleleka okuhlukahlukene, kufaka phakathi isifo seLyme, kuye kwahlanganiswa naso.

Ezinye izimo ezingadala i-INO zifaka:

• i-brainstem encephalitis
• Isifo sikaBehcet, isimo esingajwayelekile esidala ukuvuvukala kwemithambo yegazi
• i-cryptococcosis, isifo sokukhunta esihambisana nengculaza
• Isifo se-Guillain-Barré
• Isifo seLyme nezinye izifo ezithwalwa imikhaza
• i-lupus (i-systemic lupus erythematosus)
• ukuhlukumezeka ekhanda
• izicubu zobuchopho

Izicubu ezifana ne-pontine gliomas noma i-medulloblastomas yizimbangela ezibalulekile ze-INO ezinganeni.

Kutholakala kanjani?

Udokotela wakho uzothatha umlando wezokwelapha futhi ahlole ngokucophelela ukunyakaza kweso lakho. Izimpawu ze-INO zingase zicace kangangoba kudingeka ukuhlolwa okuncane ukuze kuqinisekiswe ukuxilongwa.

Udokotela wakho uzokucela ukuthi ugxile emakhaleni abo, bese ususa ngokushesha amehlo akho emunweni obekelwe eceleni. Uma iso lidlula lapho liphenduka ohlangothini, kuwuphawu lwe-INO.

Ungahlolwa futhi ukunyakaza okubuyela emuva naphambili kweso elithunjwa (nystagmus).

Lapho kutholakala ukuxilongwa, udokotela wakho angenza izivivinyo ze-imaging ukuthola ukuthi umonakalo utholakala kuphi. I-MRI futhi mhlawumbe ne-CT scan inga-oda.

Kuze kufike kubantu kungenzeka bakhombise umonakalo othile obonakalayo ku-medial longitudinal fasciculus nerve fiber kuskena se-MRI.

I-Proton-density imaging nayo ingasetshenziswa.

Izinketho zokwelashwa

I-INO ingaba uphawu lwesimo esibucayi esibucayi okufanele silashwe. Uma unesifo sohlangothi esibuhlungu, kungadingeka ukuthi ulaliswe esibhedlela. Ezinye izimo ezifana ne-MS, izifo kanye ne-lupus kuzodingeka zilawulwe ngudokotela wakho.

Lapho imbangela ye-ophthalmoplegia yangaphakathi yenuzi iyi-MS, ukutheleleka, noma ukuhlukumezeka, abantu babonisa ukululama okuphelele.

Ukubuyiselwa ngokugcwele uma imbangela kungukushaywa unhlangothi noma enye inkinga ye-cerebrovascular. Kepha ukululama ngokugcwele ukuthi ngabe i-INO ukuphela kwempawu yezinzwa.

Uma umbono ophindwe kabili (i-diplopia) ungenye yezimpawu zakho, udokotela wakho angancoma umjovo we-botulinum toxin, noma i-prresnel prism. I-prresnel ye-Fresnel ifilimu encane epulasitiki enamathela ebusweni bezibuko zakho zamehlo ukulungisa umbono ophindwe kabili.

Uma kwenzeka okuhlukile okunzima kakhulu okwaziwa njenge-WEBINO, ukulungiswa okufanayo kokuhlinzwa okusetshenziselwa i-strabismus (amehlo awele) kungasetshenziswa.

Izindlela zokwelapha ezintsha ze-stem cell ziyatholakala ukwelapha ukukhishwa esikhundleni, njenge-MS noma ezinye izimbangela.

Uyini umbono?

I-INO imvamisa kutholakala ngokuhlolwa komzimba okulula. Umbono ulungele amacala amaningi. Kubalulekile ukubona udokotela wakho futhi ukhiphe umthetho, noma welaphe, izimbangela ezingaba khona.